In December 2007, the MH PCN Steering Committee submitted a proposal to the Mississauga Halton LHIN under the Aging at Home Strategy Call for proposal. Titled Mississauga Halton Integrated Palliative Care Services, it proposes a number of strategies to improve access to quality palliative care services for all residents of the Mississauga Halton LHIN.  Proposals that were funded include- additional Pain and Symptom Management Consultants, a much -needed Medical Director for the network,and additional training for advance care planning.

The Patient and Family Subcommittee has completed on the development of a common referral form for all palliative care services in this region.  The committee was also involved in the development  of the Symptom Management Kit for this region and participated to the assessment of the implications of the implementation of the new Do not Resuscitate Confirmation Form which will be in place provide-wide effective Feb 1, 2008.

The Education Committee is working closely with the Palliative Care Consultation Program as it  implements new educational programs – The Fundamentals, Advanced Hospice Palliative Care Education (AHPCE) and Comprehensive Palliative Care Education (CAPCE). The committee is exploring the opportunities for evidence based knowledge to be made available to the care providers of this community using the mechanisims available from the Seniors Health Research Transfer Network.  It also contributed to the development of education strategies regarding the new DNRC Form.  

Our Research and Outcome Measures Committee is moving ahead to collect statistical information to provide a high level picture of the hospice palliative care currently provided in our region, including the acute care sector. It is also exploring the technology solutions that would enhance the reach of the current pallaitive care serivces and provide beteer communciations to support integrated seamless care.  

What is the OCSMC? 
The Ontario Cancer Symptom Management Collaborative (OCSMC) was launched in 2008 as the second phase of the Provincial Palliative Care Integration Project (PPCIP). It was in alignment with Cancer Care Ontario’s (CCO) 3-year strategic plan for years 2008-2011, under one of its’ six main goals; “#4: Improve the patient experience across the continuum of care.” (1)-reference below

How is it being implemented?
Each cancer centre was partially funded for a resource to continue to support the initial aims of implementing and standardizing the use of the common assessment tools Edmonton Symptom Assessment System (ESAS) and Palliative Performance Scale (PPS) for all cancer populations across Ontario. These would facilitate common language and promote processes of earlier identification, documentation, and communication of clients’/patients’ symptoms to optimize symptom management and collaborative care planning. In Mississauga Halton and Central West LHINs, a regional improvement coordinator position was maintained to facilitate these aims. 

Progress Report for Local Health Integration Networks (LHINs) 5 and 6
The most recent progress report for ESAS as the indicator of symptom screening/management will be released sometime this month in CCO’s website. It will show under the Cancer System Quality Index (CSQI) (average of 3 months Oct to Dec 2008 which is reported as Q3 2008/2009) that to the specified period of time, our region has achieved the initial aim of 90 % ESAS uptake (2)-reference below for the target populations of all cancer diagnosed populations who visited the Peel Regional Cancer Centre (PRCC).    Congratulations to all who participated towards this achievement!

Current Activities and Goals
1) The Peel Regional Cancer Program is actively pursuing the opportunity to disseminate this initiative and implement the common assessment tools across our communities.

2) The complimentary tools Symptom Management Guidelines (SMGs), Collaborative Care Plans (CCPs), and evidence-based care pathways are also being developed and/or enhanced by multidisciplinary groups and will be shared freely across the province.

3) CCO is developing the interface capacity for the electronic version of the ESAS tool which is ISAAC (Interactive Symptom Assessment and Collection) in order to integrate it with existing health information systems. This would eliminate manual documentation, duplicate entries, improve the accuracy and quality of data collected, as well as a cost-savings in staff and time resource. The initial implementation of ISAAC will take place in PRCC, prior to seeking the opportunity to offer this tool to other healthcare partners (satellite clinics, hospitals, CCACs) in our LHINs.

4) CCO is also developing tele-ISAAC, which is the automated telephone version of ESAS.   

References and Contact

(1) http://www.cancercare.on.ca/
(2) ESAS Indicator definition: % of cancer popultaion who completer ESAS at least once per month.