St Columba’s Hospice Care ECHO HUB

St Columba’s Hospice Care can provide specialist palliative care support to care homes in North Edinburgh but also supports care homes through the virtual education and support model ECHO – Extensions for Community Health Outcomes.

Along with many other Hospices in the UK, St Columba’s Hospice Care uses the ECHO model to widen access to palliative care knowledge and skills by supporting people who deliver palliative and end of life care in settings other than the hospice, such as care homes. The model uses ZOOM technology to allow multidisciplinary health and social care staff from the hospices, NHS and care homes to join a central ‘hub’ (hospice) to share, learn and reflect together on their individual and collective roles in supporting the complex care needs of people living in care homes. 

What is unique about ECHO?

• Creates a multidisciplinary community of practice or network to harness the most important resources for care homes – the experience, skills and knowledge of care home, NHS and social care staff.
• Based on values of collaboration, inclusion and participation where the learning programmes are developed with care homes staff to identify their leaning needs and gaps in knowledge.
• Creates a learning space where ‘everyone is a learner and everyone is a teacher’, and all involved can gain a better understanding of the issues around delivering care in care homes from reflection and sharing of practice-based case studies from care home staff. 
• Provides specific facilitation skills required for virtual learning.

Developing an ECHO Network

Potential participants are invited to an initial ‘start-up meeting’ (virtual) with the aim to begin to develop a ‘community of practice’ and a learning programme. The programme/number of sessions will depend on the number of topics and frequency of session (3 weekly or monthly works best). There is also discussion on the benefits and opportunities of ECHO, expectations, technology, data protection, attendance and presenting case studies.

An ECHO session 60-90 minutes with strict adherence to start and finish time.

1. Sharing of Knowledge – A short PowerPoint presentation (10-15min) from an ‘expert’ on the session topic. The expert is someone who shares knowledge and new leaning and can be from the network or external.

2. Reflection on Practice – Facilitated open discussion and reflection on two case-based experiences from care home staff. This is more important than the presentation from the ‘expert’!

Previous Networks

From 2018 until March 2020, 18 Edinburgh care homes were part of 6 ECHO Care Home Networks. Some networks were in collaboration with Edinburgh Health & Social Care Partnership, Anticipatory Care Planning Team and Marie Curie Hospice, who also provide specialist support to care homes in South Edinburgh.

Expert presenters have included- community palliative care nurse specialists, palliative care consultants, Hospice doctors, dietician, social worker and counsellor. GP, District Nurses, Hospital @ Home doctor, Scottish Ambulance Service Clinical Lead, Parkinson’s CNS and Medicine of the Elderly Consultant.

Our evaluation showed that the ECHO methodology provided care homes staff with access to a wide range of new knowledge from health professional not normally available to them, a safe space for reflection and opportunities to share and learn from practice-based experiences with peers.

Quotes for Care home staff

“The reflection on practice was very beneficial in generating discussion with staff on how we can improve things and resulted in several chats afterwards”  

“I found out more information about delirium. It was good to hear other care homes stories, and it gave us time to reflection and think what we would do in similar situation.”