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Improving Equity in Access to Palliative Care

This collaborative aims to improve access to equity-oriented palliative care with and for people experiencing homelessness or vulnerable housing.

A large group of people is posed outdoors for a group photo on a paved area with steps and greenery in the background. The group consists of several rows, with some seated in front and others standing behind. Most individuals are wearing name tags and casual or business-casual attire. The sky is overcast.
Topics
  • Health Equity
  • Primary and community care
Audience

  • Quality or safety improvement lead

  • Healthcare leader

  • Community organization

What is the Improving Equity in Access to Palliative Care collaborative?

Many current models of palliative care are not prepared to meet the needs of people who are vulnerably housed, staying in shelters or living in outdoor spaces. There are often barriers to diagnosis, treatment and support needs, which means that health conditions that could be preventable or treatable may become life threatening. This makes it difficult to access palliative care when it is needed most.

Improving Equity in Access to Palliative Care brings together diverse perspectives and experiences, including people with lived and living experiences to design, implement and evaluate initiatives that will improve access to equity-oriented palliative care. These initiatives ensure care is delivered in a timely way, reducing emergency department visits and hospital admissions and allowing to people to receive care with dignity in the environment of their choice.

What is the Improving Equity in Access to Palliative Care collaborative?

Many current models of palliative care are not prepared to meet the needs of people who are vulnerably housed, staying in shelters or living in outdoor spaces. There are often barriers to diagnosis, treatment and support needs, which means that health conditions that could be preventable or treatable may become life threatening. This makes it difficult to access palliative care when it is needed most.

Improving Equity in Access to Palliative Care brings together diverse perspectives and experiences, including people with lived and living experiences to design, implement and evaluate initiatives that will improve access to equity-oriented palliative care. These initiatives ensure care is delivered in a timely way, reducing emergency department visits and hospital admissions and allowing to people to receive care with dignity in the environment of their choice.

Meeting people where they are at: Palliative Advocacy & Care Team (PACT)

In this blog, learn how Thunder Bay’s PACT is improving access to palliative care for people experiencing homelessness through equity-focused outreach, advocacy and lived-experience support.

Learn more
A grey map of Canada with numerical values per province indicating the number of teams participating in the Improving Equity in Access to Palliative Care collaborative.

Improving Equity in Access to Palliative Care Communities

Healthcare Excellence Canada and the Canadian Partnership Against Cancer are supporting 23 communities through the Improving Equity in Access to Palliative Care, a collaborative designed to make measurable improvement in access to palliative care with and for people experiencing homelessness or vulnerable housing.

Participating communities and projects

The following teams have been accepted to participate in Improving Equity in Access to Palliative Care.

A benefit I was not expecting in joining the collaborative but have found incredibly valuable is the opportunity to connect with other teams across the country who are doing similar or related work. We are able to learn from their experiences and benefit from their collective wisdom to help move not only our project but also our broader palliative care services forward.

Umilla SteadRegional Lead, Palliative Approach to Care, Vancouver Coastal Health
Skip carousel Improving Equity in Access to Palliative Care in action
  • Team members and coaches participating in the Improving Equity in Access to Palliative Care collaborative participating in a land-based learning session facilitated by Wanuskewin staff.
  • Team members representing The Grey-Bruce Ontario Health Team / Brightshores Health System and Fort Erie Native Friendship Centre exchanging learnings about their initiatives at a program workshop.
  • Dr. Holly Prince, one of the Improving Equity in Access to Palliative Care coaches, facilitating group discussions with team members representing Alberta Health Services, Champlain Hospice Palliative Care Program, Bruyère, Fort Erie Native Friendship Centre, Niginan Housing Ventures, and NL Health Services – Labrador-Grenfell Zone at a program workshop.
  • Team members representing Huron Shores Family Health Team, NL Health Services – Eastern Rural/Urban Zones and Victoria Cool Aid Society learning about the Saskatoon Tribal Council Health Bus which is a collaborative initiative between Medavie Health Services, the Saskatoon Tribal Council and the Government of Saskatchewan serving seven First Nations communities.
  • Dr. Kelli Stajduhar, one of the Improving Equity in Access to Palliative Care coaches, sharing reflections at a program workshop joined by team members representing Thunder Bay’s Palliative Advocacy and Care Team (PACT) and Victoria Cool Aid Society.
  • Team members and coaches participating in the Improving Equity in Access to Palliative Care collaborative participating in a guided walk facilitated by Wanuskewin staff.

