Palliative Medicine - Windsor
Palliative Care Windsor – Hospice of Windsor and Essex County
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Contact person: |
Dr. Thomas Burgess |
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Email: |
PALLIATIVE MEDICINE – Community Palliative Medicine (home visits) and Residential Hospice Care (Hospice of Windsor and Essex County)
The Community Palliative Medicine Program is a home-visit based service for patients with terminal illnesses that have complex symptom management needs and/or are approaching the terminal phase of their illness. Residents will manage pain and other symptoms as well as complex medical, social, psychological, and spiritual issues that arise in patients with advanced malignancy or other life-threatening illnesses. Residents will develop end of life care plans that may include placement in a palliative care placement facility or providing end of life care in the home setting.
The Hospice of Windsor and Essex County has two residences for end-of-life care. The Windsor site has 12 beds, the Erie Shores site is in Leamington and has 11 beds. The resident assumes responsibility for the admission and care of the patients at one of these sites when rounding 3 times per week and addressing issues throughout the week as they arise.
In both settings, the resident works as a fully integrated member of the interdisciplinary team. The resident will have an opportunity to attend interdisciplinary team meetings. The resident will also collaborate with other team members, including Nursing, Social Work, Spiritual Care, and other team members to provide effective, holistic care to the patient and their family.
The Resident will be available for one-week of home call, including a weekend. This will typically be during the last week/weekend of the rotation. During this time they will be supported by the attending physician in ensuring urgent issues are managed appropriately in the community and residence setting. Additionally, the resident will deliver a twenty-minute presentation reviewing a palliative care topic of interest or challenging case. The goal of this presentation is to encourage reflection and generate conversation amongst attendees. Other learners may also be present during the rotation, including palliative care PGY-3 fellows or medical students. The resident will have an opportunity to provide teaching during the rotation if appropriate.
Learning Objectives:
CLINICAL REASONING
- Practice evidence-based palliative care utilizing the principle texts of palliative medicine and the growing journal literature on end-of-life care, and develop skills in critical evaluation of the current fund of knowledge
- Demonstrate diagnostic and therapeutic skills for ethical and effective patient care
Access and apply relevant information to clinical practice
Demonstrate effective consultation services with respect to patient care, education, and legal opinions
Understand ethics, law, and policy governing palliative care delivery in Canada
- Medical management - education will be based on clinical situations that present during the rotation.
Demonstrate the knowledge of classification and neurophysiology of pain
Demonstrate the use of the standard tools used in symptom assessment
Demonstrate understanding of Opioid-Induced Neurotoxicity and appropriate management
Familiarity with non-pharmacologic approaches to pain management including anesthetic and surgical options
Demonstrate and understanding of the pathophysiology and treatment of dyspnoea, delirium, nausea, and vomiting, constipation, bowel obstruction, decubitus ulcers, anxiety, depression.
Emergencies - Describe a management plan for urgent/emergent problems in the palliative setting including spinal cord compression, hypercalcaemia, superior vena cava syndrome, pathologic fractures, seizures, and hemorrhage.
COMMUNICATION SKILLS/ PATIENT CENTERED APPROACH
- Develop strategies for conducting discussions of difficult issues and working with patients who present challenging personality problems and families with complex family dynamics.
- Acquire practical strategies for introducing discussions of patient fears, hopes, goals, and wishes regarding care at the end-of-life, including use of life-sustaining technology, balancing hope and honesty in discussing treatment options, and dealing with the ethical issues that arise at the end-of-life.
- Demonstrate understanding of confidentiality and capacity issues.
- Demonstrate an understanding of cultural/spiritual issues and alternative of unorthodox therapies as they relate to the palliative care situation.
- Demonstrate familiarity with issues related to bereavement of families and caregivers, including management of grief.
- Determine, record, revise, and implement goals of care through effective communication with patient, family, and other caregivers
- Demonstrate the ability to manage and/or co-ordinate care of patients across health care settings including the use of appropriate referrals
- Describe models of palliative/end-of-life care and the role of family physicians in the provision of such care
PROFESSIONALISM
- Residents will develop an understanding of ethical principles and issues in end-of-life care, including contemporary approaches to advance care planning and substituted judgment and the debate over hastening death.
