GAPS
In October 2001, health services in Griffith, New South Wales, began a project to improve access to, and the integration of, local palliative care services. The Griffith Area Palliative Care Service (GAPS) project was funded as a national demonstration project with support from the Commonwealth and State governments and the Greater Murray Area Health Service. One motivation for the project was the recognition of various weaknesses in the organisation of services in Griffith. But another, broader, aim was to assess how the National Palliative Care Strategy could be translated into a model of care that is appropriate for rural Australia.
The GAPS model of care grew out of a partnership between Griffith Base Hospital, Murrumbidgee Division of General Practice (MDGP) and the Griffith Community Health Centre. Considerable time was spent planning the project prior to it being funded, and the above stakeholders were joined by the (private sector) Griffith Nursing Services, Griffith Ministers Fraternal and the Griffith Volunteer Support Group as partners in the project. The project aimed locally to improve palliative care services for residents in the Griffith region (Western Riverina), starting in Griffith (approx 20000 residents) and later being extended to residents in the surrounding areas of Coleambally, Darlington Point, Hay and Hillston. At a broader level, the project aimed to develop a model of care that could be appropriate for other rural communities.
The generalist model of service delivery was built around various elements, the most important being:
The adoption of common referral criteria for palliative services to improve access, including access for people with non-malignant conditions;
The adoption of weekly, one hour case conference meetings involving GPs, community nurses, staff from the Griffith Base Hospital oncology/palliative care unit;
The establishment of a 1800 number, and an on-call nursing roster, to provide 24 hour, 7 days access to palliative care services;
Local GPs being given VMO arrangements at Griffith hospital to allow them to attend their palliative patients if they present to the emergency department or are admitted;
The adoption of shared service protocols that promote continuity of care;
The creation of a patient-held record so that the patient, their carers and each service provider understands the contribution of each provider and the care that is required;
The implementation of an computer information system that enables richer patient data to be stored and analysed, and that facilitates a more consistent approach to patient assessment;
Expanded professional education for staff;
The employment of a project coordinator; and
The creation of a Board of Governance to oversee the development and running of the project.
This report describes an evaluation of the GAPS project from October 2001 to March 2003.
This report descibes findings from a re-evaluation of the GAPS project in 2006, in particularly the sustainablity of project interventions as it became a mainstream program.
The Griffith Area Palliative Care Service, A Pilot Project was published in the Australian Health Review in 2003.
Rural Palliative Care Program
Through it's involvement with GAPS, MGPN (then MDGP) established a sound record in delivering a generalist Pallitiave Care model that worked effectively in rural Australia. NSW Health engaged MDGP to assess and report on the feasibility of developing similar models of care for other communities in south west NSW. Building directly on the evidence arising from GAPS, MDGP provided a consultancy to AGPN (then ADGP) for the development of the Rural Palliative Care Project, testing similar models of palliative care in eight rural sites across Australia.
AGPN enegaged MGPN to develop resources in relation to two key elements of the project, governance and sustainability. The tool can be viewed by clicking here.