Compassionate Honesty Quality Forum 2015 Dr 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

minutes

VCH Location of death: 44% Acute Care 26% Res Care 14% Home 15 % Hospice (70% want to die at home)

Symptom burden Cancer = others

10 10x Without palliative care:

11 Nobody Without palliative care:

minutes

1300 deaths per year weeks 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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