Health Care Consent Advance Care Planning Community of Practice

Publication/Event Date: 
Thursday, January 14, 2016

What is a Community of Practice (CoP)?

Communities of practice are groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly. Three characteristics are crucial:

  • The domain: A community of practice has an identity defined by a shared domain of interest. Membership therefore implies a commitment to the domain, and therefore a shared competence that distinguishes members.
  • The community: In pursuing their interest in their domain, members engage in joint activities and discussions, help each other, and share information. They build relationships that enable them to learn from each other.
  • The practice: Members of a community of practice are practitioners. They develop a shared repertoire of resources: experiences, stories, tools, ways of addressing recurring problems—in short a shared practice. This takes time and sustained interaction.

It is the combination of these three elements that constitutes a community of practice. And it is by developing these three elements in parallel that one cultivates such a community.  Communities develop their practice through a variety of activities including: problem solving; requests for information; seeking experience; reusing assets; coordination and synergy; discussing developments; documentation; site visits; creation of materials and resources   and mapping knowledge and identifying gaps.

How CoPs Make a Difference

The benefits of this type of mutuality and co-participation include:

  • More perspective and understanding of the problems and issues = Improved solutions
  • Shared Practice = Less duplication and reduced cost and time
  • Shared Knowledge = Stronger workforce and more sources of expertise
  • Meaningful participation = Improved performance and outcomes
  • Increased trust and confidence = Increased success and sustainability

Background

The Health Care Consent Advance Care Planning Community of Practice (HCC ACP CoP) was created to respond to the need for a provincial resource for health care consent and advance care practice utilizing an Ontario legal framework. Both national and provincial initiatives related to Advance care planning have contributed to help drive the work and activities by this group.  Goals are reflective of an Ontario legal framework and reinforce the link between HCC & ACP to the public and health care providers. This Community of Practice has been in existence since 2010 in various forms.  The Alzheimer Knowledge Exchange initially supported it until the spring of 2013.  It continued to work after the funding from Seniors Health Research Transfer Network (SHRTN) ended, and later officially transitioned to Hospice Palliative Care Ontario (HPCO) where it has been principally led by a dedicated group of HCC ACP expert leaders. 

A key link to the HCC ACP CoP is Speak-Up Ontario, which is a partnership between HPCO and the Canadian Hospice Palliative Care Association (CHPCA) and began in February 2012.  This is the Ontario version of the National Speak-Up Campaign, which provides training and Ontario based tools and resources across the province.  As a result of these collaborative partnerships, the first Ontario webinar was held in February 2012 which trained approximately 50 people in HCC & ACP.  An additional 30 people were then trained at the Annual HPCO conference in April 2012. 

Additionally, the National ACP workbook was revised by the HCC ACP CoP to meet Ontario standards.  HPCO then secured funding for 3,000 workbooks that were broadly distributed across the province.  The increasing demand for these resources, including from organizations ordering the Speak-Up Ontario workbooks, resulted in HPCO funding an additional 10,000 English and 1,000 French workbooks. In total, almost 20,000 Ontario workbooks have been distributed to-date.

The HCC ACP CoP has also created public education materials that teach advance care planning in relation to Health Care Consent based on the Ontario legal framework including:

  • Health Service Provider Workshop on Health Care Consent in Relation to Advance Care Planning
    • This presentation provides education for health service providers on the topic of health care consent as it relates to advance care planning.  Both full length and condensed versions of the PowerPoint materials have facilitator guides to prepare the facilitator to present the material.
    • Public Education Session on Advance Care Planning in Relation to Health Care Consent
      • This presentation is designed for health service providers and educators to use in information sessions for the public on the topic of health care consent as it relates to advance care planning. Both full length and condensed versions of the PowerPoint materials have facilitator guides to prepare the facilitator to present the material.

