Palliative Education and Care for the Homeless (PEACH): A Model of Outreach Palliative Care for Structurally Vulnerable Populations

Nicole Buchanan; Naheed Dosani; Andrew Bond; Donna Spaner; Alissa Tedesco; Nadine Persaud; Trevor Morey

doi:10.12927/hcq.2023.27055

Palliative Education and Care for the Homeless (PEACH): A Model of Outreach Palliative Care for Structurally Vulnerable Populations

Healthc Q. 2023 Apr;26(1):24-30. doi: 10.12927/hcq.2023.27055.

Authors

Nicole Buchanan¹, Naheed Dosani², Andrew Bond³, Donna Spaner⁴, Alissa Tedesco⁵, Nadine Persaud⁶, Trevor Morey⁷

Affiliations

¹ Is a palliative care fellow at the University of Toronto, based in Toronto, ON. She is interested in improving the accessibility of palliative care for structurally vulnerable populations. Nicole can be reached by e-mail at nicole.buchanan@medportal.ca.
² Is a palliative care physician at the Department of Family and Community Medicine of St Michael's Hospital at Unity Health Toronto and an assistant professor at the University of Toronto, based in Toronto, ON. A health justice activist, Naheed is the founder and lead physician of the PEACH program at ICHA.
³ Is a medical director and community justice physician at ICHA and a lecturer at the Department of Family and Community Medicine, University of Toronto, based in Toronto, ON. He is the founder and co-chair of the Canadian Network for the Health and Housing of People Experiencing Homelessness. As a physician executive, he is dedicated to radically rethinking the design and delivery of healthcare systems bringing together health, home and community for population health equity.
⁴ Is a clinical director at the Palliative Care Program - Toronto Grace Health Centre and a PEACH physician at ICHA, based in Toronto, ON. She has an interest in working with structurally vulnerable clients and has been with the PEACH program since 2016.
⁵ Is a palliative care physician at the Temmy Latner Centre for Palliative Care, Sinai Health System, and a PEACH physician at ICHA, based in Toronto, ON. She is also a lecturer at the University of Toronto who works to improve equitable access to high-quality care to structurally vulnerable populations through her work.
⁶ Is the executive director at Kensington Hospice and the senior director of Client Services at Kensington Health, based in Toronto, ON. She has been working in the palliative care field for the past 16 years. Through her multiple leadership positions and her clinical practice, Nadine works to ensure that palliative care is equitable and accessible with the overall goal of supporting individuals to live well.
⁷ Is a palliative care physician at PEACH, ICHA, based in Toronto, ON. He has a passion for ensuring equitable access to palliative care.

PMID: 37144698
DOI: 10.12927/hcq.2023.27055

Abstract

The Palliative Education and Care for the Homeless (PEACH) program comprises a community palliative care team serving some of the most complex clients in the healthcare system. Formal partnerships bring together physician, nursing, psychosocial and homecare, health and housing navigation supports. PEACH has served over 1,000 clients, leading field-defining research, medical education and public advocacy. The PEACH program demonstrates that innovation through deep interorganizational and intersectoral integration can drive value-based impact for the most complex clients, providing instructive lessons for public health system reform well beyond the margins faced by people who are unhoused. This paper describes how PEACH's unique model, critical community partnerships and research have been necessary for it to become a leader in community-based palliative care for structurally vulnerable people.

MeSH terms

Home Care Services*
Humans
Palliative Care*
Vulnerable Populations