Team profiles :

Department of Health, Government of Nunavut

At a Glance   

Region: Nunavut

Setting: Remote and Northern

EAIP program principle(s): 

• Access to specialized healthcare services 

Implementation (new, spread, and/or expand): 

• New

Team Profile  

The organization leading this initiative is the Department of Health, Government of Nunavut. Collaborative team members include a variety of organizational staff, including administrators, consultants, team leads (home care, nursing, pharmacy), and an evaluation and measurement lead.  

Community

• Nunavut is the largest territory in Canada, and with population of approximately 40,692 residents as of 2023, it is also the most sparsely populated. Nunavut is accessible year-round solely by air, and more than 80% of the residents in Nunavut are Inuk (Inuit).  
• As of 2021, Nunavut was home to a significant Elder population, with over 4,000 individuals aged 55 and above, comprising approximately 12% of the territory's total population and the largest proportion of Elders the territory has had to date. This number is expected to grow by approximately 6% in the next 20 years. 
• Due to Nunavut’s remote location, many communities in the territory have limited access to healthcare services and resources, often having to travel out of community to receive care.  

Program Focus 

Program Description  

• To pilot and implement Continuous Ambulatory Delivery Device (CADD) systems, specifically CADD-Solis Ambulatory Infusion pumps, within communities across the territory. This program aims to enhance the homecare program for individuals with life-limiting illnesses. By facilitating adequate comfort measures (e.g., effective pain management), the goal is to provide comprehensive support and access to care, minimizing the need for long-term care respite beds and enabling individuals to receive the care they need in their home and community.  
• By implementing the CADD-Solis Ambulatory Infusion pumps, the team aims to achieve several long-term outcomes. These include reducing the need for medical travel to access palliative services outside the community, decreasing the reliance on long-term care respite beds, and enhancing the capacity to repatriate individuals who have received palliative care outside the territory. 

Implementation Approach: 

• Development of an implementation plan: The team will collaborate with regional leadership to select the initial participating communities. These communities will be based on several criteria including population size, clinical need, recommendations by regional homecare managers, available healthcare resources, and the ability to transport medications safely.  Discussions will cover logistical aspects such as medication compounding and preparation, as well as quality assurance measures. The selection of communities for the pilot program is expected to be finalized by late 2024.  
• Education, training, and resource development: Development of the CADD pump drug library will occur in collaboration with stakeholders and additional supports (e.g., Ottawa Hospital) to ensure quality assurance and functionality of the pumps prior to deployment. Furthermore, comprehensive training programs for both pharmacy and homecare nursing teams will be developed. 
• CADD-Solis Ambulatory Infusion Pump rollout: The team will facilitate the distribution and implementation of CADD pumps starting with the initial pilot communities. The anticipated rollout for these communities is early 2025. The pilot program will begin with a small subset of communities in the Baffin region, with the aim to roll-out the program across the territory as the logistics of procurement/transportation are established. Currently there are 13 devices available for distribution throughout the territory, 5 of which will be used in the pilot communities. As logistics for program expansion are identified, the remaining pumps will be distributed. 
• Spread, expansion, sustainability, and evaluation: An evaluation of the program will be completed, incorporating feedback from program participants and their caregivers, to inform adjustments and ensure sustainability. This feedback-driven approach aims to support the sustainability and expansion of the program to additional communities.