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Evidence to Improve Care

Palliative Care

Care for Adults With a Progressive, Life-Limiting Illness

Click below to see a list of brief quality statements and scroll down for more information.


Quality standards are sets of concise statements designed to help health care professionals easily and quickly know what care to provide, based on the best evidence.

See below for the quality statements and click for more detail.

Quality Statement 1: Identification and Assessment of Needs
People with a progressive, life-limiting illness have their palliative care needs identified early through a comprehensive and holistic assessment.


Quality Statement 2: Timely Access to Palliative Care Support
People with identified palliative care needs have access to palliative care support 24 hours a day, 7 days a week.


Quality Statement 3: Advance Care Planning—Substitute Decision-Maker
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.


Quality Statement 4: Goals of Care Discussions and Consent
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.


Quality Statement 5: Individualized, Person-Centred Care Plan
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.


Quality Statement 6: Management of Pain and Other Symptoms
People with identified palliative care needs have their pain and other symptoms managed effectively, in a timely manner.


Quality Statement 7: Psychosocial Aspects of Care
People with identified palliative care needs receive timely psychosocial support to address their mental, emotional, social, cultural, and spiritual needs.


Quality Statement 8: Education for Patients, Substitute Decision-Makers, Families, and Caregivers
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.


Quality Statement 9: Caregiver Support
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.


Quality Statement 10: Transitions in Care
People with identified palliative care needs experience seamless transitions in care that are coordinated effectively among settings and health care providers.


Quality Statement 11: Setting of Care and Place of Death
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.


Quality Statement 12: Interdisciplinary Team-Based Care
People with identified palliative care needs receive integrated care from an interdisciplinary team, which includes volunteers.


Quality Statement 13: Education for Health Care Providers and Volunteers
People receive palliative care from health care providers and volunteers who possess the appropriate knowledge and skills to deliver high-quality palliative care.


8

Education for Patients, Substitute Decision-Makers, Families, and Caregivers

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.


For people with a progressive, life-limiting illness, their substitute decision-makers, and their family and caregivers, education plays a vital role in increasing their knowledge about their care, providing reasonable expectations about illness progression and palliative care, and preparing them for the decisions they will need to make. Education can increase a person’s sense of self-control and well-being. Education about symptom management and coping strategies improves symptom control for patients at the end of life and improves quality of life for caregivers. It is important that the education provided be sensitive to health literacy and linguistic and cultural preferences. The information can be delivered in a variety of formats, from in-person interaction to using written materials, online self-training, or hands-on skills practice and problem-solving.

For Patients, Families, and Caregivers

Your care team should give you, your family, your substitute decision-maker, and your caregivers information about palliative care. They should also give you information about resources and supports,such as counselling, hospice volunteers, wellness programs, spiritual care, or support groups. This knowledge can help you understand your treatment and service options, how palliative care can improve your quality of life, and how to connect with available supports.


For Clinicians

Provide education about palliative care to patients, their families, and their caregivers, and offer information about available resources and supports.


For Health Services

Ensure that educational resources and tools about palliative care are available for health care professionals, patients, their families, and their caregivers.

Process Indicators

Percentage of people with identified palliative care needs (or their caregivers) who state that health care professionals helped them understand palliative care and provided information about available resources and supports

  • Denominator: total number of people with identified palliative care needs (or their caregivers)

  • Numerator: number of people in the denominator who state that health care professionals helped them understand palliative care and provided information about available resources and supports

  • Data source: local data collection

Percentage of people with identified palliative care needs (or their caregivers) who state that a health care professional helped them understand what to expect and how to prepare for each stage of the journey toward the end of life

  • Denominator: total number of people with identified palliative care needs (or their caregivers)

  • Numerator: number of people in the denominator who state that health care professionals helped them understand what to expect and how to prepare for each stage of the journey toward the end of life

  • Data source: local data collection

  • Similar question available in the CaregiverVoice Survey: “Did your healthcare providers help you, the caregiver, understand what to expect/how to prepare for his/her death?” (Response options: “Yes; No, I was not aware of these services but I would have liked to use them; No, I was not aware of these services but I was not interested anyway; No, I was aware of these services but I was not interested anyway; Not sure”)


Structural Indicator

Local availability of resources and tools for health care professionals to provide education about palliative care to patients, families, and caregivers

  • Data source: local data collection
Education

Education topics may include symptom management, grief and loss, coping strategies, available community resources, system navigation, patient rights, health decision-making, medication, practical and physical care, death and dying, vigil practices, and care after death.

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