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The CHCA is collaborating with home-based palliative care providers across Canada, aiming to boost the skills of nurses and personal care workers and foster emotionally intuitive care. Our project includes raising awareness about the Canadian Interdisciplinary Palliative Care Competency Framework and creating cutting-edge Emotional Intelligence training and tools. Through our innovative SPRINT-eiCOMPASS Collaborative, we are empowering organizations to embrace the benefits of the Competency Framework and our EI training programs. Our goal is to assist organizations in enhancing recruitment processes, evaluating staff performance, creating customized educational content, and fostering efficient, high-performing multi-disciplinary teams that consistently exceed palliative care standards.
What experts are saying about the Competency Framework
“At Pallium Canada, we believe it is essential to equip health care professionals with the skills and knowledge to provide earlier, more effective and more compassionate palliative care. The Competency Framework is informing our continuous learning programming and content. As part of the Palliative Care ECHO Project, the Learning Journey App will make these competencies even more applicable. The App will allow busy health care workers to create a personalized learning plan to equip them with the skills and knowledge to provide better palliative care to more Canadians.”
Jeffrey Moat, Chief Executive Officer
PALLIUM CANADA
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“People in Canada want and deserve highly skilled providers able to provide palliative care that supports their physical, psychosocial and spiritual needs. The Canadian Interdisciplinary Palliative Care Competency Framework establishes a minimum pan-Canadian standard to ensure healthcare providers have knowledge and skill to deliver quality palliative care that helps people live more fully, and more comfortably throughout their cancer journey.”
Erika Nicholson, Vice President, Cancer Control
CANADIAN PARTNERSHIP AGAINST CANCER
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“The Competency Framework provides a good business case for the appropriate staffing needs for palliative care as it enforces the importance of interdisciplinary palliative education and teamwork.”
Dr. Ebru Kaya, President
CANADIAN SOCIETY OF PALLIATIVE CARE PHYSICIANS
Departmental Division Director Palliative Medicine
UNIVERSITY OF TORONTO
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“The Competency Framework holds us accountable to meet those higher standards in delivering quality end-of-life care or quality palliative care that is culturally and socially safe. We really value being able to provide person-centred, high-quality palliative care.”
Laurel Gillespie, Chief Executive Officer
CANADIAN HOSPICE PALLIATIVE CARE ASSOCIATION
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“It was just incredible to have the domains and competencies outlined in the Competency Framework. Prior to the framework, I had to rely solely on my experiences as an educator and a hospice palliative care nurse. Now the competencies help provide assurance that what we are teaching and what students are learning is consistent across the country.”
Kath Murray , CEO
LIFE AND DEATH MATTERS
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“I think that having a national Competency Framework helps everybody get on the same page and use similar language in their educational materials. This creates consistency across the country for the competencies that you need to deliver high-quality palliative care.”
Nadine Valk , Director, Education and Strategic Partnerships
HOSPICE PALLIATIVE CARE ONTARIO
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“The Competency Framework helps give our work credibility through standardization so we can continue to help people get the spiritual care they need at a very difficult time.”
Vivian Stang, Spiritual Care Practitioner
CANADIAN ASSOCIATION FOR SPIRITUAL CARE
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Canadian Interdisciplinary Palliative Care Competency Framework
A curriculum guide for educators and reference manual for people providing palliative care
The Canadian Partnership Against Cancer and Health Canada, working with an extensive network of palliative care experts and stakeholders, have developed the Canadian Interdisciplinary Palliative Care Competency Framework. This document establishes a minimum national standard for palliative care in Canada, and it seeks to direct consistent implementation and measurement of palliative care competencies in practice. It serves as a guiding document for jurisdictions that lack an explicit set of palliative care competencies, and also as high-level guidance for provinces that have built their own competency frameworks.
Click on the palliative care competencies below to learn more about the skill-sets needed for nurses and personal support workers providing home-based palliative care.
1. Principles of a palliative approach to care
Palliative care aims to improve the quality of life of people with life-limiting conditions and their designated families or caregivers. This person-centred care ideally begins at diagnosis, continues into bereavement, and is for people of any age.