Additional Videos added to the resources include:

  • Speak Up Ontario – Train the Trainer Workshop Video (For Health Service Providers and Educators from the National and Ontario Speak Up campaigns)
    • This presentation provides practical ways to promote advance care planning.  It presents “Advance Care Planning 101” –why ACP is important and what it is, and is not.  The video introduces the Speak-Up Ontario Campaign – describing tools and how to use them.  It provides suggestions for facilitating ACP in your community.
    • Health Care Consent and Advance Care Planning: getting it Right in Ontario for Health Care Practitioners
      • This video presentation is designed for health care practitioners (physicians, nurses) utilizing the Ontario legal framework and the 2014 Law Commission report on the state of ACP and HCC in Ontario.

Today HPCO remains dedicated to hosting and supporting the HCC ACP CoP, managing the Ontario Speak-Up campaign, distributing the workbooks and continuing with the work that encourages HCC ACP discussions, reinforces the connections, and participates in the shared dialogue and opportunities of CoP collaboration.

Goals

  1. To create opportunities to influence policy and system issues related to Health Care Consent and Advance Care Planning in an Ontario legal framework.
  2. To develop as an active and engaged community of practice advancing the goals as defined by its members.
  3. To create awareness and educational materials and opportunities about health care consent and advance care planning within an Ontario legal framework.

Activities

  • Participate in regional and provincial discussions/opportunities in regard to HCC and ACP based on the Ontario legal framework.
  • Support, when able, HCC ACP activities and initiatives as requested by regional and local areas.
  • Discussions related to challenges, issues and opportunities to improve knowledge, consistency and practice related to HCC and ACP in Ontario.
  • Creation of education materials (videos, webinars, PPT’s, facilitation manuals for public and healthcare providers) based on Ontario legal framework
  • Build on existing Ontario centric materials and frameworks that advance best practices.

Structure

The HCC ACP CoP is responsive to its membership and has evolved to meet the growing interest and demand for leadership and resources throughout Ontario.  As such the current structure includes:

  • Leadership Advisory Team – HCC ACP Ontario experts that meet approximately 8 times a year with additional meetings as required to advise HPCO and the HCC ACP CoP on recommended Ontario tools, resources, promotion, awareness, etc. and review content, context, materials, etc.,
  • Regional Champions Group – Champions from each LHIN that have a lead role for promoting and implementing HCC ACP within their geography, ideally at a LHIN wide level, that meet quarterly to provide a forum for information exchange, knowledge transfer and share information about HCC ACP initiatives within the Ontario framework; and to promote the recommended Ontario tools and resources and build awareness.
  • Broad-based Community of Practice - A group of healthcare practitioners and administrators, caregivers, policymakers, researchers, educators and leaders who are interested in coming together to exchange information and promote HCC ACP in Ontario; and to promote the recommended Ontario tools and resources and build awareness.  These community members make a commitment to support and learn from one another and to develop new knowledge to advance a field of practice.
  • Working Groups - Ad Hoc Projects determined by the membership and advised by the Leadership Advisory Committee, i.e., developing and offering HCC ACP:
    • Ontario website and Interactive Workbook
    • Leadership Tools
    • Common Language
    • Education

Platform Support

HPCO provides the HCC ACP CoP with an online version of SharePoint as the platform to support a workspace for use by committees, teams, individuals, and organizations.  It is used for document storage, discussion forms, scheduling, and collaboration.   Access to the SharePoint site is restricted to authorized users and CoP members and requires a user name and password.

The HCC ACP CoP has the following features enabled to assist them in advancing their work:

  • Discussion forum
  • Announcement board
  • Calendar
  • Event planning with event specific sub-site
  • Lists of web links,
  • List of CoP members
  • Libraries for documents and other materials
  • Surveys – the CoP uses this to collect seminar info
  • The ability to create collaborate workspace for working groups, leadership, etc. that are open only to member of the specific groups.

    Health Care Consent Advance Care Planning Community of Practice structure

Contact

Julie Darnay, CoP Lead
416-304-1477 or 1-800-349-3111 ext. 30

jdarnay@hpco.ca