Palliative care is a growing focus in Ontario. A key step in improving Ontario’s palliative care system has been the establishment of the Ontario Palliative Care Network and the launch of their first Action Plan, which presents a way forward for palliative care services in the province. There is also a wealth of research currently happening in palliative care in Ontario. Here, we present a few recent publications with an Ontario focus.
The goal of palliative care is to improve the quality of life of people with life-limiting illnesses. There is perhaps no other aspect of care for which it is so important to provide patient-centred care, with health care providers listening to and respecting patients’ wishes.
This rapid review by Dr Deborah Dudgeon discusses the impact of measuring patient-reported outcome measures on quality of and access to palliative care.
One patient-centred indicator that is sometimes used to measure the quality of palliative care is whether the patient died in their preferred place of death – which, for many, is their home.
As discussed in Health Quality Ontario’s 2016 report, Palliative Care at the End of Life, the majority of palliative patients die in hospital, not in their home or in a residential hospice. Tanuseputro et al (2018) conducted a population-level study of all deaths in Ontario over a three-year period to investigate whether receiving palliative care visits in the home can reduce the likelihood of a patient dying in hospital. After adjusting for multiple potential confounders, the authors found that receiving a home visit from a physician near the end of life is strongly associated with an out-of-hospital death.
An important component of palliative care is advance care planning, which refers to the process by which patients plan for a time when they cannot make decisions themselves. It may be appropriate for family physicians to initiate these conversations with patients; however, these discussions may not occur as frequently as they could. Howard et al (2018) conducted a survey of health care providers in Ontario, Alberta, and British Columbia to identify barriers to and enablers of advance care planning with patients in primary care.
You may also be interested in Changing the Culture around Advanced Care Planning
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