Q. Presentation Report based on increasing number of people preferring end of life care at home in Waterloo region
SOLUTION: – Enhancing end of life care for geriatric patients in the waterloo region
-Increasing in community access to nurses and doctors at home level care
-Increasing Awareness among public for end of life care options
-CCAC – LHIN
-Increasing necessities for the patients requiring end of life care
There is more and more evidence that suggests aged patients prefer to stay at home for their end-oflife care. Traditional methods of hospice or palliative care centers are being rejected by elders. There needs to be an integrated facility that provides many of the benefits that are available in a hospice or a palliative care center at home. This organization can manage to provide this care to patients who would like to spend the end of life with their family at their own homes. Enhancing the end-of-life care options for geriatric Patients’ is an organization that we are intending to initiate to facilitate this care delivery in the region of Waterloo. Care for the elderly will be upgraded and tailored to everyone’s specific needs, preferences, and cultures. As a result, the end of life will be calmer and more courteous. Care options for the elderly will grow, and patients and their families will have a more active part in medical decision-making. This increased engagement and choice will lead to higher levels of satisfaction with the treatment provided.
When given the choice between standard long-term care facilities and retirement homes, many elderly people in Waterloo region, Ontario, would much rather spend their final days at home. As per studies, the palliative care patients, in the last year of life were more likely to die in the facility where they received care than those who did not receive palliative care (Canadian Hospice Palliative Care Association, 2020, p. 8). The main challenge with this decision is it can be difficult to provide patients with the essential medical and supporting care while also satisfying the patients’ requirements and making sure they are comfortable at the end-of-care (Woo et al., 2006, para 12)
The proposed solution is to develop and implement a comprehensive program that enhances end-of-life care options for geriatric patients in the Waterloo region. The focus of this program is to ensure that the elderly have access to high-quality care in the most appropriate and comfortable environment for them, whether that be their own homes or community-based facilities (The Way Forward National Framework, 2015, p. 4). The program will provide for the medical, psychological, and spiritual needs of patients and their families during the entirety of their illness, not just at the end of life. By emphasizing the individual’s right to make decisions about his or her own health care and encouraging participation, person-centered care aims to make patients and their loved ones feel more in charge of their treatment with the help and collaboration of healthcare professionals, community groups, and other interested parties (
The group will continue to develop the project from Report 1 by developing elements of an implementation plan. Each group member will be responsible to write one section of Report 2. The sections of the report are:
Each group member will submit the full report including all sections noted above merged into a professionally formatted report which clearly identifies which group member wrote each element. The report must include appropriateAPA formatted citations and references.
All group members will work together to ensure that all the deliverables are related to the same idea or proposed solution. The coordination of information will be completed in meetings which will involve your Professor as well as additional group meetings and communications amongst group members outside of these formal meetings.
ENHANCING THE
END-OF-LIFE CARE OPTIONS
FOR GERIATRIC PATIENTS
IN WATERLOO REGION
HEALTH CARE ADMINSTRATION AND SERVICE MANAGEMENT, CONESTOGA COLLEGE
MGMT8590-ADMINSTRATION AND SERVICE MANAGEMENT CAPSTONE
GROUP 8
Deepika Mohil
Sam Thundil Varghese
Iknoor Dhami
Sivacharan Lakshminarayanan
Needs Assessment
Project Charter
Vision Framework
Gantt Chart & Budget
INDEX
1-EXECUTIVE SUMMARY ……………………………………………………………………………………………………. 4
2-NEEDS ASSESSMENT ……………………………………………………………………………………………………… 5
INTRODUCTION ………………………………………………………………………………………………………………. 5
CURRENT SITUATION ……………………………………………………………………………………………………… 5
IDENTIFYING STAKEHOLDERS ………………………………………………………………………………………… 6
GERIATRIC PATIENTS …………………………………………………………………………………….. 7
FAMILY ………………………………………………………………………………………………………….. 7
HEALTHCARE PROVIDERS & LONG-TERM CARE FACILITATORS …………………….. 7
GOVERNMENT AGENCIES ………………………………………………………………………………. 8
COMMUNITY ORGANIZATIONS ………………………………………………………………………… 8
RESEARCHERS AND ACADEMICS …………………………………………………………………… 8
DATA COLLECTION METHOD ……………………………………………………………………………………………. 8
SURVEYS …………………………………………………………………………………………………… 9-10
INTERVIEWS…………………………………………………………………………………………………………………….. 11
DOCUMENT ANALYSIS…………………………………………………………………………………………………… 11
DATA ANALYSIS …………………………………………………………………………………………………………….. 11
FINDINGS AND RECOMENDATIONS ……………………………………………………………………………….. 11
CONCLUSION ……………………………………………………………………………………………………………….. 11.
REFERENCES …………………………………………………………………………………………………………… 12-14
3.PROJECT CHARTERRISKS/BARRIERS ……………………………………………………………………………. 14
INTRODUCTION …………………………………………………………………………………………………………….. 14
PROBLEM ……………………………………………………………………………………………………………………… 15
PROPOSED SOLUTION ………………………………………………………………………………………………….. 16
EXPECTED OUTCOMES …………………………………………………………………………………………………. 16
MEASURES ……………………………………………………………………………………………………………………. 16
RISKS AND BARRIERS …………………………………………………………………………………………………… 17
SCOPE …………………………………………………………………………………………………………………………….. 18
HIGH LEVEL SCHEDULE ………………………………………………………………………………………………… 18
STAKEHOLDER ANALYSIS ……………………………………………………………………………………………… 18
CONCLUSION ………………………………………………………………………………………………………………… 18
REFERENCES ……………………………………………………………………………………………………………….. 19
4. VISION FRAMEWORK ………………………………………………………………………………………………….. 20
VISION ………………………………………………………………………………………………………………………….. 21
MISSION………………………………………………………………………………………………………………………… 22
CRITICAL SUCCESS FACTOR……………………………………………………………………………………………. 23
KEY PERFORMANCE INDICATORS …………………………………………………………………………………. 23
CORE PROCESS ……………………………………………………………………………………………………………. 23
5. BUDGET ……………………………………………………………………………………………………………………….. 23
BUDGET …………………………………………………………………………………………………………………… 24-25
GANTT CHART ………………………………………………………………………………………………………………. 26
REFERENCES ……………………………………………………………………………………………………………….. 27
Executive Summary
There is more and more evidence that suggests aged patients prefer to stay at home for their end-oflife care. Traditional methods of hospice or palliative care centers are being rejected by elders.
There needs to be an integrated facility that provides many of the benefits that are available in a
hospice or a palliative care center at home. This organization can manage to provide this care to
patients who would like to spend the end of life with their family at their own homes. Enhancing the
end-of-life care options for geriatric Patients’ is an organization that we are intending to initiate to
facilitate this care delivery in the region of Waterloo.
Care for the elderly will be upgraded and tailored to everyone’s specific needs, preferences, and
cultures. As a result, the end of life will be calmer and more courteous. Care options for the elderly
will grow, and patients and their families will have a more active part in medical decision-making. This
increased engagement and choice will lead to higher levels of satisfaction with the treatment
provided.
This report consists of a needs analysis that talks about an in-depth understanding of the rising
number of senior individuals refusing long-term care in the Waterloo Region. We acquired useful
insights into the viewpoints, desires, and issues related to this topic by identifying key stakeholders
and using a mixed-methods approach.
Based on the evaluation and the patient’s objectives and preferences, a care plan is developed that
contains the specific interventions, therapies, and services required to address the patient’s physical,
emotional, and psychological needs. The plan includes information on symptom management,
medication management, daily living activities, and psychological support.
Palliative home care connects palliative patients to a greater range of therapies than acute care does.
These services can range from pain and symptom treatment to family caregiver support, and they
enable patients and carers to be more involved in decisions concerning their care. Access to home
care also affects how patients interact with hospitals: in 2021-2022, patients supported by palliative
home care spent fewer days in the hospital on average in the last year of their lives than those who
received palliative care only in the hospital (CIHI, 2023)
The total cost that has been estimated for the project is $549,000 and is planned to start from July
2023 with a pilot project for 6 months. There is an assessment phase lasting for 2 months the second
phase which is the implementation phase lasting 3 months and the evaluation phase for the last
month.
