2019 Program

Expanding Our Reach Together

This Group Learning program has been certified by the College of Family Physicians of Canada and the Alberta Chapter for up to 12.25  Mainpro+ credits.

This event is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada, and approved by the University of Calgary Office of Continuing Medical Education and Professional Development. You may claim a maximum of 12.25 hours (credits are automatically calculated).

NEW FOR 2019

  • Awards presentations will be part of the Welcome Reception on Thursday evening, May 23.  The Reception is included in your registration – no extra cost to attend.
  • Friday evening will be free time to explore Calgary and to network with colleagues
  • Members Showcase on Saturday morning.  Authors of top poster abstracts will give short oral presentations about their work.
  • The Saturday program has been condensed so you can travel home in the afternoon.  The conference will end at 2:30 instead of 3:45.


Wednesday, May 22

12:00-17:00 Pre-conference POCUS Workshop 

Thursday, May 23
View speaker biographies

09:30-11:00 National Academic Half Day for Residents Only
Interaction with audience (Q&A, discussion)
Stigmatization in Palliative Care:  Origins, Effects, Mitigation
Dr. Hawley will explore the origins of stigma and how it is manifest in palliative care, then discuss some strategies for turning stigma into strength.
Interaction with audience (Q&A, discussion)
CSPCP SPECIAL SESSION PART I – Expanding our Reach Together:  Accelerating our Actions and Impact
Moderator:  Leonie HerxPalliative Care in the 21st Century: Where do we go From Here?
Review a 21st Century Model for Palliative Care, including the Bow Tie Model and integration of Specialist and Primary Palliative Care, referral triggers for timely versus early palliative care, and the public health approach to Palliative Care.
Speakers: David Hui, Pippa Hawley, Jeff Myers
15:45-16:00 Break
Interaction with audience (Q&A, discussion)
CSPCP SPECIAL SESSION PART II – Expanding our Reach Together:  Accelerating our Actions and Impact
Workforce Planning and Credentialing for Palliative Physicians
Present a CSPCP Staffing Model for planning palliative care programs and discuss national standards for credentialing specialist palliative physicians
Speakers: Anne Boyle, David Henderson, Leonie Herx

Overview of the priorities and next steps for the National Framework for Palliative Care
Speaker: Venetia Lawless

17:30-18:15 Welcome Reception with Exhibitors
18:15-18:45 Awards Presentations
18:45-20:00 Welcome Reception with Exhibitors Continues

Friday, May 24

07:30-08:00 Continental Breakfast, Poster Viewing and Exhibits
08:00-09:00 Residents’ Presentations (this session is not accredited)
Daniel Carter Ramirez, McMaster University
Developing a Framework for Evaluating a Palliative Approach to Care in Family Practice

Nicolas Chin-Yee, University of Ottawa
Red Blood Cell Transfusion in Palliative Care: A Retrospective Observational Cohort Study

Zhimeng Jia, University of Alberta
Development of a cachexia integrated nomogram to predict survival for inpatients with advanced cancer.

Interaction with audience (Q&A, discussion)
KEYNOTE – Corey Metcalf
Topic: Immunotherapy from Both an Oncological and a Palliative Care Perspective

10:00-10:30 Health/Networking Break, Poster Viewing and Exhibits
Interaction with audience (Q&A, discussion)
WORKSHOP SESSION I – Choice of 6 Workshops (repeated in PM)
Workshop 1 Corey Metcalf
Oncological and Palliative Aspects of Immunotherapy

