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About Us

Projects & Initiatives

The Right Patient, in the Right Place, at the Right Time - Hospice Palliative Care Across the Care Continuum

Many care settings and services are required to provide adequate Hospice Palliative Care to patients throughout their palliative journey.

The ESC EOLCN has taken a leadership role in work related to “right patient in the right place at the right time” for care across the Hospice Palliative Care continuum. The ESC EOLCN has gained significant insight into how the sectors fit together and has determined what typically differentiates care in each of the key patient locations. Some of this work is detailed in the preliminary report created by ESC EOLCN “Report on Current Services and Recommendations for Future Systems” .

Subsequently, summary documents have been created for each county:

• Chatham Kent
• Sarnia Lambton
• Windsor Essex

  Each of these documents contains tables and charts summarizing the following:

  • Typical HPC interventions/procedures/services provided on site

    These tables summarize typical HPC interventions/procedures/services provided on site at various patient care settings in ESC. Locations are 24/7 care settings. Mobile/transportable patients may travel from this primary location to receive these interventions/procedures/services as outpatients at hospitals and Cancer Centres.

  • Typical eligibility criteria by patient location

    These tables summarize typical eligibility/service criteria for Hospice Palliative Care in ESC. Locations are 24/7 care settings. These criteria are based on services that are available in each setting. Day programs/clinics/ambulatory care services may support patients in these locations particularly patients in their own homes.

  • Tipping points which contribute to patients’ move from home to another care setting.

    The flow charts illustrate a few of the decision points related to end-of-life care in the home. This was drafted by ESC care providers in answer to the question, “Why don’t all patients requiring HPC stay in their own home throughout their journey?” The answer to this question is very complex and includes factors such as:

    • patient/family choice.
    • an acute medical crisis.
    • uncontrolled symptoms.

Case studies, which describe the patient and family experience accessing care from various sectors, have been created by two counties.

Caveat - Palliative Care is holistic and explicitly considers all domains of issues (as described in CHPCA model). Because of the multifactor nature of patient and family needs and resources, it is rarely one issue alone which triggers a move from one level of care to another. Thus when describing what differentiates care in each patient location, it must be acknowledged that many factors beyond those summarized (in the tables, flow charts and case studies) will impact decisions about admission to various levels of care.