Leamington and Area Family Health Team (LAFHT) is committed to changing the culture around advance care planning (ACP).
In recognition of this work, LAFHT was the 2017 recipient of the Association of Family Health Teams of Ontario’s (AFHTO) Bright Lights award for the category Employing and Empowering the Patient and Caregiver Perspective.
To help change the culture around ACP, LAFHT organizes community information sessions and in-house education sessions for patients and caregivers. They understand that ACP improves the experience of patients and their families, reduces caregiver trauma, increases the chance of being cared for in a preferred setting, and reduces unwanted interventions, treatments, and hospitalizations.
Since implementing their program, they have also helped other FHTs and Nurse Practitioner Led Clinics build similar capacity.
We asked Bill Baker, Executive Director, Lisa Durocher, Clinical Lead, and Linda Thiessen-Belch, Nurse Educator, about their experience implementing this program.
We know that 50% of Canadians haven’t discussed their end-of-life care wishes with anyone. What are some of the barriers you heard from your community information sessions?
Misinformation is the biggest barrier. When people hear “advance care planning”, they think about planning a will or making funeral arrangements, but they are not necessarily thinking about how they wished to be cared for when their health starts to decline.
Discomfort around having these conversations is another barrier. But once the topic is broached, people are more open to having these conversations.
From a provider’s perspective, there’s a misconception that if you talk about ACP you're taking away people's hope. Instead, talking about ACP is a means to discuss treatment options, not about taking away hope.
Why is this important to patient experience? How does it help the system?
When we get it right, it's a win-win for the patient and for the system. Patients get cared for how they wished to be cared for, which puts the patient first. ACP benefits the system by alleviating crisis decisions which can lead to costly, inappropriate interventions.
What advice do you have for other organizations looking to improve advance care planning for their patients and caregivers?
Getting a group of people together who have a passion for this topic is important. Talk to everyone from administrative staff to front line clinicians. Get a core group together and start reviewing the right information. For example, you’ll have to follow Ontario’s Legal Framework. Speak Up Ontario references everything pertinent in Ontario law with lots of resources to initiate programming. Hospice Palliative Care Ontario (HPCO) has also created a community of practice; by contacting the regional champion in your LHIN, you will be navigated to evidence-based tools so no one needs to recreate the wheel. It’s about building internal capacity and having supports around you.
Read more about LAFHT’s Culture Change – What to Know Before You Go work from the AFHTO website.
Do you have questions about advanced care planning in your organization? Reach out to Bill Baker or Lisa Durocher on Quorum.