Provincial Palliative and End-of-Life Care
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Provincial Palliative
and End-of-Life Care
October 2018
Provincial Palliative and End-of-Life
Innovations Steering Committee
As many of you know, here in Alberta, we skip Fall and go straight to Winter. As the snow begins to fly in
September - better exchange those flip flops for a pair of boots (and maybe grab some mittens while you’re at it).
To cheer everyone one up, the Provincial Palliative and End-of-Life (PEOLC) has some exciting updates on the great
work happening to date.
This last quarter, the Provincial and End-of-Life Innovations Steering Committee (PPAL/EOL ISC) has prioritized the
following work for 2018/2019. Read more about this work in the following pages:
Advance Care Planning and Goals of Care EMS PEOLC Assess, Treat and Refer (page 4)
Designation (page 2)
Provincial PEOLC Rural in Home Funding (page 5)
Patient’s Death in the Home Setting Guideline
(page 3)
Provincial PEOLC Website (page 3)
The PEOLC Provincial team is excited to announce the hiring of their new Project Coordinator,
Alexandra (Alix) Donnelly. Alix has a very diverse background and academic history. Her previous
role was as a Project Coordinator for federally funded project of national-scope and she has a
Masters in Biomedical Technology where she focused in bone and joint health. She is working
towards her Project Management Professional (PMP) designation and her Masters in Health
Administration. In her spare time, she enjoys being a Provincial Soccer Referee where she gets to
“whistle while she works” and is an avid reader, cyclist and soccer player. She is excited to learn,
contribute and grow with the PEOLC team and work towards providing Albertans with the best
possible care.
We are also excited to announce the hiring of our new Lead for the Provincial EMS Palliative and
End-of-Life Care Assess Treat and Refer Program, Ian McEwan. Ian has been in EMS since 1995,
starting as an Emergency Medical Technician in Innisfail Alberta. He started his dream job as a
paramedic in Calgary in the fall of 1998. Ian prides himself on learning everything he can about his
profession. Ian has a bachelor’s degree in communications from Royal Roads University. Ian also
has experience as a Paramedic Clinical Educator, Simulation specialist. He most recently was a
Senior Strategist with Quality Patient Services. He has also been involved with the Alberta College
of Paramedics for the past 15 years as first an examiner and then as the College President. Ian has
a beautiful bride of 21 years, 2 children and a dog. In his spare time he enjoys cooking where 5
years ago he got into the slow and low BBQ world and became a Kansas City Certified BBQ judge.
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Advance Care Planning
Goals of Care Designation (ACP/GCD) Palliative and End-of-Life
www.conversationsmatter.ca Care Dashboard
Advance Care Planning Goals of Care Designation (ACP/GCD)
Throughout the province, many people put
activities has been brisk this summer. Exciting
in a lot of time and effort in collecting,
developments include:
amalgamating, cleaning, visualizing and
Frequent Connect Care consultations making sure ACP/
analyzing data. Every contribution adds up
GCD conversations, determinations and documentation allowing for us to tell a story and inform
appears in the core build. We are grateful to our team of future decisions and choices; it acts as our
experts who are generously giving their time and compass that guides us in developing a high
expertise to this important project. quality healthcare system that better serves
Health Systems Evaluation and Evidence have completed our patients and staff.
the 2017-18 Evaluation Report. It will first be shared with The Provincial PEOLC team is working on
PEOLC Seniors Health leaders and then sent to the ACP/ updating the PEOLC Tableau Dashboard.
GCD Community of Practice (COP) for their perusal. Stay
We have recently received vital statistic
tuned for slide decks and infographics that summarize
data that will allow us to enhance and
key findings and recommendations.
improve some of our existing data. We will
Four ACP/GCD webinar Skype sessions are being planned
be reconvening the Dashboard working
for 2018-19, check the PEOLC Education Bulletin for group to make recommendations to the
details. PPAL/EOL ISC on which components are
Three ACP/GCD E-learning modules are being updated to most useful and applicable for PEOLC
reflect updates to the policy and more current practice. provincially.
