PRIORITIES / Operational Excellence in Home-Based Palliative Care

IMPLEMENTING A LEADING PRACTICE

Through the SPRINT-WCPR Implementation Collaborative™ the CHCA helped local practice teams adapt and implement Whole Community Palliative Rounds (WCPR). Profiled as a High Impact Practice, WCPR is a strategy used to engage inter-professional palliative care teams in purposeful and timely communication, shared decision making and collaborative care planning.

Through the SPRINT-WCPR Implementation Collaborative, teams tested, adopted, and implemented a new way to support rapid, clinical problem solving for symptom burden in high-risk individuals with palliative care needs. This approach enhanced community capacity to deliver palliative care and shift care policies and programming. Implementing WCPR through the SPRINT-WCPR Collaborative improved operational excellence in home and community-based palliative care. Although the collaborative timeframe did not allow for the evaluation of quantitative data, members of the practice teams experienced early successes including:

  • More holistic patient care
  • Increased provider satisfaction
  • More effective teamwork and improved relationships
  • Engagement of physicians and timely feedback on patients’ conditions
  • Advancement of provincial palliative care goals and strategies
  • Increased exposure and awareness of best practices across the country

Experiences of the SPRINT-WCPR Practice Teams

All practice teams successfully implemented a whole community palliative round by the end of the Collaborative. The number of health care professionals who participated in the WCPR circle of care and the number of clients discussed at each round varied among practice teams.

Alberta Health Services – Edmonton Zone encouraged patients to be involved in their WCPR and tested the concept through several mock rounds where the spiritual advisor and others reviewed cases in a holistic manner. (Presentation not available)

Bayshore Health Care practice team focused their work on creating effective WCPR for patients living in the Stormont, Dundas, Glengarry region who have a life-limiting disease/condition.
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CarePartners Practice team wanted to implement WCPR in the northern region of Ontario (North Bay). Download Presentation

Eastern Health established a weekly WCPR in the Clarenville area that included interdisciplinary representation from acute care, community care, primary care and long-term care/personal care homes. Download Presentation

Health PEI practice team’s goals were to optimize and expand the existing palliative rounds in Prince County, include the mobile integrated health coordinator (linkage to community paramedics) and gain greater involvement at rounds by acute care. Download Presentation

New Brunswick Extra-Mural Program practice team focused on redefining and enhancing the circle of care. Their goal was to facilitate an interprofessional palliative care rounds team through the WCPR approach in Miramichi. Download Presentation

SE Health practice focused their implementation of WCPR on broad population bases that included individuals receiving a palliative approach to care for frailty, advanced dementia, end-stage CHF and COPD. Download Presentation

All three Saskatchewan Health Authority practice teams collaborated on a WCPR practice change, Enhancing the Circle of Care. Download Presentation

Southern Health goal was to complete five WCPR by November 28, 2019 with a focus on improving communication and shared decision-making between providers, as well as ensuring the continuity and quality of care for individuals receiving a palliative approach to care. Download Presentation

TOOLS AND RESOURCES

SPRINT-WCPR Collaborative – On-boarding and education forum workbook

The goal of the two-day session was to provide an overview of the structure and approach of a SPRINT Collaborative and prepare teams to test and adapt WCPR. Download

National key messages and benefit statements

These messages target communication for health care leaders on how the SPRINT-WCPR Implementation Collaborative advances a national priority and aligns with the Framework on Palliative Care in Canada. Download 

Value statements for front-line clinicians

This information addresses key concerns and reinforces how WCPR leads to better outcomes for patients and saves time for clinicians. Download 

Value statements for physicians/palliative care specialists

Customized to this audience (building on the Patient’s Medical Home concept for the College of Family Physicians of Canada), this piece profiles ways that physicians should participate (or have their practice participate) in WCPR; how WCPR can help achieve better clinical outcomes for patients with palliative care needs; and why attending is an effective use of their time. Download 

Summary of provincial privacy laws

This table summarizes provincial privacy legislations across Canada, including extracts regarding the use and disclosure of personal information. Download 

Testing for knowledge quick reference guide

This quick reference guide outlines the differences between testing for improvement (PSDA), program evaluation (QI) and research (experimentation) to help teams understand how to collect and analyse data. Download 

Planning for Sustainable Change Tool

This manual describes several evidence-informed factors that can impact long-term success. The factors were adapted to reflect the SPRINT-WCPR Collaborative approach: success factors for behaviour change (COM-B) and success factors for evaluation and evidence. Download 

SPRINT-WCPR Virtual Learning Sessions

Session 1: Identifying Approaches and Action for Rapid Testing (PDSA cycles). Presentation

Session 2: Tactical Tools and Resources to Promote Behaviour Change Specifically for WCPR Practice Changes Presentation

Session 3: Lesson learned and Success Factors for Hosting a WCPR. Presentation

Session 4: Successful PDSA – Process and Outcome Measures. Presentation

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