July 19, 2016


Please contact us for help in launching the PoET project in your long term care home.

PoET is rooted in strong evidence collected over 5 years; during these years it has also been gaining organizational and external support from Health Quality Ontario, public hospitals, and both public and private LTC Homes. From what we have learned through numerous tests of change, we know that to be successful this work must include both residents and their substitute decision makers, as well as staff and physicians.

Increase in CWLHIN LTC homes participating in PoET Project since 2014
Reduction in error-based end-of-life transfers since 2012
CWLHIN LTC homes using PoET Project tools

In 2011, a report showed that some transfers from LTC to hospital ED were error-based. Data from this report also showed that some LTC residents were transferred to hospital multiple times prior to death, and that some residents did not live very long after admission (almost 20% died within two weeks). We recognized the project’s potential to alleviate ED congestion and improve end-of-life care. In 2012, our tests of change to reduce error-based transfers through consultation and education failed; however, we recognized the immense opportunities in removing the Level of Care Form. We published our work in 2013, showing a 22% reduction in error-based transfers. In 2013, we also discovered a palliative care gap that reflects a misunderstanding of what end of life services are available in LTC homes. Since 2012, there has been a 56% decrease in the number of LTC residents who die in hospital and had been transferred there at least one other time in the two month period prior to death.

To access our research, please use the links below

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Oliver J., Chidwick P. Transfers of LTC Residents to Hospital EDs: An Ethics Quality Improvement Project to Minimize Non-beneficial and Unwanted Hospital Transfers and Maximize System Efficiency. Healthcare Quarterly. Vol.17 No.1 2014. 54-59.

Oliver J., Chidwick P. Removing level-of-care forms in long-term care homes and addressing the palliative care gap. Long Term Care Today. Vol.25 No.3 2014. 20-22.

Please contact us for help in launching the PoET project in your long term care home.