An overview of priorities in managing a service
Palliative care volunteer services aim to support the local palliative care team in providing care to clients and their family with compassion and dignity. In general the priorities for services are based on maintaining their relationships with:
- People in palliative care and their loved ones.
- The referring clinicians.
- Volunteers and the community.
1. Relationships with people in palliative care and their loved ones
The primary role of the volunteer service is to improve the patient-journey and contribute positively to the experience or people receiving palliative care, their family and loved ones. The manager, although (usually) not one of the volunteers, is expected to model this behaviour through interactions and behaviour around clients and family members.
Being relevant to and respectful of the people who are receiving palliative care, their families and loved ones includes customising the service’s programs to the needs of the local catchment. For example a service might provide a local services guide, or acquire resources not otherwise available locally but which are of value to the individuals.
It also includes properly training, preparing, supporting and managing their volunteers so that the optimum quality of support is provided.
2. Relationship with the referring clinicians
The relationship between a palliative care volunteer service and the palliative care team is an important one. Ideally volunteers are included as part of the palliative care team wherever possible, through a process of referrals from clinicians to the volunteer service.
The flow of these referrals is essential, without which the work of the volunteer service may grind to a halt. Not all clinicians will be as supportive of volunteer involvement as others. Some will need more reassurance, or more evidence, or more awareness of the role of the volunteer.
The manager can make the most of the opportunity to obtain referrals by ensuring that the volunteer service has credibility with the palliative care service and has good working relationships with clinicians in the team. Having the support of senior management within the health service is also helpful.
The challenge of relationship management varies depending on the service context. About 70% of palliative care volunteers services in NSW are within larger health settings like hospitals, with about 26% are smaller not for profit services that are separate entities to the referring clinicians.
3. Relationships with the volunteers and the community
Maintaining faith with the volunteers is also an essential part of your role as a manager. This is important not only in terms of volunteers donating their time, but also in terms of the community donating their money and offering support through volunteering.
Acknowledging the contribution of volunteers as members of the health workforce is essential in attracting good quality and long serving volunteers and ensuring the best outcomes for the service.
Acknowledging the contribution of volunteers as members of the community is essential in maintaining the relationship with the local community. This is not only important in promoting opportunities for volunteering and to engender community confidence in the palliative care service, but in a pragmatic way is important for securing material contributions, donations and sponsorships.
Palliative care volunteers are regarded as non-clinical members of the palliative care team. Volunteers perform different roles depending on local need, these roles may include biography, bereavement support, community visiting, complementary therapies, inpatient support, memorial services and paediatric (children) support. A paediatric service may deliver programs differently to a service which focuses on adults. For an overview of volunteer roles see this website.
Managing relevant issues and risks
As manager you will be involved in managing risks specific to your service, as well as risks generic to health and volunteer services. Often these risks will depend on the roles undertaken by your palliative care volunteers.
Your organisation’s Policy and Procedures should be the first point of reference. Some local health districts may have a district-wide Volunteer Policy. If your service is a not for profit organisation you might additionally be subject to the external requirements of the referring palliative care team, and/or to any agreement with funding bodies.
Additionally NSW Health has published the Framework for Engaging, Supporting and Managing Volunteers as a policy directive for all NSW Health services that should be referred to in reviewing or developing your policies. They also provide a reference guide to all NSW Health policy directives and guidelines that have direct and indirect relationship to activities involving NSW Health volunteers.
Starting a new service
If your service is new it is worth making sure that your volunteer support and management processes (policies, management systems) are sorted out before you start recruitment and training.
Some common areas for consideration include appropriate behaviour, privacy, confidentiality, workplace health and safety, driving and vehicle use, grievances and complaints, traveling with clients, safe community visiting, reimbursement, performance and disciplinary matters.
Other risks associated with specific program areas will also need to be addressed. On the VolunteerHub website you will find some sample policy and procedure documents that can be adopted for your use including a Sample Policy Manual for NGOs that can be used as a starting point for your own manual.
If you are introducing a new role for your volunteers spend some time making sure that the clinicians are supportive and that you have fully communicated the role of the volunteer and how they will be selected and managed. This is essential not only to provide a safe working environment but also to ensure that the volunteer is fully embraced as a team member.
Some organisations provide a summary of the organisation’s policies and behavioural expectations in a Volunteer Handbook. The Volunteer Handbook is also useful as a common reference point for all involved (including volunteers & clinicians) about what to expect from the volunteers.
The following is a list of suggested content for a Volunteer Handbook (and also serves as a helpful checklist of policies and procedures for your service).
- Welcome / overview of the service
- Volunteer rights, responsibilities, authorities, delegations and scope of practice
- Who to contact for support
- How to claim for expenses
- Declaring and managing conflicts of interests
- Emergency procedures
- Health and safety policy (alcohol and drug impairment policies)
- Acceptable workplace behaviour (antidiscrimination, sexual harassment, bullying)
- Working with vulnerable clients, working with children and families, police screening checks
- Driving and vehicle use
- Privacy and confidentiality
- Property and intellectual property
- Procedures for giving feedback, performance review, setting goals, ending the relationship
- Complaints and grievances
- Reporting and recording volunteer activity
- The extent of insurance cover for volunteers, things to consider, scope of activities
- Communication, social media, responsibility to fairly represent role and service, defamation
Other Relevant Standards and Guidelines
In addition to the mandatory requirements of your organisation, local health district and NSW Health you might find one or more of the following Standards and Guidelines to be helpful in shaping your policy development:
The National Standards for Volunteer Involvement (2015) have been recently revised for use within an accreditation program. Published by Volunteering Australia they ‘provide a framework for organisations to consider the role of volunteers within the organisation and the impact effective volunteer involvement can have on achieving the strategic goals and aims of the organisation’.
The Victorian Palliative Care Volunteer Standards (2007) provide program standards and volunteer service standards for the Victorian palliative care sector, designed to; foster greater awareness of the role of volunteers in palliative care, support and promote volunteer engagement in palliative care, limit organisation legal liability with regard to volunteer engagement in palliative care services. A selection of resource documents are included to assist organisations compile volunteer policies and procedures.
Palliative Care Australia publishes the National Palliative Care Standards 5th Edition (2018) which are generic to palliative care services. The standards identify service performance outcomes across 13 domains and are a guide for palliative care services to optimise and reflect on service delivery characteristics. Compliance with the standards is optional.
The Australian Commission on Safety and Quality in Health Care is the national oversight agency for health care standards and publish the National Safety and Quality Health Service (NSQHS) Standards 2nd Edition. Compliance with the NSQHS is mandatory for continuation of funding for health services.
Smaller, less complex and less diverse organisations require a commensurate accreditation system. The Australian Service Excellence Standards, the Home Care Standards and the Health and Community Services Standards are examples of accreditation systems measuring generic service characteristics and tailored to smaller organisations.
Performance data on palliative care services is also collected through the Palliative Care Outcomes Collaboration (PCOC) based at the University of Wollongong which is a national program measuring patient outcomes using standard clinical assessment tools.
Other planning resources
The NSW Agency for Clinical Innovation have published several reports describing the current service system in NSW and setting goals for future development including the Blueprint for Palliative and End of Life Care – A Blueprint for Improvement.