Antineoplastic treatments are ever expanding and changing. With the introduction of immunotherapy, new treatment paradigms are being considered that impact on patient selection, expectations, and prognostication. These will be explored both from the perspective of an oncologist, but also on how this impacts on introducing and delivering palliative care.
Workshop 2 Amane Abdul-Razzak, Alison Murray
Top Practice Changing Articles of 2018-2019
In an interactive format, Dr. Abdul-Razzak and Dr. Murray will present and analyze 5 potentially practice-changing articles of 2018.  Articles will be primarily chosen for methodological rigour and relevance to clinical practice. We will discuss as a group, the methods and quality of the studies, and debate how they apply to our palliative care practice.
Workshop 3 Tara Lohmann
Providing Palliative Care for People with Advanced COPD: Current Challenges and Strategies
This interactive, case-based workshop will allow participants to explore the unique challenges faced by people living and dying with advanced COPD, as well as the difficulties faced by their caregivers and their health care providers. Through sharing of experience and knowledge, participants will learn strategies for reducing dynamic hyperinflation and improving the central perception of dyspnea in people with COPD and will develop an understanding of the other common symptoms that accompany dyspnea in this patient population.
Workshop 4 Janis Miyasaki
Palliative Care and Neurologic Illness
This session will review the pathophysiology, disease course, symptom burden and treatment for neurodegenerative disease, multiple sclerosis and brain tumours
Workshop 5 Ronald Spice
Support from a Distance – Using Technology to Connect with Palliative Care Patients
The use of web-based videoconferencing (WBVC) to connect with palliative patients in their homes will be discussed. Based on research conducted in Southern Alberta, the presentation will look at supporting and consulting on palliative patients by WBVC and consider the implications for practice in rural (and maybe urban) areas.
Workshop 6 Jessica Simon, Amy Tan, John You
Implementing the Serious Illness Care Program into “Non-palliative Care” Settings
The Serious Illness Care Program (SICP) is an evidence-based system intervention designed to enable more frequent, more person-centered, and earlier conversations about goals of care with patients who have serious illness. We will share our experiences implementing the SICP in “non-palliative care” settings (i.e., family practice and general medical wards of hospitals) as part of a national program of research. By sharing this information and enabling small group discussion amongst workshop participants focused on potential barriers and enablers to the implementation of the SICP, we aim to enhance palliative care practitioners’ ability to engage colleagues in other disciplines to implement system changes (such as SICP) that integrate a palliative approach to care in their own clinical settings.
11:45-13:00 Networking Lunch, Poster Viewing and Exhibits
Interaction with audience (Q&A, discussion)
WORKSHOP SESSION II – Choice of 6 Workshops
Repeat of Session I
14:15-15:15 Health/Networking Break, Poster Viewing and Exhibits
Interaction with audience (Q&A, discussion)
WORKSHOP SESSION III – Choice of 6 Workshops (non-repeating)
Workshop 1 Amit Arya
“Don’t tell Mom.” Developing Cultural Competency in Goals of Care Discussions
Palliative Care Physicians may face great challenges in engaging in goals of care conversations. When patients or families make decisions that conflict with provider recommendations, this can present ethical and legal difficulties. Often, these decisions are made in the context of cultural and religious variables which are poorly understood by health care teams. This may lead to increased health care utilization as well as “over-medicalization” of the dying process. What are some of the cultural and community based values which could impact decision making and be driving aggressive care at end-of-life? Is there a point at which the needs of the patient become less important than the needs of the family and community at large? How do we define “futility” from an ethical perspective and how is this influenced by the factors above? This interactive workshop will involve multiple small group case discussions and use the “ABCDE” tool. Different communication strategies will be discussed and applied using these cases. We will highlight different styles of decision making, and discuss end-of-life discussions in a global context. The workshop will examine the importance of patient, family, economic, religious & cultural factors.
Workshop 2 James Downar, Ahmed Jakda
Approaches to Early Identification of Patients who Would Benefit From Palliative Care – Better Tools, Better Systems
Palliative care may offer benefits to patients as they near the end of life, but there are numerous barriers to providing palliative care. One of the most important barriers is patient identification- the simple process of determining which patients will benefit at any given moment. Approaches such as the Gold Standards Framework or SPICT™ have been advocated, but studies have shown that these provider-dependent approaches are limited by the operating characteristics of the tools and the unreliability of the process when assigned to frontline care providers. An improved system would involve reliable, automated tools for identifying such patients and triggering an appropriate response, particularly for populations that traditionally receive little palliative care (e.g. organ failure, frailty). Several such tools have been developed that use existing datasets with little or no disruption of workflow, and empower frontline teams to reliably identify patients with unmet palliative needs. Some of these tools have been tested in different settings (e.g. primary care, acute care and long-term care settings) and shown encouraging results. In this workshop, we will review the challenges with early identification experienced by the audience, and the potential role that newer tools might play in overcoming these challenges. We will explore the potential use of big-data driven tools on a broad scale, to help frontline care providers in multiple settings identify and respond to patients with unmet palliative needs. We will also briefly summarize the science behind notification systems, and how these can be made more effective for the purpose of changing clinician and patient behaviour. We will use interactive methods to help participants think about how such tools could be used in their institutions.
