Victorian Healthcare Association

Developing a new model for end-of-life care in Victoria

Paper Giant facilitated a diverse and complex group of healthcare organisations to start working together, to implement the new assisted dying legislation in Victoria.

Workshop participants seated at a table, with facilitator Reuben checking in and listening to them talk.
  • Co-design with a complex group of healthcare organisations

  • A model of care designed in response to new legislation


The impact of legislative change

In 2018, the Victorian Government passed legislation to allow eligible people to request an assisted death when faced with a terminal illness. When major healthcare legislation such as this is passed, providers across the state need to work through the complexity of enabling access for patients in their region.

We were asked by the Victorian Healthcare Association (VHA) – the not-for-profit peak body supporting Victoria’s public health services – to help a working group of hospitals, aged-care facilities, palliative care organisations, and specialist health services work through this complexity.

Screenshots of news articles about the new voluntary assisted dying legislation. The first is titled "Voluntary assisted dying will soon be legal in Victoria, and this is what you need to know" and shows an image of someone in bed. The second is titled "Euthanasia: Victoria becomes the first Australian state to legalise voluntary assisted dying" and shows an image of a press conference.
A table of five participants at a workshop being facilitated by Reuben. They are looking towards one participant who is taking notes.

Facilitating a diverse group to start working together

Paper Giant facilitated a workshop with the VHA working group to help them design a new ‘model of care’, by mapping the various issues their organisations would face in implementing this legislation.

We collaborated with researchers at RMIT University to build empathy and a ‘patient-centred’ mindset into the workshop. This method used real-life patient cases to give participants the understanding needed to design a model with appropriate guidelines to enable fair access for everybody.

Remaining patient-centred is a particular priority for these organisations. Each organisation faces unique pressures – some operate in a rural environment, many are under-resourced and under-staffed, and some have ethical and moral views that prohibit them from participating in voluntary assisted dying altogether.

By bringing this group together, we ensured that the model was designed from a system-wide perspective, rather than each individual organisation addressing only their own specific issues or operational limitations.

Workshop participants at a table, including a man with his arms crossed and listening, and a women who is pursing her lips and looking intently at the table.
A workshop activity sheet on a table in front of a person.
A photo of two participants in a workshop. The person closest to the camera is looking to the right and speaking. Another person is in the centre of the frame, listening intently.

Strategies to improve end-of-life care

Once the workshop was complete, we worked with VHA to draft a model of care that the working group further developed and tested with service providers. This initial model of care was developed by VHA into a set of guidelines, principles, safeguards and practices for healthcare organisations to give patients the best set of care options when they request assisted dying.

The legislation and model of care is now in effect. The first person to access assisted dying was Kerry Robertson, a 61-year-old woman with terminal cancer. Her daughters described her death as “peaceful and surrounded by love. It was the way she wanted to leave this world.”

By using co-design as to bring organisations from across the sector together, we helped ensure all Victorians can access good end-of-life care, whatever that looks like for each person.

A research report, open on a white table. It shows a flow chart, titled VHA Pathways.

A flow diagram showing the potential pathway for a person looking to go through volunteered assisted dying.

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