The Coordinated Implementation of Pallium Canada s LEAP Curriculum in Nova Scotia. Beth R. Tupala, RN, CHPCN(C) Cheryl Tschupruk, M.S.W., R.S.W.

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1 The Coordinated Implementation of Pallium Canada s LEAP Curriculum in Nova Scotia Beth R. Tupala, RN, CHPCN(C) Cheryl Tschupruk, M.S.W., R.S.W.

2 Today s Objectives Provincial Objectives Context Process Evaluation Observations Next Steps

3 Context

4 Recommended Actions Establish a working group to recommend standardized training modules for health care teams. Identify qualified individuals/teams to assist in providing training.

5 Provincial Objectives Have certified LEAP facilitators in palliative care services where previously there were none. Increase the number of LEAP facilitators in the province. Have minimum of 2 certified facilitators in each palliative care service Increase the coaching capacity in the province. Have a minimum of 2 coaches in the province Increase the number of LEAP Core offerings in the province. Host a minimum of 2 LEAP Cores per zone per year Host facilitator training on a regular basis. Host facilitator training annually

6 Provincial Objectives Have certified LEAP facilitators in palliative care services where previously there were none. Demonstrate positive change in attendees comfort, knowledge and attitudes toward the palliative care approach. LEAP pre-and post-scores demonstrate improvement Demonstrate satisfaction with the LEAP structure and curriculum (attendees and facilitators) LEAP evaluations are positive Facilitator feedback is positive after delivering a LEAP course Demonstrate that facilitators perceive the teaching of LEAP to have a positive effect on their role and their community. Facilitators provide feedback to this effect

7 Facilitator training Process Coach training Spring LEAP sessions Summer meetings Fall LEAP sessions Facilitator training 2018

8 Have we met our objectives? Evaluation Certified Facilitators Coaches 2018 Uncertain

9 Facilitator Training LEAP Core LEAP Onco LEAP LTC LEAP Paramedic: Provided to all Paramedics across Nova Scotia * VON 2016 Have we met our objectives?

10 1= Not at all comfortable 7= Very comfortable Comfort Level: Symptom Management Pre-LEAP Post-LEAP Cachexia Cancer pain Delirium Shortness of breath Nausea

11 Overall, the course was a good learning experience I would recommend this course to colleagues

12 Overall, how would you describe your experience of organizing your most recent LEAP course? Very Easy Easy Neutral Challenging Very Challenging Not Applicable

13 Overall, considering the time and effort that was required and the perceived impact of the course, how satisfied are you with LEAP as an option for basic palliative care education?

14 The entire nature of our collaboration has changed as their comfort level with palliative care increases. Referrals to our service have decreased, and the ones we are receiving are more appropriate for the specialty team. Consequently I see patients receiving quality palliative care earlier in their disease I have noticed practice change with some of those who have taken LEAP in regards to better symptom management and appropriateness of referrals. There has also been a gain of respect for the Palliative Care Consult Nurses and a better understanding of what their role is on the team

15 Enablers Observations Barriers Project Lead NSHA Leadership Communications Partnerships Relationship with Pallium Time Facilitators Participants Money Teams Participants Space Geography Technology Facilitators Participants Engagement Facilitators Participants

16 Observations Course Cancellations Lost Facilitators Technical Difficulties Time & Money

17 Next Steps Interprofessional Practice Continuing Care Specific Requests Continued Evaluation LEAP LTC Education Committee and Planning Transition of Project Lead (2018)

18 Acknowledgements The NSHA Palliative Care Strategy Leadership NSHA Palliative Care Teams, including our network of facilitators Dr. David Henderson and Dr. Anne Frances D Intino

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