CFHI expanding access to innovative palliative approach that will improve end-of-life care

OTTAWA, Jan. 15, 2019 /CNW/ - The Canadian Foundation for Healthcare Improvement (CFHI) today announced that it is working with seven organizations across five provinces and one territory to spread Embedding Palliative Approaches to Care (EPAC). EPAC is a proven innovation that helps staff in long term care identify residents who could benefit from a palliative approach to care, have conversations with them and their families about what they want, and develop and implement comprehensive care plans. 

Palliative care improves the quality of life for people with life threatening conditions and their families, helping to manage their pain and other physical, psychosocial and spiritual issues, make informed decisions about aggressive treatments, and helping them to die in their place of choice.

Teams announced: CFHI will provide funding to support the following organizations to spread the approach to 22 homes in this initial expansion. 

• Yukon Health and Social Services 
• Institute for Continuing Care Education and Research (ICCER), Alberta 
• Parkwood Seniors Community, Waterloo, Ontario 
• Haliburton Highlands Health Services, Haliburton, Ontario 
• Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Mauricie-et-du-Centre-du-Québec, Quebec 
• New Brunswick Association of Nursing Homes 
• Western Health, Newfoundland and Labrador 

Using a train-the-trainer approach, this model will then be spread throughout regions where participating organizations have regional responsibilities. 

EPAC was developed by a team at Vancouver Coastal Health in British Columbia and implemented in 48 long term care homes. From April 2014-March 2018 the program resulted in a 56 percent decrease in emergency department transfers, and a 45 percent reduction in number of days residents spent in acute care in the last 3 months of their life. In 2017, CFHI identified it as an innovation ready for scale as part of its Call for Innovations in Palliative and End-of-Life care. 

The EPAC approach supports healthcare teams in long term care to: 

• identify those residents who would benefit from a palliative approach to care, 
• discuss goals for care with the resident / substitute decision maker, and 
• develop and implement a comprehensive care plan that is unique to the needs and wishes of each resident.

Offering a common, consistent approach to supporting residents who are near the end-of-life creates opportunities – and provides permission – for death and dying to be openly discussed, normalized and supported. 

The EPAC collaboration will run until November 2019. This program is part of ongoing efforts at CFHI to work with partners across Canada to improve care and ensure it responds to the needs of patients and families. 

Quick facts

• 86 percent of Canadians believe palliative care should be provided at home as much as possible. 
• Of Canadians who have a preference, 75 percent would prefer to die in their home. For residents in long term care, this is their home. 
• Few Canadians (15 percent) have early access to palliative home care. 
• 62 percent of Canadians who received palliative care did so in an acute care hospital and mostly in their last month of life.

Quotes
"Being able to discuss goals of care and have those wishes respected is important to Canadians who face life-threatening illness," said Jennifer Zelmer, President and CEO of CFHI. "That's why we're excited to partner with long term care teams in five provinces and Yukon to spread a proven approach for ensuring that care plans reflect the unique needs of each resident."  

"Earlier conversations about end-of-life are crucial to ensure people's wishes are known and respected. Typically these conversations are held during a healthcare crisis when emotions run high. These conversations often focus on goals of treatment rather than wishes, values, hopes and fears. Very often we wait for a healthcare condition to indicate that death is near," said Jane Webley, Vancouver Coastal Health Regional Program Leader for End of Life Care and the program's innovator. "However, by this stage, many people have lost the ability to communicate their wishes and family members are faced with a huge burden to decide what they should do. Earlier conversations about things that matter provide permission for collaborative planning and saying goodbye in a meaningful way, creating lasting memories. I call this the 'Gift of Time' that we, as healthcare providers, can offer residents and the people that are important to them."

"Palliative care is a crucial part of our health care system, providing much-needed support to individuals with life-threatening illnesses and to their families at one of the most difficult times of their lives," said the Honourable Ginette Petitpas Taylor, Minister of Health. "I am pleased to see the expansion of successful projects like this, as they align with priorities identified in the recently released Framework on Palliative Care in Canada. Together we can help more Canadians with life-limiting illnesses who wish to remain independent and receive the care they need at home or in their community."

About the Canadian Foundation for Healthcare Improvement
The Canadian Foundation for Healthcare Improvement works shoulder-to-shoulder with partners to identify proven innovations and accelerate their spread across Canada to improve patient care, the health of Canadians and value-for-money. CFHI is a not-for-profit organization funded by Health Canada. Visit cfhi-fcass.ca for more information.

The views expressed herein do not necessarily represent the views of Health Canada.

SOURCE Canadian Foundation for Healthcare Improvement