Palliative Care is an approach to care that focuses on comfort and quality of life. The goal is much more than comfort in dying; palliative care is about living well, through meticulous attention to control of pain and other symptoms, supporting emotional, spiritual, and cultural needs, and maximizing functional status. Palliative care is appropriate for any individual with a life-limiting illness, and patients and families who would benefit from a palliative approach to care may be identified in any care setting, including hospitals, primary care, and community care. Importantly, palliative care helps to ensure that the most vulnerable patients receive care that is catered to their preferences.
Patients with palliative care needs represent a significant portion of the hospital inpatient population. Unfortunately, due to gaps in palliative care education and training, healthcare providers often have difficulty identifying when someone may benefit from palliative care, are uncomfortable initiating conversations to explore a person's goals of care and are unaware of how to access palliative care services.
When patients do not have access to well-organized, high-quality palliative care, they are more likely to have uncontrolled pain and symptoms, higher levels of stress and poorer quality of life. They are also more likely to have an unplanned emergency department (ED) visit in their last days of life and to die in hospital.
All Ontarians deserve the best palliative care that we can provide. In April 2018, Health Quality Ontario, in collaboration with the Ontario Palliative Care Network (OPCN), released the Palliative Care Quality Standard that lays out 13 quality statements about the care that patients and families needing palliative care should expect to receive.
A framework to advance palliative care services
The OPCN is a partnership of community stakeholders, health service providers and health system planners from across Ontario. Since 2016, we have been working together to develop a coordinated and standardized approach for delivering hospice palliative care to patients across this province.
The Palliative Care Health Services Delivery Framework (Delivery Framework) released in April 2019, outlines a model of care that will enable adults with a life-limiting illness who are living at home or in community settings, and their family/caregivers, to remain at home as long as possible. It is designed to enable care to be delivered according to the Palliative Care Quality Standard, ensuring that patients and their family/caregivers have timely, equitable access to high-quality care and support. Importantly, implementation of the recommendations in the Delivery Framework is expected to improve patient experience, while supporting sustainability, and more effective use of palliative care resources, ultimately leading to reduced hospitalizations and unnecessary ED visits.
Tools to enable better care for patients and their families wherever they receive their care
To support implementation of the Delivery Framework, and to address known gaps in palliative care, the OPCN has also created ready-to-use tools that can be used in all settings, including hospitals.
The Ontario Palliative Care Competency Framework is a comprehensive guide that hospitals can use to equip their providers with the appropriate knowledge and skills to deliver high-quality palliative care. Applying these competencies in practice will lead to better care for people with a life-limiting condition, and encourage collaboration among professionals and organizations that provide palliative care.
The Tools to Support Earlier Identification for Palliative Care is a document that recommends tools that can be used across sectors to support earlier identification of patients who would benefit from palliative care.
Finally, the Goals of Care Resources are tools that hospital providers can use to support them in engaging their patients in discussions to better understand their preference and goals for their care, to enable care that is person-centred and aligned with their wishes. These can be found in the OPCN's online Palliative Care Toolkit, under "Assess".
The OPCN resources can help to support the delivery of high-quality palliative care services when and where they are needed. Patients and their families will have confidence that Ontario's healthcare system will support them throughout their lives.
For more information about the OPCN Delivery Framework, Competency Framework and other tools and resources, visit https://www.ontariopalliativecarenetwork.ca.