Competencies for home care nurses*
Understanding the core philosophy of palliative care and the palliative approach to care
Identifying people who would benefit from a palliative approach
Understanding the interdisciplinary team
Addressing barriers to care
Including designated family or caregiver(s) in the unit of care
Seeing people holistically
Competencies for personal support workers**
Understanding the core philosophy of palliative care and the palliative approach to care
Identifying people who would benefit from a palliative approach
Understanding the interdisciplinary team
Including designated family or caregiver(s) in the unit of care
Seeing people holistically
Learn more about the Interdiscipinary Palliative Care Competency Framework
* This discipline includes registered nurses, registered psychiatric nurses, licensed practical nurses, registered practical nurses, clinical nurse specialists, and nurse practitioners. Nurse practitioners may also share many competencies with physicians.
* ** Across Canada, in different provinces and territories, and in different settings, personal support workers may be identified as continuing care assistants, health care assistants, nursing assistants, and by other similar titles. We have used the title of personal support workers here for simplicity; however, we are referring to all the titles that apply within this discipline.
2. Cultural safety and humility
This domain is built on a foundation of seeking to understand and address power differentials and inequities in the social, political, and historical context of healthcare. Through self-reflection and consideration of the concepts of racism, discrimination, and prejudice, health care providers can practice relationship-based care.
Competencies for home care nurses*
Engaging in self-reflection
Supporting cultural practices
Recognizing and respecting the diversity of people, designated families or caregivers, and communities
Competencies for personal support workers**
Supporting cultural practices
Engaging in self-reflection
Acting as an advocate
Learn more about the Interdiscipinary Palliative Care Competency Framework
* This discipline includes registered nurses, registered psychiatric nurses, licensed practical nurses, registered practical nurses, clinical nurse specialists, and nurse practitioners. Nurse practitioners may also share many competencies with physicians.
* ** Across Canada, in different provinces and territories, and in different settings, personal support workers may be identified as continuing care assistants, health care assistants, nursing assistants, and by other similar titles. We have used the title of personal support workers here for simplicity; however, we are referring to all the titles that apply within this discipline.
3. Communication
Communication is essential in care of those affected by life-limiting illness. The person, their designated family or caregivers, and team may experience uncertainty and strong emotions. Effective communication helps to establish therapeutic relationships, ensures that people, and designated families and caregivers understand and participate in decision-making, enables interdisciplinary teamwork, and facilitates smooth transitions between care settings. Communication may be verbal or written, and may include the use of technology.
Competencies for home care nurses*
Promoting ongoing collaborative communication
Listening and providing emotional support
Adapting communication for children
Using appropriate supports to communicate effectively
Delivering difficult news and managing essential conversations
Competencies for personal support workers **
Recognizing and respecting that each person and their designated family or caregiver(s) has a unique perspective
Listening and providing emotional support
Adapting communication for children
Using appropriate supports to communicate effectively
Communicating collaboratively
Learn more about the Interdiscipinary Palliative Care Competency Framework
* This discipline includes registered nurses, registered psychiatric nurses, licensed practical nurses, registered practical nurses, clinical nurse specialists, and nurse practitioners. Nurse practitioners may also share many competencies with physicians.
* ** Across Canada, in different provinces and territories, and in different settings, personal support workers may be identified as continuing care assistants, health care assistants, nursing assistants, and by other similar titles. We have used the title of personal support workers here for simplicity; however, we are referring to all the titles that apply within this discipline.
4. Optimizing comfort and quality of life
Optimizing comfort and quality of life as defined by the person and their designated family or caregiver(s) by addressing their holistic needs. This is an ongoing, dynamic, and proactive process, aimed at relieving and preventing suffering. The process includes effective symptom management in alignment with the person’s and their designated family or caregiver’s goals of care.
Competencies for home care nurses*
Promoting self-management/care
Maintaining dignity
Caring for people holistically
Involving the designated family or caregiver(s) in care
Screening, assessing, and managing pain and other symptoms and psychosocial concerns
Understanding the severity of the person’s pain, other symptoms, and condition
Competencies for personal support workers **
Maintaining dignity
Recognizing changes in health status
Promoting self-management/care
Caring for people holistically
Offering presence
Involving the designated family or caregiver(s) in care
Screening, assessing, and managing pain and other symptoms and psychosocial concerns
Learn more about the Interdiscipinary Palliative Care Competency Framework
* This discipline includes registered nurses, registered psychiatric nurses, licensed practical nurses, registered practical nurses, clinical nurse specialists, and nurse practitioners. Nurse practitioners may also share many competencies with physicians.
