Creating Compassion with Palliative Care: A A Provincial Perspective Dr. Ahmed Jakda March 28, 2018
What is the Ontario Palliative Care Network?
Drivers for Change in Hospice Palliative Care in Ontario In October 2014, the former Hospice Palliative Care Provincial Steering Committee identified that the gaps called out in the Declaration, still existed. Inadequate & Limited & Lack of clear inequitable Inadequate inequitable accountability access to Lack of system support for service capacity for the delivery integrated, high integration caregivers across all care of hospice quality hospice settings palliative care palliative care There was still no formalized provincial network with clear accountability to drive the delivery of quality coordinated hospice palliative care. 3
What is the Ontario Palliative Care Network? An organized partnership of community stakeholders, health service providers and health systems planners responsible for the development of a coordinated, standardized approach to the delivery of hospice palliative care services in Ontario. Accountable for the OPCN Shared leadership responsibility Health Quality Quality Hospice Palliative The LHINs CCO Ontario Care Coalition of Ontario Collectively, these partners have the skills, knowledge, resources and reach to provide the leadership, practical knowledge, oversight and governance to deliver on the mandate of the network. 4
The Mandate of the Ontario Palliative Care Network 5
Our Past, Present & Future Work
Working Towards High Quality Palliative Care in Ontario High gh qua quality, coor ordinated ed, ho hosp spice pa palliative care e in n On Ontari rio Prov Pr ovinci cial OPCN’s Perf rform rmance e 3-Yea ear Sum ummary ry Act ction on Plan Palliative e Care Qua Quality y Stand ndard (2017 2017-18 18) PA John n Fras raser er Report rt: Five e Pr Priori rities es (201 016) Declaration on of Part rtnersh ship: p: 6 Pr Priori rities es (201 011) 20
OPCN’s Work to date Since the launc nch h of the e OPCN, we have e accom omplish shed ed the followi wing ng: Used a data-driven and evidence-based approach to provide recommendations on allocation of new residential hospice beds Supported the LHINs with regional capacity planning data Put processes in place to ensure ongoing access to high-strength long-lasting opioids for patients requiring these medications for palliative purposes Engaged 200+ stakeholders in development of a the OPCN Action Plan and the development of provincial indicators for quality hospice palliative care 21
OPCN’s Work Moving Forward: The OPCN Action Plan The Action Plan guides our work between now and March 2020, it: • Places patients and their caregivers at the centre • Supports coordinated system level change through alignment of planning, implementation, monitoring, and reporting both at and across the regional and provincial levels of focus • Aligns with the structural changes occurring in Ontario’s health system through the Patients First initiative • Addresses the full spectrum of settings in which palliative care services are delivered (home, community, long-term care, hospice, or hospital) as well as the broad range of geographies in which Ontarians live (north and south; urban, rural, and remote) 9
Action Areas for the OPCN Action Plan A • Enhancing Patient and Caregiver Engagement in Palliative Care B • Aligning the Planning for Palliative Care Across the Province C • Enabling Early Identification of those Who Would Benefit from Palliative Care D • Establishing Palliative Models of Care that Enable Adoption of the Quality Standard E • Identifying and Connecting Palliative Care Providers F • Building Provider Competencies in Palliative Care G • Measuring and Reporting on our Progress 10
OPCN Work Currently Underway: 1. Developing a Palliative Care Quality Standard for Ontarians 2. Developing recommendations on the ideal model of care for patients receiving palliative care services within their last year of life 3. Developing recommendations on the educational requirements for health care providers providing palliative care 4. Supporting early identification of patients who would benefit from palliative care 5. Prioritizing indicators to enable performance measurement and reporting 6. Building stronger understanding of palliative care needs within priority populations (vulnerably housed/homeless, FNIM, pediatrics, Francophone) 11
1. Developing a Palliative Care Quality Standard • As a key OPCN Partner, HQO is supporting the development process • The focus is on palliative care for adults with progressive life-limiting illness. • The product is a go-to resource containing a set of evidence-based, measurable statements outlining what high-quality palliative care should look like for patients, caregivers, and health care providers • OPCN Provincial Clinical Co-Lead co-chairs the Palliative Care Quality Standard Working Group which has diverse representation across geography, health sectors, lived experience, and health disciplines 12
Draft Quality Statements of the Quality Standard 1. People with a progressive, life-limiting illness have their palliative care needs identified early through a comprehensive and holistic assessment. 2. People with identified palliative care needs have access to palliative care support 24 hours a day, 7 days a week . 3. People with a progressive, life-limiting illness know who their future substitute decision-maker is. They engage in ongoing communication with their substitute decision-maker about their wishes, values, and beliefs , so that the substitute decision-maker is empowered to participate in the health care consent process if required. 4. People with identified palliative care needs or their substitute decision-makers have discussions with their interdisciplinary health care team about their goals of care to help inform their health care decisions . These values-based discussions focus on ensuring an accurate understanding of both the illness and treatment options so the person or their substitute decision-maker has the information they need to give or refuse consent to treatment. 13
Draft Quality Statements of the Quality Standard 5. People with identified palliative care needs collaborate with their primary care provider and other health care professionals to develop an individualized, person-centred care plan that is reviewed and updated regularly. 6. People with identified palliative care needs have their pain and other symptoms managed effectively, in a timely manner . 7. People with identified palliative care needs receive timely psychosocial support to address their mental, emotional, social, cultural, and spiritual needs. 8. People with a progressive, life-limiting illness, their future substitute decision-maker, their family, and their caregivers are offered education about palliative care and information about available resources and supports . 14
Draft Quality Statements of the Quality Standard 9. Families and caregivers of people with identified palliative care needs are offered ongoing assessment of their needs , and are given access to resources, respite care, and grief and bereavement support, consistent with their preferences. 10. People with identified palliative care needs experience seamless transitions in care that are coordinated effectively between settings and health care providers. 11. People with identified palliative care needs, their substitute decision-maker, their family, and their caregivers have ongoing discussions with their health care professionals about their preferred setting of care and place of death . 12. People with identified palliative care needs receive integrated care from an interdisciplinary team , which includes volunteers. 13. People receive palliative care from health care providers and volunteers who possess the appropriate knowledge and skills to deliver high-quality palliative care. 15
2. Developing Recommendations on the Ideal Model of Care • A Health Service Delivery Framework (HSDF) Working Group was established to describe and recommend a model of care for palliative care that: • Delivers high quality, culturally relevant care to all of the population in need • Builds sufficient capacity among community care providers that will sustain the system over the long term • Enables the implementation of the HQO Palliative Care Quality Standard • The first area of focus is adult patients receiving care within the last year of life and residing at home (e.g. patient’s living in their usual place of residence*). • As per the Working Group’s advice, HSDF will focus on more than the last year of life • Testing the recommended model of care will align with testing of early identification tools • The Recommendations will be tested and evaluated to assess the feasibility and effectiveness of the recommended Models of Care. *Usual place of residence can include long-term care homes and retirement homes 16
Recommend
More recommend
