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

Rich, SA; Philip, J; Williams, A; Griffith, A; Wilkins, K; Li, C; Steer, C; Davey, D; Hensel, M; Webb, N; Dawe, T; Underhill, C

Author(s): Rich, SA; Philip, J; Williams, A; Griffith, A; Wilkins, K; Li, C; Steer, C; Davey, D; Hensel, M; Webb, N; Dawe, T; Underhill, C;
Details: Publication Year 2026-06,Volume 34,Issue #3,Page e70224
Journal Title: Australian Journal of Rural Health
Publication Type: Research article
Abstract: OBJECTIVE: 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. METHODS: 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. DESIGN: 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. SETTING: A regional public health service in Victoria, Australia, seeking to establish an outpatient early referral palliative care clinic for people with advanced cancer. PARTICIPANTS: Purposefully sampled stakeholders (patients/carers, oncologists, palliative care clinicians, cancer care coordinators, Aboriginal health worker, managers, and researchers) took part in two online workshops. MAIN OUTCOME MEASURES: Co-designed model structure and components, perceived feasibility in a resource-constrained regional context, and agreed service scope and patient eligibility. RESULTS: 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. CONCLUSIONS: 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.
Publisher: Wiley
Keywords: Humans; *Palliative Care/organization & administration; *Referral and Consultation/organization & administration; Victoria; Resource-Limited Settings; *Rural Health Services/organization & administration; Neoplasms/therapy; brief co‐design; early referral; model of care development; palliative care; rural health care
Department(s): Palliative Care
Publisher's Version: https://doi.org/10.1111/ajr.70224
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2026-06-30 06:01:54

Last Modified: 2026-06-30 06:02:00