CIHI., (2023). Access to palliative care in Canada. Retrieved from.
https://www.cihi.ca/sites/default/files/document/access-to-palliative-care-in-canada-2023-reporten.pdf
Increasing Number of Geriatric Patients
Refusing Long-Term Care in Waterloo Region:
A Health Care Administration Issue
Deepika Mohil (8820113)
Group- 8
Increasing Number of Geriatric Patients Refusing Long-Term Care in
Waterloo Region: A Health Care Administration Issue
NEEDS ASSESSMENT
Introduction
The healthcare administration problem of geriatric patients in the Waterloo Region declining long-term
care is becoming more prevalent. This needs assessment is focused on recognizing the root causes
and main obstacles related to the refusal of long-term care among elderly patients. By gaining insight
into these needs, healthcare administrators can create specific approaches to tackle the problem
efficiently and enhance the standard of care provided to this group.
Current Situation
The Waterloo Region is experiencing a rise in the number of geriatric patients who are opting out of
long-term care facilities. This trend has created concerns among healthcare professionals and
administrators as it poses challenges in providing appropriate care and support to elderly individuals.
To develop effective solutions, a comprehensive needs assessment is essential.
IDENTIFYING STAKEHOLDERS
A thorough stakeholder analysis is crucial to understanding the
Geriatric patients
F
perspectives and needs of various individuals and organizations involved
in the care of geriatric patients. The key stakeholders in this needs
assessment include:
1. Geriatric patients: Their preferences, concerns, and reasons for
refusing long-term care need to be explored to gain insights into their
Healthcare providers
& Long term care
facilitators
decision-making process.
2. Family members: The perspectives of family members who play a
significant role in the decision-making process of geriatric patients need
to be understood to develop strategies that address their concerns.
Community
organizations
R
nts
ders
are
s
3. Healthcare providers & Long-term care facilitators: Healthcare providers, including physicians,
nurses, and other professionals involved in geriatric care, along with administrators and staff in longterm care facilities, play significant roles in understanding the challenges faced in providing long-term
care to geriatric patients. They can offer valuable insights into the
obstacles they encounter, current practices within their respective roles,
and potential areas for improvement.
Family members
Engaging both healthcare providers and long-term care facility
stakeholders can provide a comprehensive understanding of the
perspectives and needs of those directly involved in geriatric patient
care.
Government
agencies
4. Government agencies: Representatives from government agencies
involved in healthcare policymaking and regulation can provide insights
into the existing policies and potential opportunities for intervention.
5. Community organizations: Non-profit organizations and community
Researchers and
academics
groups involved in geriatric care can offer perspectives on community
resources, support services, and gaps in the current system.
6. Researchers and academics: Experts in geriatric care and healthcare administration can contribute
knowledge [Name]
and expertise to inform the needs assessment process and potential solutions (Ontario
Ministry of Health, 2022), (Canadian Institute for Health Information, 2019.)
DATA COLLECTION METHODS
To gather comprehensive data for the needs assessment, a mixed-methods approach will be
employed, combining qualitative and quantitative research methods. The following data collection
methods will be utilized:
1. Surveys: Structured surveys will be distributed to geriatric patients, family members, and healthcare
providers to gather quantitative data on their perspectives, preferences, and challenges related to longterm care refusal, allowing for a comprehensive analysis of the factors influencing their decision-making
process.
2. Interviews: In-depth interviews will be conducted with a sample of geriatric patients, family
members, healthcare providers, and long-term care facility administrators. This will help us to gain a
deeper understanding of their experiences, concerns, and reasons for refusing long-term care.
3. Document Analysis: Relevant government articles, research papers, and review articles will be
analyzed to gain insights into existing policies, regulations, and best practices related to long-term care
for geriatric patients (Canadian Institute for Health Information, 2019.)
DATA ANALYSIS
The collected data will be analyzed using qualitative and quantitative analysis techniques. Qualitative
data from interviews will be analyzed using thematic analysis to identify common themes and patterns
in participants’ responses. Quantitative data from surveys will be analyzed using descriptive statistics
and inferential analysis to identify trends and correlations among variables (Saunders et al., 2021.)
FINDINGS AND RECOMMENDATIONS
Based on the analysis of the data, the needs assessment will provide a comprehensive understanding
of the reasons behind the increasing refusal of long-term care among geriatric patients in the Waterloo
Region.
The findings will inform the development of strategies and interventions to address the challenges
identified. These recommendations will aim to improve the quality of care, enhance communication with
geriatric patients and their families, and ensure that alternative care options are readily available and
suitable for their needs (Canadian Institute for Health Information, 2019.)
CONCLUSION
This needs assessment has provided a comprehensive understanding of the increasing number of
geriatric patients refusing long-term care in the Waterloo Region. By identifying the key stakeholders
and utilizing a mixed-methods approach, we have gained valuable insights into the perspectives,
preferences, and challenges associated with this issue.
The findings of this needs assessment highlight several crucial factors contributing to the refusal of
long-term care, including personal preferences, concerns about loss of independence, inadequate
communication and information sharing, limited availability of suitable alternative care options, and
gaps in the current healthcare system. These factors must be addressed to ensure the well-being and
satisfaction of geriatric patients while maintaining the highest standards of care.
Change is possible and can be made by implementing various recommendations. Healthcare
administrators in the Waterloo Region can proactively address the increasing number of geriatric
patients refusing long-term care. This will lead to improved patient satisfaction, better utilization of
healthcare resources, and ultimately, enhanced quality of care for the aging population. It is essential
for all stakeholders to collaborate and work together to ensure that the healthcare system meets the
evolving needs of geriatric patients and provides comprehensive and patient-centered care options.
REFERENCES
1. Saunders, N. R., Toulany, A., Deb, B., Strauss, R., Vigod, S. N., Guttmann, A., Chiu, M., Huang,
A., Fung, K., Chen, S., & Kurdyak, P. (2021). Acute mental health service use following onset of
the COVID-19 pandemic in Ontario, Canada: a trend analysis. CMAJ open, 9(4), E988–E997.
https://doi.org/10.9778/cmajo.20210100
2.
Ontario
Ministry
of
Health.
(2022).
Long-Term
Care.
Retrieved
from
https://www.health.gov.on.ca/en/public/programs/ltc/default.aspx
3. Canadian Institute for Health Information. (2019). Seniors in transition: Exploring pathways
across the care continuum. Retrieved from https://www.cihi.ca/en/seniors-in-transitionexploring-pathways-across-the-care-continuum
PROJECT CHARTER
8814187
SAM THUNDIL VARGHESE
GROUP 8
CAPSTONE PROJECT
INTRODUCTION
The number of Canadians with terminal diseases like cancer or kidney failure is rising in tandem
with the general population’s increased longevity. As a result, there is a growing need for palliative care,
which aims to lessen patients’ pain and improve their quality of life as they near the end of their lives.
Palliative care is more common among Canadians between the ages of 45 and 74 than among either
younger adults or older seniors (CIHI,2023, p. 6). Hospice palliative care is seen as part of a continuum
of care that can improve patients’ quality of life at any stage of their disease or the aging process, rather
than as a separate service provided to terminally ill patients once curative treatment has been
exhausted (Canadian Hospice Palliative Care Association, 2020, p. 3).
PROBLEM
When given the choice between standard long-term care facilities and retirement homes, many
elderly people in Waterloo region, Ontario, would much rather spend their final days at home. As per
studies, the palliative care patients, in the last year of life were more likely to die in the facility where
they received care than those who did not receive palliative care (Canadian Hospice Palliative Care
Association, 2020, p. 8). The main challenge with this decision is it can be difficult to provide patients
with the essential medical and supporting care while also satisfying the patients’ requirements and
making sure they are comfortable at the end-of-care (Woo et al., 2006, para 12)
PROPOSED SOLUTION
The proposed solution is to develop and implement a comprehensive program that enhances
end-of-life care options for geriatric patients in the Waterloo region. The focus of this program is to
ensure that the elderly have access to high-quality care in the most appropriate and comfortable
environment for them, whether that be their own homes or community-based facilities (The Way
Forward National Framework, 2015, p. 4). The program will provide for the medical, psychological, and
spiritual needs of patients and their families during the entirety of their illness, not just at the end of life.