* ** Across Canada, in different provinces and territories, and in different settings, personal support workers may be identified as continuing care assistants, health care assistants, nursing assistants, and by other similar titles. We have used the title of personal support workers here for simplicity; however, we are referring to all the titles that apply within this discipline.
5. Care planning and collaborative practice
Care planning and collaboration enables integrated, coordinated, person-centred care that optimizes comfort and quality of life. Collaboration involves the person and their designated family or caregiver(s), interdisciplinary team, and often multiple agencies or sectors. Care planning includes assessing current needs, planning for future illness deterioration, and possible transitions between care settings.
Competencies for home care nurses*
Understanding interdisciplinary collaboration, transitions, and roles
Modifying care plans as needed
Making informed decisions
Understanding advance care planning
Competencies for personal support workers**
Understanding interdisciplinary collaboration, transitions, and roles
Acting as an advocate
Promoting advance care planning
Learn more about the Interdiscipinary Palliative Care Competency Framework
* This discipline includes registered nurses, registered psychiatric nurses, licensed practical nurses, registered practical nurses, clinical nurse specialists, and nurse practitioners. Nurse practitioners may also share many competencies with physicians.
* ** Across Canada, in different provinces and territories, and in different settings, personal support workers may be identified as continuing care assistants, health care assistants, nursing assistants, and by other similar titles. We have used the title of personal support workers here for simplicity; however, we are referring to all the titles that apply within this discipline.
6. Last days and hours
Particular care should be paid to addressing the person’s and their designated family or caregiver’s care needs that are unique to the last days and hours of a person’s life.
Competencies for home care nurses*
Anticipating changes as death nears
Supporting death rituals
Involving and supporting the designated family or caregiver(s)
Competencies for personal support workers**
Anticipating changes as death nears
Facilitating death rituals
Involving and supporting designated family or caregiver(s)
Learn more about the Interdiscipinary Palliative Care Competency Framework
* This discipline includes registered nurses, registered psychiatric nurses, licensed practical nurses, registered practical nurses, clinical nurse specialists, and nurse practitioners. Nurse practitioners may also share many competencies with physicians.
* ** Across Canada, in different provinces and territories, and in different settings, personal support workers may be identified as continuing care assistants, health care assistants, nursing assistants, and by other similar titles. We have used the title of personal support workers here for simplicity; however, we are referring to all the titles that apply within this discipline.
7. Loss, grief, and bereavement
People, and designated families and caregivers, may experience loss and grief from the time of diagnosis, during the illness, into bereavement, and after death. Health care providers assess needs, identify issues, and provide information and support.
Competencies for home care nurses*
Supporting diverse responses to loss
Recognizing complicated grief
Using support services
Competencies for personal support workers**
Supporting individual responses to loss
Facilitating the use of support services
Learn more about the Interdiscipinary Palliative Care Competency Framework
* This discipline includes registered nurses, registered psychiatric nurses, licensed practical nurses, registered practical nurses, clinical nurse specialists, and nurse practitioners. Nurse practitioners may also share many competencies with physicians.
* ** Across Canada, in different provinces and territories, and in different settings, personal support workers may be identified as continuing care assistants, health care assistants, nursing assistants, and by other similar titles. We have used the title of personal support workers here for simplicity; however, we are referring to all the titles that apply within this discipline.
8. Self-care
Self-care is paramount for health care providers. It encompasses a spectrum of knowledge, skills, and attitudes, including self-awareness and reflection, maintaining professional boundaries, and practising holistic wellness strategies for the individual provider and the team.
Competencies for home care nurses*
Promoting self-awareness
Promoting healthy behaviours for self and team
Preventing compassion fatigue
Competencies for personal support workers**
Supporting healthy behaviours for self and team
Addressing compassion fatigue
Demonstrating self-awareness
Learn more about the Interdiscipinary Palliative Care Competency Framework
* This discipline includes registered nurses, registered psychiatric nurses, licensed practical nurses, registered practical nurses, clinical nurse specialists, and nurse practitioners. Nurse practitioners may also share many competencies with physicians.
* ** Across Canada, in different provinces and territories, and in different settings, personal support workers may be identified as continuing care assistants, health care assistants, nursing assistants, and by other similar titles. We have used the title of personal support workers here for simplicity; however, we are referring to all the titles that apply within this discipline.
