19 Do palliative care champions increase staff confidence to have difficult conversations

Background Previous research and recent media coverage have identified that healthcare professionals who don’t work in a palliative care setting do not feel comfortable talking to patients about palliative-related issues. As caseloads become more frail and complex, there is an increasing need for staff members at all levels to feel more confident discussing issues such as advanced life planning, deteriorating function, and future care needs. Champions have proven to be highly effective in knowledge translation in order to instigate positive changes in healthcare, however there is no evidence evaluating the ‘champion approach’ in palliative care or in a rehabilitation setting. Aim To evaluate the introduction of the palliative care champion role on staff confidence and patient outcomes. Methods A cohort study of four bed-based intermediate care units (2 intervention, 2 control) was used. Three champions based in the two intervention units received specialist training and disseminated this to the remaining cohort. This was followed by a 5 month data collection period. Results Confidence of the intervention unit staff increased an average of 1.9 points on a scale of 1–10 post training (0.1 control). This confidence continued to increase to an average of 2.4 points following the 5 month intervention period (0.3 control). There was no change to perceived contact with palliative patients or barriers to conversation. Conclusion Introducing palliative care champions could be an easy, cost-effective way of increasing staff confidence to have difficult conversations with patients.