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Challenging Clinical Care Needs for Palliative & End-of-Life Care Patients and their Families

Using “advanced cancer shared care letters” to improve shared care between oncologists and family physicians

Jessica Simon


Emily Schorr, Patricia Tang, Safiya Karim, Patricia Biondo, Sharon M. Watanabe, Amy Tan, Aynharan Sinnarajah, Jessica Simon, Dean Ruether, Jillian Hurst, Maureen McCall, Simon Mairs, Camille Piquette


Participants will: 1. Learn about the made-in-Alberta “advanced cancer shared care letters”, their benefits, and how to use them; 2. Learn about the key factors that improved the uptake of this quality improvement initiative; 3. Learn about other initiatives underway in Alberta to improve shared care for people living with cancer.

Brief Abstract

A coordinated and shared palliative approach is critically important for patients with metastatic cancer. We implemented “advanced cancer shared care letters” in two Alberta cancer centres to improve care coordination and earlier access to palliative care. Key challenges included cueing oncologists within clinic workflow and avoiding change fatigue. Several factors influenced uptake including implementation funding, operational leaders’ and local clinical champion support, behaviour modeling, training, enablement, and environmental restructuring.

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