A Fresh Look at Palliative Care: Reward for Innovation

March 09, 2017

​By: Tim Wilson (March 1, 2017 for CanadianHealthcareNetwork.ca)

There aren't many among us who would view palliative care as a hot-bed of innovation and new thinking. However, that might be about to change, given that the Canadian Foundation for Healthcare Improvement (CFHI) has launched an open call for innovations in palliative and end-of life care.

"We know from studies and surveys that only 30% of Canadians receive specialized palliative care," says Maria Judd, senior director at the Canadian Foundation for Healthcare Improvement (CFHI). "There are communities where people are getting good palliative care, with models and programs that are working well, but it's a patchwork across the country."

Approximately 220,000 Canadians die each year, and for many of those who receive palliative care services a referral is initiated only within the last weeks of life. One of the drivers for the call from the CFHI is to identify areas where palliative care is working well, and to improve access. Clearly, more needs to be done here.

"The CFHI is not a palliative care organization, but we have a mission and track record of identifying and supporting the spread of innovative models and approaches," says Judd. "This includes identifying and putting together teams to work together from across the country—sometimes at the provincial level, and sometimes in local hospitals."

The intention is to improve the experience for patients and caregivers, as well as health outcomes and value for money, all of which can be supported and adapted to a specific area.

"A lot of work is required to adapt a model to a local context," says Judd. "You have to determine who the stakeholders are, which patients will benefit, and where the improvements will be delivered. At the CFHI we provide the wraparound support."

A recent article in the Canadian Medical Association Journal, written by researchers at the University of Calgary, suggested that doctor-assisted suicide could save the Canadian healthcare system up to $139 million annually. The article, which grabbed headlines and its fair share of criticism, nonetheless underpins the importance in having high-quality palliative care available to all Canadians.

"Other countries with medical-assisted dying have also invested in palliative and end-of-life care," says Judd. "This helps to make sure patients and families have all the options available to them."

The CFHI's open call for innovations has a dual focus, with categories for "emerging" as well as "demonstrated" innovations. Winners will receive a 2017 CFHI Innovation Award and be recognized as an innovator, while also presenting their innovation at the CFHI CEO Forum on June 21 in Toronto. Winners will also benefit from CFHI support to identify opportunities for further spread of their palliative care innovation.

"For winners in the demonstrated category, we'll design supportive programming to help spread the innovation across country," says Judd. "We can act as a partner to build support, with a structured program to roll this out. And for the emerging innovations, we'll help support enhanced evaluation to see if these really are ideas that are ready to spread."

The winners will be chosen by a peer review panel that includes palliative care leaders, practitioners, and family advisors, with the innovations assessed under the following working definition: "a model, program, approach or tool that is improving—or has the potential to improve—the experience, quality of life and value for money provided by palliative care for people with life-limiting conditions and their families."

The concept itself could include a specific technology that supports an effective model for the delivery of palliative care.

"For example, it could be a model for built-in support to facilitate communication and coordination of care between doctors and various settings in communities, with technology acting as an enabler," says Judd.

The CFHI, a non-profit that is funded primarily under an agreement with Health Canada, knows there are many palliative care innovations happening across Canada. The challenge is to identify and spread integrated approaches, while also better understanding their impact on quality of life and the cost to all stakeholders, including patients, caregivers, providers and systems.

"We are a country of pilot projects," says Judd. "The way that we organize, govern, and pay for healthcare differs across the country. This isn't plug and play. We need to support the larger innovation journey, including change management."

The CFHI is open to working with partner organizations such as Canada Health Infoway to support technological innovations for palliative care. There may be an opportunity to expand the hospice model, which is much less expensive than using hospitals, and can allow for greater family inclusion. Given that more than 50% of Canadians die in hospitals—where care is most expensive—and the majority of family doctors haven't received formal palliative care training, this is an area ripe for innovation. We'll find out just how much on June 21, when the award winners are announced.

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Article originally published on the Canadian Healthcare Network. Register for free online to access more articles.

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