The purpose of the Consensus Statement is to describe the essential elements for delivering safe and high‑quality, end of life care in Australia.
The guiding principles and essential elements apply to all services where health care is provided to people approaching the end of their life, including hospitals, hospices, residential aged care facilities and home settings.
Access the full Consensus Statement, including recommended actions and considerations, from the Australian Commission on Safety and Quality in Health Care website.
Guiding principles
Safe and high‑quality end‑of‑life care should:
- Be person‑centred and include family and carers.
- Align with values, needs and wishes.
- Provide people with information they can understand.
- Consider cultural, spiritual and psychosocial needs.
- Include qualified, skilled and experienced multidisciplinary care.
- Ensure the right to refuse medical treatment.
- Not be burdensome or harmful.
- Not offer unreasonable hope.
- Continue after a person has died.
Essential elements
The 10 essential elements for safe and high-quality end of life care are categorised into care and organisational processes.
A. Care processes
The essential elements 1–5 describe how end‑of‑life care should be approached:
- Recognising end of life – The first step in providing safe and high‑quality end‑of‑life care is to recognise people who would benefit from such care. Routine use of simple trigger tools and questions can prompt healthcare workers to use their clinical judgment to make a holistic assessment of whether a person might benefit from end‑of‑life care.
- Person-centred communication and shared decision making – Healthcare workers should adopt a person‑centred approach to communication and decision‑making, to assist a person who is dying to make choices about their care. All communication processes should recognise and be responsive to the individual preferences and needs of the person.
- Multidisciplinary collaboration and coordination of care – Overall responsibility for coordinating a person’s end‑of‑life care and ensuring effective communication and collaboration should be allocated. This responsibility could be allocated to a general practitioner, nurse, allied health professional, family member or someone else depending on the circumstances.
- Comprehensive care – The goal of healthcare workers providing end‑of‑life care should be to deliver comprehensive care that is culturally safe and appropriate to the needs and condition of the person at the end of their life. It should also be aligned with their expressed wishes and goals.
- Responding to concerns – When concerns are raised about a person approaching the end of their life or decision‑making is particularly complex, timely and appropriate assistance should be obtained from a suitably skilled healthcare worker or team.
B. Organisational processes
The essential elements 6–10 describe the organisational processes required for the effective delivery of safe and high‑quality end‑of‑life care:
- Leadership and governance – A systematic approach and committed leadership are necessary to improve the experiences of someone at the end of their life.
- Support, education and training – All healthcare workers should have a shared understanding of the healthcare services terminology, policies, processes and practices.
- Care setting – The care setting is an important consideration for both a person at the end of their life and their family. Access to private physical spaces for gatherings contributes to the quality of care offered at the end of a person’s life.
- Evaluation, audit and feedback – All deaths where end‑of‑life care has been provided by a healthcare service should be routinely reviewed to determine the safety and quality of the person’s end‑of‑life care and how care could be improved.
- Systems to support high-quality care – End of life care should be integrated into existing organisational systems, and safety and quality systems to support sustainability and provide opportunities for organisational learning.
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