By emphasizing the individual’s right to make decisions about his or her own health care and
encouraging participation, person-centered care aims to make patients and their loved ones feel more
in charge of their treatment with the help and collaboration of healthcare professionals, community
groups, and other interested parties (The Way Forward National Framework, 2015, p. 14).
EXPECTED OUTCOMES
Improved end-of-life care quality
Care for the elderly will be improved and centered around each person’s unique
requirements, choices, and cultures. The end of life will be more peaceful and
respectful because of this.
Increased patient contentment
Care alternatives for the elderly patients will expand, and the patients and their
families will have a more integral role in medical decision-making. This
increased involvement and choice will result in greater satisfaction with the care
received.
Enhanced community assistance to patients
Collaboration between healthcare providers, community organizations, and other
interested parties to better serve the community’s needs. As a result of working
together, there will be greater care coordination, more available resources, and
more people understanding their alternatives for how to spend their final days.
MEASURES
For the success of the program, the patients’ health and social quality of life will be evaluated.
Health systems and organizations are collecting data on these measures (e.g., using tools like the
InterRAI Community Health (CHA) Assessment Form, the Palliative Performance Scale, and the
Palliative Outcomes Scale) can be used to evaluate the efficacy of end-of-life care (Ontario palliative
care network, 2019, p.15). Also, indicators of health outcomes will be compared to those collected
before it was implemented. Some of the indicators can be utilized to develop norms for a coordinated
system of palliative care.
Patient and Family
Feedback Surveys
Overall Wellness
Indicators
a) Pain
Management
b) Symptom
Control
c) Emotional
Well-being
Utilization of
Resources
✓ Geriatric patients and relatives will be surveyed regularly.
✓ These questionnaires will evaluate their end-of-life care, decisionmaking, and program experience.
✓ The surveys’ data will be harmonized and validated.
✓ Feedback will reveal program strengths and weaknesses
The program’s performance in enhancing end-of-life care will be
measured by key health outcome indicators.
✓ Standardized pain scales will be used to evaluate the degree of
discomfort felt by elderly people.
✓ The objective is to make sure the pain is being properly managed and
stop any unnecessary suffering (Hospice Palliative Care, 2023, para.
3).
✓ Healthcare providers and self-reporting will measure symptom
management.
✓ To mitigate and control symptoms including nausea, exhaustion,
shortness of breath, and anxiety that with terminally ill elderly
individuals.
✓ Geriatric individuals’ mental health will be assessed with tools like
depression and anxiety scores.
✓ Hence to promote psychological ease for participants in their final
days by offering emotional support and counselling services (Hospice
Palliative Care, 2023, para. 4).
✓ End-of-life care preferences of regional geriatrics will be polled.
✓ Record how many patients want in-home, community-based, or
institutional care.
✓ The obtained data will show how these options affect patients’
decisions and preferences.
RISKS AND BARRIERS
Financial
Challenges
Opposotion to
Changes
Public Stigma
and Opinions
Limitation of
Workforce
Limited
Community
Resources and
Capacity
SCOPE
In-Scope
•
•
•
The program’s primary goal is to
improve the quality of death care for
the target demographic of geriatric
patients aged 65 and above residing
in the Waterloo region.
The goal of the initiative is to expand
access to high-quality end-of-life care
in a variety of locations, such as
patients’ homes, community centres,
and assisted living facilities.
Stakeholders in the project will
include those with a stake in the
provision or support of end-of-life
care services, including healthcare
professionals, community
organizations, caregivers, and family
members.
HIGH-LEVEL SCHEDULE
Out of Scope
•
•
•
•
Patients below the age of 65-yearsold.
Acute care hospitals are important in
end-of-life care, but the approach
emphasizes on non-institutionalized
care. The project is not focused on
acute care hospital interventions.
The project focuses on Waterloo
region, and it may not address endof-life care issues in other regions or
geographical areas outside the
defined scope.
The project advocates for policy
reforms to improve end-of-life care
alternatives but does not directly
execute them and the project will
follow all the aspects of existing law.
Initiation
Phase
STAKEHOLDER ANALYSIS
Stakeholders
Impact on the project
Influence on the project
Engagement Levels
Geriatrics & High Leveltheir families Direct impact on
patients by improving
end-of-life care, quality
of life, and satisfaction.
High LevelGeriatric patients and
their families’ feedback
and experiences shape
the program’s
development and
evaluation.
High LevelMajorly role in the
success of the project. It
is crucial to have their
support, acceptance of
new methods, and
engagement in the
program’s execution.
Surveys, Decisionmaking, Participation
at every stage,
Critical to program
design and evaluation
Medium Level-.
coordinating services and
ensuring smooth care
transitions with
community organizations.
Medium to High levelThey make a difference
by being involved,
dedicated, and helpful in
the provision of highquality medical services
Cooperative ideas for
communities, Direct
meetings, Sharing
best practices,
Healthcare High Levelproviders End-of-life care and
quality depend on
healthcare
practitioners. The
project depends on
their cooperation and
adoption of innovative
care approaches.
Community Low to Medium Levelorganizations They support local
and support resources and
services awareness of end-oflife options.
Caregivers Medium to High leveland volunteers They lessen caregiver
burden and improve
patient and family
Investors and High Level- The
governing success of the project
bodies is heavily reliant on the
financial backing and
policy changes made
by funders and
government
High Level- The project’s
viability and sustainability
are profoundly impacted
by the choices made
regarding funding, policy
shifts, and regulatory
frameworks.
Training
opportunities, training
consultations, forums
for exchanging best
practices, and
participation in the
design and execution
of programs.
Access to educational
resources, moraleboosting initiatives,
public
acknowledgement of
their efforts, and
networking forums
Advocacy for new
policies and constant
communication to
gain funding.
Consistent reports on
the project’s
development and its
effects on the
community.
CONCLUSION
In conclusion, the project aims to improve end-of-life care alternatives, so patients receive highquality care in their preferred locations. Better care, patient satisfaction, and community support are
predicted. Stakeholder engagement—patients, families, healthcare providers, community groups,
funders, policymakers, carers, and volunteers—is essential to the project’s success. The program aims
to develop a compassionate, comprehensive care system that respects patients’ preferences and
enhances end-of-life experiences. After reviewing the pilot project’s results, the project should be
expanded with more services and patient criteria. That dream requires the project’s success.
Multidimensional thinking and ensuring project completion.
REFERENCES
Canadian Hospice Palliative Care Association. (2020, March). Fact sheet 2020 – hospice palliative
care in Canada. https://www.chpca.ca/wp-content/uploads/2020/03/CHPCA-FactSheet-D.pdf
Woo, J. A., Maytal, G., & Stern, T. A. (2006). Clinical Challenges to the Delivery of End-of-Life
Care. Primary care companion to the Journal of clinical psychiatry, 8(6), 367–372.
https://doi.org/10.4088/pcc.v08n0608
The Way Forward National Framework – HPCINTEGRATION.CA. (2015, April). A roadmap for an
integrated palliative approach to care http://www.hpcintegration.ca/media/60044/TWFframework-doc-Eng-2015-final-April1.pdf
Canadian Institute for Health Information (CIHI). Access to Palliative Care in Canada. Ottawa,
Ontario: 2023 https://www.cihi.ca/sites/default/files/document/access-to-palliative-care-in-canada2023-report-en.pdf
Hospice Palliative Care. Canadian Hospice Palliative Care Association. (2023, May 9).
https://www.chpca.ca/about-hpc/
Ontario palliative care network. (2019, April). Tools to support earlier identification for palliative care.
https://www.ontariopalliativecarenetwork.ca/sites/opcn/files/202101/OPCNToolsToSupportEarlierIdentificationForPC.pdf
Report1: Vision Framework
Iknoor Singh Dhami
Healthcare Administration and Service Management, Conestoga College
MGMT8590: Administration and Service Management
Jane Van Alphen
Assignment Due Date: June 23rd, 2023
Vision
Our goal is to provide comprehensive, person-centered, and compassionate care to elderly patients in the
comfort of their own homes who reject long-term care facilities for end-of-life care. To enable these people to
obtain high-quality care while respecting their preferences, we see a range of services that cater to their
physical, emotional, and social requirements.
