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Palliative Care

 

Hospice Palliative Care Admission Criteria

Discharge planning will be initiated for patients whose condition stabilizes and who have care needs that can be met in another care environment.

Goals of care need to be discussed with the patient or Substitute Decision Maker/POA Care prior to referral so triage to the appropriate level of care can occur.

Referring Your Patient to Hospice Palliative Care In-patient Services

Bruyère Palliative Care Unit and Hospice Care Ottawa

 

What is hospice palliative care?

Palliative care uses an interdisciplinary approach with the goal to improve quality of life for patients and their families who are facing symptoms associated with a life-limiting illness (cancer or non-cancer). Palliative care helps patients achieve the best possible quality of life and through the management of symptoms and integrates the psychosocial and spiritual aspects of patient care.


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
  • Need for blood warmer
  • Some High Flow Oxygen requirements using equipment such as MAXTECH
  • 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.

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)

The professional completing the application must identify when a referred patient has requested Medical Assistance in Dying with details on the status of the request. Patients who meet the admission criteria may be admitted to either Bruyère PCU or Hospice Care Ottawa and will be supported with high quality palliative care. However the patient must be aware that Medical Assistance in Dying is not provided on site and they will need to be transferred elsewhere for the procedure.