- Residents are expected to demonstrate:
Compassion, integrity, and respect for others
Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation
- Deliver the highest quality of care with integrity, honesty, and compassion
- Exhibit appropriate personal and interpersonal professional behaviours
- Practice medicine ethically, consistent with the obligations of a physician
Scheduling: 1 resident per block; 2 residents can be considered depending on scheduling of other learners.
PLEASE NOTE: ELECTIVES MUST BE ONE BLOCK IN DURATION (PART OF A BLOCK IS NOT ACCEPTABLE).
Palliative Care - Inpatient Palliative Medicine
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Contact person: |
Dr. Wendy Kennette |
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Email: |
PALLIATIVE MEDICINE - Inpatient Palliative Medicine (Windsor Regional Hospital) and Inpatient Palliative Medicine Unit (Hotel Dieu Grace Healthcare)
Inpatient Palliative Medicine Consultation Service at WRH sees patients throughout the hospital, helping the medical and surgical services manage pain and other symptom issues as well as providing assistance with end-of-life care. Residents will manage difficult pain and symptom problems as well as dealing with complex medical, social, psychological, and spiritual issues that arise in patients with advanced malignancy or other life-threatening illnesses.
The HDGH Palliative care unit is comprised of a 20 bed in-patient unit. Patients are admitted to this unit directly from the community or transferred from other acute care hospitals for end of life care. The resident works as a full member of the interprofessional team providing care to the patients and families. The resident assumes responsibility for the admission and care of the patient when rounding 3 times per week including attendance at family meetings.
Learning Objectives:
CLINICAL REASONING
- Practice evidence-based palliative care utilizing the principle texts of palliative medicine and the growing journal literature on end-of-life care, and develop skills in critical evaluation of the current fund of knowledge
- Demonstrate diagnostic and therapeutic skills for ethical and effective patient care
Access and apply relevant information to clinical practice
Demonstrate effective consultation services with respect to patient care, education, and legal opinions
Understand ethics, law, and policy governing palliative care delivery in Canada
- Medical management - education will be based on clinical situations that present during the rotation.
Demonstrate the knowledge of classification and neurophysiology of pain
Demonstrate the use of the standard tools used in symptom assessment
Demonstrate understanding of Opioid-Induced Neurotoxicity and appropriate management
Familiarity with non-pharmacologic approaches to pain management including anesthetic and surgical options
Demonstrate and understanding of the pathophysiology and treatment of dyspnoea, delirium, nausea, and vomiting, constipation, bowel obstruction, decubitus ulcers, anxiety, depression.
Emergencies - Describe a management plan for urgent/emergent problems in the palliative setting including spinal cord compression, hypercalcaemia, superior vena cava syndrome, pathologic fractures, seizures, and hemorrhage.
COMMUNICATION SKILLS/ PATIENT CENTERED APPROACH
- Develop strategies for conducting discussions of difficult issues and working with patients who present challenging personality problems and families with complex family dynamics.
- Acquire practical strategies for introducing discussions of patient fears, hopes, goals, and wishes regarding care at the end-of-life, including use of life-sustaining technology, balancing hope and honesty in discussing treatment options, and dealing with the ethical issues that arise at the end-of-life.
- Demonstrate understanding of confidentiality and capacity issues.
- Demonstrate an understanding of cultural/spiritual issues and alternative of unorthodox therapies as they relate to the palliative care situation.
- Demonstrate familiarity with issues related to bereavement of families and caregivers, including management of grief.
- Determine, record, revise, and implement goals of care through effective communication with patient, family, and other caregivers
- Demonstrate the ability to manage and/or co-ordinate care of patients across health care settings including the use of appropriate referrals
- Describe models of palliative/end-of-life care and the role of family physicians in the provision of such care
PROFESSIONALISM
- Residents will develop an understanding of ethical principles and issues in end-of-life care, including contemporary approaches to advance care planning and substituted judgment and the debate over hastening death.
- Residents are expected to demonstrate:
Compassion, integrity, and respect for others
Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation
- Deliver the highest quality of care with integrity, honesty, and compassion
- Exhibit appropriate personal and interpersonal professional behaviours
- Practice medicine ethically, consistent with the obligations of a physician
Scheduling: Can accommodate 2 residents/block.
