Models of Care Toolkit

This cross-jurisdiction program supports the early integration of palliative care initiatives in several jurisdictions including British Columbia, Ontario, Saskatchewan, Nova Scotia, Prince Edward Island, Newfoundland and Labrador, the Yukon and Northwest Territories. It includes three main components:

• Inter-professional palliative care education that provides practical knowledge and skills to primary health and cancer care teams and supports a connected and collaborative approach to decision making
• Early identification of patients with palliative care needs through routine symptom screening, functional assessments and patient consultations
• Planning and management activities including working with patients to incorporate goals of care and advanced care planning discussions and implementing routine symptom management and functional assessments.

Linkages to community, primary care and specialized palliative care enhance the value and impact of this approach.

Innovative programs developed in Nova Scotia, Alberta and Prince Edward Island equipped paramedics to deliver palliative care support to patients at home. Working with Healthcare Excellence Canada, the Partnership helped to scale and spread this model to improve care across Canada. It includes three main components:

• A clinical practice guideline or protocol specific to palliative care that allows paramedics to provide care in the home without transporting patients to the emergency department
• Paramedic-specific education on palliative care
• A tool to share patients’ goals of care between paramedics and the rest of the multi-disciplinary team and enable care consistent with those care wishes.

The paramedics providing palliative care model supports:

• Paramedic comfort and confidence with providing palliative approaches to care
• Patient and caregiver abilities to manage symptoms at home
• Decreased use of emergency departments
• Access to palliative care supports regardless of location and time of day
• Positive patient and family experience of care, including reduced burden of care
• System capacity to provide care consistent with patient wishes

Learn more about the paramedics providing palliative pare model²⁶.

A small community in New Zealand developed a model to support the delivery of palliative care services across a broad geographic area. A centralized hospice serves as a hub of palliative care expertise, providing inpatient and home care services. It also consults and provides expert guidance for primary health care providers who serve as the palliative care spokes within the community and at regional hospitals.

The model aims to have most palliative and end-of-life care delivered by primary health care providers, with specialist palliative care services dedicated to complex cases and providing guidance where necessary.

New Zealand’s model supports:

• Regional collaboration
• Standardization of care and quality
• Equitable access across the district and economical use of resources

Learn more about New Zealand’s hub-and-spoke model²⁷.