Print resources like the Guidebook and trifold brochure
are also being refreshed. As frontline workers “live the
policy” new resources are required to assist patients and
families understand GCDs and the importance of ACP. For PEOLC education opportunities,
review the Provincial PEOLC
Website and FAQ enhancements are ongoing. If you have
Education Bulletin link.
suggestions for additional FAQs, please contact
sharon.iversen@ahs.ca. www.albertahealthservices.ca/info/
page14438.aspx
Advance Care Planning /Goals of
Care Designation Practice
Improvement Education Sessions
Alberta Hospice Palliative Care
Association Award Nomination
Compassionate Communities:
Caring for our Caregivers
Grief and Adjustment through a
Trauma Informed Lens
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Provincial Guideline for Patient’s Death in the Home Setting
(Patient receiving Home Care services in private home or seniors’ lodge)
The Patient’s Death in the Home Care Setting Guideline, launched on
January 2018, provides direction for regulated and unregulated Home Care
providers (AHS employed and contracted) on how to prepare for and/or
approach an expected or unexpected death of a Home Care patient.
Implementation of the Guideline for Patient’s Death in the Home Setting
occured in a gradual fashion based on Zone readiness. As of April 30, 2018
all Zones should be following the new Guideline.
An online toolkit with access to the Guideline and supporting documents
for Home Care healthcare providers is available at the following website:
https://www.albertahealthservices.ca/info/Page15828.aspx.
The toolkit includes algorithms, frequently asked questions, education, and
other resources.
Also available is the Before and After an Expected Death in the Home –
Information for Families of Home Care Patients in a Private Home or
Seniors’ Lodge booklet. This free resource for Home Care healthcare
providers can help assist in conversations with patients and their families
around preparing for an expected death at home.
In the upcoming months the Working Group will focus on conducting an
evaluation on the Guideline, including a survey of frontline Home Care
healthcare providers.
Please contact palliative.care@ahs.ca with any questions or concerns.
Palliative and End of Life Care Website
https://myhealth.alberta.ca/palliative-care
Content will be progressively updated; please check the website regularly for new information.
The Website Working Group has not met over the Palliative and End-of-Life journey.
summer but will be meeting in September to continue the We also updated seven PEOLC pages including: “what is
enhancement and maintenance of the Provincial PEOLC PEOLC?”; “who is it for?”; and “how to get it?”. Within the
website. next quarter, the Working Group will be completing the
The working group will be providing feedback on a final review of the myHealthAlberta pages and will
number of palliative specific myHealthAlberta pages. receive and examine the website analytics.
Recently added to the website are the five digital stories If anyone has any questions or comments on the website
from Calgary Zone where family advisors shared what content or user experience, please email the PEOLC team
matters most to them and their family during the at palliative.care@ahs.ca.
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EMS PEOLC Assess, Treat, and Refer
Within the Palliative and End of Life Care (PEOLC) Alberta Provincial Framework 2014, standardizing and spreading
palliative emergency symptom management support provided by clinicians and Emergency Medical Services (EMS)
within every zone was identified as a top priority. Over the past several years, all the zones have worked
collaboratively to help develop a provincial EMS PEOLC Assess, Treat and Refer Program (EMS PEOLC ATR).
This program helps to support patients experiencing symptom crisis within the community. Over the last three fiscal
years, the program has rolled out across the province and broadened to allow greater access to patients and
families. Continuing to provide additional palliative care education for paramedics, expanding the program to the
pediatric population, evaluation and sustainability planning are priorities this fiscal year’s work (Phase III).
Recent Program Activities/ Highlights
Continue to support Phase II implementation across the
province.
Held two Learning Essential Approaches to Palliative Care
(LEAP) Paramedic courses on September 22 and 26.
