The RESPECT predictive algorithm

Bruyère is home to the Centre for Individualized Health. This centre hosts a collection of predictive algorithms that leverage province-wide data to better plan for care for aging people. Thanks to a generous anonymous donation of $1 million from a local family in 2018, the hope is that the centre will impact treatment plans at a systems level that ultimately improve the patient and caregiver experience.

A Bruyère and Ottawa Hospital collaborative, one of these predictive algorithms is RESPECT*, which helps identify when a person may be nearing the end of life.

Why is a tool like this helpful?

Our existing research, drawing from provincial databases, indicates that there is a considerable gap when it comes to who is receiving palliative care in Ontario. Only half of all decedents receive any palliative care in the last year of life. Among those who had palliative supports in the last year of life, just one third received palliative home care and less than a quarter of decedents received a physician home visit.

With RESPECT, we address this gap by better identifying the need for palliative care and relaying that information to the Ministry of Health so, from a systems level, we can identify the resources, both financial and human, required to meet this need. Ultimately, this improves care and experience for patients and caregivers at the end of life.

Importantly, at the individual level, this tool provides a way to initiate difficult conversations on the topic of end of life, enabling families to plan and identify palliative or other care needs.

One group participant stated: “When I asked the neurologist [at the time of] diagnosis ‘Are we looking at one year, five years, ten years?’ he couldn’t tell me. My mom’s been sick my whole life and that’s the first time that someone’s ever given me a [prediction].”

RESPECT allows families and loved ones to plan. For example, when an adult child might need to prepare to take a leave of absence from work to be with a parent or decide when to take the last family vacation. It also provides a way to track the health of an individual over time so you could objectively spot declines in well-being and access the support one needs.

Another user of RESPECT stated the following: “The results on life expectancy [have] helped us think about having more milestones for my mom… Like encouraging her to travel to visit my relative for Thanksgiving or planning her care when my brother is away. RESPECT has changed the way I feel about planning for my mum’s care and given me [a better idea] of what my family needs to do for mum.”

RESPECT is used in community settings in Windsor-Essex, is being tested by the Champlain LHIN palliative home care program, and will soon be available in some clinical settings at Bruyère.

*RESPECT stands for the Risk Evaluation for Support: Predictions for Elder-life in the Community Tool.