{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T23:54:35Z","timestamp":1781826875738,"version":"3.54.5"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>There is an acute unmet need for specialist palliative care services in Residential Aged Care Homes (RACHs). Palliative care needs rounds (Needs Rounds) are a promising evidence-based outreach approach to improve access to specialist care for this population. This study aimed to evaluate the feasibility and cost effectiveness of implementing needs rounds across a metropolitan Australian health service.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective pre\u2013post cohort study was conducted comparing outcomes from May\u2013October 2021 with the same period in 2019. Primary outcomes were emergency department (ED) presentations and hospital admissions among RACH residents. Secondary outcomes included estimated cost savings and released hospital capacity. Analyses were conducted from the perspective of the public health service provider. Findings are descriptive, and no formal statistical hypothesis testing was undertaken.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Needs rounds were implemented in 39 of 56 RACHs (70%) within the first nine months. Facilities not participating were primarily affected by operational constraints, including staffing pressures and pandemic-related disruptions. Compared with 2019, ED presentations declined by 20% and hospital admissions by 64%. Estimated cost savings associated with reduced hospital utilization were AU$498,315 per month. These findings should be interpreted cautiously given concurrent system-wide changes associated with the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Needs rounds appear feasible to implement at scale and may reduce hospital utilization among RACH residents. Preliminary economic findings suggest potential cost savings and released capacity within the health system. However, causal attribution remains uncertain, and full implementation costs were not captured. Further controlled studies incorporating patient-centred outcomes are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afag173","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T11:23:03Z","timestamp":1780312983000},"source":"Crossref","is-referenced-by-count":0,"title":["Feasible and cost effective: a retrospective cohort study of palliative care needs rounds in residential aged care"],"prefix":"10.1093","volume":"55","author":[{"given":"Nicola","family":"Morgan","sequence":"first","affiliation":[{"name":"Gold Coast Hospital and Health Service - Supportive and Palliative Care Services , Southport, Queensland ,","place":["Australia"]},{"name":"Bond University Faculty of Health Sciences and Medicine - School of Medicine , Gold Coast, Queensland ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harish","family":"Aakula","sequence":"additional","affiliation":[{"name":"Bond University Faculty of Health Sciences and Medicine - School of Medicine , Gold Coast, Queensland ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey","family":"Norling","sequence":"additional","affiliation":[{"name":"Gold Coast Hospital and Health Service - Supportive and Palliative Care Services , Southport, Queensland ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Tripp","sequence":"additional","affiliation":[{"name":"Gold Coast Hospital and Health Service - Supportive and Palliative Care Services , Southport, Queensland ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uyen","family":"Duong","sequence":"additional","affiliation":[{"name":"Gold Coast Hospital and Health Service - Supportive and Palliative Care Services , Southport, Queensland ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Smith","sequence":"additional","affiliation":[{"name":"Townsville Hospital and Health Service - Speech Pathology , Townsville, Queensland ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Merlo","sequence":"additional","affiliation":[{"name":"Queensland Government Department of Health and Ageing - Health Improvement Unit , Brisbane, Queensland ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Broadbent","sequence":"additional","affiliation":[{"name":"Gold Coast Hospital and Health Service - Supportive and Palliative Care Services , Southport, Queensland ,","place":["Australia"]},{"name":"Bond University Faculty of Health Sciences and Medicine - School of Medicine , Gold Coast, Queensland ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Mickan","sequence":"additional","affiliation":[{"name":"Bond University Faculty of Health Sciences and Medicine - School of Medicine , Gold Coast, Queensland,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"2026061819370617800_ref1","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1136\/bmjspcare-2015-000943","article-title":"Necessary but not yet sufficient: a survey of aged residential care staff perceptions of palliative care communication, education, and delivery","volume":"6","author":"Frey","year":"2016","journal-title":"BMJ Support Palliat Care"},{"key":"2026061819370617800_ref2","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1071\/PY17168","article-title":"Identifying palliative care needs in residential care","volume":"24","author":"Liyanage","year":"2018","journal-title":"Aust J Prim Health"},{"key":"2026061819370617800_ref3","volume-title":"The National Palliative Care Strategy 2018\u20132019","author":"Australian Government Department of Health","year":"2019"},{"key":"2026061819370617800_ref4","volume-title":"Final Report of the Royal Commission into Aged Care Quality and Safety","author":"Australian Royal Commission into Aged Care Quality and Safety","year":"2019"},{"key":"2026061819370617800_ref5","volume-title":"Conversations: Creating Choice in End of Life Care","author":"Bartel","year":"2016"},{"key":"2026061819370617800_ref6","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3928\/00989134-20140909-01","article-title":"Evaluating the impact of palliative or hospice care provided in nursing homes","volume":"40","author":"Cimino","year":"2014","journal-title":"J Gerontology Nursing"},{"key":"2026061819370617800_ref7","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1093\/ageing\/afz174","article-title":"Care home residents who die in hospital: exploring factors, processes and experiences","volume":"49","author":"Alcorn","year":"2020","journal-title":"Age Ageing"},{"key":"2026061819370617800_ref8","doi-asserted-by":"publisher","first-page":"e93762","DOI":"10.1371\/journal.pone.0093762","article-title":"Actual and preferred place of death of home-dwelling patients in four European countries: making sense of quality