9. Professional and ethical practice
Ethical care is focused on the person’s and their designated family or caregiver’s values, needs, and wishes, while the health care provider maintains professional and personal integrity. This domain guides decision-making as life-limiting illnesses progress and health care needs change.
Competencies for home care nurses*
Addressing ethical issues
Advocating for inclusion of the person’s and their designated family or caregiver’s beliefs and values
Understanding legislation and policy
Understanding MAiD
Competencies for personal support workers**
Understanding MaiD
Addressing ethical issues
Advocating for inclusion of the person’s and their designated family or caregiver’s beliefs and values
Maintaining boundaries
Learn more about the Interdiscipinary Palliative Care Competency Framework
* This discipline includes registered nurses, registered psychiatric nurses, licensed practical nurses, registered practical nurses, clinical nurse specialists, and nurse practitioners. Nurse practitioners may also share many competencies with physicians.
* ** Across Canada, in different provinces and territories, and in different settings, personal support workers may be identified as continuing care assistants, health care assistants, nursing assistants, and by other similar titles. We have used the title of personal support workers here for simplicity; however, we are referring to all the titles that apply within this discipline.
10. Education, evaluation, quality improvement, research
Palliative care education, as well as consistent evaluation and research, are important for all parties. Care providers participate in palliative care continuing education initiatives, and lead or participate in the evaluation of palliative care services, including the person’s and their designated family or caregiver’s experiences. In doing so, they contribute to ongoing quality improvement. They promote, contribute to, or lead research, keeping abreast of current evidence, and invite potential participants to research studies.
Competencies for home care nurses*
Accessing continuing education
Educating and supporting learners
Contributing to quality improvement
Evaluating person outcomes
Promoting knowledge generation, translation, and synthesis
Competencies for personal support workers**
Accessing continuing education
Educating and supporting learners
Contributing to quality improvement
Collecting data
Learn more about the Interdiscipinary Palliative Care Competency Framework
* This discipline includes registered nurses, registered psychiatric nurses, licensed practical nurses, registered practical nurses, clinical nurse specialists, and nurse practitioners. Nurse practitioners may also share many competencies with physicians.
* ** Across Canada, in different provinces and territories, and in different settings, personal support workers may be identified as continuing care assistants, health care assistants, nursing assistants, and by other similar titles. We have used the title of personal support workers here for simplicity; however, we are referring to all the titles that apply within this discipline.
11. Advocacy
Individuals advocate for funding and access to palliative care services and associated educational opportunities, contribute to policy development, and address the social determinants of health.
Competencies for home care nurses*
Advocating for the person, designated family or caregiver(s), and societal rights
Acting as an advocate
Competencies for personal support workers**
Advocating for the person, designated family or caregiver(s), and societal rights
Learn more about the Interdiscipinary Palliative Care Competency Framework
* This discipline includes registered nurses, registered psychiatric nurses, licensed practical nurses, registered practical nurses, clinical nurse specialists, and nurse practitioners. Nurse practitioners may also share many competencies with physicians.
* ** Across Canada, in different provinces and territories, and in different settings, personal support workers may be identified as continuing care assistants, health care assistants, nursing assistants, and by other similar titles. We have used the title of personal support workers here for simplicity; however, we are referring to all the titles that apply within this discipline.
12. Virtual care
Virtual care is the application of technologies to expand the provision of healthcare beyond traditional in-person encounters and healthcare settings. It can include synchronous and asynchronous communication, remote monitoring, messaging, phone, video visits, e-consults, and other modalities. Virtual care is meant to complement rather than replace in-person care.
Competencies for home care nurses*
Identifying people who would be suitable for and benefit from virtual care
Adapting care to a virtual modality
Delivering care virtually
Learn more about the Interdiscipinary Palliative Care Competency Framework
* This discipline includes registered nurses, registered psychiatric nurses, licensed practical nurses, registered practical nurses, clinical nurse specialists, and nurse practitioners. Nurse practitioners may also share many competencies with physicians.
* ** Across Canada, in different provinces and territories, and in different settings, personal support workers may be identified as continuing care assistants, health care assistants, nursing assistants, and by other similar titles. We have used the title of personal support workers here for simplicity; however, we are referring to all the titles that apply within this discipline.
This project has been made possible through a financial contribution from Health Canada.
The views expressed herein do not necessarily represent the views of Health Canada.
This post is also available in: French