Mission
Our goal is to provide geriatric patients with compassionate, individualised, and comprehensive support in their
own homes when they reject long-term care facilities for end-of-life care. Their physical, emotional, and social
wellbeing are given priority, and we work to protect their dignity and respect their decisions.
Critical Success Factors
Respect for Patient Autonomy: The ability to successfully provide home care services for elderly patients who
reject long-term care facilities depends on the ability to respect and honour the patient’s autonomy. This entails
actively including them in decision-making procedures and adjusting the care plan to suit their requirements and
principles.
Detailed Care Planning: It is essential to have a complete care plan that considers the patient’s physical,
emotional, psychological, and social needs. Creating individualised care plans that are frequently reviewed and
changed to reflect shifting requirements and preferences is essential to success.
Competence and Training of the Carer: It is essential to guarantee that carers and healthcare professionals
have the requisite abilities, information, and training in geriatric and end-of-life care. Carers who are capable
and compassionate can deliver top-notch care, handle complex medical requirements, and offer emotional
support.
sufficient resources and assistance: The success of home care services depends on having enough people and
material resources. This entails providing patients and their families with enough competent carers, medical
tools, medications, and supplies, as well as access to community services and support systems (Comission,
2023).
Key Performance Indicators
Percentage of patients actively participated in care planning: This KPI assesses how much elderly patients
actively participate in decisions about their end-of-life care, demonstrating how much their autonomy is
respected.
The frequency of care plan reviews and revisions: to account for any alterations in the patient’s condition,
preferences, or goals is measured by this KPI. It guarantees that care plans continue to be applicable and
efficient over time.
Feedback from patients and their families: on the competence of carers is captured by this KPI, which
measures the effectiveness and calibre of care delivered by carers. It sheds light on the competence of the carers
to address the requirements of elderly patients who are nearing the end of their lives.
Availability of community support networks: This KPI assesses the presence of community support networks
that can offer elderly patients and their family’s extra resources and assistance, such as local organisations,
volunteers, and support groups (Comission, 2023).
Core Process
Making an informed decision: requires that the patient have complete knowledge about the range of treatment
options, including their advantages, disadvantages, and alternatives. This gives the patient the ability to decide
on their own behalf based on their beliefs, interests, and end-of-life care goals.
Care Plan Development: A care plan is created that includes the precise interventions, therapies, and services
needed to meet the patient’s physical, emotional, and psychosocial requirements based on the assessment as well
as the patient’s goals and preferences. Details on symptom management, medication management, daily living
activities, and psychosocial support are included in the plan.
Continuous Education and Professional development: Carers are urged to participate in continual education
and professional development activities to increase their competence. Attending conferences, webinars,
workshops, seminars, or earning extra certificates or credentials in end-of-life care may be necessary to achieve
this.
Resource Allocation: Based on the results of the evaluation, the proper resources and support are assigned to
suit the patient’s unique needs. This could include access to community services or programmes, personal care
items, assistive technology, home modifications, medical equipment, and tools for managing medications.
REFERENCES
Comission, C. Q. (2023). Palliative / End of Life Care for Elderly. Retrieved from Care Quality
Comission: https://ready-care.co.uk/palliative-end-of-life-care/
Report1: Budget and Gantt Chart
Sivacharan Lakshminarayanan
Healthcare Administration and Service Management, Conestoga College
MGMT8590: Administration and Service Management
Jane Van Alphen
Assignment Due Date: June 23rd, 2023
Budget
A budget is a monetary blueprint that details an entity’s planned revenue and spending for a particular
duration, typically one financial year. It is an agenda for how the organization will deploy its financial
assets to fulfill its goals and objectives.
The federal government contributes to provincial healthcare expenditure through time-limited
agreements, the most significant of which is the Home and Community Care and Mental Health and
Addictions Services Funding Agreement. Through 2026-27, the province will receive a total of $4.2
billion under this 10-year deal, including $465 million in 2022-23. (FAO.,2023)
The Governments of Canada and Ontario have announced an agreement in principle for a shared
plan that will invest $73.97 billion in federal funding in Ontario over ten years, including $8.413 billion
for a new bilateral agreement focusing on the four shared healthcare priorities and $776 million
through an immediate, one-time CHT top-up to address urgent needs.
One of the shared health goals where collaborative effort is currently happening is assisting
Canadians to age with dignity, closer to home, and with access to home care or care in a safe longterm care facility.
BUDGET PRESENTATION ( 6 months Project
Plan)
1REVENUE
Grants
Pilot 1
Annualized
$550,000
$550,000
$550,000
$550,000
1 Full time
$28,800
$28800
1 Full time
18,000
$18,000
1 Part-time
$12,600
$12,600
1 full time
$25,200
$25,200
5 Full time
$108,000
$108,000
1 Full time
$28800
$14,400
Home and
Community Care
and Mental Health
and Addictions
Services
Total
Revenue
from
Grants
2EXPENSES
Human
Resources
Project Manager
1FTE *$40/hr.*
30hrs/ week
Administrative
Assistant
1FTE*$25/hr.*
30hrs/week
Paramedic
Technician
1/2FTE*$35/hr.*
15hrs/week*
Nurse for training
1FTE*$35/hr.*
30hrs/week
Nurse 5 FTE*$
30/hr.*30hrs/Week
Physiotherapist for
training
1FTE$40/hr.*
30hrs/week
Physiotherapy
Assistant 5FTE*
16/hr.*30hrs/week
Personal Support
worker10
FTE*16/hr.
30hrs/week
HR Subtotal
Benefits
5 Full time
$72,000
$72,000
10 Full time
$129,600
$129,600
$423,000
$423,000
$105,750
$105,750
$528,750
$528,750
25% of HR
Subtotal
HR Total
–
3-Start-Up
Costs
Computer
3no’s* $600
$1800
–
Printer
1no* $299
$299
–
Chairs
10no’s *$99
$990
–
Corner Table
2no’s *$285
$570
–
Office table
Total Startup
Costs
5no’s *$170
$850
$4850
–
Travel for House
Visit
$3000
$3000
Office area rent
Miscellaneous
$12000
$1000
$12000
$1000
Total Operating
Costs
$16000
$16000
TOTAL
$549,600
$544,750
4Operating
Costs
Gantt Chart
A Gantt chart, which is widely used in project management, is one of the most popular and
practical methods of displaying activities (tasks or events) against time. The chart has a list of
activities on the left and a time scale along the top. Each action is represented as a bar, with
the location and length of the bar reflecting the activity’s start, duration, and finish dates.
Gantt Chart
Task
Duration Start date
End date
Phase 1 (Pre-assessment)
Collaboration with Ontario MOHLTC
20
2023-07-01
2023-07-20
Consultation With community
11
2023-07-21
2023-07-31
Budget and approval
30
2023-08-01
2023-08-30
Phase 2 (Planning and implementation)
Setting Up office
10
2023-08-31
2023-09-09
Staff Recruitment
15
2023-09-10
2023-09-24
Staff Training
11
2023-09-25
2023-10-05
Surveying the community for Patients
10
2023-10-06
2023-10-15
Approaching patients for home care
15
2023-10-16
2023-10-30
Assesments of Patient needs
10
2023-10-31
2023-11-09
Trial Run for Patient Care
16
2023-11-10
2023-11-25
Changes to the care ( If required)
10
2023-11-26
2023-12-05
Phase 3(Evaluation)
Care assesment
10
2023-12-06
2023-12-15
Reporting to MOHLTC
16
2023-12-16
2023-12-31
2023-07-01
2023-07-21
2023-08-10
2023-08-30
2023-09-19
2023-10-09
2023-10-29
2023-11-18
2023-12-08
2023-12-28
Phase 1 (Pre-assessment)
Collaboration with Ontario MOHLTC
Consultation With community
Budget and approval
Phase 2 (Planning and implementation)
Setting Up office
Staff Recruitment
Staff Training
Surveying the community for Patients
Approaching patients for home care
Assesments of Patient needs
Trial Run for Patient Care
Changes to the care ( If required)
Phase 3(Evaluation)
Care assesment
Reporting to MOHLTC
References
Best buy. (N.d). Retrieved from.https://www.bestbuy.ca/en-ca/product/hp-laserjet-mfp-m234sdwemonochrome-wireless-all-in-one-laser-printer/15397883
Government of Canada. (2023). The Government of Canada and Ontario Reach Agreement in
Principle to Improve Health Services for Canadians. https://www.canada.ca/en/healthcanada/news/2023/02/the-government-of-canada-and-ontario-reach-agreement-in-principle-toimprove-health-services-for-canadians.html
Government of Canada. (2023). Registered nurse (RN) in Ontario.
