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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 Care26% Res Care
14% Home15 % Hospice
(70% want to die at home)
Symptom burden
Cancer = others
10
10xWithout palliative care:
11
NobodyWithout 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”
Photo by Taylor.McBride™ - Creative Commons Attribution License https://www.flickr.com/photos/33537150@N06 Created with Haiku Deck
Photo by Simon Daniel Photography - Creative Commons Attribution License https://www.flickr.com/photos/63054407@N03 Created with Haiku Deck