Kingston General Hospital

The Kingston General Hospital (KGH) is a teritiary level acute care teaching hospital that services the population of Southeastern Ontario.  As a tertiary care hospital, it is fully resourced with access to all modern investigational and interventional technologies.  The Palliative Care Medicine Service at Kingston General Hospital is an interprofessional team of health care professionals and volunteers that provides primary palliative care for patients in 3 Complex Palliative Medicine beds, acute care consultation services and concurrent care for patients from all services who are in need of such expertise.  Consultations include symptom control as well as advice and support for psychosocial and spiritual concerns.  The interprofessional palliative care team, which includes a palliative medicine physician, advanced practice nurse in palliative care, social worker, volunteer co-ordinator, chaplain, and dietitian, meets on a weekly basis to discuss patients.  The Palliative Care Medicine Service sees a total of approximately 600 new patients annually and provides approximately 5000 visits per year.  Many referrals originate from Medical and Radiation Oncology, however, the spectrum is not specific to cancer care only.  Patients are referred for both consultation and concurrent care from Surgery, Urology, Gynaecology, Cardiology, Nephrology and General Medicine.

Cancer Centre of Southeastern Ontario

The Cancer Centre of Southeastern Ontario (CC-SEO)is an outpatient, tertiary cancer centre affiliated with the Kingston General Hospital.  It is a regional referral centre for medical oncology, radiation oncology, gynaecological oncology, pediatric oncology and surgical oncology. 

CC-SEO is well resourced with academic Medical and Radiation Oncologists who provide care to adult and pediatric patients with all tumour types.  Approximately 4500 new patients are seen per year.  Follow-up visits include radiation therapy and chemotherapy treatment visits.  For the Palliative Medicine resident who is not a specialist in Oncology, there is a one month rotation in each of Medical and Radiation Oncology. Residents attend ambulatory care clinics assessing patients to learn more about the natural history of different cancers, available treatment options, and complications of treatments.

Palliative Medicine Clinics

Five ambulatory Palliative Medicine Clinics are held weekly in the Cancer Centre of Southeastern Ontario. The clinics provide a consultation service for the management of difficult symptoms in patients who are followed by the CC-SEO.  Patients are seen in follow-up until their symptoms are well managed and then they are returned to the care of their family physician or primary oncologist.  Others are followed on an ongoing basis.  Approximately 250 new consults and 800 visits occur in the five Clinics annually.  The Palliative Medicine consultant works closely with the Oncologists, members of the Palliative Medicine and Supportive Care Program (e.g. social worker, dietitian, pharmacist) and Community Care Access Centre case managers in the management of patients.  The resident attends one of the clinics on a regular basis throughout the year.

The CC-SEO uses the resources of ISAAC (Interactive Symptom Assessment and Collection) with touch-screen technology enabling all patients attending the CC-SEO to complete ESAS prior to their appointment.  The care team is provided with a cumulative print-out to assist with quality care.