Palliative Care Tools and Resources

Find tools and resources to improve the quality of palliative care delivery.

Palliative Care Health Services Delivery Framework

The Palliative Care Health Services Delivery Framework is comprised of three models of care, supported by the Palliative Care Competency Framework, and Tools to Support Earlier Identification for Palliative Care. Used together, these resources complement the Quality Standard for Palliative Care: Care for Adults with a Progressive, Life-Limiting Illness .

Quality standards are concise sets of statements that help patients, residents, families, and care partners know what to ask for in their care. They also help health care professionals know what care they should be offering, based on available evidence and expert consensus.

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    Models of Care

    The Palliative Care Health Services Delivery Framework outlines recommendations to guide future organization and delivery of palliative care. 

    Focus Area 1: Adults Receiving Care in Community Settings

    The Palliative Care Model of Care for community settings will ensure:

    • palliative care is provided by an interprofessional palliative care team so that the right care is provided by the right provider
    • the patient and their family/care partners are actively engaged as members of the interprofessional palliative care team and make decisions about their care
    • the patient and their family/care partners have seamless access to palliative care and support 24/7. To ensure services are integrated, every patient will have a designated care coordinator
    • high-quality, person-centred palliative care is provided to patients wherever they are

    Specific attention is paid to priority populations such as First Nations, Inuit, Métis and urban Indigenous people, francophones, homeless and vulnerably housed people, and those living in long-term care homes.

    This model of care builds on existing capacity and supports local flexibility. Ultimately, it leads toward sustainable, equitable and coordinated palliative care.

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    Palliative Care Competency Framework

    This reference guide for health professionals and volunteers describes the knowledge, personal attributes and skills providers need to deliver high-quality palliative care in Ontario. Applying these competencies in practice will lead to better care for people with a serious illness and encourage collaboration among professionals and organizations providing palliative care. 

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    Tools to Support Earlier Identification for Palliative Care

    Identifying palliative care needs earlier in the course of disease significantly contributes to positive patient, family and system outcomes. This document supports providers and system-level leadership in earlier identification of patients who would benefit from palliative care. The tools recommended in this document can:

    • help providers determine when to introduce palliative care
    • be integrated into all settings of care
    • be integrated into digital platforms that support patient care
    • help to promote the scale and spread of earlier palliative care

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    Toolkit

    These best-practice tools from around the world support primary care providers with palliative care delivery. They are organized according to the 3-step model of best practice proposed by the Gold Standards Framework  used in the United Kingdom.

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    Step 1: Identify

    Identify if the patient would benefit from palliative care earlier in their illness trajectory. The Tools to Support Earlier Identification for Palliative Care  recommends tools that can be used to determine when to introduce palliative care.

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    Step 2: Assess - Screening Tools

    Assess the person’s current and future needs and preferences across all domains of care. Include validated screening tools, an in-depth history, physical examination and relevant laboratory and imaging tests.

    Use validated screening tools to identify if the patient, their family or caregiver have any needs that require urgent intervention. Type and timeliness of screening will depend on the severity, urgency and complexity of the symptoms or needs identified.

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    Step 2: Assess - Holistic Assessment Tools

    Assess the person’s current and future needs and preferences across all domains of care. Include validated screening tools, an in-depth history, physical examination and relevant laboratory and imaging tests.

    Explore symptoms and needs across all domains in more detail through history and examination. Specific details on domains of issues associated with illness and bereavement are described in the Canadian Hospice Palliative Care Association’s Model to Guide Hospice Palliative Care. Continue to screen regularly for distress and other needs.

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    Step 2: Assess - Conversation and Consent Tools

    Assess the person’s current and future needs and preferences across all domains of care. Include validated screening tools, an in-depth history, physical examination and relevant laboratory and imaging tests.

    Use the results of screening and assessment to prompt further discussions about a person’s wishes, values, beliefs, understanding of wellness and any illnesses, and goals for current and future care. These conversations are ongoing and should be revisited regularly.                       

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    Step 3: Plan and Manage

    Plan and collaborate ongoing care to address needs identified during the assessment. This includes prompt management of symptoms and coordination with other care providers.

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    Health System Forms

    Other Resources

    Last Updated: August 26, 2024