Grant: Operating Grant

Dying is something that will happen to everyone and good quality of care at the end of life is a basic human right. As people get older, and with more seniors living with some illnesses for a long time (like heart disease), we will need more health care for people who are dying, or palliative care (PC) services. There has been more money spent on PC services recently but we really don't know much about the quality of care that people get. Much of the research in PC looks at how many people went to the hospital or where they died, but doesn't examine the quality of the health care received. In Ontario, we have relevant data that can help us examine the quality of PC services. These data come from a survey that is completed when people are dying and receiving home care. This survey was created by interRAI, a group of researchers and clinicians from 23 different countries. In Ontario, the home care staff complete the interRAI survey with the person and their family. This survey includes important information about the quality of care patients are receiving. It includes questions about a person's pain, mood, whether they are having trouble breathing, whether they can look after themselves (e.g., getting dressed, and if they have someone to help them). From the survey questions we will define a set of quality indicators (QIs) that look at things like pain, fatigue, depression and falls. These QIs will focus on the home care setting, although our vision is to follow up on this project with research that develops QIs for other health care settings. Each of these QIs will be reported as a percent (e.g., percent of people with moderate to severe pain) so we can see how well different home care providers are doing. By having these QIs, palliative care providers can see how they are doing and how they compare to other places. In this way, they can figure out where they need to work more to improve the quality of care that they provide.