EMS PEOLC ATR Phase III expansion to the pediatric
population is nearing completion. A Dispatch form,
Specialized Treatment Protocol, Pediatric EMS PEOLC ATR
Protocol and Supplemental document has been
developed. They are currently undergoing a review and
approval process prior to implementation across the
province.
Will be developing education for EMS and Home Care
providers on Phase III.
Will be developing an Evaluation plan specific to
pediatrics.
Zone ATR Reps
North: terri.woytkiw@ahs.ca Calgary: kristy.schafer-blood@ahs.ca
Edmonton julia.arsenault@ahs.ca South: carolyn.gouw@ahs.ca
Central: pansy.angevine@ahs.ca
Inquiries from EMS related to the Assess, Treat and Refer program may be directed to: ems.palliative@ahs.ca.
For more information on EMS PEOLC ATR see EMS Initiative on https://myhealth.alberta.ca/palliative-care
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Provincial Rural In Home Funding Program
Rural patients, families, communities and clinicians face unique challenges and obstacles when accessing and
providing healthcare services. To better support those in rural communities, the provincial Home Care and
Palliative and End-of-Life Care team will be leveraging the ‘Calgary Zone Rural Palliative Care In-Home Funding
Program’ and expand the program to other zones for rural and rural remote patients so that patients, families and
communities from across Alberta can all benefit from this valuable program. This funding program will support
patients with palliative conditions, who live in rural areas throughout Alberta, to stay at home when desired and
when they require additional care beyond existing home care services. In collaboration with patients and their
families, the rural palliative and home care teams identify, and authorize the amount and level of additional care
that is needed.
A current state analysis is being conducted looking at what is currently available in Alberta. We will strike a working
group in late September 2018 to work towards creating a provincial model, an implementation strategy and
communication plan to best address the needs of those in rural communities.
Calgary Zone
This year we had 2 submissions accepted for the The annual 30+ grief groups are facilitated by one of the
International Congress of Palliative Care in Montreal. professional staff and 2-3 volunteers. The volunteers are
Janice Hagel will be presenting the Digital Story Project and supported through ongoing training to keep their skills
Linda Read Paul will be presenting the Calgary Rural In fresh and current. They develop skills on how to facilitate
Home Funding (CRPHF) program. The Canadian Home Care small-groups by practicing the facilitation of groups in
Association has requested a CRPHF presentation at their actual case scenarios. The training on Trauma-Informed
annual conference to demonstrate innovative home based Care brings our volunteers a greater awareness and
palliative care. sensitivity on how to work with clients with elements of
We welcome the following new leaders in our program: trauma in their grief story. Regular debriefing is common
practice when volunteers are working with a grief group, to
Dr. Amane Abdul-Razzak - Medical Director for IPCU
provide support and feedback. All of these opportunities
Chandra Vig - Care Manager Palliative Care Consult allow for our volunteers to be prepared to manage the
Service diversity of clients and losses the program serves.
Monique Vanderveen - Manager Hospice Operations We celebrate our volunteers annually at our volunteer
and Hospice Access social, a time for everyone to re-connect, we provide them
Our Spotlight on the Grief Support Program Volunteers: with an overview of the program over the year, and thank
The Grief Support Program is grateful for the 50+ them for being open and vulnerable with our clients in
volunteers that assist with grief support groups, admin, their pain.
library, and education nights. The volunteers, many who We truly could not run our program without them, and we
have come through the program, provide hope and the acknowledge their amazing contributions to the program.
‘lived experience’ connection for our clients in the midst of We want to say “thank-you,” and hold gratitude on behalf
their grief journey. of the Grief Support Program for all that they do for us.
