A Comparative Case Study Exploring How Ontario Health Teams are Strengthening Palliative Care in Two Local Communities
Notice bibliographique
Résumé
Demographic and population health shifts, including an aging population and a rise in chronic conditions, have led to an increased need to strengthen access to health and social supports across the care continuum, from prevention to palliative and end-of-life care. Ontario Health Teams were implemented in 2019 and have since introduced a new approach to health care planning and delivery: they aim bring together one collaborative team of health care providers meant to enhance care delivery, including palliative and end-of-life, to build a more connected, person-centered, and inclusive health system. This importance and recognized priority of palliative care alongside the recent implementation of a major health system change - Ontario Health Teams -provides the ideal context to explore progress toward strengthened access to palliative care. This qualitative research study employs a comparative case study analysis to examine how two geographically diverse Ontario Health Teams are enhancing—or not enhancing—palliative care services within their regions. Ten semi-structured interviews were conducted with key stakeholders, including healthcare providers, administrators, and care partners. Walt and Gilson’s policy triangle framework guided the development of interview questions and supported the analysis and interpretation of the findings. The introduction of OHTs holds potential in strengthening the coordination of health services, though little attention had been paid, to date, on palliative care services specifically. This research uncovered the strategies and approaches implemented by two OHTs to strengthen access to and coordination of palliative care services in the community. In doing so, it identified the relationships, roles, and processes of stakeholder involvement and how these factors have shaped the direction of palliative care initiatives within their respective OHTs. The study found that OHTs are advancing palliative care through tailored initiatives, such as planning days, integrated technology solutions, informational phone number, and single referral systems for palliative services, all of which involve various levels of stakeholder engagement and leverage existing partnerships. Challenges related to resource allocation, geographic proximity, fragmented communication, collaboration, and care partner engagement were identified. Despite these obstacles, there is a strong sense of optimism and dedication from both OHTs to continue improving palliative care by engaging care partners, healthcare providers, patients, families, and all necessary stakeholders to create a successful palliative care ecosystem. Overall, this research sheds light on several challenges and successes in implementing palliative care within OHTs. It also serves as a valuable resource for policymakers, practitioners, and stakeholders who are committed to improving patient- and care partner-centered care.
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Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,024 | 0,007 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,005 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».