This indicator measures the proportion of long-term care home residents with a progressive, life-threatening illness who have had their palliative care needs identified early through a comprehensive and holistic assessment.

Quality Improvement Plans (QIPs)

Effective

Outcome

Limitations to this measure include that the needs change over time. Assessment quality will not be captured, only completions

The intent of the indicator is to influence a system change to 1) identify residents who would benefit from palliative care as early as possible using a screening tool, and 2) to conduct a holistic assessment of their needs earlier. Identification does not mean a referral to a palliative care specialist. Instead, identification should prompt a comprehensive and holistic assessment to determine the resident’s full range of needs. In long-term care, it would be anticipated that a large percentage of the population may be identified to benefit from palliative care. Families and residents need more time for critical conversations, and these should be initiated earlier. Who are these residents? • The resident population will likely include identifying residents with palliative care needs earlier than has been done in the past. • Newly diagnosed, serious and life-limiting conditions • Newly diagnosed cancer with significant risk of progression • End-stage organ failure (s) • Frailty • Dementia • Multiple medical conditions • Existing condition with a new development Step 1: Early Identification (the denominator): Ask yourself, what screening process is currently in place in our organization to identify residents earlier who may have progressive, life-limiting illnesses, and would benefit from palliative care? Early identification: The Ontario Palliative Care Network’s Palliative Care Toolkit lists tools for reference for Step 1. The Ontario Palliative Care Network’s Tools to Support Earlier Identification for Palliative Care is a great resource to help when determining this denominator. Step 2: Assessment of palliative care needs (the numerator): Once screening has identified residents who would benefit from palliative care, ask yourself, what process is currently in place in our organization to do a comprehensive and holistic assessment of the resident’s needs? How often is it repeated? Needs assessment: The resident’s current and future needs and preferences should be assessed across all domains of care. The Ontario Palliative Care Network’s Palliative Care Toolkit outlines the process and suggested tools for Step 2. Health Quality Ontario’s Palliative Care Quality Standard includes 13 Quality Statements. This indicator closely aligns with Quality Statement #1. A relevant Canadian resource for long-term care is the Quality in Long Term Care Palliative Care toolkit.

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