ARCHIVED - Canadian Strategy on Palliative and End-of-Life Care
The Canadian Strategy on Palliative and End-of-Life Care was established in 2002. The development of the strategy began in March 2002 when Health Canada's Secretariat on Palliative and End-of-Life Care brought together over 150 national, provincial, territorial and regional practitioners, researchers and decision makers in palliative and end-of-life care for a three-day National Action Planning Workshop on End-of-Life Care held in Winnipeg. Participants from across Canada considered priority end-of-life theme areas and reached a consensus on five key areas, resulting in the establishment of five Working Groups:
- Best Practices and Quality Care
- Education for Formal Caregivers
- Public Information and Awareness
These five Working Groups, along with a Coordinating Committee established to oversee progress and to provide general direction to the Working Groups, led the primary initiatives of the Canadian Strategy on Palliative and End-of-Life Care. The Canadian Strategy on Palliative and End-of-Life Care ended in March 2007. The Working Groups' purposes and key accomplishments are outlined below. Further details can be found in the Canadian Strategy on Palliative and End-of-Life Care: Final Report.
Best Practices and Quality Care
The purpose of the Best Practices and Quality Care Working Group was to promote, facilitate and coordinate activities related to improving the quality of palliative and end-of-life care. The Working Group's accomplishments included:
- collaborating on the development of an accreditation process for palliative and end-of-life care in Canada, including national standards and measurement tools, completed by the Canadian Council on Health Services Accreditation (now known as Accreditation Canada)
- collaborating on the development of Pediatric Hospice Palliative Care: Guiding Principles and Norms of Practice. The goal of this work was to create national norms of practice for pediatric hospice palliative care.
- developing A Model for Volunteer Best Practice and Collaboration in Canadian Hospice Palliative Care to serve as a framework to enhance the quality of service of volunteers in interdisciplinary palliative care teams. This framework includes standards for volunteer practice in palliative and end-of-life care, as well as educational tools.
Education for Formal Caregivers
The Education for Formal Caregivers Working Group worked to improve the quality and accessibility of education and training for formal caregivers in palliative and end-of-life care. The Working Group's accomplishments included:
- identifying the core palliative and end-of-life care competencies that apply to physicians, nurses, social workers, pharmacists and pastoral care workers at the undergraduate and post-graduate levels. This led to further engagement with physicians, nurses and social workers to develop discipline-specific competencies.
- collaborating to secure Health Canada support for the project Educating Future Physicians in Palliative and End-of-Life Care (EFPPEC). The goal of this project was to ensure that by 2008, all undergraduate medical students and clinical post-graduate trainees at Canada's medical schools would receive education in palliative and end-of-life care and graduate with competencies in these areas.
- collaborating on the implementation of an education "commons" in Edmonton in September 2005. This initiative provided an opportunity for more than 100 Canadian and international stakeholders to share their work and to learn about and collaborate on interdisciplinary educational initiatives.
Public Information and Awareness
The Public Information and Awareness Working Group was created to address methods to increase awareness of palliative and end-of-life care issues among Canadians. These included identifying the sources of information and tools to disseminate relevant information. The Working Group's accomplishments included:
- developing a Hospice Palliative Care: Public Awareness Raising Framework
- developing a synthesis report called The information needs of informal caregivers involved in providing support to a critically ill loved one
- developing a glossary of terms called Advance Care Planning: The Glossary Project: Final Report. Advance care planning refers to the process of coming to understand, reflect on, discuss and plan for the possibility that one may no longer be able to communicate and make medical decisions for oneself.
- developing Cross-Cultural Considerations in Promoting Advance Care Planning in Canada in collaboration with the British Columbia Cancer Agency
The Research Working Group was established to enhance research on palliative and end-of-life care. The Working Group's accomplishments included:
- collaborating on the development and implementation of a virtual network of palliative and end-of-life care researchers. The network is housed on the website of the Canadian Virtual Hospice. This website also includes palliative and end-of-life care research tools and resources.
- supporting initiatives to explore how researchers could make their results more relevant to those who might need them. This process, called knowledge translation and exchange, was supported through:
- meetings where researchers and the users of research results could sit down together
- a review of the literature and interviews with people already working to improve this area
- examining tools and resources that might be useful to researchers in sharing their results in a more effective way
- collaborating with the growing community of researchers addressing terminal illnesses other than cancer
- supporting the Canadian Institutes of Health Research (CIHR) in a major initiative to increase the number of and supports for researchers in palliative and end-of-life care. This initiative included funding for 19 pilot projects for one year, 10 teams for five years, and a training program to help graduate-level students who want to build a career in palliative research.
- supporting a special committee at CIHR to review applications for funding focusing on palliative and end-of-life care research. This committee ensures that applications are reviewed by experts on the special characteristics of palliative care research.
The Surveillance Working Group was created to develop a system for collecting and using information about who needs palliative and end-of-life care, who receives it, and how to measure its quality. The Working Group's focus was to lay the groundwork to create this system. The Working Group's accomplishments included:
- collaborating on a two-phase pilot project to test a method for and assess the feasibility of collecting standardized data on palliative care patients across Canada. The results of the first phase were published in 2002 in an article titled Developing Palliative Care Surveillance in Canada: Results of a Pilot Study in the Journal of Palliative Care.
- supporting an extensive literature review on ways to measure the performance of palliative and end-of-life care programs and services. This resulted in an inventory of performance measures that palliative program administrators can use to assess the quality of their services.
- facilitating a national meeting to assess the data needs of different stakeholders, including clinicians, program administrators and government officials, to inform the policy, planning and evaluation of palliative and end-of-life care services
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