https://www.jobbank.gc.ca/marketreport/wages-occupation/993/ON
Government of Canada. (2023). Physiotherapist in Ontario.
https://www.jobbank.gc.ca/wagereport/occupation/18214
Government of Canada. (2023). Physiotherapy Assistant in Ontario.
https://www.jobbank.gc.ca/wagereport/occupation/4466
Government of Canada. (2023). Personal Support Worker In Ontarrio.
https://www.jobbank.gc.ca/wagereport/occupation/24584
Home Depot. (N.d). Retrieved from.https://www.homedepot.com/p/Jamesdar-78-in-L-Shaped-GrayBlack-Computer-Gaming-Desk-with-Shelf-JCDES111/312112028
Ikea. ( N.d) Retrieved from.https://www.ikea.com/ca/en/p/renberget-swivel-chair-bomstad-black20503284/
Office Depot. (N.d). Retrieved from. https://www.officedepot.com/a/products/4597693/LenovoIdeaCentre-AIO-5i-Desktop-PC/
ENHANCING THE
END-OF-LIFE CARE OPTIONS
FOR GERIATRIC PATIENTS
IN WATERLOO REGION
HEALTH CARE ADMINSTRATION AND SERVICE MANAGEMENT, CONESTOGA COLLEGE
MGMT8590-ADMINSTRATION AND SERVICE MANAGEMENT CAPSTONE
GROUP 8
Deepika Mohil
Sam Thundil Varghese
Iknoor Dhami
Sivacharan Lakshminarayanan
Needs Assessment
Project Charter
Vision Framework
Gantt Chart & Budget
INDEX
1-EXECUTIVE SUMMARY ……………………………………………………………………………………………………. 4
2-NEEDS ASSESSMENT ……………………………………………………………………………………………………… 5
INTRODUCTION ………………………………………………………………………………………………………………. 5
CURRENT SITUATION ……………………………………………………………………………………………………… 5
IDENTIFYING STAKEHOLDERS ………………………………………………………………………………………… 6
GERIATRIC PATIENTS …………………………………………………………………………………….. 7
FAMILY ………………………………………………………………………………………………………….. 7
HEALTHCARE PROVIDERS & LONG-TERM CARE FACILITATORS …………………….. 7
GOVERNMENT AGENCIES ………………………………………………………………………………. 8
COMMUNITY ORGANIZATIONS ………………………………………………………………………… 8
RESEARCHERS AND ACADEMICS …………………………………………………………………… 8
DATA COLLECTION METHOD ……………………………………………………………………………………………. 8
SURVEYS …………………………………………………………………………………………………… 9-10
INTERVIEWS…………………………………………………………………………………………………………………….. 11
DOCUMENT ANALYSIS…………………………………………………………………………………………………… 11
DATA ANALYSIS …………………………………………………………………………………………………………….. 11
FINDINGS AND RECOMENDATIONS ……………………………………………………………………………….. 11
CONCLUSION ……………………………………………………………………………………………………………….. 11.
REFERENCES …………………………………………………………………………………………………………… 12-14
3.PROJECT CHARTERRISKS/BARRIERS ……………………………………………………………………………. 14
INTRODUCTION …………………………………………………………………………………………………………….. 14
PROBLEM ……………………………………………………………………………………………………………………… 15
PROPOSED SOLUTION ………………………………………………………………………………………………….. 16
EXPECTED OUTCOMES …………………………………………………………………………………………………. 16
MEASURES ……………………………………………………………………………………………………………………. 16
RISKS AND BARRIERS …………………………………………………………………………………………………… 17
SCOPE …………………………………………………………………………………………………………………………….. 18
HIGH LEVEL SCHEDULE ………………………………………………………………………………………………… 18
STAKEHOLDER ANALYSIS ……………………………………………………………………………………………… 18
CONCLUSION ………………………………………………………………………………………………………………… 18
REFERENCES ……………………………………………………………………………………………………………….. 19
4. VISION FRAMEWORK ………………………………………………………………………………………………….. 20
VISION ………………………………………………………………………………………………………………………….. 21
MISSION………………………………………………………………………………………………………………………… 22
CRITICAL SUCCESS FACTOR……………………………………………………………………………………………. 23
KEY PERFORMANCE INDICATORS …………………………………………………………………………………. 23
CORE PROCESS ……………………………………………………………………………………………………………. 23
5. BUDGET ……………………………………………………………………………………………………………………….. 23
BUDGET …………………………………………………………………………………………………………………… 24-25
GANTT CHART ………………………………………………………………………………………………………………. 26
REFERENCES ……………………………………………………………………………………………………………….. 27
Executive Summary
There is more and more evidence that suggests aged patients prefer to stay at home for their end-oflife care. Traditional methods of hospice or palliative care centers are being rejected by elders.
There needs to be an integrated facility that provides many of the benefits that are available in a
hospice or a palliative care center at home. This organization can manage to provide this care to
patients who would like to spend the end of life with their family at their own homes. Enhancing the
end-of-life care options for geriatric Patients’ is an organization that we are intending to initiate to
facilitate this care delivery in the region of Waterloo.
Care for the elderly will be upgraded and tailored to everyone’s specific needs, preferences, and
cultures. As a result, the end of life will be calmer and more courteous. Care options for the elderly
will grow, and patients and their families will have a more active part in medical decision-making. This
increased engagement and choice will lead to higher levels of satisfaction with the treatment
provided.
This report consists of a needs analysis that talks about an in-depth understanding of the rising
number of senior individuals refusing long-term care in the Waterloo Region. We acquired useful
insights into the viewpoints, desires, and issues related to this topic by identifying key stakeholders
and using a mixed-methods approach.
Based on the evaluation and the patient’s objectives and preferences, a care plan is developed that
contains the specific interventions, therapies, and services required to address the patient’s physical,
emotional, and psychological needs. The plan includes information on symptom management,
medication management, daily living activities, and psychological support.
Palliative home care connects palliative patients to a greater range of therapies than acute care does.
These services can range from pain and symptom treatment to family caregiver support, and they
enable patients and carers to be more involved in decisions concerning their care. Access to home
care also affects how patients interact with hospitals: in 2021-2022, patients supported by palliative
home care spent fewer days in the hospital on average in the last year of their lives than those who
received palliative care only in the hospital (CIHI, 2023)
The total cost that has been estimated for the project is $549,000 and is planned to start from July
2023 with a pilot project for 6 months. There is an assessment phase lasting for 2 months the second
phase which is the implementation phase lasting 3 months and the evaluation phase for the last
month.
CIHI., (2023). Access to palliative care in Canada. Retrieved from.
https://www.cihi.ca/sites/default/files/document/access-to-palliative-care-in-canada-2023-reporten.pdf
Increasing Number of Geriatric Patients
Refusing Long-Term Care in Waterloo Region:
A Health Care Administration Issue
Deepika Mohil (8820113)
Group- 8
Increasing Number of Geriatric Patients Refusing Long-Term Care in
Waterloo Region: A Health Care Administration Issue
NEEDS ASSESSMENT
Introduction
The healthcare administration problem of geriatric patients in the Waterloo Region declining long-term
care is becoming more prevalent. This needs assessment is focused on recognizing the root causes
and main obstacles related to the refusal of long-term care among elderly patients. By gaining insight
into these needs, healthcare administrators can create specific approaches to tackle the problem
efficiently and enhance the standard of care provided to this group.
Current Situation
The Waterloo Region is experiencing a rise in the number of geriatric patients who are opting out of
long-term care facilities. This trend has created concerns among healthcare professionals and
administrators as it poses challenges in providing appropriate care and support to elderly individuals.
To develop effective solutions, a comprehensive needs assessment is essential.
