QELCA © – Transforming care at end of life globally

Last year on this blog, Dr Heather Richardson, Joint CEO of St Christopher’s Hospice in London, UK, described how St Christopher’s education programme was changing to reflect contemporary opportunities and challenges. Today, Liz Bryan, Education Consultant at St Christopher’s, explains how the QELCA © Train the Trainer programme contributes to new ways of delivering quality end-of-life care.

Liz Bryan (centre) pictured with Members of  The Living Will Promotion Association that has successfully implemented the QELCA© Train the Trainer programme across China.

From Beijing to Buenos Aires, end-of-life care is changing as health and social care organisations consider the benefits of a palliative model over a curative one. Multi-disciplinary teams are rising to the challenge of delivering quality end-of-life care to the growing ageing population globally. One example of this change is not a traditional palliative care education programme, but a flexible, leadership and change management programme tailored to the needs of every individual who participates and their organisation: QELCA© (Quality End of Life Care for All).

The QELCA© programme began in 2008 at St Christopher’s Hospice in London, when I was approached by an acute hospital which needed to improve care for dying patients. Rather than facilitate practice placements, I proposed an alternative way for the team to learn how best to care for this patient group: a five-day programme that would include three days in the classroom and two clinical days.

This cohort, and the dozens that have followed since then, were asked to consider what they would want if they were dying, to relay their personal experiences of caring for the dying, to reflect on the most important things they learned in the clinical setting and then to set priorities for change. The QELCA© Trainers then supported participants to complete an action plan to be delivered over six months, during which time the group met to assess progress on their priorities for change – for them, their team and their organisation.

Thanks to the QELCA© TtT (Train the Trainer) programme, the QELCA© programme is now successfully growing globally with three satellites in the UK and five across the globe in China, South Korea, Argentina, Brazil and Canada. The Living Will Promotion Association, a social movement organisation in China, initially sent one doctor to St Christopher’s to complete the QELCA© TtT  programme. Five years on, and there are now 66 trained trainers representing more than 30 organisations across China.

Most organisations that sign up for the QELCA© TtT programme do so with the intention of becoming a QELCA© satellite, giving them the platform to further cascade quality end-of-life care in their country or region. Before deciding whether to become a satellite, an organisation will send at least two staff members to train as QELCA© Trainers. All new QELCA© Trainers, as a requirement for registration, have to critically reflect on their first programme and submit an assignment for assessment and certification. All satellites are represented on a QELCA© Research and Development Forum; this ensures a standardisation of approach to delivery while also exploring opportunities to gather further evidence of its impact.

In Argentina, Marcela Specos, the Director of Education at a hospice in Buenos Aires, told me that she felt that sending a clinical team into the hospitals to share palliative care skills could not deliver the cultural change that was required. She realised that it is not a question of ‘injecting’ the hospice model into a hospital, but rather helping each institution understand their own needs and priorities. In January 2020, Marcela and two colleagues completed the QELCA© Train the trainer programme via Zoom.

Although initially sceptical, Marcella felt that using Zoom proved a bonus, saying, “When we closed down Zoom at the end of the session, because we were in our setting, I could immediately speak to members of my team [and] reflect with colleagues about ways we could implement things.”

Even before the coronavirus pandemic, the Action Learning element of QELCA© and QELCA© TtT were offered via Zoom by St Christopher’s. The international accessibility of Zoom has made it a preferred communication tool for satellites and this digital flexibility has allowed each satellite to make its own adjustments based on national and local social distancing guidelines.

Subsequently, Marcella and her colleagues were in a strong position to answer a call for help from a major hospital in Buenos Aires to prepare for large numbers of Covid-19 deaths. As Marcella explained to me:

“You give them the framework and show them the range of tools that are available. You let them describe what it is they want to build. Once they’ve identified what they want to change, then together we make an action plan. You are very conscious that participants have to look for the knowledge for themselves, but you can see the results on the first day.”

To find out more…

The next QELCA© Train the Trainer programme will be delivered online in September 2020. There will be more in 2021. As QELCA© trainers deliver the programme in pairs, it’s essential they complete the course in pairs too.

For more information please contact Liz Bryan or view more here

Links


It’s not too late to register… Join palliative care specialists from across the world at the 11th World Research Congress Online of the European Association for Palliative Care. Interactive online sessions take place 7 to 9 October 2020 and on-demand content is available from 21 September 2020 to 31 January 2021.

All registered delegates will receive a unique login to access the platform on the day the congress goes live on 21 September – so keep an eye on your inbox! 

A blend of Pre-recorded On-demand Sessions, Live Presentations, Live Panels hosted by international experts, Children’s Seminar, Meet the Expert, Poster Sessions and EAPC Group Meetings, will bring you all the latest research from the world’s top researchers in palliative and end-of-life care. CME accreditation will be available. Meet some of our plenary speakers on the EAPC YouTube channel. Find out more and view/download the full programme here. Register here.

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