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Palliative Institute
Alberta Palliative Care Competency
Framework project has begun Palliative Care Matters initiative is embarking on a national
following agreement of the PPAL/EOL stakeholder analysis for palliative care. Sharon Anderson has
ISC to be the project steering joined the Institute to lead this work. The aim of the proposed
committee. The purpose of the stakeholder analysis [SHA] is to promote collaborative efforts
project is to develop a multi- among individuals and organizations towards improving public
disciplinary provincial palliative care access to quality palliative care services in Canada. In other words,
competency framework (phase one), how can like-minded palliative care organizations, governments,
and identify and describe palliative caring communities, patients, and families work towards equitable
educational opportunities (phase two) access to a national palliative approach that maximizes quality of
in relation to competencies. The goal life in the last years of life and a good death for all Canadians?
is to support health care providers to We plan to survey the interests, investments, and resources of
effectively choose amongst palliative stakeholders in palliative care initiatives to achieve the following
educational opportunities based on objectives:
their professional and personal 1. Identify areas for collective national development: goals/
learning needs. benefits common to all stakeholders and fit work with
In the next quarter, many of you will legislation and national strategy
have the opportunity to join discipline 2. Reduce duplication of efforts
specific working groups to confirm
3. Inform national strategic planning of research, policy,
Alberta palliative care competencies.
programs, education, and service delivery methods and
Please talk to your steering
approaches
committee representatives for more
information, or call the Palliative 4. Promote collaboration and guide development of a Canadian
Institute palliative care network
(780) 735-9637. 5. Develop a platform for sharing the information.
Canadian Hospice Palliative Care Association (CHPCA)
The Advance Care Planning (ACP) Canadian initiative, in The resulting toolkit will be available for download on the
partnership with the BC Centre for Palliative Care, is Advanced Care Planning Canada website at the following
leading a 1 year project to conduct a knowledge synthesis link: http://www.advancecareplanning.ca/
of the legal differences in ACP and substitute decision For more information, please contact ACP in Canada
making across all provinces and territories. This synthesis Program Manager Chad Hammond at
will lead to a public-facing toolkit to help Canadians mailto:chammond@chpca.net
understand their jurisdiction’s laws and more effectively
This project is funded by the Canadian Bar Association for
engage in ACP where they live. The project leads will
Law for the Future Fund.
engage legal professionals, health professionals and
patients and families regarding how to create a toolkit
that is clear, informative and accessible.
6
North Zone
We are very pleased to WELCOME the following new staff to the Specialty Programs:
Jakie Schmidt, PCRN, Area 1 (High Level) effective Sept 3 but will be in the office Sept 19, 2018. Jakie has
worked in Area 1 communities all of her career. Most recently working in Endoscopy/OR and Emergency, Jakie
has experience in labor and delivery, public health, as a flight nurse and as a Health Care Aide instructor. She has
also led a number of special projects in Area 1 in various areas of practice.
Susan Idell and Brandi Campbell, PCRN, Educators effective September 17, 2018. Susan Idell worked at the
Queen Elizabeth ll Hospital for several years prior to joining the North Zone Palliative Care Team as a Resource
Nurse in Grande Prairie. As a member of the Palliative Care Team, she has taken a lead role in developing and
delivering professional and Health Care Aide education, and is a strong advocate for patient and family centered
care.
Brandi Campbell moved to a Clinical Nurse Educator role several years ago and has led obstetrical education at
the Peace River Health Care Center. She has a long standing passion for palliative care that she has supported
with continued learning in this area. Brandi was also a key team member in the implementation of CoACT-
Collaborative Care at this site.
Referrals to the North Zone Palliative Care team can be made through the Continuing Care Access line (phone 1-855
-371-4122 or fax 1-855-776-3805).
Central Zone
have amazing palliative volunteers, who are eager and
passionate about palliative care.
Camrose, will be hosting their annual fall symposium, on
November 16, 2018. This fall's annual symposium
Central Zone Palliative Care team would like to welcome
features Dr. Rob Rutledge, Radiation Oncologist and
Karen Duke, RN to our team. Karen will be covering a
Associate Professor in the Faculty of Medicine at
leave position as a Palliative Resource Nurse for the next
Dalhousie University, based in Halifax, Nova
year. She has a wealth of knowledge as the charge nurse
Scotia. Camrose will also be offering two Grief and
from a palliative medical unit. WELCOME!
