Palliative Care - a message to our community

Oct. 23, 2015

Current local print media attention is focused on palliative care services, particularly at St. Joseph’s Health Care London (St. Joseph’s). On behalf of the many devoted staff, physicians, leaders and volunteers who started and now, more than 30 years later, continue to deliver excellent, responsive palliative care to people facing the most vulnerable time of their lives, I provide this statement:

In 2012 the joint senior leadership committee of London’s hospitals mandated an external review of our respective palliative care services in the spirit of collaboration and system planning our organizations enjoy together.  This review was aimed at identifying ways our services could better serve the London-Middlesex community.  There were a range of observations and recommendations made in the external review report, which was endorsed by the hospitals. The report was also discussed with St. Joseph’s quality care committee of the board. 

One of the numerous observations made in the report was the need for all private rooms for palliative care patients. One media outlet has chosen to focus on this point in relation to the current bed configuration at Parkwood Institute Main Building.  To this we must respond.

St. Joseph’s has recognized the need for private rooms, and we are doing something about it.  This spring, a renovated unit at Parkwood Institute will see the expansion of beds from 14 to 18, all in private rooms. The current palliative care unit has 6 private and 2 ward rooms. In 1999, this unit was renovated – thanks to donor and community support through the St. Joseph’s Health Care Foundation – to make it a more homelike environment, including replacing traditional hospital beds with sleigh beds, adding more family quiet and kitchen space and enhancing privacy through the creation of additional private care space and the use of armoires as privacy partitions.   

Provincial standards for health care facilities have changed since the Main Building at today’s Parkwood Institute opened in 1985.  This is where the palliative care beds are located. Newer construction standards call for private rooms due to privacy, infection control and other patient care needs, as exemplified in our new mental health care building at Parkwood Institute.  Having a mix of new and older facilities is not uncommon across provincial and national health care centres.  

It is important to note there are different needs and levels of palliative care: at home, in other settings such as long term care, in hospice, and within the hospital system.  How to best use these precious resources was the focus of attention in the extensive follow-up work resulting from the report. 

A joint palliative care steering committee (physician and hospital leaders) worked together on the future palliative care needs and roles for each hospital. Two real-time assessments were conducted over two, two-month periods, several months apart.  The assessments looked at admissions and the care needs of people coming to each hospital’s respective palliative care program. There was also collaboration with other care providers outside of our hospitals to understand their future plans for services, particularly as London’s hospice care was expanding at this time through the St. Joseph’s Health Care Society. The hospitals’ senior leaders continued to receive updates and progress reports.

From the assessments, the teams have greater clarity as to where to best meet the needs of people requiring different levels of palliative care.  This led to better determination as to what bed capacity is needed in our respective hospitals. 

By January 2015 the joint palliative care steering committee unanimously agreed that 4 beds needed to shift from LHSC to St. Joseph’s Parkwood Institute. Achieving consensus was not easy and we recognize it took time. It is a testament to the system focus and comprehensive follow-up assessments that this outcome was reached. This plan will be before the South West Local Health Integration Network (LHIN) board in November. 

We appreciate how our community supports care, environments and research that would otherwise not be possible. We are delighted the St. Joseph’s Health Care Foundation is stepping up to support the creation of a new care environment at Parkwood Institute.  Again, all 18 beds will be in private rooms with spaces for families, enhancing the well-established care and compassion provided by our team.  This will be a key project in our 26th annual Season of Celebration Campaign which raises funds for patient and resident care and comfort across St. Joseph’s.  The pink lights of caring and hope will once again dot our sites and signal the generosity of our community.

Wherever a person facing a life-threatening or terminal condition is – home, long term care, hospital or hospice – it is people who provide care, not facilities.  The care environment certainly is important, and we have recognized more investment is needed.  At St. Joseph’s and across the region, we are blessed to have teams devoted to bringing the best in palliative care to people where and when they need it.  There are gaps and we know that a more comprehensive, government-supported approach is needed.  We are proud to be a part of regional and provincial planning and to have collaborated with our partners in stepping up together with the external review and the actions taken as a result.

Palliative care at St. Joseph’s is exemplary.  92.8% of patient and family feedback rates the overall quality of care as very good/excellent.  94.7% of families rate Parkwood as the best place to have had the palliative care service, and 94.5 % said yes, their privacy as a family unit was respected. We do receive comments from families from time-to-time expressing the need for more private rooms. 

"When my husband was first admitted to palliative care he was in a private room, and then was moved to a ward room," says Marjorie Parker. "I must say this move was the best thing that could have happened to Ted.  He was like a changed man after the move; he was much more alert and talkative and it gave him the chance to have more social interaction. The care was absolutely superb and nothing was ever too much trouble.  They are angels on Palliative Care." 

On October 21, 2015, palliative care and all programs across St. Joseph’s received Exemplary Standing from Accreditation Canada.  Palliative care met all accreditation standards, all required organizational practices and priority processes.  The surveyors also noted our planning in support of private rooms.

“As a palliative care physician working across the City of London, at Parkwood, hospice and the London Regional Cancer Program, I want to re-enforce the compassionate and skilled work of the team at Parkwood Institute and all teams devoted to palliative care," says Dr. Anita Singh. "At Parkwood, I know I can count on the team to respond to each person’s physical, emotional and spiritual needs. They help people live each day fully and ultimately, to die in comfort with dignity.”

We strive to earn everyone’s complete confidence.  Our palliative care team responds to each patient’s unique needs, including privacy even within our current facility configuration.  Sometimes people need our care for longer periods of time and want more social interaction. We see how families support one another; how patients comfort each other.  What ever the need, our staff, physicians and volunteers act with the greatest skill, sensitivity and compassion.  This is health care at its finest.  This is what St. Joseph’s is all about.

Dr. Gillian Kernaghan
President and CEO
St. Joseph’s Health Care London

If you or someone you know would like more information, would like to provide feedback to us, or would like to be part of the design and fundraising for the new palliative care unit at St. Joseph’s Health Care London, please email askgillian@sjhc.london.on.ca or call our Communication and Public Affairs department at 519 646-6034.

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