Documentation and Analysis of GASHA Hospice Palliative Care Delivery Processes
Euloth, Ene (Ann)
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The internship placement took place at the StFX Centre for Logic and Information (CLI) in Antigonish, NS, and reported directly to the director of CLI, Dr. Wendy MacCaull, professor of Mathematics, Statistics and Computer Science at StFX University. The internship work was performed over a thirteen-week period from May 7, 2008 through to August 1, 2008. The internship work was focused on Hospice Palliative Care and contributed to two major projects at the Centre: 1)‘Building Decision-Support through Dynamic workflow Systems for Healthcare’ funded by ACOA through the Atlantic Innovation Fund (AIF) and 2) ‘Decision Support and Information Management for the Policy Maker focusing on Patient-Centered Palliative Care in GASHA. The objectives for the internship were twofold 1) To map the Canadian Hospice Palliative Care Association (CHPCA) Norms of Practice for the Care Delivery Process to the Guysborough Antigonish Strait Health Authority (GASHA) processes of delivering hospice palliative care services. 2) To develop a domain ontology at the GASHA Decision and Policy Maker (i.e. Strategic and System) level for provision of Hospice Palliative Care (HPC) services. Objective 1 was accomplished by first documenting the GASHA Care Delivery processes, and to a level of detail that allowed a comparison to the CHPCA norms. A Gap Analysis was then conducted to identify any missings or required enhancements. This analysis revealed that enhancements needed to be made to the Medication Reconciliation, Fall prevention, Setting of Care, and Essential Services processes. This work was further developed to then map these norms to the CCHSA standards for Palliative Care and End of Life Services. This ensured that not only were the GASHA processes standardized to the 2002 CHPCA Model to Guide Palliative Care, but that there was also a direct correlation to the CCHSA standards. The CCHSA indicators could then be used to measure the performance of the processes at meeting the norms. Another Gap Analysis was conducted to identify any required data that was not being collected through the processes. Objective 2 was accomplished by superficially documenting processes at the Strategic and System (Senior Management) level of GASHA. From there a Use Case was developed and then a diagrammatic representation of Palliative Care Ontology Flow was created. Key recommendations from this internship: • Because of the truly interdisciplinary nature of Hospice Palliative Care, development of common processes and language for GASHA PC services and Continuing Care is a must. • Document remaining GASHA HPC services processes in the same manner as Care Delivery processes. • Further develop GASHA processes for medication Reconciliation, Fall Prevention, Setting of Care and Essential services, to meet all the CHPCA Norms of Practice for the Care delivery step. • Develop ontology to inform GASHA Health Administration policies at the Manager and Director (Operational) level, and not at the Senior Management (Strategic and System) level. The internship proved to be a valuable learning experience for the author and provided an opportunity to gain an in-depth understanding of Hospice Palliative Care, the 2002 CHPCA National Model, the NS provincial model and the GASHA/Continuing Care Integrated model, as well as the CCHSA standards for Palliative Care and EOL Services. These exciting and relevant projects afforded the author the chance to put health informatics theory, techniques and solutions into practice.