Rural Hospice Palliative Care Community of Practice


Communities of practice (CoP) are groups of people who share an interest or a passion for something they do, and a desire to share knowledge and learn as they interact regularly. Three characteristics are crucial:
  • The domain: A community of practice has an identity defined by a shared domain of interest. Membership therefore implies a commitment to the domain, and therefore a shared competence that distinguishes members.
  • The community: In pursuing their interest in their domain, members engage in joint activities and discussions, help each other, and share information. They build relationships that enable them to learn from each other.
  • The practice: Members of a community of practice are practitioners. They develop a shared repertoire of resources: experiences, stories, tools, ways of addressing recurring problems—in short a shared practice. This takes time and sustained interaction.
It is the combination of these three elements that constitutes a community of practice. And it is by developing these three elements in parallel that one cultivates such a community. Communities develop their practice through a variety of activities including: problem solving; requests for information; seeking experience; reusing assets; coordination and synergy; discussing developments; documentation; site visits; creation of materials and resources 1and mapping knowledge and identifying gaps.


The benefits of this type of mutuality and co-participation include:
  • More perspective and understanding of the problems and issues = Improved solutions
  • Shared Practice = Less duplication and reduced cost and time
  • Shared Knowledge = Stronger workforce and more sources of expertise
  • Meaningful participation = Improved performance and outcomes
  • Increased trust and confidence = