Hospice Palliative Care Admission Criteria
Referring Your Patient to Hospice Palliative Care In-patient Services
A palliative approach to care helps patients manage pain and symptoms associated with chronic, life limiting illness and patients who are at the end of life.
Did you know that palliative care treats people with serious illness of any age and any stage and not just at end of life? Palliative care can:
- Improve quality of life.
- Reduce or relieve symptoms.
- Help you make important decisions.
- Provide support to you and your loved ones throughout your illness, from the time of diagnosis.
Who should be referred to hospice palliative care?
Required Admission Criteria:
- Must have a life-limiting illness
AND
- No longer require intensive treatments such as curative intent IV chemotherapy, curative radiation therapy, complex diagnostic investigations (i.e. MRI or CT) or surgical consultations
AND have at least one of the following
- Active symptoms requiring continued daily medication titration or daily physician assessments
- Require continued symptom control post procedural intervention
- Approaching end of life with care needs that cannot be met in the community such as nursing or personal care needs that exceed what is provided by the LHIN Home and Community Care.
- Have psychosocial, emotional and family needs that are best supported by an inpatient team
What is the difference between Bruyère Palliative Care Unit and Hospice Care Ottawa residences?
Hospice Care Ottawa patients must meet the admission criteria above AND also have:
- A Palliative Performance Scale equal to or less than 40% or ECOG of 3-4 (average length of stay at hospice is approximately 2-3 weeks)
- A documented Do No Resuscitate (DNR) order in place.
Bruyère’s Palliative Care Unit patients must meet the admission criteria above and
- Require short-term symptom management across the illness trajectory and/or for end of life care.
- A Palliative Performance Scale is not a requirement for Admission to the PCU. The length of stay will vary from days to weeks based on a patient’s needs and medical complexity (Average length of stay on the PCU is 18 days)
- Do not require a DNR order in place, but it is expected the majority of patients will have either DNR order or goals of care discussion clearly documented on the application outlining the patient’s agreement to a conservative medical approach focusing on symptom management, comfort and improving quality of life.
What are the exclusion criteria for Bruyère Palliative Care Unit and Hospice Care Ottawa?
- Patients requiring 1:1 care or monitoring
- Bariatric Patients weighing more than 350 lbs.
Bruyère’s Palliative Care Unit and Hospice Care Ottawa support Ontario’s Home First Philosophy where discharges to the community with family and community support is explored when the clinical team determines the patient’s care needs can be met in that setting or the patient requests to return to the community.
How do I refer?
Any registered healthcare provider can submit an Inpatient Hospice and Palliative Care referral to the Central Referral and Triage (CRT) team. CRT is a partnership between Bruyère Continuing Care, LHIN Home and Community Care and Hospice Care Ottawa, this central intake team triages all referrals submitted for inpatient hospice palliative care in Ottawa.
To refer, please complete form (linked), encrypt and email to BruyereClinicalAdmissions@bruyere.org or fax to 613-562-6095,
For any additional questions contact The Central Referral and Triage Team 613-562-6262 ext. 1688
Process for urgent after-hours admissions for community referrals
Includes Emergency Department and Outpatient Cancer Clinics for which no application has been submitted:
Bruyère’s Palliative Care Unit : Any day of the week after 16:00 and on weekends, the referring physician should contact Bruyère telecommunications at 613-562-6262 and request the on-call staff MD for Palliative Care be paged. The referring physician will discuss details of the case with the on-call Palliative Care MD to determine if an urgent admission is warranted.
Hospice Care Ottawa : Any day of the week after 16:00 and on weekends, the referring physician should contact the on-call Nurse by calling 613-260-2906 ext. 3. The referring Physician will discuss details of the case with the on-call Nurse to determine if an urgent admission is warranted.
Medical Assistance in Dying (MAID)
As a leader in the provision of palliative care, our focus is innovation in this field to provide those who are suffering and considering MAiD with an alternative. Bruyère’s position on MAiD is aligned with our responsibilities and values as a Catholic health care institution.
We support our patients in a non-judgmental way to ensure they are provided with the appropriate physical, psychological and spiritual supports they need. Our teams work with patients, residents and loved ones to discuss goals of care and solutions, and respect the wishes of those we serve. If a patient wishes to proceed with MAiD, we refer to an external provider for information, assessments, and provision.