Project Completion Date: November 30, 2027
Project Contact: Prabhjit Malhi
The Surrey-North Delta Division of Family Practice initiated an Expression of Interest project in the fall of 2024 to identify barriers healthcare providers face in delivering palliative care for structurally vulnerable and marginalized populations (those experiencing homelessness, living in shelters, or facing precarious housing situations) and assess the barriers these populations face in accessing this care.
A gap analysis and needs assessment identified these challenges, which were validated through surveys conducted by physicians, nurses, and shelter staff in December 2024.
This patient population -- which includes refugees, newcomers, people with complex mental health issues, and individuals with substance use disorders -- has complex psychosocial needs and is significantly younger than the typical palliative care patient.
Most are unattached to primary care and often rely on emergency rooms for medical attention. Strict safety guidelines, facility limitations, and provider shortages further complicate care. Stigma, frequent transitions, consent challenges, and medication management issues add to the difficulty. Many missed appointments with no clear care coordinator, inconsistent follow-ups, and competing daily priorities are common.
Early intervention, dedicated resources, and a structured approach are essential to improve outcomes.
Project Aim:
Over the next 24 months, the working group will launch a palliative care outreach program to address barriers faced by marginalized populations in Surrey-North Delta.
This initiative will provide comprehensive, patient-centred palliative care to structurally vulnerable individuals, enhance shelter-based medical support, and foster multidisciplinary collaboration as measured by reducing the number of hospitalizations for patients whose goals are comfort care by 25% and reducing EHS calls from shelter staff for designated palliative care patients by 25%.