Workshop 3 Paolo Mazzotta, Mohamed Abdelaal
Promoting Safer Opioid use in Palliative and End of Life Care
There is a pervasive belief that addiction is rare with opioid use in patients receiving Palliative and End of Life Care (PEOLC). However, the recent opioid crisis coupled with the shifting landscape of palliative care highlights the urgent need to address the risk of aberrant opioid use and addiction in patients receiving PEOLC. We will present the results of a scoping review and newly developed Delphi expert consensus clinical guidelines on opioid safety in PEOLC. The focus will be to promote safer and effective use of opioids for symptom management by adult patients, their circle of care and health care professionals by addressing the following: (1) patient and caregiver risk assessments for aberrant opioid use; (2) monitoring, dispensing, storage and disposal of opioids by palliative clinicians and programs; (3) patient and caregiver education on opioid use. The goal of this workshop is to present and apply the findings of the scoping review and expert consensus guidelines on opioid safety in palliative care using a case-based approach.
Workshop 4 Michael Slawnych
Optimal Management of Cardiac Devices at the End of Life
The field of cardiology has significantly evolved over the last several decades, with many of these changes being secondary to technical advances. As a result, cardiac patients now have access to a host of device therapies including general pacemakers, leadless pacemakers, cardiac resynchronization therapy (CRT) pacemakers, implantable cardioverter defibrillators (ICDs), and ventricular assist devices (VADs). While indications for implantation of these various devices are well documented in various practice guidelines, the management of these devices at or near the end of life is less well formalized. As a result, significant uncertainty exists in terms of optimal device management during the final stages of life. Several cases will be reviewed in this interactive workshop, including cases reviewing the management of pacemakers, ICDs and VADs near the end of life. This workshop is aimed at a broad target audience including palliative care physicians and other specialists, family medicine physicians, nurses, clinical nurse specialists, and medical residents. General resource documents will be provided, as well as key references.
Workshop 5 Martin Chasen, Rardi Van Heest
Oncology Survivorship – Alleviating Distress and Providing Symptom Management
In the next decade, it is anticipated that the number of cancer survivors will greatly increase. The National Cancer Institute estimates that in the USA, the number of cancer survivors will increase by 31%, and survivors who are more than 5 years post diagnosis will increase by 35%. Many cancer survivor patients suffer long term sequelae as a result of their diagnosis and treatment. Therefore, physicians will need to be prepared to treat all aspects of these patients, and their unique survivorship needs. Distress in cancer patients has been recognized as the 6th vital sign, and the Canadian Association of Psychosocial Oncology has published national guidelines on screening for distress, and other unmet needs in the survivorship patient group. Survivorship management is a part of integrated palliative care as illustrated in the “bow-tie” model. The palliative care physicians’ skill set places them in a unique position to identify these unmet, complex needs across the cancer trajectory. As well as by providing distress treatment and developing local programs to address the unrecognized distress in this large, and expanding, patient group. Our course will engage participants in the five domains of survivorship, and using our findings at William Osler Health System (WOHS), we will focus on how to determine the level of distress, which a cancer survivorship patient is experiencing and how to mitigate the symptoms.
Workshop 6 Leonie Herx, Margaret Cottle
Moral Distress and Moral Residue in Palliative Care
Moral distress and its chronic expression, moral residue, are discussed academically and have become an increasing focus of clinical research. This workshop will explore the concrete consequences of these issues in palliative care, and in the wider context of the problems in medicine today. Moral distress and moral residue are demonstrable dangers that lead to burn out, compassion fatigue, and loss of clinicians from practice. This not only threatens our work in palliative care, but our very selves, our teams and most importantly, our patients and their loved ones. Whatever the source, society at large and our commitment to those among us who are fragile are both endangered by moral distress and moral residue. In this workshop, the concepts of moral distress and moral residue will be explored as it pertains to practicing palliative care medicine in Canada in the 21st Century. Ethical concepts will also explored in their relationship to moral distress, including autonomy, moral injury, and professionalism. Examples of moral distress and moral residue will be discussed by Dr. Leonie Herx and Dr. Margaret Cottle, with additional insights provided by Dr. Nuala Kenny and Dr. John Scott. Participants will be invited to consider sources of moral distress in their own practices. Strategies for identifying and addressing moral distress and moral residue in ourselves, within our palliative care teams, and in medicine in general will be discussed. Ample time will be allotted in this workshop for collaborative, creative, hopeful, practical, and robust responses to this distress as palliative care physicians.
16:30-17:45 CSPCP AGM

