Evaluation of the Encouraging Better Practice in Aged Care (ebpac) Initiative Final Report

3.6National roll-out projects

Both national roll-out projects built on work that was carried out in Round 2: the Implementation of a comprehensive evidence based palliative approach in residential aged care (CEBPARAC) project and the Creating champions for skin integrity project. This included updating and refining the resources developed in Round 2.

Each national roll-out project focused on actively disseminating the resources by running workshops across the country, but with a slightly different approach. One primarily ran workshops for people about the Palliative Approach Toolkit, whereas the other project (RC2) ran train-the-trainer workshops for people who had been identified by their facilities as skin integrity champions, with the intention that those people would then return to their facilities to train other people as part of their role. Those attending the RC2 workshops were requested to develop a plan to implement the CSI model in their own facility and send a 1-page report on progress with implementation three months after the workshop. There was no such post-workshop activity with the palliative care workshops.

The two projects ran a similar number of workshops, with a similar distribution across the country according to level of remoteness. In response to strong demand, the Department funded additional CSI workshops in regional areas. Each project achieved their target for number of workshops by project end.

The RC1 project trained 1,995 people from 1316 facilities; the RC2 project trained 1286 people from 835 facilities. The distribution of residential aged care facilities represented at the workshops was similar for each project and reflected the distribution of facilities across the country (Table ).

Table Location of workshops and facilities represented at workshops, national roll-out projects

	Location of workshops				Location of facilities represented at workshops
Remoteness category	RC1		RC2		RC1	RC2	Distribution of facilities in Australia
	No. of workshops	% of total	No. of workshops	% of total	% of total	% of total
Major cities	20	56%	23	62%	67%	64%	61%
Inner Regional	12	33%	11	30%	24%	22%	25%
Outer Regional	3	8%	3	8%	8%	13%	12%
Remote/very remote	1	3%	0	0%	1%	1%	2%
Total	36	100%	37	100%	100%	100%	100%

Note: the distribution by remoteness category for the RC1 project is based on data for all workshops; for the RC2 project it is based on data from the first 15 workshops.

The RC1 project adapted their training resources to meet local needs. In Victoria, this involved half-day train-the-trainer workshops for the North and West Metropolitan Palliative Care Consortium. In Western Australia, the workshop material was adapted for a half-day ‘update’ workshop targeted at staff that had previously received training in the Palliative Approach Toolkit.

In addition to the workshops, hard copies of the resources – the Palliative Approach Toolkit and the Champions for Skin Integrity Guide and Resource Pack – were distributed nationally to residential aged care facilities and each project undertook activities to market the resources (e.g. conference presentations, articles in industry newsletters). The RC1 project was able to host its resources on the CareSearch website, the central repository for palliative care resources in Australia²⁸. The RC2 project resources are available on the Queensland University of Technology website²⁹.

Neither project was directly responsible for changing practices in facilities; rather, any practice changes arising from these projects were determined by those attending the workshops and other staff in their facilities. Practice changes implemented by facilities were an indication of the impact of the workshops (see Appendix 4 and 5).

Both projects experienced delays in producing their respective resources but in only one case (RC1) was this significant (six months). The RC2 project took a couple of months longer than anticipated to conduct an evidence review of their resources but were able to make up this delay with improvements to the scheduling of workshops. Both projects experienced higher than expected costs for running workshops, either because of the high costs of venue hire (RC2) or the larger than expected number of attendees, resulting in the need for greater administrative support for the workshops (RC1).

The results of a survey of workshop participants conducted for the program evaluation were remarkably similar for both projects, with a very high proportion of participants rating the workshops as either meeting or exceeding their expectations; agreeing that the materials and small group activities used during the workshops assisted their learning; and rating the length of the workshop as ‘about right’. Almost all participants would recommend the workshops to their colleagues and saw the workshops as a preferred mode of delivery for this type of education (Table ).

Table Responses to survey of participants, national roll-out projects

Question or statement	Response to question or statement	% of respondents
		RC1	RC2
Please rate the workshop in terms of meeting your expectations	Met, exceeded or greatly exceeded my expectations	99%	97%
The PowerPoint slides, handouts and other resources used during the workshop assisted my learning	Agree or strongly agree	95%	95%
The length of the workshop was	‘About right’	89%	91%
Is attending a workshop your preferred mode of delivery for this type of education?	Yes	97%	97%
Would you recommend the workshop to a colleague?	Yes	98%	98%
Did the small group activities used in the workshop support your learning?	Yes	94%	93%

Participants believed that the resources that formed the basis of both sets of workshops (the Palliative Approach Toolkit and the Champions for Skin Integrity Guide and Resource Pack) were the most valuable aspect of the workshops (Table ). The opportunity to network with colleagues at the workshops was also much appreciated. Further details regarding the results of the survey of workshop participants can be found in Appendix 4 and 5.

Table Resources developed by the national roll-out projects

Project	Resources developed
RC1	Palliative Approach Toolkit, available on the CareSearch website. The Toolkit includes a comprehensive range of resources: workplace implementation guide, training support guide, clinical guidelines, three learning modules, four self-directed learning packages, three DVDs, flipcharts, information brochures and various clinical tools and forms. Training materials to support two workshops: one to train workshop trainers, the other to run half-day ‘update’ workshops (much of the activity of this project was to run 1-day workshops about the Toolkit, the training materials for which had been previously developed as part of the EBPRAC program).
RC2	Champions for Skin Integrity Guide and Resource Pack, a resource package for those who want to become a Champion for Skin Integrity (CSI), available in hard copy or online, supported by a CSI Resource CD which includes a copy of all the material and a training package about the use the accompanying data collection tools. The CIS Guide and Resource Pack includes eight clinical guideline summaries (e.g. skin care, wound care, nutrition and wound healing) and short ‘tip sheets’ for clients and carers, each including a list of simple ‘dos and don’ts’. Training resources to run 1-day train-the-trainer workshops for skin integrity champions.