Effectiveness of telehealth palliative care Needs Rounds in rural residential aged care during the COVID-19 pandemic: A hybrid effectiveness-implementation study

Specialist palliative care improves quality of death and dying in residential aged care (RAC) through Needs Rounds triage meetings, which are regular meetings between palliative medicine physicians and RAC staff. However, face-to-face Needs Rounds are limited in rural and remote areas. For the first time, an Australian study has evaluated the effectiveness and feasibility of using telehealth for Needs Rounds in rural RAC. Twenty-five Needs Rounds (15 telehealth, 10 face-to-face) took place in rural New South Wales over nine months, with forty-seven residents were discussed at least once by RAC staff. Compared to a metropolitan RAC study, telehealth was shown to be just as effective as face-to-face mode for completion of end-of-life plans and number of residents discussed. Telehealth enabled Needs Rounds to continue in existing sites and be implemented in new sites, facilitiating end-of-life care planning. Clinical benefits included access to after-hours specialist advice for residents. While infrastructure issues were frustrating for residents, RAC staff were committed to overcoming technical issues and carrying out Needs Rounds for residents. This study demonstrates that telehealth may be a feasible option to conduct Needs Rounds and improve accessibility to specialist palliative care for rural and remote Australians. These findings around telehealth in palliative care are particularly timely due to face-to-face restrictions in metropolitan and rural RAC with the ongoing pandemic.
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