In the Home and Community Care Support Services Central West area, 36 per cent of people are living with more than one chronic condition, and by 2025 the number of seniors in our region will dramatically increase by 62 per cent. These numbers underscore the need for coordinated palliative care tailored to the unique needs of patients with advancing illness.

As part of our commitment to a regional palliative pledge – Together, we will deliver outstanding palliative care – we collaborated with the Central West Palliative Care Network (CWPCN) on a project that will help identify patients as palliative earlier in their illness. Patients receiving early, well-coordinated palliative care can greatly improve their quality and length of life.

We took this concept to Ontario’s IDEAS Applied Learning Project, where we piloted a number of tools including the Supportive & Palliative Care Indicators Tool (SPICT) and CWPCN Early identification and Prognostic Guide to assess patients who would benefit from early palliative care. Education and information sessions with both Care Coordinators in our Dufferin neighbourhood team and their aligned family practice physicians enabled the successful implementation of this approach.

The project team set a goal to increase the identification of patients that have palliative care needs, and could benefit from a hospice palliative approach to care, by 10 per cent. By March 31, 2016,​ we increased identification of patients in the Dufferin area to 16 per cent and this neighbourhood team continues to exceed targets well above our initial goal.

This early success is a catalyst to fully implement this practice throughout the Central West neighbourhood teams. Primary care providers will also be engaged so they can identify patients in their practices that could benefit from early palliative intervention.​​