PACE Steps to Success Intervention
The ‘PACE Steps to Success’ intervention has been adapted from the ‘Route to Success’ programme which was developed by the End-of-Life Care Programme in the United Kingdom. The programme aims to help staff caring for frail older people in long-term care facilities (LTCFs) to deliver high quality palliative and end of life care (DoH 2010).
The ‘PACE Steps to Success’ course aims to integrate palliative care into daily practice so that it becomes embedded within the delivery of care and helps to create sustainable and realistic change within LTCF across Europe. To enable these sustainable changes to be shaped it requires a LTCF manager with a clear vision to create a strong foundation where the lifelong learning of staff is firmly embedded and encouraged within practice. Each country involved in PACE has a trainer/s to implement, support and deliver the ‘PACE Steps to Success’ training course in each of the LTCFs. The country trainers work with the LTCF managers to help identify key staff from within each care home to be the PACE Coordinator for their facility. The PACE Coordinators’ role is to work in collaboration with the PACE country trainer throughout the introduction and implementation of the ‘PACE Steps to Success’ to help advocate and implement change amongst their peers and encourage sustainable changes that are embedded into practice.
The ‘PACE Steps to Success’ training course is delivered over a year; the initial two months are to help prepare for implementing the PACE training in the LTCFs. PACE co-ordinators are invited to a two-day training programme facilitated by a country trainer. This provides the PACE Coordinators with an overview of the whole training programme and where their role fits within each of the care homes. The country trainer will then start to put the programme into practice through the delivery of training sessions every month in each of the LTCFs over the course of six months. Following this there is a four month phase of ensuring the programme is properly embedded into practice including a review of previously taught sessions and encouragement and support for the PACE coordinator to independently deliver the training within the care homes.
The six steps of the training course introduce skills that aim to empower staff and value their contribution in the continuity of care. The programme provides the opportunity to address key issues concerning the delivery of palliative care in LTCFs, a step at a time:
Step 1 – Discussions about current and future care
To enhance communication by staff with frail older residents and their families about their current and future preferences and wishes.
Step 2 – Assessment and review
To encourage care staff to work collaboratively to optimise the ongoing care of residents and help identify any changes in need.
Step 3 – Co-ordination of palliative care
To establish cohesive and sustained support networks with external health care professionals to meet the needs of residents who require palliative care through a multi-disciplinary team meeting.
Step 4 – Delivery of high quality care: symptom management
To support good symptom management and the use of assessment tools to help identify pain and depression in resident’s that are living with or without dementia.
Step 5 – Care in the last days of life
To ensure staff can understand and recognise the process of dying and introduce documentation to guide them in the delivery of care in the last days of life’ and support the needs of residents and their families at the end of life.
Step 6 – Care after death
To implement facilitated reflective de-briefing sessions for staff and introduce a chart to audit all resident’s deaths.
By embedding an educational culture of ongoing learning the study aims to uphold the continuing work of LTCFs and support them to provide high quality palliative and end of life care.
For further information, do not hesitate to get in touch with Eleanor Sowerby, country trainer Lancaster University, firstname.lastname@example.org