IDENTIFYING STAKEHOLDERS
A thorough stakeholder analysis is crucial to understanding the
Geriatric patients
F
perspectives and needs of various individuals and organizations involved
in the care of geriatric patients. The key stakeholders in this needs
assessment include:
1. Geriatric patients: Their preferences, concerns, and reasons for
refusing long-term care need to be explored to gain insights into their
Healthcare providers
& Long term care
facilitators
decision-making process.
2. Family members: The perspectives of family members who play a
significant role in the decision-making process of geriatric patients need
to be understood to develop strategies that address their concerns.
Community
organizations
R
nts
ders
are
s
3. Healthcare providers & Long-term care facilitators: Healthcare providers, including physicians,
nurses, and other professionals involved in geriatric care, along with administrators and staff in longterm care facilities, play significant roles in understanding the challenges faced in providing long-term
care to geriatric patients. They can offer valuable insights into the
obstacles they encounter, current practices within their respective roles,
and potential areas for improvement.
Family members
Engaging both healthcare providers and long-term care facility
stakeholders can provide a comprehensive understanding of the
perspectives and needs of those directly involved in geriatric patient
care.
Government
agencies
4. Government agencies: Representatives from government agencies
involved in healthcare policymaking and regulation can provide insights
into the existing policies and potential opportunities for intervention.
5. Community organizations: Non-profit organizations and community
Researchers and
academics
groups involved in geriatric care can offer perspectives on community
resources, support services, and gaps in the current system.
6. Researchers and academics: Experts in geriatric care and healthcare administration can contribute
knowledge [Name]
and expertise to inform the needs assessment process and potential solutions (Ontario
Ministry of Health, 2022), (Canadian Institute for Health Information, 2019.)
DATA COLLECTION METHODS
To gather comprehensive data for the needs assessment, a mixed-methods approach will be
employed, combining qualitative and quantitative research methods. The following data collection
methods will be utilized:
1. Surveys: Structured surveys will be distributed to geriatric patients, family members, and healthcare
providers to gather quantitative data on their perspectives, preferences, and challenges related to longterm care refusal, allowing for a comprehensive analysis of the factors influencing their decision-making
process.
2. Interviews: In-depth interviews will be conducted with a sample of geriatric patients, family
members, healthcare providers, and long-term care facility administrators. This will help us to gain a
deeper understanding of their experiences, concerns, and reasons for refusing long-term care.
3. Document Analysis: Relevant government articles, research papers, and review articles will be
analyzed to gain insights into existing policies, regulations, and best practices related to long-term care
for geriatric patients (Canadian Institute for Health Information, 2019.)
DATA ANALYSIS
The collected data will be analyzed using qualitative and quantitative analysis techniques. Qualitative
data from interviews will be analyzed using thematic analysis to identify common themes and patterns
in participants’ responses. Quantitative data from surveys will be analyzed using descriptive statistics
and inferential analysis to identify trends and correlations among variables (Saunders et al., 2021.)
FINDINGS AND RECOMMENDATIONS
Based on the analysis of the data, the needs assessment will provide a comprehensive understanding
of the reasons behind the increasing refusal of long-term care among geriatric patients in the Waterloo
Region.
The findings will inform the development of strategies and interventions to address the challenges
identified. These recommendations will aim to improve the quality of care, enhance communication with
geriatric patients and their families, and ensure that alternative care options are readily available and
suitable for their needs (Canadian Institute for Health Information, 2019.)
CONCLUSION
This needs assessment has provided a comprehensive understanding of the increasing number of
geriatric patients refusing long-term care in the Waterloo Region. By identifying the key stakeholders
and utilizing a mixed-methods approach, we have gained valuable insights into the perspectives,
preferences, and challenges associated with this issue.
The findings of this needs assessment highlight several crucial factors contributing to the refusal of
long-term care, including personal preferences, concerns about loss of independence, inadequate
communication and information sharing, limited availability of suitable alternative care options, and
gaps in the current healthcare system. These factors must be addressed to ensure the well-being and
satisfaction of geriatric patients while maintaining the highest standards of care.
Change is possible and can be made by implementing various recommendations. Healthcare
administrators in the Waterloo Region can proactively address the increasing number of geriatric
patients refusing long-term care. This will lead to improved patient satisfaction, better utilization of
healthcare resources, and ultimately, enhanced quality of care for the aging population. It is essential
for all stakeholders to collaborate and work together to ensure that the healthcare system meets the
evolving needs of geriatric patients and provides comprehensive and patient-centered care options.
REFERENCES
1. Saunders, N. R., Toulany, A., Deb, B., Strauss, R., Vigod, S. N., Guttmann, A., Chiu, M., Huang,
A., Fung, K., Chen, S., & Kurdyak, P. (2021). Acute mental health service use following onset of
the COVID-19 pandemic in Ontario, Canada: a trend analysis. CMAJ open, 9(4), E988–E997.
https://doi.org/10.9778/cmajo.20210100
2.
Ontario
Ministry
of
Health.
(2022).
Long-Term
Care.
Retrieved
from
https://www.health.gov.on.ca/en/public/programs/ltc/default.aspx
3. Canadian Institute for Health Information. (2019). Seniors in transition: Exploring pathways
across the care continuum. Retrieved from https://www.cihi.ca/en/seniors-in-transitionexploring-pathways-across-the-care-continuum
PROJECT CHARTER
8814187
SAM THUNDIL VARGHESE
GROUP 8
CAPSTONE PROJECT
INTRODUCTION
The number of Canadians with terminal diseases like cancer or kidney failure is rising in tandem
with the general population’s increased longevity. As a result, there is a growing need for palliative care,
which aims to lessen patients’ pain and improve their quality of life as they near the end of their lives.
Palliative care is more common among Canadians between the ages of 45 and 74 than among either
younger adults or older seniors (CIHI,2023, p. 6). Hospice palliative care is seen as part of a continuum
of care that can improve patients’ quality of life at any stage of their disease or the aging process, rather
than as a separate service provided to terminally ill patients once curative treatment has been
exhausted (Canadian Hospice Palliative Care Association, 2020, p. 3).
PROBLEM
When given the choice between standard long-term care facilities and retirement homes, many
elderly people in Waterloo region, Ontario, would much rather spend their final days at home. As per
studies, the palliative care patients, in the last year of life were more likely to die in the facility where
they received care than those who did not receive palliative care (Canadian Hospice Palliative Care
Association, 2020, p. 8). The main challenge with this decision is it can be difficult to provide patients
with the essential medical and supporting care while also satisfying the patients’ requirements and
making sure they are comfortable at the end-of-care (Woo et al., 2006, para 12)
PROPOSED SOLUTION
The proposed solution is to develop and implement a comprehensive program that enhances
end-of-life care options for geriatric patients in the Waterloo region. The focus of this program is to
ensure that the elderly have access to high-quality care in the most appropriate and comfortable
environment for them, whether that be their own homes or community-based facilities (The Way
Forward National Framework, 2015, p. 4). The program will provide for the medical, psychological, and
spiritual needs of patients and their families during the entirety of their illness, not just at the end of life.
By emphasizing the individual’s right to make decisions about his or her own health care and
encouraging participation, person-centered care aims to make patients and their loved ones feel more
in charge of their treatment with the help and collaboration of healthcare professionals, community
groups, and other interested parties (The Way Forward National Framework, 2015, p. 14).
EXPECTED OUTCOMES
Improved end-of-life care quality
Care for the elderly will be improved and centered around each person’s unique
requirements, choices, and cultures. The end of life will be more peaceful and
respectful because of this.
Increased patient contentment
Care alternatives for the elderly patients will expand, and the patients and their
families will have a more integral role in medical decision-making. This
increased involvement and choice will result in greater satisfaction with the care
received.
Enhanced community assistance to patients
Collaboration between healthcare providers, community organizations, and other
interested parties to better serve the community’s needs. As a result of working
together, there will be greater care coordination, more available resources, and
more people understanding their alternatives for how to spend their final days.
MEASURES
For the success of the program, the patients’ health and social quality of life will be evaluated.
Health systems and organizations are collecting data on these measures (e.g., using tools like the
InterRAI Community Health (CHA) Assessment Form, the Palliative Performance Scale, and the
Palliative Outcomes Scale) can be used to evaluate the efficacy of end-of-life care (Ontario palliative
care network, 2019, p.15). Also, indicators of health outcomes will be compared to those collected
before it was implemented. Some of the indicators can be utilized to develop norms for a coordinated
system of palliative care.
