This project is advancing a Palliative Approach to Care (PAC) at the Stonechurch Family Health Centre (SFHC) by assessing current practices, identifying factors influencing implementation, and informing the design of a feasible, system-aligned intervention guided by the Healthcare Services Delivery Framework.
We have completed a mixed-methods evaluation, guided by Normalization Process Theory, that included chart reviews, staff surveys, and focus groups. Chart review findings revealed frequent goals-of-care discussions and strong nursing involvement; however, important elements such as structured symptom assessment and cultural or spiritual care were less consistently addressed.
Staff engagement has been strong, with 60 team members contributing insights through survey and focus groups. Most expressed strong support for PAC and its value in improving patient and caregiver experiences. However, they identified system-level challenges, including unclear workflows, limited shared understanding of roles, gaps in EMR support, and the need for enhanced training and resources.
In response, the team is co-designing a structured PAC pathway with standardized processes, clearer team roles, and practical tools to support implementation. This work aims to integrate PAC more consistently into routine care, with a focus on earlier, proactive, and team-based support for patients living with complex and life-limiting illness.
Project Lead: Erin Gallagher Contact: Neha Arora (narora@mcmaster.ca); Karla Freeman (karla.freeman@mcmaster.ca)
Research Project Update
Prison Health, Research Project Update