Saturday, May 25

07:30-08:00 Hot Breakfast and Poster Viewing
08:00-09:15 CSPCP Members’ Showcase (this session is not accredited)

Presentation of top Abstracts
Moderator: Yoko Tarumi

Assessing Preferences for Early Palliative Care Among Rural-Living Advanced Cancer Patients and Caregivers
Amane Abdul-Razzak

Referral Practices of Cardiologists to Specialized Palliative Care in Canada
Michael Bonares

Palliative Care Education in Canadian EM Residency Programs: A National Cross-Sectional Survey
Skye Crawford

Assessing Goals of Care Conversation Quality During Serious Illness Care Program Quality Improvement Initiative
Christina Ma, Lauren Riehm

Working Group Presentations
Moderator: Kim Taylor

EFPPEC Undergrad Competencies
Amanda Roze des Ordons

PACE Postgrad Competencies
Carl Bromwich 

Clinical Rotations Project
Bruno Gagnon

Online Study Modules
Ebru Kaya

Case Based Manual
Anne Boyle 

Interaction with audience (Q&A, discussion)
WORKSHOP SESSION IV – Choice of 6 Workshops
Workshop 1 Pippa Hawley
Methadone for Pain: a practical basic to advanced workshop

This workshop will review the reasons for a trial of methadone, and the different methods of starting it in different situations, with lots of examples for participants to work through.
Suitable for new prescribers and for the experienced to become comfortable teaching their colleagues. It is recommended for attendees to complete the methadone4pain.ca online module in advance, which is free in Canada and fully CME-accredited.
Workshop 2 Martin Labrie
Palliative Care in Canadian Prisons
Multiple barriers to access to palliative and end of life care exist for offenders who are incarcerated in Canadian prisons. The rapid evolution of palliative care in the Canadian Health Care system has not been reflected in the health services available in our corrections institutions. Using a case-based approach, this workshop will explore the current status of palliative care in these settings, and consider opportunities to advocate for improved access.
Workshop 3 Barbara Pesut
Nav-CARE: A Compassionate Community, Volunteer-based Intervention for Seniors Living at Home with Advancing Chronic Illness
Recent evidence suggests that one in five seniors experience emotional distress and have difficulty coping day to day. Many feel they aren’t getting the support they need to live happier, more fulfilling lives. This is particularly the case with seniors living at home with advancing chronic illness. Canadian policy documents have consistently cited the need for early palliative support for this population and called for greater use of volunteers in providing this support.Nav-CARE is an intervention in which specially trained volunteers work with seniors living at home with advancing chronic illness to help improve their quality of life. Like a helpful neighbour or friend, Nav-CARE volunteers visit seniors regularly in the home to facilitate their access to needed resources and to provide social support. Unlike healthcare navigators who facilitate access to healthcare resources, Nav-CARE volunteers focus on improving quality of life through enhancing community connections and through assisting clients to meet basic daily needs such as transportation, household maintenance, and social engagement.Nav-CARE is evidence-based and has been implemented and evaluated in communities across Canada. In this session, evidence from this scale-out will be shared alongside what we have learned about facilitators and barriers to implementing a community-based program such as Nav-CARE. Participants will have the opportunity to provide input into how this intervention might be adapted or enhanced to better meet the needs of this population.
