Research impact

A photo of a woman in a black hoodie and pants standing behind a black bicycle. She is talking in a cellphone.
Katie Leahy, a palliative care nurse with the PORT initiative. Photo courtesy UVic

Establishing a Pan-Canadian Community of Practice to inform equity-oriented palliative approaches to care

Our Pan-Canadian Community of Practice, led by Drs. Stajduhar and Dosani and made up of members of Victoria’s Palliative Outreach Resource (PORT), Calgary Allied Mobile Palliative (CAMMP), and Toronto’s Palliative Education and Care for the Homeless (PEACH) teams, among others across Canada, work together to develop resources and tools, programs and services that produce ‘real world’ impact for those who are often excluded from mainstream palliative care services.

Our collaborations have resulted in the development and expansion of these evidence-informed mobile palliative care programs and has generated considerable international attention and local community support. Our collective work is grounded in participatory, strengths-based approaches that include recognizing the capacity of communities to show up and attend to death and dying wherever it happens.

More research impact

Palliative Outreach Resource Team (PORT)

In 2011, a group of inner city service providers came together to advocate for better access and quality of care at end-of-life for their clients living homeless and vulnerably housed and impacted by stigma, racism, and isolation. They approached Dr. Kelli Stajduhar and, from 2014-2017, partnered on CIHR-funded research to shine a light on barriers to care at end-of-life for those experiencing structural vulnerability.

Informed by study findings as presented in the Too Little, Too Late report, the Palliative Outreach Resource Team (PORT) re-launched in 2019 with funding from SE Foundation and Island Health. PORT is currently co-led by Victoria Cool Aid Society and Island Health and consists of a registered nurse, palliative physician, outreach worker and social worker. PORT is a mobile, equity-informed palliative care service supporting the delivery of high quality palliative care for people facing inequities. UVic works alongside these organizations to support evidence-informed implementation and evaluation of the service. For more information on PORT, please visit the PORT page on the ePAC website.

Equity-Informed Advance Care Planning

The cover of "My Advance Care Plan User Guide"
The ACP User Guide is one of the tools developed from iPAC research.

For many years, workers and street family have witnessed their peers, clients, and loved ones end up in hospitals and other healthcare settings without their wishes documented and unable to speak for themselves. Without an equity-informed approach to Advance Care Planning (ACP), chosen family caregivers are often unprepared to make important decisions, or they are excluded from these decisions altogether leaving them dismissed, disrespected, and distraught.

During the iPAC Inner City project, one inner city worker reviewed BC Ministry of Health’s 40-page “My Voice” ACP document pulling out key questions relevant to her experiences. This work was featured in the Globe & Mail in April 2019. Our team spent over a year workshopping ACP tools with housing, shelter, support, and peer workers from six inner city organizations. In October 2020, we launched the Equity-Informed Advance Care Planning tools and made them publicly available on our community website. Several individuals and organization are currently making use of these tools. For more information on their development see our blog.

ePAC crew

As the news of Palliative Outreach Resource Team (PORT) and Equity in Palliative Care research has spread, so too have been expressions of interest and support from community members. In January 2020, a small group of community members began meeting biweekly and coalesced to form the ePAC Crew to support the needs of structurally vulnerable folks who require palliative attention.

Guided by principles of inclusiveness, equity, and collaboration, ePAC Crew members have mobilized to cook and delivery food and other supplies to individuals living with serious illness and their caregivers who are socially isolated. Members of our Crew have participated in an Advance Care Planning (ACP) initiative adapting ACP language and resources for inner city settings. A couple of Crew members have had the honour of providing companionship for dying people, holding vigil, and connecting them with family whenever possible. For more information on the ePAC Crew, see our blog.

iPANEL

ipanel logo

iPANEL was the sole recipient of the BC Nursing Research Initiative (BCNRI) Investigative Team Program Award funded through Michael Smith Foundation for Health Research (MSFHR). This award was developed with the advice of the Nursing Research Advisory Council (NRAC). It was one of several programs funded through this initiative to build capacity for, and to support, practice-relevant health services research focused on the roles of nurses within the context of the broad health services practice community.

iPANEL was led by Dr. Kelli Stajduhar (Researcher – University of Victoria) and Carolyn Tayler (Clinical Nurse Leader – Fraser Health Authority) active from January of 2011 until December of 2018. In that time our research/clinician partnership (which included 16 core team members from each of the BC Health Authorities, and all the major University Nursing Schools in BC) produced 46 academic publications; 22 Knowledge/Translation resources (reports, white papers, media pieces, infographics, videos); and gave over 175 presentations at local, provincial, federal, and international meetings and conferences.

iPANEL at its’ core was a research and practice partnership. We ensured that the clinical nurse and the academic researcher voice were always at the table. As a foundational ethos of our team, this strengthened many of our grant submissions and helped to ensure that our research questions were located in the “here and now”.

We formed strong and lasting partnerships with health authorities (Interior Health, Fraser Health, Island Health), technology/innovation software teams (Cambian), other practice teams (inner city palliative approach to care - PEACH (Toronto), CAMPP (Calgary)), other research teams (Carer Support Needs Assessment Team in the UK), and expanded across disciplines to include researchers from mathematics, psychometric testing and evaluation, medicine, health geography, and sociology.

Through the infrastructure provided by the iPANEL initiative, we were successful in over 32 grant submissions in 7 years, totaling just under $8.25 Million in research funds, these funds have been awarded for many types of research and they have been (and continue to be allocated) by many sources such as:

  • CIHR (Team, Project, New Investigator, Doctoral Awards, Knowledge Synthesis, eHIPP, Meeting, Dissemination, SPOR)
  • Vancouver Foundation (Participatory Investigation)
  • MSFHR (Project, REACH)

Most importantly we have seen our work leave our hands and be led by the Health Authorities through their own initiatives.