PLEASE NOTE: ELECTIVES MUST BE ONE BLOCK IN DURATION (PART OF A BLOCK IS NOT ACCEPTABLE).
Palliative Care - Outpatient Palliative Medicine
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Contact person: |
Dr. Nicole Freeman |
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Email: |
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PALLIATIVE MEDICINE – Ambulatory/Outpatient Palliative Medicine (Windsor Regional Cancer Centre) and Inpatient Palliative Medicine Unit (Hotel Dieu Grace Healthcare)
The outpatient Palliative Medicine Clinic at Windsor Regional Cancer Centre provides consultation and follow up for patients with a life-limiting oncologic diagnosis.
The palliative medicine service works collaboratively with Oncology and Radiation Oncology, providing care to patients who are living in the local community.
Residents will be involved in the management of difficult pain and symptom issues, as well as with complex medical, social, psychological, and spiritual issues that arise in patients with advanced malignancy.
The HDGH Palliative care unit is comprised of a 18-bed in-patient unit. Patients are admitted to this unit directly from the community or transferred from other acute care hospitals for end-of-life care.
The resident works as a full member of the interprofessional team, providing care to the patients and families. The resident assumes responsibility for the admission and care of the patient when rounding 3-4 times per week, including attendance at family meetings.
Of note - There is no on-call or after-hours care required during this rotation.
Learning Objectives:
CLINICAL REASONING
- Practice evidence-based palliative care utilizing the principal texts of palliative medicine and the growing journal literature on end-of-life care, and develop skills in critical evaluation of the current fund of knowledge.
- Demonstrate diagnostic and therapeutic skills for ethical and effective patient care
Access and apply relevant information to clinical practice;
Demonstrate effective consultation services with respect to patient care, education, and legal opinions;
Understand ethics, law, and policy governing palliative care delivery in Canada.
- Medical management - education will be based on clinical situations that present during the rotation.
Demonstrate the knowledge of classification and neurophysiology of pain;
Demonstrate the use of the standard tools used in symptom assessment;
Demonstrate understanding of Opioid-Induced Neurotoxicity and appropriate management;
Familiarity with non-pharmacologic approaches to pain management including anesthetic and surgical options;
Demonstrate an understanding of the pathophysiology and treatment of pain, dyspnea, delirium, nausea, and vomiting, constipation, bowel obstruction, wounds, anxiety and depression;
Emergencies - Describe a management plan for urgent/emergent problems in the palliative setting including spinal cord compression, hypercalcaemia, superior vena cava syndrome, pathologic fractures, seizures, and hemorrhage.
COMMUNICATION SKILLS/ PATIENT CENTERED APPROACH
- Develop strategies for conducting discussions of difficult issues and working with patients who present challenging personality problems and families with complex family dynamics.
- Acquire practical strategies for introducing discussions of patient fears, hopes, goals, and wishes regarding care at the end-of-life, including use of life-sustaining technology, balancing hope and honesty in discussing treatment options, and dealing with the ethical issues that arise at the end-of-life.
- Demonstrate understanding of confidentiality and capacity issues.
- Demonstrate an understanding of cultural/spiritual issues and alternative of unorthodox therapies as they relate to the palliative care situation.
- Demonstrate familiarity with issues related to bereavement of families and caregivers, including management of grief.
- Determine, record, revise, and implement goals of care through effective communication with patient, family, and other caregivers.
- Demonstrate the ability to manage and/or coordinate care of patients across health care settings including the use of appropriate referrals.
- Describe models of palliative/end-of-life care and the role of family physicians in the provision of such care.
PROFESSIONALISM
- Residents will develop an understanding of ethical principles and issues in end-of-life care, including contemporary approaches to advance care planning and substituted judgment and the debate over hastening death.
- Residents are expected to demonstrate:
Compassion, integrity, and respect for others;
Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.
- Deliver the highest quality of care with integrity, honesty, and compassion.
- Exhibit appropriate personal and interpersonal professional behaviours.
- Practice medicine ethically, consistent with the obligations of a physician.
Scheduling: Can accommodate 2 residents/block. There is no on-call or after-hours care required during this rotation.
PLEASE NOTE: ELECTIVES MUST BE ONE BLOCK IN DURATION (PART OF A BLOCK IS NOT ACCEPTABLE).
