Scaling-Up the SPA-LTC Palliative Program in Long-Term Care Homes in New Brunswick

• In Canada, more than 25% of all annual deaths occur in long-term care (LTC) homes.  
• Despite these high rates, very few LTC homes in New Brunswick have a formal palliative program that includes training for staff and allows residents to receive a palliative approach within the facility. 
• The Strengthening a Palliative Approach in Long-term Care (SPA-LTC) program aims to improve quality of care and decrease the need for residents to receive care in hospitals, especially at the end-of-life stage. 
• 61 LTC homes in New Brunswick selected two staff members to serve as palliative "Champions". 
• As part of the program, these Champions participated in virtual training, including SPA-LTC e-learning modules, a 2-day virtual Learning Essential Approaches to Palliative Care (LEAP) Course, three SPA webinars/modules, and an optional one-on-one meeting with the Provincial Palliative Champions. 
• The aim of this project was to evaluate how the SPA-LTC program’s education and resources enhanced palliative program uptake in LTC homes across the province. 
• 49 of the LTC staff Champions who completed the program participated in the evaluation. 

• The results show that the SPA-LTC program has a positive impact on LTC staff champions’ confidence and comfort with palliative care skills. The program is highly acceptable and feasible, and the LTC sector is eager to implement it.
• The education about the two core components of the SPA-LTC program increased the uptake for these components, which are the foundation for building a palliative care program. 
• All 73 LTC homes in the province now have access to SPA e-learning modules through their internal learning management system. 
• The SPA-LTC program has the potential to increase satisfaction with care and reduce family and staff distress, decision-making strain, and transfers of residents to hospitals for palliative and/or end-of-life care. 

• Continue the role of the provincial palliative champions. One indigenous champion should be hired to be more inclusive of cultural views on palliative care and coordinate efforts to meet needs for cultural training and resources. 
• Expand education and mentorship to personal support workers 
• Establish a community of practice for front-line staff and administrators/directors to enable peer  
• Support between LTC homes for a palliative approach.  
• Develop a protocol for monitoring indicators of palliative care and evaluate impacts on family, residents, and the healthcare system. 
• Further engage and educate primary care providers in LCT homes (e.g. medical directors and nurse practitioners) to facilitate the implementation of a palliative approach and the SPA-LTC program. 
• Examine opportunities to support and evaluate special care homes in delivering palliative care using SPA-LTC. 

To learn more read the complete project findings (PDF 145 KB)