ArticleBMC geriatrics2026
The Palliative Aged Care Outcomes Program (PACOP): establishing a national framework to improve palliative care in long-term care facilities for older people.
Article in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWith an aging population worldwide, many countries face increasing challenges in delivering quality palliative care in long-term care facilities for older people (LTCFs). In Australia, a Royal Commission into Quality and safety of Aged Care in 2021 highlighted significant gaps in this field. In response, the Palliative Aged Care Outcomes Program (PACOP), a person-centred outcomes framework, was developed to address gaps in identification, assessment and management of palliative care needs in LTCFs.
objectiveTo present the development, implementation and early process evaluation of PACOP.
designA cross-sectional mixed-methods study with embedded qualitative open-ended questions.
methodsPACOP was co-designed with sector stakeholders and informed by insights from the Palliative Care Outcomes Collaboration (PCOC)-Wicking trial. Launched in 2022, it comprises two key components: the Profile and Outcomes Collections, supported by national benchmarks, improvement facilitators, training, data and IT infrastructure. A process evaluation, guided by Normalisation Process Theory (NPT), used the NoMAD instrument and open-ended questions to explore healthcare workers’ experiences of the PACOP implementation.
resultsBy June 2025, 440 of 2,622 (16.8%) LTCFs in Australia participated in PACOP. Key facilitators included organizational buy-in, leadership support, the train-the-trainer model and improvement facilitators. Participants reported that PACOP improved early identification of residents’ palliative care needs, supported structured care planning and informed service improvement. However, challenges such as workforce instability, inexperienced staff and limited IT integration were identified.
conclusionPACOP has achieved substantial uptake and early signs of successful implementation in Australian LTCFs. Continued investment in organizational systems change, tailored training, digital integration, along with responsive benchmarking and feedback mechanisms, are essential to sustaining its implementation and enhancing palliative care quality in LTCFs.
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