The iValidate “Identifying Values, Listening, and Advising High-risk Patients in Acute Care” program was developed by experts in communication, ethics, end-of-life care, and clinical leaders from Barwon Health and Deakin University, with the goal to improve communication and shared decision-making for end of life care. “Although talk about patient-centred care is ubiquitous in modern health care, one of the greatest challenges of turning the rhetoric into reality continues to be routinely engaging patients in decision making”. Barry MJ, N Engl J Med. 2012


Follow the link above to register for an upcoming course. Contact CET@barwonhealth.org.au to register interest or ask for any further details.

  • The Core iValidate course is online and run via Zoom.
  • The courses runs over 2 days with a blend of eLearning modules to complete in your own time, and 2 x 6 hours webinars.
  • The communication skills for engaging with patients with life limiting illness are taught through real life scenarios, video and participants’ own experiences.
  • Participants need to complete all components of the blended program to obtain recognition for CPD or college competency.
  • Duration:14 hours total. 12 hours webinar, 2 hours online content.
Registered Participants Information

Registered participants can access all course details via our Learning Management System (Grow). Log in to Grow for:

  • Information about the course
  • Find the online pre-learning modules
  • Workbook and other resources
  • Access to the course evaluation
Login details will be sent to participants once their registration is processed from the iValidate Team via CET@barwonhealth.org.au

Dates for the upcoming courses including those in 2024 have been confirmed and are as follows:

  • Tuesday 11th & 18th June 2024 (via Zoom)
  • Wednesday 21st & 28th August 2024  (via Zoom) 
  • Friday 23rd & 30th August 2024 (via Zoom)
  • Thursday 19th & 26th September 2024  (via Zoom)
  • Friday 1st & 8th November 2024  (via Zoom)
  • Wednesday 4th & 11th December 2024 (via Zoom)

Click Here for a Demonstration

Life-limiting illness can be defined using objective indicators such as the UK Gold Standard Framework (GSF), and the Supportive and Palliative Care Indicators Tool (SPICT). The goal of these indicators is to aid the identification of patients in or approaching the last year of life, to aid the delivery of patient-centred care.  Overall patients can be classified into a clinical trajectory group of cancer, organ system failure, frailty/comorbidity/dementia, or no LLI. These classifications have been tested and used extensively in community and hospital based settings.

Over the last 5 years we have collected data on over 2000 patients in UHG, looking at trajectory of survival, and evidence of discussions about care, for patients with and without life limiting illness (LLI).  

We have learnt that

  • At least a third of patients in UHG, or referred to ICU, have a life limiting illness
  •  The clinical trajectories of cancer, frailty, or organ failure, reliably identify patients with a high one-year mortality. Patients without a LLI have excellent outcomes.
  • Less than half of patients with a LLI return to independent living
  • Goals of care are identified in only 34% of patient with a LLI while in hospital
  1. Thurston LM, Milnes SL, Hodgson CL, Berkovic DE, Ayton DR, Iwashyna TJ, Orford. Defining patient-centred recovery after critical illness – A qualitative study. J Crit Care. 2020 Feb 6;57:84-90. doi: 10.1016/j.jcrc.2020.01.028
  2. Ragg J, Ragg M, Milnes S, Bailey M, Orford N. Patients with life-limiting illness presenting to the emergency department. Emerg Med Australia. 2019 Oct 30 [epub ahead of print].
  3. Orford N. What is an intensive care specialist? Med J Aust 2019; 211(7)
  4. Simpson N, Milnes S, Martin P… Orford N.  iValidate – A communication-based clinical intervention in Life Limiting Illness. BMJ Supportive & Palliative Care. 2019 Apr 11. doi: 10.1136/bmjspcare-2018-001669
  5. Orford NR, Milnes S, Simpson N, et al. Effect of communication skills training on outcomes in critically ill patients with life-limiting illness referred for intensive care management: a before-and-after study. BMJ Supportive & Palliative Care. 2019;9(1):e21-e21. 
  6. Orford N. Grief After Suicide. JAMA. 2018;320(18):1861-1862. 
  7. Milnes S, Corke C, Orford NR, Bailey M, Savulescu J, Wilkinson D. Patient values informing medical treatment: a pilot community and advance care planning survey. BMJ Support Palliat Care. 2017 Mar 2.
  8. Orford NR, Milnes S, Lambert N, etal. Crit Care Resusc 2016. Prevalence, goals of care and long-term outcomes of patients with life-limiting illness referred to a tertiary ICU. Crit Care Resusc 2016;18(3):181-8.
  9. Orford NR. Mothers: Respect the strong, selfless women in your life. The Age/SMH https://www.smh.com.au/opinion/hospitals-must-shift-focus-of-endoflife-c…
  10. Orford NR. Give death its due in a system focused on life. The Age / SMH https://www.smh.com.au/opinion/hospitals-must-shift-focus-of-endoflife-c…
  11. Milnes S, Orford NR, Berkeley L, et al.  A prospective observational study of prevalence and outcomes of patients with Gold Standard Framework criteria in a tertiary regional Australian Hospital.  BMJSPC, 2015. 
  12. Corke C, Milnes S, Orford N, et al.  The influence of medical enduring power of attorney and advance directives on decision-making by Australian intensive care doctors.  Crit Care Resusc 2009 Jun;11(2):122-128.