The British Columbia (BC) Practice Support Program, supported by the General Practice Services Committee (a joint program of the BC Medical Association, the Ministry of Health), has been an effective strategy to change and influence the care being offered in GP offices throughout BC. This innovative program has engaged 2000 GPs (of ∼3500 caring for 4.5 million people) in practice redesign since 2007 and now is providing a module to improve the identification, assessment and management of patients at the end of life, including redesign of office processes and procedures that need to be implemented to support a new approach. It integrates aspects of the Gold Standards Framework (UK), the BC Chronic disease management framework, the triple aim of the Institute for Health Care Improvement, with the norms and practices of Hospice Palliative Care in Canada. Participants include GP champions as the teachers together with local palliative care providers, home care nurses, specialist physicians and general practitioners and their MOAs. There are 3 learning sessions interspersed with 2 action periods during which physicians are supported to implement changes in practice like a registry; flags to alert the physician to key changes; more collaborative practice and supports for Advance Care Planning. The algorithm and the clinical support tools embedded in the algorithm have been well received and reinforce a best practice approach. The results of the evaluation will be presented. This may enable others tasked with physician education and practice support to learn from a successful, innovative provincial implementation.
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