A Comparative Case Study Exploring How Ontario Health Teams are Strengthening Palliative Care in Two Local Communities
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.024 | 0.007 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".