Patient and Family
Feedback Surveys
Overall Wellness
Indicators
a) Pain
Management
b) Symptom
Control
c) Emotional
Well-being
Utilization of
Resources
✓ Geriatric patients and relatives will be surveyed regularly.
✓ These questionnaires will evaluate their end-of-life care, decisionmaking, and program experience.
✓ The surveys’ data will be harmonized and validated.
✓ Feedback will reveal program strengths and weaknesses
The program’s performance in enhancing end-of-life care will be
measured by key health outcome indicators.
✓ Standardized pain scales will be used to evaluate the degree of
discomfort felt by elderly people.
✓ The objective is to make sure the pain is being properly managed and
stop any unnecessary suffering (Hospice Palliative Care, 2023, para.
3).
✓ Healthcare providers and self-reporting will measure symptom
management.
✓ To mitigate and control symptoms including nausea, exhaustion,
shortness of breath, and anxiety that with terminally ill elderly
individuals.
✓ Geriatric individuals’ mental health will be assessed with tools like
depression and anxiety scores.
✓ Hence to promote psychological ease for participants in their final
days by offering emotional support and counselling services (Hospice
Palliative Care, 2023, para. 4).
✓ End-of-life care preferences of regional geriatrics will be polled.
✓ Record how many patients want in-home, community-based, or
institutional care.
✓ The obtained data will show how these options affect patients’
decisions and preferences.
RISKS AND BARRIERS
Financial
Challenges
Opposotion to
Changes
Public Stigma
and Opinions
Limitation of
Workforce
Limited
Community
Resources and
Capacity
SCOPE
In-Scope
•
•
•
The program’s primary goal is to
improve the quality of death care for
the target demographic of geriatric
patients aged 65 and above residing
in the Waterloo region.
The goal of the initiative is to expand
access to high-quality end-of-life care
in a variety of locations, such as
patients’ homes, community centres,
and assisted living facilities.
Stakeholders in the project will
include those with a stake in the
provision or support of end-of-life
care services, including healthcare
professionals, community
organizations, caregivers, and family
members.
HIGH-LEVEL SCHEDULE
Out of Scope
•
•
•
•
Patients below the age of 65-yearsold.
Acute care hospitals are important in
end-of-life care, but the approach
emphasizes on non-institutionalized
care. The project is not focused on
acute care hospital interventions.
The project focuses on Waterloo
region, and it may not address endof-life care issues in other regions or
geographical areas outside the
defined scope.
The project advocates for policy
reforms to improve end-of-life care
alternatives but does not directly
execute them and the project will
follow all the aspects of existing law.
Initiation
Phase
STAKEHOLDER ANALYSIS
Stakeholders
Impact on the project
Influence on the project
Engagement Levels
Geriatrics & High Leveltheir families Direct impact on
patients by improving
end-of-life care, quality
of life, and satisfaction.
High LevelGeriatric patients and
their families’ feedback
and experiences shape
the program’s
development and
evaluation.
High LevelMajorly role in the
success of the project. It
is crucial to have their
support, acceptance of
new methods, and
engagement in the
program’s execution.
Surveys, Decisionmaking, Participation
at every stage,
Critical to program
design and evaluation
Medium Level-.
coordinating services and
ensuring smooth care
transitions with
community organizations.
Medium to High levelThey make a difference
by being involved,
dedicated, and helpful in
the provision of highquality medical services
Cooperative ideas for
communities, Direct
meetings, Sharing
best practices,
Healthcare High Levelproviders End-of-life care and
quality depend on
healthcare
practitioners. The
project depends on
their cooperation and
adoption of innovative
care approaches.
Community Low to Medium Levelorganizations They support local
and support resources and
services awareness of end-oflife options.
Caregivers Medium to High leveland volunteers They lessen caregiver
burden and improve
patient and family
Investors and High Level- The
governing success of the project
bodies is heavily reliant on the
financial backing and
policy changes made
by funders and
government
High Level- The project’s
viability and sustainability
are profoundly impacted
by the choices made
regarding funding, policy
shifts, and regulatory
frameworks.
Training
opportunities, training
consultations, forums
for exchanging best
practices, and
participation in the
design and execution
of programs.
Access to educational
resources, moraleboosting initiatives,
public
acknowledgement of
their efforts, and
networking forums
Advocacy for new
policies and constant
communication to
gain funding.
Consistent reports on
the project’s
development and its
effects on the
community.
CONCLUSION
In conclusion, the project aims to improve end-of-life care alternatives, so patients receive highquality care in their preferred locations. Better care, patient satisfaction, and community support are
predicted. Stakeholder engagement—patients, families, healthcare providers, community groups,
funders, policymakers, carers, and volunteers—is essential to the project’s success. The program aims
to develop a compassionate, comprehensive care system that respects patients’ preferences and
enhances end-of-life experiences. After reviewing the pilot project’s results, the project should be
expanded with more services and patient criteria. That dream requires the project’s success.
Multidimensional thinking and ensuring project completion.
REFERENCES
Canadian Hospice Palliative Care Association. (2020, March). Fact sheet 2020 – hospice palliative
care in Canada. https://www.chpca.ca/wp-content/uploads/2020/03/CHPCA-FactSheet-D.pdf
Woo, J. A., Maytal, G., & Stern, T. A. (2006). Clinical Challenges to the Delivery of End-of-Life
Care. Primary care companion to the Journal of clinical psychiatry, 8(6), 367–372.
https://doi.org/10.4088/pcc.v08n0608
The Way Forward National Framework – HPCINTEGRATION.CA. (2015, April). A roadmap for an
integrated palliative approach to care http://www.hpcintegration.ca/media/60044/TWFframework-doc-Eng-2015-final-April1.pdf
Canadian Institute for Health Information (CIHI). Access to Palliative Care in Canada. Ottawa,
Ontario: 2023 https://www.cihi.ca/sites/default/files/document/access-to-palliative-care-in-canada2023-report-en.pdf
Hospice Palliative Care. Canadian Hospice Palliative Care Association. (2023, May 9).
https://www.chpca.ca/about-hpc/
Ontario palliative care network. (2019, April). Tools to support earlier identification for palliative care.
https://www.ontariopalliativecarenetwork.ca/sites/opcn/files/202101/OPCNToolsToSupportEarlierIdentificationForPC.pdf
Report1: Vision Framework
Iknoor Singh Dhami
Healthcare Administration and Service Management, Conestoga College
MGMT8590: Administration and Service Management
Jane Van Alphen
Assignment Due Date: June 23rd, 2023
Vision
Our goal is to provide comprehensive, person-centered, and compassionate care to elderly patients in the
comfort of their own homes who reject long-term care facilities for end-of-life care. To enable these people to
obtain high-quality care while respecting their preferences, we see a range of services that cater to their
physical, emotional, and social requirements.
Mission
Our goal is to provide geriatric patients with compassionate, individualised, and comprehensive support in their
own homes when they reject long-term care facilities for end-of-life care. Their physical, emotional, and social
wellbeing are given priority, and we work to protect their dignity and respect their decisions.
Critical Success Factors
Respect for Patient Autonomy: The ability to successfully provide home care services for elderly patients who
reject long-term care facilities depends on the ability to respect and honour the patient’s autonomy. This entails
actively including them in decision-making procedures and adjusting the care plan to suit their requirements and
principles.
Detailed Care Planning: It is essential to have a complete care plan that considers the patient’s physical,
emotional, psychological, and social needs. Creating individualised care plans that are frequently reviewed and
changed to reflect shifting requirements and preferences is essential to success.
Competence and Training of the Carer: It is essential to guarantee that carers and healthcare professionals
have the requisite abilities, information, and training in geriatric and end-of-life care. Carers who are capable
and compassionate can deliver top-notch care, handle complex medical requirements, and offer emotional
support.
sufficient resources and assistance: The success of home care services depends on having enough people and
material resources. This entails providing patients and their families with enough competent carers, medical
tools, medications, and supplies, as well as access to community services and support systems (Comission,
2023).
Key Performance Indicators
Percentage of patients actively participated in care planning: This KPI assesses how much elderly patients
actively participate in decisions about their end-of-life care, demonstrating how much their autonomy is
respected.
