Heading to the BC Patient Safety and Quality Council’s annual Quality Forum on June 6-8? Be sure to check out BCCPC’s presentations, posters and information booth to learn more about our work advancing the palliative approach to care in BC. 
The Quality Forum brings together BC’s healthcare community to explore ways to improve quality across the continuum of care. Our presentations will be part of a varied and vibrant event, including international plenary speakers, workshops, rapid fire presentations and more.
Here’s what you can expect to see from BCCPC:
Strengthening your core: Developing, Piloting, and Assessing Interactive Learning for All Health Care Providers in the Palliative Approach
(Rapid-fire presentation)
Presented by Kathleen Yue and Stephanie Stuerle
All health care providers will likely interact with patients with life-limiting illnesses regardless of setting or focus of their work, yet most do not feel well-prepared. The BC Centre for Palliative Care conducted a resource review and found that there is no single, online course that addresses the core palliative care competencies. To address this learning gap BCCPC co-created, with key health care disciplines and an instructional designer, eight learning modules available on the Provincial Learning Hub.
Launched in early 2022, the format of these 15-minute modules was informed by a survey about online learning style preferences. The resulting bite-sized interactive sessions have been completed by over 650 people as of March 2023. Learners come from a wide range of disciplines including health care assistants, nurses, physicians, social workers, counsellors, as well as volunteers, clerks, recreation assistants and paramedics.
Building on the success of these interactive and innovative learning modules, BCCPC next piloted a series of 30-minute interactive ECHO sessions. Each session is facilitated by a content expert in palliative care, who values the context expertise of all participants. ECHO is an ideal combination of education, peer connection, and collaboration, fostering an “all teach, all learn” approach across the care team. Utilizing Zoom, ECHO brings together participants from across the province. These short sessions provided an opportunity for learners to discuss experiences with other healthcare providers that is accessible during a break in their workday.
As of March 2023, the first ECHO pilot concluded, we are currently running a second round of sessions and the Learning Hub modules have been available for just over a year. During implementation, rapid improvement cycles were conducted. Now, BCCPC is assessing and evaluating the value of this unique approach to learning on the experience of the care providers, and impact on patient care. Some evaluation has been completed, but more is needed to fully assess this unique learning approach.
How can I walk with you if I don’t know where you want to go?
(Workshop)
Presented by Kathleen Yue and Melody Jobse
Although everyone’s health is an individual journey, no one does it alone. We all need people to walk alongside us in our healthy times, when we experience illness, and as we approach the end of life. Part of sharing the journey is knowing what really matters to us and to the other person. In this workshop, we will explore the many points in a person’s life when it is essential to have conversations about goals, values and wishes for future health care. Since these conversations can be difficult, we will practice using tools and resources to help individuals, families, communities, health care organizations and clinicians to talk about what really matters.
Participants will:
- Recognize the impact of essential conversations on the quality of life of people with serious/terminal illness
- Identify opportunities for initiating essential conversations in families, communities and health care contexts.
- Practice using evidence-informed tools to facilitate essential conversations
- Explore the roles of community and health care systems in promoting essential conversations
Frontline Perspectives Considering the Dual Experience of Homelessness and Bereavement
(Poster)
Presented by Joshua Black, PhD
The incidence, impact, and experience of bereavement in the context of homelessness has not been meaningfully recognized by current literature. Given the high frequency of deaths in this population, an urgent systemic response towards providing better bereavement support is desperately needed. This research study explored the dual experience of homelessness and bereavement in British Columbia (BC) from the perspectives of frontline workers who provide health or social support for individuals experiencing homelessness.
An environmental scan of resources, programs, and services offering support to individuals experiencing homelessness across BC was conducted to develop a list of organizations to invite to the study. After emailing the organizations, a total of 72 frontline workers participated in the survey. The questionnaire was compromised of quantitative and qualitative questions asking about their organization, role, perceptions of their client’s bereavement, as well as their own bereavement responses in the event of a death of a client.
The survey data exposed narratives of broadly unmet needs, and a lack of grief-informed approaches for both the person accessing services and staff. Primary gaps identified were: 1. Accessibility with late care or no care at all, 2. Stigma with it being rare for clients to have positive outcomes and interactions within institutions, and 3. Complexity of needs with bereavement increasing struggles with mental health and substance use.
Questions remain related to what is needed and helpful in the dual context of homelessness and bereavement. Future research should aim to interview individuals with lived experience of bereavement and homelessness to better understand their experience and what they desire for bereavement support. Additionally, we need to investigate the impacts of workplace bereavement on retention for frontline workers in this field.
Understanding the barriers and enablers in implementing the Serious Illness Conversation Program
(Poster)
Presented by Laura Finkler-Kemeny
The Serious Illness Conversation Guide (SICG) is a clinical tool to guide conversations about values, wishes and goals related to illness with patients and their families. Effective conversations have profound implications and outcomes in the illness and dying experience. In addition to supporting individual practice, the ‘SIC Program’ (SICP) refers to applying quality improvement principles to integrate the SICG into operational workflows, policy and processes.
Since 2016, in alignment with the provincial End-of-Life Care Action Plan, the BC Centre for Palliative Care (BCCPC) has supported the development of over 250 trained facilitators who provide SICG education in healthcare organizations, educational institutions and clinicians across BC. While a growing body of literature exists on the clinical, cultural, and social outcomes of the SICG education and use in practice, less is understood on how it has been integrated within our health care system.
In this project we aim to go beyond asking “does the SICP work?” to “does it work in this context?”. Through discussions with healthcare providers, administrators and healthcare leaders, we will investigate the process of integrating the SICP. We will use appreciative inquiry, implementation science, realist methods and interpretive description to identify and understand the barriers, and enablers of implementing the SICP. We also plan to work with partnering organizations to co-create recommendations for evaluation of provincial and regional SICP integration through identifying and testing the feasibility of performance measurement indicators.
Ultimately, this work will inform the development of a Quality Improvement Toolkit to support healthcare organizations in implementing the SICP. Given the current healthcare challenges, it is more important than ever to support clinicians and healthcare systems in having early, well-timed and quality conversations about serious illness.
