Paramedics and Palliative Care: Caring for people where they want it, when they need it most

This Paramedic Services Week (May 22-28, 2022) we want to recognize and thank paramedics for their vital work in our healthcare system through successive waves of the COVID-19 pandemic. As this year’s theme “The Faces of Paramedicine” highlights, paramedics do much more than transport patients to hospital during a health emergency. For example, we have been privileged to work with teams across the country to bring in-home palliative approaches to care to people where they want it, when they need it most.

Traditional paramedic responses assess, treat and transport patients to the emergency department. This provides a rapid response when needed and created a new opportunity to better meet the wishes of people who would prefer to have their pain and symptoms managed at home.

In 2018, Healthcare Excellence Canada and the Canadian Partnership Against Cancer teamed up to enable paramedics to support people to achieve their care goals – including providing comfort and symptom relief within the context of palliative care.

Working closely with innovators in Nova Scotia, Prince Edward Island and Alberta, we spread this approach to other areas of the country. During this four-year collaboration, more than 6,000 paramedics across six provinces received training to assess people with palliative care needs and treat them at home without transferring the person to hospital, if appropriate.

The results are something to celebrate. The program’s person-centred approach has improved access to palliative care supports regardless of the patient’s location and time of day with paramedics taking up to 80 per cent fewer palliative care patients to the hospital. Paramedics also reported significantly improved confidence delivering palliative and end-of-life care, and families expressed comfort in knowing that the program was available to them 24/7. There are system-level benefits too: the program helps reduce avoidable emergency department visits and hospitalizations, saves paramedics up to an hour per call and supports system capacity to provide care consistent with patient wishes.

Ten teams across nine provinces have successfully implemented this approach to care, but the work doesn’t end there. This approach can be applied in other jurisdictions and to other areas of care. That’s why we are sharing the Paramedics and Palliative Care: Bringing Vital Services to Canadians change package, bringing together the experiences and learnings of those who have implemented a palliative approach to care for paramedic services. This resource synthesizes the core principles and elements required to successfully develop and implement a palliative approach to care for paramedic services, and we hope it serves to both inspire and inform similar approaches.

During Paramedic Services Week and beyond, let’s recognize the valuable contributions of paramedics – including bringing in-home palliative approaches to care and comfort to families when they need it most.

By Jennifer Zelmer, PhD, President and CEO, Healthcare Excellence Canada and Dr. Craig Earle, CEO, Canadian Partnership Against Cancer