Results from the PoET Southwest Spread Project (PSSP)

The PoET Southwest Spread Project was a joint venture between William Osler Health System’s Ethics Quality Improvement Lab and McMaster University’s Department of Family Medicine.  Through $1.5 million in funding from Health Canada’s Health Care Policy Contribution Program the PoET Southwest Spread Project made PoET available to 54 long-term care homes in Ontario between 2019-2022.  Over a 1-month period, long-term care homes worked with a PoET Spread Leader to align their habits, practices, and policies with Ontario’s Health Care Consent Act;  following implementation, the effects of PoET on transfer rates and palliative care were measured.  The results of this evaluation are summarized below.  



Participation in PoET is associated with lower transfer rates.

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Participation in PoET is associated with lower transfer rates at end of life.

there were



Participation in PoET is associated with higher rates of palliative care encounters.

there were

Please click the button below to see these results in a printable format.

A few questions and answers about the PoET Southwest Spread Project (PSSP).

The PoET Southwest Spread Project was a joint venture between the Ethics Quality Improvement Lab of William Osler Health System and the Department of Family Medicine at McMaster University.  It was made possible through a financial contribution from Health Canada.

Information about the team’s individual members is available below.

Fifty four long term care homes in Ontario implemented PoET during the project.

Yes.  Because of the COVID-19 pandemic we had to pause implementation, and then pivot to a 100% virtual model toward the beginning of our implementation period.  The pandemic affected recruitment into the project, but by the end of our implementation period we had launched at the high end of our targeted range, which was 54 long-term care homes.

Yes, these results will be available in a forthcoming publication.  Details to this publication will be posted on this website when available.

Implementation of PoET is possible through the newly-launched Provincial PoET Program, which is open to any long-term care home in Ontario.

If a home is not yet ready to implement PoET, we also have A La Carte activities available.

Homes that have not yet implemented PoET and are part of the Greater Hamilton Health Network (GHHN) can also participate through our next project, PoET-LInC.

Yes, there is! You can find it here.

Click on the question that applies to your query, and the answer will be revealed.

PSSP Implementation Team

Jill Oliver PhD

Community Ethicist & PoET Project Lead

Dr. Jill Oliver is a Health Care Ethicist whose expertise focuses on consent, capacity, substitute decision making, and end-of-life issues as they arise in long-term care settings. Jill has a PhD in Philosophy from the University of Waterloo, an Academic Fellowship in Clinical and Organizational Ethics from the University of Toronto Joint Centre for Bioethics, and has also completed internships in Clinical Ethics at both Baycrest Centre for Geriatric Care, and William Osler Health System. Jill is currently leading the PoET (Prevention of Error-based Transfers) Project, an Ethics Quality Improvement Project for William Osler Health System.

Paula Chidwick PhD

PoET Project Lead and Director of Research & Corporate Ethics

Dr. Paula Chidwick is the Director Research & Corporate Ethics at William Osler Health System and the founding Director of the Osler’s Ethics Quality Improvement Lab. She has a PhD in Philosophy specializing in Bioethics from the University of Guelph and a Fellowship in Clinical Ethics from the University of Toronto Joint Centre for Bioethics. She has a certificate from Rotman’s in Integrative Thinking and from the Dalla Lana School of Public Health Institute of Health Policy, Management and Evaluation in Adaptive Leadership. She has been appointed Adjunct Assistant Professor at Queen’s University School of Nursing. Paula is a Health Quality Ontario IDEAS Advanced Learning Program Graduate and faculty at Osgoode’ s Certificate in Clinical Risk, Negligence, & Claims Management in Health Care. She provides ethics services to health care organizations throughout Ontario and across Canada. Paula has won >1.8M$ in contributions and grants supporting innovative work and research in the areas of ethics quality improvement, ethics in transitions, and end-of –life. In Fall 2020, the EQI Ethics Team was awarded a World Health Organization Ethics Grant to conduct a global survey on ethical issue in long-term care during the COVID19 pandemic. She has served on the Canadian Bioethics Society Executive, Health Canada’s Scientific and Expert Advisory Panels, MOHLTC Critical Care Coaching Teams and Critical Care Services Ontario. She is founding member the Healthcare Consent Quality Collaborative (HCQC), Regional Bioethics Groups, (RBG, RBG North), Ontario Ethics Quality Improvement Network (OEQIN).

Theresa Nitti, RPN

PoET Spread Leader

Theresa has experience in a wide range of health care settings including family practice, supportive housing, adult day programs, long term care, and hospital. Most recently Theresa held nursing positions at both the Palliative and General Medicine units at Etobicoke General Hospital. While working as a nurse at William Osler Health System Theresa facilitated multiple safety and quality improvement initiatives.

Megan Bailey, MA

PoET Spread Leader

Megan Bailey is a Master of Arts (MA) graduate in Health Policy & Equity from York University. Her clinical experience as
a program coordinator and clinical ethics intern has afforded Megan with a solid foundation in the field of bioethics. Megan intersects her clinical experience in ethics with her academic background in health policy in her current work with the PoET Project. Megan has dedicated her academic and professional development and extracurricular time towards her passion for
health justice, supported through the PoET Project’s work. Megan aspires to continue her academic career in health law to further her research in the right to health, health policy, and health justice. 

Marina Salis, HBA, MHSc

PoET Spread Coordinator

Marina has a deep love and passion for the bioethics field, recently completed her double honours bachelor of arts in biomedical ethics, philosophy, and equity at the University of Toronto. She is currently working towards completing her Master of Health Science in Bioethics at the University of Toronto and is the current president of the University of Toronto Bioethics Society. Marina aspires to get her PhD specializing in quality improvement research on the intersections of neurodegenerative disease, policy, and person-centered care. Marina dedicates her profession and studies to the Ethics Quality Improvement Lab who have been integral to her development in the field, and her grandfather whose battle with Alzheimer’s have driven her to ensure that all residents receive care that aligns with their life narrative. 

PSSP Evaluation Team

Henry Siu MSc, MD, CCFP (COE)

Project co-lead, Evaluation Lead

Henry Siu joined the Department of Family Medicine as a full-time faculty member in 2013. He received his certificate of added competence in care of the elderly from the College of Family Physicians of Canada in 2015. He currently has a full-time academic teaching family practice, leads the local interdisciplinary memory clinic, works as an attending physician at a long-term care home, and is the program director for the care of the elderly enhanced skills program at McMaster University. His current research interests focus on improving the care provided to elderly patients, particularly in long-term care

Dawn Elston M.A.

Evaluation Coordinator

Dawn’s research interests reflect a diverse range of positions working in the social and health sciences at McMaster University. Dawn has been a staff member in the Dept. of Family Medicine since 2014 working on Advance Care Planning projects in primary care and long-term care.

Abe Hafid MPH

Performance Measurement Specialist

Abe’s research interests include large scale health administrative data, quantitative analyses, and evidence informed health economics and policy. Abe has been a staff member in the Dept. of Family Medicine since January 2019, working on end-of-life care focused projects in primary care. As the Performance Measurement Specialist, Abe is responsible for data collection, analysis, and translation of statistical findings for the PoET Southwest Spread Project.

2022 Stakeholder Meeting Video

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2021 Stakeholder Meeting Video 

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2020 Stakeholder Meeting Video

What's the one word that PSSP participants said represents PoET?

JAMDA Letter to the Editor

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