This indicator measures the proportion of patients with a progressive, lifelimiting illness who were identified to benefit from palliative care who subsequently have their palliative care needs assessed using a comprehensive and holistic assessment.

Quality Improvement Plans (QIPs)

Effective

Outcome

Limitations of this measure include that the needs change over time, and needs may have been assessed in other settings. Assessment quality will not be captured, only completions.

Identification does not mean a referral to a palliative care specialist. Instead, identification should prompt a comprehensive and holistic assessment to determine the patient’s full range of needs. Who are these patients? • The patient population will likely include identifying patients 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 patients 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. Some tools used in Ontario include the adaptation of the UK Gold Standards Framework Prognostic Indicator Guidance for Ontario. Step 2: Assessment of palliative care needs (the numerator): Once yourself, what process is currently in place in our organization to do a comprehensive and holistic assessment of their needs? Needs assessment: The patient’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.

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