The Griffith Area Palliative Care Service (GAPS): an evaluation of an Australian rural palliative care model
Quantitative and qualitative data, including service utilisation, health records, a provider survey and participant observation, were used to describe the impact of a new model of palliative care on patients, carers and staff in rural Australia. A total of 95 patients were enrolled between October 2001 and February 2003, for an average of 147 days. Deaths per month averaged 3.5. Participating general practitioners were positive about the model. The experiences of 14 patients or carers and 3 people who had cared for a relative with terminal illness prior to the new model were also positive. As one illustration, patients and carers commented that trips to the emergency department prior to the GAPS programme often involved long waiting times and unnecessary investigations and that this had now improved. The elements of the model that worked most effectively were weekly case conferences, the on-call nursing roster, patient-held records and shared protocols and procedures. The model achieved its aim of improving palliative care services and still continues with some modifications. The generalisability of the model is now being tested in eight rural and remote communities across Australia.