Integrating paramedics into primary care to optimize patient time in the community at end of life

Many, if not most, Canadians die from a chronic condition which can benefit from a supportive palliative care approach, with a goal of quality of life. As our population ages, this number is rising, and the costs are rising too. This is an important issue facing Canadians. Primary care teams may be ideal to provide this support at the end of life, but are not often able to give that support off-hours or in a symptom crisis when a rapid response is needed. In a unique and innovative program, some of the team members for this project developed the Paramedics Providing Palliative Care at Home Program. Through this Program, paramedics in Nova Scotia now have training and protocols that enable them to meet the need for a universally available rapid response for palliative support. The Program also worked to expand the existing Special Patient Program, so that patient wishes and goals of care can be easily accessed by paramedics. The current project builds on the research done for the Program, by comparing some key benchmarks before and after the Program, and also between Nova Scotia where there is the Program, and British Columbia where there is no Program. We will compare the amount of time people are able to spend at home in the community at the end of life, with and without the Program. We will also bring together key people to talk about how to scale this up to other locations. This will have an important potential to help people stay in the community, where they want to be, at the end of life.