The View From Five: Moving Care Forward

Too often, people in the final stages of life were being transported to emergency departments simply because no other option was available – not because that's where they wanted or needed to be.  

Paramedics and Palliative Care set out to change that by training and equipping paramedics to deliver palliative care closer to home, improving the end-of-life care experience for people in participating communities: 

• More than half of calls enabled people to remain at home rather than being transported to an emergency department — saving an average of 31 minutes per call.

• Nearly 7,000 calls were received from people wishing to access palliative care in their homes.

• Over 92 percent of surveyed patients and families reported being satisfied with the care they received.

• More than 7,500 paramedics gained new skills and confidence.

  The learnings from this program have been compiled into a change package – a practical guide drawing on the experiences of 10 teams across nine provinces and territories – so that any paramedic service in the country can implement this approach in their own community. 

Antipsychotics carry serious risks for people living with dementia, including confusion, stroke, and death. Progress in reducing their inappropriate use had been made before the pandemic reversed that trend – and rates have been climbing back ever since. 

Sparking Change in Appropriate Use of Antipsychotics was one of the programs built to renew that momentum, in addition to OPUS-AP PEPS, Reimagining LTC and LTC+: Acting on Pandemic Learning Together. Through Sparking Change in Appropriate Use of Antipsychotics, 341 long-term care teams across 11 provinces and territories were provided with the tools, coaching and peer connections to replace medication with person-centred approaches tailored to each resident's individual needs. The impact has been measurable both in data and in lives changed: 

• At one British Columbia long-term care home, inappropriate antipsychotic use dropped by a third.  

• In Newfoundland, two residents regained the ability to speak, eat and engage in daily life after their antipsychotic medications were discontinued.  

The participating teams continue to be part of a growing pan-Canadian community – and their collective learnings are captured in the AUA Toolbox, a free resource designed to help any long-term care home, team or care partner take the next step. 

For too many people living in northern, rural and remote communities, access to primary care is not a given. Family doctor shortages, geographic barriers and under-resourced health systems mean that people often lack adequate access – or turn to emergency departments when they have no other option.

Strengthening Primary Care brought together 20 teams to change that, each developing solutions shaped by the unique needs of the communities they serve: 

• In Ontario, a nurse practitioner-led clinic set up inside a local library expanded access for a community where more than 4,000 residents are without a family doctor.

• In Northern Quebec, a virtual nurse on-call service triaged over 6,200 after-hours calls in Cree communities, resolving more than half without an in-person visit.