Using Pragmatic Co-Design Processes in a Resource-Constrained Regional Health Service: Insights From the TROPICAL-VIC Early Referral to Palliative Care Project.

Authors

Stacey Ann Rich, Jennifer Philip, Annie Williams, Anna Griffith, Kathleen Wilkins, Chi Li, Christopher Steer, Diane Davey, Michelle Hensel, Nicole Webb, Tanya Dawe, Craig Underhill

Published in

The Australian journal of rural health. Volume 34. Issue 3. Pages e70224.

Abstract

To describe an evidence-informed, experience-based co-design process used to adapt metropolitan early palliative care referral models for implementation in a regional Australian health service.
A scoping review of palliative care delivery and early referral models to inform evidence-informed, experience-based co-design workshops involving consumers, clinicians, and health service staff.
Sequential mixed-methods development study comprising evidence synthesis to identify model components, followed by two iterative workshops to construct and refine a context-appropriate outpatient early referral model.
A regional public health service in Victoria, Australia, seeking to establish an outpatient early referral palliative care clinic for people with advanced cancer.
Purposefully sampled stakeholders (patients/carers, oncologists, palliative care clinicians, cancer care coordinators, Aboriginal health worker, managers, and researchers) took part in two online workshops.
Co-designed model structure and components, perceived feasibility in a resource-constrained regional context, and agreed service scope and patient eligibility.
The process generated a regionally tailored early referral pathway incorporating needs-based screening, prioritisation to manage limited capacity, and staged roll-out initially focused on selected cancer groups. These adaptations, while pragmatic, highlight the resourcing disparities faced by rural and regional services and the equity implications of resource-driven variation in care delivery.
Evidence-informed co-design enabled pragmatic adaptation of metropolitan palliative care models to a regional setting and offers a transferable approach for other rural and regional services.

PMID:
42322143
Bibliographic data and abstract were imported from PubMed on 20 Jun 2026.

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