Hamilton Health Sciences
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HHS is committed to Quality End-of-Life Care for all patients


Approximately 2000 people die annually at Hamilton Health Sciences (HHS), most from chronic or progressive diseases where death is foreseeable weeks or months in advance.  Although research shows that patients and families want to be engaged in planning for end-of-life, it is often hard for healthcare professionals to engage in these difficult conversations. As a result, some patients aren't given the opportunity to be proactively involved in preparing for death and many die without a clear end-of-life plan recorded.

That is why, starting in 2009, all staff and physicians have had the opportunity to learn about a new protocol that puts the wishes, values, goals and best interests of a patient with a life-threatening or life-limiting condition and the needs of the patient's family at the forefront of care.

The Quality End-of-Life Care protocol encourages all members of the care team to ask themselves, "Would I be surprised if this patient died within the next year, even with optimal treatment?" If the answer is 'no', the care team is encouraged to initiate conversations with the patient and family about the patient's end-of-life wishes and document a clear end-of-life plan.

Once in place, this plan ensures that patients receive treatment that is beneficial, and supports a better understanding of the goals of care between family members and the care team.

The protocol aims to help improve end of life care for all of our patients-from neonates to elders.

"This is not an easy discussion for anyone," said Andrea Frolic, Clinical and Organizational Ethicist. "Our hope is that the Quality End-of-Life Care protocol will provide individuals with the tools and encouragement they need to initiate these conversations earlier, when patients have options. Our patients and families deserve the opportunity to participate in crucial decisions about their life's journey."

Helpful Links & Resources

SDM Pamphlet

Make Wishes Known Pamphlet

Introduction to Post Video

End of Life Conversations Video

Posters for QEoL

Click here to view staff poster

For more information

Ontario's advance care planning guide is available at:

Resources for advance care planning including a workbook for patients from Fraser Health (BC)

Speak Up:  Advance Care Planning:

Finding Your Way: Medical Decisions When They Count Most:

Resources for people facing life-limiting illness, their families, and professional caregivers by palliative care physician Dr. Ira Byock:

 Hard Choices for Loving People:

"Food and Fluids When Nearing the End of Life."  Dr. Elizabeth Latimer, Hamilton Health Sciences - patient education. 
Available at


Hamilton Health Sciences • Hamilton, Ontario • 905.521.2100

Disclaimer: Hamilton Health Sciences (HHS) offers Google Translate to better facilitate access for our community. However, HHS makes no claims regarding the accuracy of translations. Any and all health information should be verified by a health care professional.