    • “As a group we saw human rights, dignity and equity not being upheld and we tried to make a difference. And we did.”

    • “It takes a village to do equity work. This is my village.”

    • “This collaborative is proof that the work can be done.”

    • “This is a group that has shared passion and purpose that is bigger than themselves. That is worth sharing.”

    • “You have to slow down to get to where you want to go.”

      From workshop to action: takeaways on equitable access to palliative care

      In this blog, Improving Equity in Access to Palliative Care program coaches share takeaways from a health equity workshop, and the importance of improving access to palliative care with – and for – people experiencing homelessness.

      Learn more

      Promising Practices for Improving Equity in Access to Palliative Care

      Many current models of palliative care are not prepared to meet the needs of people who are vulnerably housed, staying in shelters or living in outdoor spaces. The healthcare system can make inequities worse as people who are already structurally vulnerable can experience stigma, discrimination and racism when accessing care. There are often barriers to diagnosis, treatment and support needs, which means that health conditions that could be preventable or treatable may become life threatening.

      In response, communities across Canada have designed innovative models of equity-oriented palliative care to improve access to safe and high-quality palliative care for those experiencing structural vulnerabilities. These models ensure care is delivered in a timely way, help reduce emergency department visits and hospital admissions and allow people to receive care with dignity in their environment of their choice.

      The promising practice summaries were created to profile leading innovative equity-oriented palliative care models from across the country. These summaries offer details about:

      • how the promising practice works

      • partnerships and collaborations

      • evaluation and impacts

      • lessons learned, including enablers and challenges

      "These promising practices demonstrate the impact of designing and delivering compassionate, person-centred, trauma-informed care while incorporating principles of harm reduction, anti-oppressive practice, interprofessional approaches and culturally safe(r) care.

      By working in new and innovative ways we can improve care, together.

      People who experience homelessness and other structural vulnerabilities often lack equitable access to palliative care."

      Dr. Kelli Stajduhar | Dr. Naheed DosaniProfessor and Canada Research Chair (Tier 1), Palliative Approaches to Care in Aging and Community Health, University of Victoria | Palliative Care Physician, Department of Family & Community Medicine, St Michael's Hospital at Unity Health Toronto

      What is Equity-Oriented Palliative Care?

      Palliative care that meets people where they are at

      Most definitions of palliative care focus on improving quality of life and alleviating pain and suffering for people throughout the course of their serious illness. It is generally understood that the goal of palliative care is to enable people to die with dignity. This involves taking a holistic and person-centered approach to ensure the specific needs and preferences of each person is met. This approach also includes supporting friends and families in their grief and bereavement.

      While this definition helps us to understand what palliative care might look like in practice, the underlying social, economic, cultural structures that create and perpetuate health inequities are often overlooked. These are known as the structural determinants of health.

      An equity-oriented definition of palliative care recognizes system barriers and seeks to address them to ensure access to high-quality and safe care.

      In the Improving Equity in Access to Palliative Care (IEAPC) collaborative, we are learning how communities are shifting their approach to palliative care to better meet the needs of people who are experiencing structural vulnerabilities.

      A colorful illustration titled “What does equity-oriented palliative care mean to you?” featuring six individuals with speech bubbles expressing their views: Culturally-safe(r), trauma-and-violence informed care and harm reduction; It's more than pain and symptom management; Individualizing care! It could be food, water, clothing or a hug; Centre the person, not the system; Justice, inclusion access, agency and power!; Develop policies that support us to meet the unique needs of each person.

      While examples of equity-oriented palliative care might look slightly different in each community, we encourage you to consider how more equitable access to palliative care can be improved in your community by:

      Reflecting on aspects of your organization that create barriers to care.

      This could include policies, physical spaces, location and more. Engage your community in these conversations.

      Collaborating across sectors to identify and address system gaps.

      Build meaningful partnerships with community-based organizations that are already doing the work to integrate care.

      Identifying opportunities to build capacity.

      Exchange learnings within your community and across organizations.

      Planning for sustainability in mind.

      Consider what data you can start collecting (or may already collect) that will help you better understand who is accessing care in your community and where.

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