PoET Southwest Spread Project

PoET Southwest Spread Project (PSSP)

The award-winning PoET (Prevention of Error-Based Transfers) Project is available to interested long-term care homes in the MHLHIN and HNHB LHINs through 2022!


 Through $1.5 million in funding from Health Canada’s Health Care Policy Contribution Program the PoET Southwest Spread Project makes PoET available to long-term care homes in the Mississauga Halton and Hamilton, Niagara, Haldimand Brant LHINs. The PoET Southwest Spread Project is a joint venture between William Osler Health System’s Ethics Quality Improvement Lab and McMaster University’s Department of Family Medicine.


There is NO COST to homes to participate! 

See more information below. 

PSSP Stakeholder Meeting, March 5th, 2020

What is PoET?

PoET is an award-winning ethics quality improvement project that has successfully sustained a 68 per cent reduction in repeated end of-life transitions of long-term care residents between care settings in the Central West Local Health Integration Network (LHIN). The project has been supported by Health Quality Ontario’s IDEAS (Improving & Driving Excellence Across Sectors) Advanced Learning Program Alumni Award and also produced the Accreditation Canada Leading Practice Individualized Summary. 

What does the implementation of PoET look like?

PoET supports long-term care homes to bring habits and practices more closely in line with Ontario’s Health Care Consent Act. When a home launches PoET, a PoET Spread Leader will work with staff to identify changes to test, and then support staff in making, measuring, and sustaining those changes. PoET-related changes homes might make include (but are not limited to): 

  • Discontinuing the use of the “Level of Care” form 
  • Inviting residents to all care conferences
  • Reviewing advance care planning documents on admission
  • Informing residents of their right to appeal a finding of incapacity
  • Ensuring that consent is obtained from the right person

What homes should participate in this project??

Any home in the MHLHIN or HNHB LHIN can participate in the PoET Southwest Spread Project. Homes that are ready to make PoET-related changes include those that: 

  • want to make a commitment to align habits and practices with Ontario’s Health Care Consent Act 
  • are interested in reducing consent-related errors and the transfers to hospital these errors can contribute to 
  • want to know more about their residents’ wishes, values, and beliefs, and 
  • are already able to provide high-quality in-home palliative care

What is a spread leader?

Long-Term Care homes that participate in the PoET Southwest Spread Project will have the support of a Spread Leader over a one-month period. Your Spread Leader will help your home to align practices with Ontario’s Health Care Consent Act, so that consent-related errors can be reduced. Specifically, the Spread Leader will: 

1. Spend time to learn about and understand your home 

2. Identify and suggest the changes that have the highest anticipated impact for your home 

3. Design and plan for the implementation of those changes with you, and 

4. Evaluate the changes you have chosen to implement, and support their refinement after launch The PoET Southwest Spread Project has two Spread Leaders who will do this work in participating homes. Find more about them here!

Theresa Nitti

Nipa Chauhan

Theresa has experience in a wide range of health care settings including family practice, supportive housing, adult day programs, longterm 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.

Nipa is a graduate of the MHSc (Bioethics) program through the Joint Centre for Bioethics at the University of Toronto. Her clinical experience comes through her work at Mount Sinai Hospital, which included ethics consultations throughout the hospital. In addition to teaching bioethics at the University of Toronto, Nipa is also the founder of Café Bioethics, a live forum encouraging accessible discussions revolving around medical ethics. 


(437) 248-3947


(437) 248-3902


What does the evaluation of the PoET Southwest Spread Project look like?

Collecting information on how PoET is working in your long-term care (LTC) home is vital to the project. The data that you share with us will help us understand why PoET is working in your home. It will also help other homes understand how to implement PoET. 

We will be collecting three types of data for this project: 

1) Routinely-collected administrative data from your home (e.g. hospital admissions) 

2) The opinions of LTC home staff, residents and loved ones about PoET through group discussions 

3) Survey data about engagement with the PoET process

What will your home be asked to do?

  • Identify a champion from your home that we can work with to identify
    how best to collect the administrative data and distribute surveys
  • Submit administrative data electronically at monthly intervals
  • Staff will be invited to complete an optional survey at three different
    times after launching PoET
  • Advertise (approved advertising will be provided) and provide space for
    one 90-minute focus group discussion

How will this benefit your long-term care home?

We want to dovetail with work that is already being done in your home to make the most of resources. Therefore, we are committed to: 

  • Providing your home with information about quality indicators and outcomes that are important to you 
  • Working with you to create custom reports that coincide with long-term care home reporting deadlines 
  • Providing important feedback from staff and clients about their experience, facilitators and barriers to providing quality care and engagement of senior and clinical leadership

The PoET Southwest Spread Project is a joint venture between
Osler’s Ethics Quality Improvement Lab and McMaster University’s Department of Family Medicine.

Production of this document has been made possible through a financial contribution from Health Canada.

The views expressed herein do not necessarily represent the views of Health Canada.