QI in Action eBulletin #88: Palliative Care Matters

In this issue

• Resources to support your team’s palliative care services
• AFHTO 2019 conference
• Stay tuned for resources to support your team’s QIP!

Palliative care, why does it matter?
Palliative Care is the broad approach to providing comfort and dignity for patients and families who are living with or are at risk of developing a life-threatening illness2. Earlier integration of palliative care may provide benefits for both the patients and the health system. Some evidence shows those who receive palliative care earlier on are less likely to visit emergency room departments frequently or receive aggressive treatment at the end of life⁴. Palliative care can also lead to better quality of life throughout the entire process from the time of being diagnosed with a life-threatening illness¹.

Why do we need to improve? Less than 60% of Ontarians in their last year of life receive palliative care and about half of patients in their last 30 days of life receive home care services. Despite patients’ preference to die at home with appropriate support, more than half of the deaths in Ontario occur in hospitals³.

Providers can be better prepared by knowing patient preferences and wishes through advance care planning. Advance care planning can have many benefits for both palliative and non-palliative patients⁷. Earlier research indicates that patients who have end-of-life conversations are much more likely to be satisfied with their care, will require fewer aggressive interventions at the end of life, and reduce anxiety and strain on caregivers⁶. Advance care planning can start early on and be apart of normal care delivery in primary care.  

Resources to support your teams palliative care services:

• Palliative Care Toolkit from the Ontario Palliative Care Network. Click here to access best practice tools to support primary care providers. The toolkit references three steps – Identify, Assess and Plan & Manage – and provides tools and resources that may be helpful to your teams.
• Palliative Care Health Service Delivery Framework. The Ontario Palliative Care Network has developed this model of care to improve palliative care services. It applies to services for adult patients living in the community and their family/caregivers. Click here to access the framework document.
• Health Quality Ontario’s Palliative Care Implementation Support Group on Quorum. This group is part of a larger effort to support the new QIP indicator that focuses on the early identification and assessment of patients who may benefit from the palliative approach to care. Click here to join.
• Palliative Care Toolkit by the eHealth Centre of Excellence. This toolkit was designed to assist primary care providers in the early identification of patients nearing the end of life and/or who could benefit from a palliative care approach. Click here for more information and to get access to the toolkit.
• The Ontario Palliative Care Network (OPCN) is partnering with a project called CAPACITI (Community Access to PAlliative Care via Interprofessional rimary care Teams Improvement Project). This project will help strengthen primary care providers’ ability to deliver community-based palliative care and to operationalize a palliative approach to care within the unique context of their primary care practice.

Teams will receive evidence, tools and supports to integrate knowledge into practice, access to staff facilitators to support team coordination and collaboration, and coaching to provide customized strategies to local barriers. To receive these supports, contact your Regional Palliative Care Network. If you’re not sure who the contacts are, please email info@ontariopalliativecarenetwork.ca.

Learn more about palliative care initiatives in AFHTO member teams:

• Community Palliative Care Rounds – Strengthening Our Expertise, Barrie and Community FHT
• Primary Palliative Care as Part of Comprehensive Care in Family Practice, McMaster FHT
• Integrating Advance Care Planning into Primary Care Teams, Sinai Health System
• Planting the Seed – Introducing Advance Care Planning Conversations In “5 Minutes Or Less”, East Wellington FHT, Upper Grand FHT, Waterloo Wellington Nurse Practitioner-Led Clinic, Woolwich CHC, eHealth Centre for Excellence

Email improve@afhto.ca if you would like to get in contact with any of the teams above to learn more about their programs.

AFHTO 2019 Conference

Here are some important dates relating to this year’s AFHTO conference taking place September 19 & 20.

• May 30, 2019: Call for Bright Lights nominations
• June 2019: Conference registration opens
• August 19, 2019: Hotel group rate deadline
• September 4, 2019: Early-bird registration ends
• Sep 19 & 20, 2019: AFHTO 2019 Conference

Stay Tuned for Resources to Support your Team’s QIP!

The 2019/20 QIPs have been submitted and are available on the QIP navigator for review. You can search the 2019/20 QIPs using QIP Query or download any organization’s QIP using Download QIPs.

Stay tuned for resources and tools AFHTO will be providing to help teams once emerging themes are identified.

References:

1. Zimmermann C, Swami N, Krzyzanowska M, Hannon B, Leighl N, Oza A, et al. Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. The Lancet. 2014; 383:1721-30.
2. Palliative Care at the End of Life. Health Quality Ontario. (2016). https://www.hqontario.ca/Portals/0/documents/system-performance/palliative-care-report-en.pdf
3. Ontario Palliative Care Network. Regional profiles tool: describing Ontario decedents’ service use in their last year of life. Version 2.0. Toronto: The Network; 2018.
4. More Canadians could benefit from palliative care. Canadian Institute for Health Information. https://www.cihi.ca/en/more-canadians-could-benefit-from-palliative-care
5. Cancer Care Ontario. (2016) Advance Care Planning Toolkit. https://www.cancercareontario.ca/sites/ccocancercare/files/assets/CCOAdvancedCareToolkit.pdf
6. Speak Up. (2014). HAVE YOU HAD THE TALK? 55% OF CANADIANS HAVE NOT. http://www.advancecareplanning.ca/acp-news/2014-acp-news-release/
7. CFPC. Guide to Advance Care Planning Discussions Developed by Residents for Residents. (https://www.cfpc.ca/uploadedFiles/Directories/Sections/Section_of_Residents/ACP-GIFT-1pager.pdf

In Case You Missed It: Check out eBulletin #87 or other back issues here!
Questions? Comments? Contact us at improve@afhto.ca.