The frequency of care plan reviews and revisions: to account for any alterations in the patient’s condition,
preferences, or goals is measured by this KPI. It guarantees that care plans continue to be applicable and
efficient over time.
Feedback from patients and their families: on the competence of carers is captured by this KPI, which
measures the effectiveness and calibre of care delivered by carers. It sheds light on the competence of the carers
to address the requirements of elderly patients who are nearing the end of their lives.
Availability of community support networks: This KPI assesses the presence of community support networks
that can offer elderly patients and their family’s extra resources and assistance, such as local organisations,
volunteers, and support groups (Comission, 2023).
Core Process
Making an informed decision: requires that the patient have complete knowledge about the range of treatment
options, including their advantages, disadvantages, and alternatives. This gives the patient the ability to decide
on their own behalf based on their beliefs, interests, and end-of-life care goals.
Care Plan Development: A care plan is created that includes the precise interventions, therapies, and services
needed to meet the patient’s physical, emotional, and psychosocial requirements based on the assessment as well
as the patient’s goals and preferences. Details on symptom management, medication management, daily living
activities, and psychosocial support are included in the plan.
Continuous Education and Professional development: Carers are urged to participate in continual education
and professional development activities to increase their competence. Attending conferences, webinars,
workshops, seminars, or earning extra certificates or credentials in end-of-life care may be necessary to achieve
this.
Resource Allocation: Based on the results of the evaluation, the proper resources and support are assigned to
suit the patient’s unique needs. This could include access to community services or programmes, personal care
items, assistive technology, home modifications, medical equipment, and tools for managing medications.
REFERENCES
Comission, C. Q. (2023). Palliative / End of Life Care for Elderly. Retrieved from Care Quality
Comission: https://ready-care.co.uk/palliative-end-of-life-care/
Report1: Budget and Gantt Chart
Sivacharan Lakshminarayanan
Healthcare Administration and Service Management, Conestoga College
MGMT8590: Administration and Service Management
Jane Van Alphen
Assignment Due Date: June 23rd, 2023
Budget
A budget is a monetary blueprint that details an entity’s planned revenue and spending for a particular
duration, typically one financial year. It is an agenda for how the organization will deploy its financial
assets to fulfill its goals and objectives.
The federal government contributes to provincial healthcare expenditure through time-limited
agreements, the most significant of which is the Home and Community Care and Mental Health and
Addictions Services Funding Agreement. Through 2026-27, the province will receive a total of $4.2
billion under this 10-year deal, including $465 million in 2022-23. (FAO.,2023)
The Governments of Canada and Ontario have announced an agreement in principle for a shared
plan that will invest $73.97 billion in federal funding in Ontario over ten years, including $8.413 billion
for a new bilateral agreement focusing on the four shared healthcare priorities and $776 million
through an immediate, one-time CHT top-up to address urgent needs.
One of the shared health goals where collaborative effort is currently happening is assisting
Canadians to age with dignity, closer to home, and with access to home care or care in a safe longterm care facility.
BUDGET PRESENTATION ( 6 months Project
Plan)
1REVENUE
Grants
Pilot 1
Annualized
$550,000
$550,000
$550,000
$550,000
1 Full time
$28,800
$28800
1 Full time
18,000
$18,000
1 Part-time
$12,600
$12,600
1 full time
$25,200
$25,200
5 Full time
$108,000
$108,000
1 Full time
$28800
$14,400
Home and
Community Care
and Mental Health
and Addictions
Services
Total
Revenue
from
Grants
2EXPENSES
Human
Resources
Project Manager
1FTE *$40/hr.*
30hrs/ week
Administrative
Assistant
1FTE*$25/hr.*
30hrs/week
Paramedic
Technician
1/2FTE*$35/hr.*
15hrs/week*
Nurse for training
1FTE*$35/hr.*
30hrs/week
Nurse 5 FTE*$
30/hr.*30hrs/Week
Physiotherapist for
training
1FTE$40/hr.*
30hrs/week
Physiotherapy
Assistant 5FTE*
16/hr.*30hrs/week
Personal Support
worker10
FTE*16/hr.
30hrs/week
HR Subtotal
Benefits
5 Full time
$72,000
$72,000
10 Full time
$129,600
$129,600
$423,000
$423,000
$105,750
$105,750
$528,750
$528,750
25% of HR
Subtotal
HR Total
–
3-Start-Up
Costs
Computer
3no’s* $600
$1800
–
Printer
1no* $299
$299
–
Chairs
10no’s *$99
$990
–
Corner Table
2no’s *$285
$570
–
Office table
Total Startup
Costs
5no’s *$170
$850
$4850
–
Travel for House
Visit
$3000
$3000
Office area rent
Miscellaneous
$12000
$1000
$12000
$1000
Total Operating
Costs
$16000
$16000
TOTAL
$549,600
$544,750
4Operating
Costs
Gantt Chart
A Gantt chart, which is widely used in project management, is one of the most popular and
practical methods of displaying activities (tasks or events) against time. The chart has a list of
activities on the left and a time scale along the top. Each action is represented as a bar, with
the location and length of the bar reflecting the activity’s start, duration, and finish dates.
Gantt Chart
Task
Duration Start date
End date
Phase 1 (Pre-assessment)
Collaboration with Ontario MOHLTC
20
2023-07-01
2023-07-20
Consultation With community
11
2023-07-21
2023-07-31
Budget and approval
30
2023-08-01
2023-08-30
Phase 2 (Planning and implementation)
Setting Up office
10
2023-08-31
2023-09-09
Staff Recruitment
15
2023-09-10
2023-09-24
Staff Training
11
2023-09-25
2023-10-05
Surveying the community for Patients
10
2023-10-06
2023-10-15
Approaching patients for home care
15
2023-10-16
2023-10-30
Assesments of Patient needs
10
2023-10-31
2023-11-09
Trial Run for Patient Care
16
2023-11-10
2023-11-25
Changes to the care ( If required)
10
2023-11-26
2023-12-05
Phase 3(Evaluation)
Care assesment
10
2023-12-06
2023-12-15
Reporting to MOHLTC
16
2023-12-16
2023-12-31
2023-07-01
2023-07-21
2023-08-10
2023-08-30
2023-09-19
2023-10-09
2023-10-29
2023-11-18
2023-12-08
2023-12-28
Phase 1 (Pre-assessment)
Collaboration with Ontario MOHLTC
Consultation With community
Budget and approval
Phase 2 (Planning and implementation)
Setting Up office
Staff Recruitment
Staff Training
Surveying the community for Patients
Approaching patients for home care
Assesments of Patient needs
Trial Run for Patient Care
Changes to the care ( If required)
Phase 3(Evaluation)
Care assesment
Reporting to MOHLTC
References
Best buy. (N.d). Retrieved from.https://www.bestbuy.ca/en-ca/product/hp-laserjet-mfp-m234sdwemonochrome-wireless-all-in-one-laser-printer/15397883
Government of Canada. (2023). The Government of Canada and Ontario Reach Agreement in
Principle to Improve Health Services for Canadians. https://www.canada.ca/en/healthcanada/news/2023/02/the-government-of-canada-and-ontario-reach-agreement-in-principle-toimprove-health-services-for-canadians.html
Government of Canada. (2023). Registered nurse (RN) in Ontario.
https://www.jobbank.gc.ca/marketreport/wages-occupation/993/ON
Government of Canada. (2023). Physiotherapist in Ontario.
https://www.jobbank.gc.ca/wagereport/occupation/18214
Government of Canada. (2023). Physiotherapy Assistant in Ontario.
https://www.jobbank.gc.ca/wagereport/occupation/4466
Government of Canada. (2023). Personal Support Worker In Ontarrio.
https://www.jobbank.gc.ca/wagereport/occupation/24584
Home Depot. (N.d). Retrieved from.https://www.homedepot.com/p/Jamesdar-78-in-L-Shaped-GrayBlack-Computer-Gaming-Desk-with-Shelf-JCDES111/312112028
Ikea. ( N.d) Retrieved from.https://www.ikea.com/ca/en/p/renberget-swivel-chair-bomstad-black20503284/
Office Depot. (N.d). Retrieved from. https://www.officedepot.com/a/products/4597693/LenovoIdeaCentre-AIO-5i-Desktop-PC/
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