Your Impact on Palliative Care
Last year was an exciting and encouraging one for the Freeman Centre for the Advancement of Palliative Care at North York General. Thanks to the support of donors, the team has numerous advancements in their mission to integrate better with the community. This included providing consultation to providers in a local LTC home and at NYGH’s Reactivation Care Centre (a Centre for those awaiting transfer to LTC, convalescent care or discharge home, where palliative care can continue). Plus, they established the North York Toronto Health Partners Integrative Palliative and Supportive Care Committee (NYTHP IPSCC) to facilitate the exchange of ideas to collectively determine how to better integrate palliative care within the community.
Here are more achievements in palliative care from this past year made possible by our generous donor community:
Initiatives to Enhance Palliative Care in the Community
Implementing Palliative Care Supports for Long-Term Care Homes: in the summer of 2023, the Freeman team started providing specialist palliative care consults at Carefree Lodge, as well as at the NYGH’s Reactivation Care Centre. This program, led by Dr. Amit Arya and Dr. Daphna Grossman, ensures that residents, caregivers and health workers in congregate care settings can benefit from extra palliative care supports rather than transferring back to hospital. Over time, the team is hoping to expand our services to include the seven other LTC homes in our area as well.
Equitable Access to Palliative Care: the Freeman Centre in collaboration with the Inner City Health Associates’ PEACH (Palliative Care and Education for the Homeless) Program is applying for a Models of Care Innovation grant from the Ministry of Health to fund improved access to palliative care for homeless individuals in the North York area. Individuals who are homeless and experience challenges of poverty, addiction, mental health issues, or racism often die early and have difficulty accessing care.
A Second Nurse Practitioner Benefitting the Geriatric Supportive Care Outreach Program. With the addition of a second Nurse Practitioner to the Edwin S.H. Leong Supportive Care Outreach Program, we have increased our capacity. Program enrollment has increased by 20%, and our team can now enhance patient care, respond to urgent referrals from the hospital more quickly and keep patients with improved life expectancies longer in the Program.
“All of the excellent home care [for my mother, pictured here] would not have been possible without her palliative care doctor, Sandy Buchman. He was her champion from the day they met. Visits from Dr. Buchman were unhurried and a huge comfort to her. Under his supervision, she had access to excellent therapists, a first-class nurse practitioner (Dusanka) and the talents of superb support staff and clinicians at North York General Hospital.”
Peter, A grateful son
Promoting a Culture of Exemplary Palliative Care
We are committed to taking a leadership role in working with our community partners to implement a palliative care approach earlier with patients who would benefit from it, and in the translation of program knowledge to other hospitals and health care providers.
Last year we reached a milestone in taking a regional approach to palliative care through the North York Toronto Health Partners Integrated Palliative and Supportive Care Committee (NYTHP IPSCC), which has started to exchange information on how to better coordinate palliative and supportive care in the community care. As well, Dr. Anand Sinha continued to work with family physicians through SCOPE (Seamless Care Optimizing the Patient Experience) to support them in managing their patients’ palliative care needs.
“My mother was a patient of the Freeman Centre. Following her cancer diagnosis, she was admitted to the Oncology Unit. We always had the amazing Freeman team to support us through chemotherapy and radiation and subsequently when she decided to no longer pursue treatments. They visited my mother at home and were there in her final days. As a caregiver, I was grateful for this constant support. My personal experience inspired me to become a Patient Experience Partner (PXP) in 2012. It has been wonderful to be part of the team that cared for my mother, and I appreciate that they embrace my ideas and feedback to help other patients and their families.”
Michelle, Patient Experience Partner
Research and Quality Improvement to Optimize Quality of Care
Hospital-One-Year-Mortality Risk (HOMR) Research Study: the Freeman team continues to participate in a multi-site project to assess the benefit of integrating an application within the electronic medical record (EMR) that identifies patients at high risk of dying within one year. Identifying these patients earlier in their disease trajectory will help improve care and quality of life. The team plans to pilot the study in a medicine unit.
Review of Palliative Care Delivery in the Inpatient Setting at NYGH: to better understand the characteristics of the patient population referred to the inpatient Palliative Care Program at NYGH, the Freeman team undertook a retrospective chart review. Results showed that patients were primarily older individuals who were typically bedbound and received pain and symptom management. Most patients who were discharged required home supports via Home and Community Care Support Services (HCCSS). The study will help optimize palliative care delivery.
Exploring the Benefit of an Advance Care Planning Workshop in the Community: a study was initiated to examine the benefit of an Advance Care Planning workshop the Freeman team delivers to individuals in the community. Feedback indicated that most participants found the workshop safe and informative, and there was a significant improvement in understanding the role of the substitute decision maker. Three months after the workshop, almost 30% of participants had discussed advance care planning with their health care provider and almost 30% had completed or were completing a Power of Attorney document.