Bereavement workshop on October 26, 2018 and
We are also excited to announce, the Pain & Symptom November 30, 2018.
Clinic, a collaborative clinic between the Central Zone
The Central Zone Team has some exciting staff training
Palliative Team and the Red Deer Cancer Centre, has seen
th coming up. They are excited to train two of our team
its first patients on Sept 19 .
palliative physicians and our nurse practitioner, as LEAP
Central Zone Palliative Care team is ready to get into full facilitators this coming fall, it’s been a long time in the
post vacation work mode after a fantastic summer. We making to coordinate this request.
have been busy training volunteers once again. We are
The Continuing Care Councilor, Nurse Practitioner and
running Palliative and End-of-Life Care Volunteer Training
Practice Lead have had the privilege of becoming Serious
throughout the zone, as well as more Grief and
Illness Conversation Guide (SICG) Facilitators. This course
Bereavement Facilitating training.
originated through Ariande Labs from Harvard and is
As well, more No One Dies Alone volunteer training accredited. They will be able to offer credits for
sessions will be coming in the future. We are fortunate to physicians attending SICG.
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Canadian Hospice Palliative Care Nurses Group
Clinical Knowledge and Content Management
The Clinical Knowledge and Content Management team, with help from the working groups, continues to work on
the three prioritized Clinical Knowledge Topics (CKT) from the PPAL/EOL ISC.
Advance Care Planning & Goals of
Care Designations (ACP/GCD), All
Ages— All Locations Care of the Imminently Dying (Last Palliative Sedation, Adult - All
Hours to Days of Life) - All Locations Locations
Topic Lead—Dr. Eric Wasylenko
Topic Lead—Lorelei Sawchuk Topic Lead—Dr. Michael Slawnych
New Clinical Knowledge Topic has
been released
CKT is complete and available on CKT is complete and available on CKT is signed off
the Clinical Guidance Viewer on the Clinical Guidance Viewer on Expected to be available on the
Insite or on the external site. An Insite or on the external site Clinical Guidance Viewer September
update version is expected to be The C2 Medication and Care Adult 2018
available September 2018 order set and Care of the
Imminently Dying documents are
in development with AHS Forms
Department
Please contact us at ckcm@ahs.ca or via the website https://www.albertahealthservices.ca/cgv/Page15918.aspx to
provide CKCM with any feedback or comments, or to express your interest.
We value your input and opinion.
Contacts
General questions or comments email: palliative.care@ahs.ca
Dr. James Silvius, Barbara O’Neill,
james.silvius@ahs.ca barbara.o’neill@ahs.ca
Provincial Medical Director, Seniors Health, Senior Provincial Director,
Community, Seniors, Addictions & Mental Health Cancer SCN & Critical Care SCN
Senior Medical Director, Seniors Health SCN
Michelle Peterson Fraser, Sharon Iversen,
michelle.petersonfraser@ahs.ca sharon.iversen@ahs.ca
Senior Consultant; Palliative & End-of-Life Care; Educator; Palliative & End-of-Life Care;
Community, Seniors, Addictions & Mental Health Community, Seniors, Addictions & Mental Health
Aurora Leang, Alix Donnelly
aurora.leang@ahs.ca Alexandra.donnelly@ahs.ca
Lead; Palliative & End-of-Life Care; Project Coordinator; Palliative & End-of-Life Care;
Community, Seniors, Addictions & Mental Health Community, Seniors, Addictions & Mental Health
Ian McEwan Samantha MacGregor,
Ian.mcewan@ahs.ca samantha.macgregor@ahs.ca
Lead; Provincial EMS Palliative and End-of-Life Care Administrative Assistant; Palliative & End-of-Life
Assess Treat and Refer Program Care; Community, Seniors, Addictions & Mental
Health
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