indicators","volume":"9","author":"De Roo","year":"2014","journal-title":"PloS One"},{"key":"2026061819370617800_ref9","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/j.colegn.2008.09.001","article-title":"The evolution of palliative care and the relevance to residential aged care: understanding the past to inform the future","volume":"15","author":"Allen","year":"2008","journal-title":"Collegian (Royal College of Nursing, Australia)"},{"key":"2026061819370617800_ref10","doi-asserted-by":"publisher","first-page":"e12295","DOI":"10.1111\/opn.12295","article-title":"What factors predict the confidence of palliative care delivery in long-term care staff? A mixed-methods study","volume":"15","author":"Frey","year":"2020","journal-title":"Int J Older People Nurs"},{"key":"2026061819370617800_ref11","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1177\/1744987108095162","article-title":"The role of education and training in achieving change in care homes: a literature review","volume":"13","author":"Nolan","year":"2008","journal-title":"Journal of Research in Nursing"},{"key":"2026061819370617800_ref12","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1016\/j.colegn.2022.04.009","article-title":"Palliative care education for care workers in aged care: a scoping review","volume":"29","author":"Norling","year":"2022","journal-title":"Collegian"},{"key":"2026061819370617800_ref13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ijnurstu.2018.02.004","article-title":"Facilitation of an end-of-life care programme into practice within UK nursing care homes: a mixed-methods study","volume":"82","author":"Kinley","year":"2018","journal-title":"Int J Nurs Stud"},{"key":"2026061819370617800_ref14","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1016\/j.ijnurstu.2012.11.001","article-title":"Does case conferencing for people with advanced dementia living in nursing homes improve care outcomes: evidence from an integrative review?","volume":"50","author":"Phillips","year":"2013","journal-title":"Int J Nurs Stud"},{"key":"2026061819370617800_ref15","doi-asserted-by":"publisher","first-page":"42","DOI":"10.3928\/00989134-20140611-01","article-title":"Comfort care rounds: a staff capacity-building initiative in long-term care homes","volume":"41","author":"Wickson-Griffiths","year":"2015","journal-title":"J Gerontol Nurs"},{"key":"2026061819370617800_ref16","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1177\/0269216314526272","article-title":"The effects of advance care planning on end-of-life care: a systematic review","volume":"28","author":"Brinkman-Stoppelenburg","year":"2014","journal-title":"Palliat Med"},{"key":"2026061819370617800_ref17","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1016\/j.jamda.2015.12.017","article-title":"The effects of advance care planning interventions on nursing home residents: a systematic review","volume":"17","author":"Martin","year":"2016","journal-title":"J Am Med Dir Assoc"},{"key":"2026061819370617800_ref18","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.ijnurstu.2016.12.003","article-title":"Preconditions for successful advance care planning in nursing homes: a systematic review","volume":"66","author":"Gilissen","year":"2017","journal-title":"Int J Nurs Stud"},{"key":"2026061819370617800_ref19","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1111\/ggi.12053","article-title":"Decision to transfer to an emergency department from residential aged care: a systematic review of qualitative research","volume":"13","author":"Arendts","year":"2013","journal-title":"Geriatr Gerontol Int"},{"key":"2026061819370617800_ref20","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1089\/jpm.2017.0050","article-title":"Preventing burdensome transitions of nursing home residents with advanced dementia: It's more than advance directives","volume":"20","author":"Palan Lopez","year":"2017","journal-title":"J Palliat Med"},{"key":"2026061819370617800_ref21","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1136\/bmjspcare-2015-001071","article-title":"Avoiding costly hospitalistion at end of life: findings from a specialist palliative care pilot in residential care for older adults","volume":"8","author":"Chapman","year":"2018","journal-title":"BMJ Support Palliat Care"},{"key":"2026061819370617800_ref22","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1177\/0269216319891077","article-title":"Reducing time in acute hospitals: a stepped-wedge randomised control trial of a specialist palliative care intervention in residential care homes","volume":"34","author":"Forbat","year":"2020","journal-title":"Palliat Med"},{"key":"2026061819370617800_ref23","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1111\/jgs.16192","article-title":"Improved quality of death and dying in care homes: a palliative care stepped wedge randomized control trial in Australia","volume":"68","author":"Liu","year":"2020","journal-title":"J Am Geriatr Soc"},{"key":"2026061819370617800_ref24","doi-asserted-by":"publisher","first-page":"e12","DOI":"10.1136\/bmjspcare-2016-001127","article-title":"Normalising and planning for death in residential care: findings from a qualitative focus group study of a specialist palliative care intervention","volume":"9","author":"Johnston","year":"2019","journal-title":"BMJ Support Palliat Care"},{"key":"2026061819370617800_ref25","volume-title":"Region Summary","author":"Australian Bureau of Statistics","year":"2020"},{"key":"2026061819370617800_ref26","volume-title":"Specialist Palliative Care in Aged Care (SPACE) Project","author":"Clinical Excellence Queensland","year":"2020"},{"key":"2026061819370617800_ref27","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1071\/AH23272","article-title":"Development and implementation of the specialist palliative Care in Aged Care (SPACE) project across Queensland","volume":"48","author":"Smith","year":"2024","journal-title":"Australian health Review: a publication of the Australian Hospital Association"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/55\/6\/afag173\/68555361\/afag173.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/55\/6\/afag173\/68555361\/afag173.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T23:37:13Z","timestamp":1781825833000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/doi\/10.1093\/ageing\/afag173\/8711295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afag173","relation":{},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"value":"0002-0729","type":"print"},{"value":"1468-2834","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6]]},"published":{"date-parts":[[2026,6,1]]},"article-number":"afag173"}}