Grant: Operating Grant

Palliative care is an approach that relieves symptom issues and improves quality of life for patients who have terminal illness. The rapidly aging population is pressuring health systems to provide palliative care outside the hospital that is high-quality and cost-effective. A lot of research has investigated "expert-consult teams" that deliver palliative care in the home. These teams consist of a nurse, palliative care physician, and involvement with family physicians. Expert-consult teams vary considerably in communities and regions across Canada, particularly in their processes of care delivery. Processes of care delivery include assessment and monitoring, coordination, and care-planning, all of which directly affect patient and family outcomes. Yet, there is a little research that describes and compares the various processes of care within multiple team models, and assesses how processes of care link to healthcare use and costs. To address this gap, this study will examine 6 palliative care, expert-consult teams across Ontario and Alberta. It will investigate whether patients who received care from an expert-consult team compared to patients who received "usual care" had reduced use of hospital days, emergency department visits, and lower costs. It will also interview the teams to compare the similarities and differences between team's processes of care, and understand which processes are important to lowering healthcare use and costs. In the end, this study will generate new knowledge about effective models to deliver palliative care in the community. The results are relevant to decision-makers across Canada and other countries, who have implemented different models of expert-consult teams in their communities, but lack evidence about which models are optimal. Ultimately, the knowledge generated will be essential to spreading effective models so that all Canadians can access high-quality palliative care.