Workshop 4 Chandra Thomas
The Palliative Medicine Physician and Conservative Kidney Management
This workshop will explore palliative care for individuals with advanced chronic kidney disease who chose not to include dialysis in their care plan. We will focus on how the palliative medicine physician can support the nephrologist and family physician caring for these individuals. The specific areas we will address are decision making around treatment options, care delivery models, medication/investigation rationalization, symptom management and end of life care.
Workshop 5 Mino Mitri, Charlie Chen
Engage Your Audience: How to Deliver Effective Presentations/Workshops to Champion a Palliative Approach to Care
Equal access to excellent palliative care requires the collaboration and involvement of our primary care and specialist colleagues. Palliative care physicians and consultants have a major role to play in the championing of the embedding of a palliative approach to care across all health care sectors. Come to the workshop to discover powerful ways to engage with your audience and deliver exceptional & memorable presentations or workshops. Learn how to promote and advocate for palliative care with evidence-based educational
activities and techniques. And have some fun in the meantime!
Workshop 6 Hayden Rubensohn, Christian Wiens
Finding Light in the Heart of Darkness — Depression in Palliative Care
It is often challenging for patients, family members, and health care practitioners to recognize if emotional distress is a normal reaction to facing a life limiting illness and the dying process or whether it represents psychiatric illness. Although depressive syndromes are a common issue in palliative medicine, depressive disorders are still often misunderstood, underdiagnosed, and undertreated. Recognizing and addressing depression is paramount as depression impacts physical well-being, amplifying symptoms such as pain and fatigue; quality of life; desire for hastened death; and decision making. Timely, accurate diagnosis and intensive/aggressive treatment reduces suffering and optimizes patient outcomes.
10:45-11:15 Networking/Health Break and Poster Viewing
Interaction with audience (Q&A, discussion)
WORKSHOP SESSION V – Choice of 6 Workshops
Repeat of Session IV
12:30-13:15 Lunch will be served in the End Rooms and delegates will be invited to take it into the plenary room (Mayfair/Belaire/Britannia) to hear the keynote during lunch.
Interaction with audience (Q&A, discussion)
KEYNOTE – Barbara Pesut
Re-imagining Rural Palliative Care: Beyond the Guns and Roses Approach

Providing high quality palliative care in rural communities has been a longstanding challenge and the focus of numerous policy documents. The debate about how to provide care is often fraught with misperceptions that arise from urban-centric policies and perspectives. Although a number of innovative programs designed to improve palliative care in rural areas have been piloted successfully, the majority of these have never been scaled up. Part of the problem stems from the ways in which we think about rural-specific solutions. Historically, proposed solutions have emphasized the one-shot approach of using standardized policy or the roses approach of building rural capacity and culture. What is required, however, is an imaginative approach in which flexible rural-friendly policy is combined with long-term capacity building strategies to support high quality palliative care.