Compassionate Honesty

Quality Forum 2015Dr Peter Edmunds

Its not surprising people are afraid of dying.

Receiving healthcare can be very dangerous in the last year of

your life.

BC deaths

Actual Projected

BC Vital stats

3100017 minutes

VCH Location of death:

44% Acute Care

26% Res Care

14% Home15 % Hospice

(70% want to die at home)

Symptom burden

Cancer = others

10

10xWithout palliative care:

11

Nobody

Without palliative care:

640082 minutes

1300 deaths per year

2009• 450 • 7 weeks

2014• 780• 16 weeks

17

70%

59% fewer ER visits

6077 days

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Less pain is better than more pain

You are more likely to choose the most beneficial treatment if you have accurate and complete information

Fewer ED visits and days in hospital

are better than more

Dying in ED is to be avoided if at all possible

ED

Community

Acute Care

In a complex world…

• One size never fits all• What works here, may not work there• Local conditions matter... “This is how we do it

here”• Bottom up leadership works

M. Gardam UHN

“Culture eats strategy for breakfast”

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