title: Enhancing family physician capacity to deliver quality palliative home care: an end-of-life, shared-care model.
abstract: OBJECTIVE
  Family physicians face innumerable challenges to delivering quality palliative home care to meet the complex needs of end-of-life patients and their families.
  
  
  OBJECTIVE
  To implement a model of shared care to enhance family physicians' ability to deliver quality palliative home care, particularly in a community-based setting.
  
  
  METHODS
  Family physicians in 3 group practices (N = 21) in Ontario's Niagara West region collaborated with an interprofessional palliative care team(including a palliative care advanced practice nurse, a palliative medicine physician, a bereavement counselor, a psychosocial-spiritual advisor, and a case manager) in a shared-care partnership to provide comprehensive palliative home care. Key features of the program included systematic and timely identification of end-of-life patients, needs assessments, symptom and psychosocial support interventions, regular communication between team members, and coordinated care guided by outcome-based assessment in the home. In addition, educational initiatives were provided to enhance family physicians' knowledge and skills.
  
  
  CONCLUSIONS
  Because of the program, participants reported improved communication, effective interprofessional collaboration, and the capacity to deliver palliative home care, 24 hours a day, 7 days a week, to end-of-life patients in the community.
authors.affiliation: McMaster University, Family Medicine, Hamilton, ON, Canada. marshald@mcmaster.ca
authors.forename: Denise
authors.initials: D
authors.lastname: Marshall
authors.forename: Doris
authors.initials: D
authors.lastname: Howell
authors.forename: Kevin
authors.initials: K
authors.lastname: Brazil
authors.forename: Michelle
authors.initials: M
authors.lastname: Howard
authors.forename: Alan
authors.initials: A
authors.lastname: Taniguchi
mesh_terms: D005194:Family Practice / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D017146:Models, Organizational; D009864:Ontario; D010166:Palliative Care / Q000592:standards*; D010348:Patient Care Team / Q000592:standards; D015397:Program Evaluation; D011787:Quality of Health Care / Q000639:trends*; D019452:Terminally Ill