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!
2022 Stakeholder Meeting Video
2021 Stakeholder Meeting Video
2020 Stakeholder Meeting Video
Frequently asked questions about the PoET Southwest Spread Project (PSSP).
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.
- 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
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
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:
- Spend time to learn about and understand your home
- Identify and suggest the changes that have the highest anticipated impact for your home
- Design and plan for the implementation of those changes with you, and
- 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!
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
- 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
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
Click on the question that applies to your query, and the answer will be revealed.
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.
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

Pam Forsyth MHSc, RD
Research Enterprise
Pam Forsyth is the Managing Director, Research at McMaster’s Department of Family Medicine. She provides strategic oversight, financial management and operational planning for the David Braley Primary Care Research Collaborative. Pam’s expertise is in planning and evaluating strategic health initiatives, facilitating systems change and managing teams to maximize their potential. She has held senior management positions in health promotion, health communications and knowledge translation. Before joining McMaster DFM, Pam was the Managing Director of the National Collaborating Centre for Methods and Tools, a federally funded organization with a mandate for building capacity for Knowledge Translation in Public Health across Canada.

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.

Erin Beaulieu MPH, RD
Knowledge Translation Specialist
Erin Beaulieu has worked for the Department of Family Medicine since March 2019. As a Knowledge Translation (KT) Specialist with the department, she assists research projects with planning, creating, and implementing KT and communications activities.
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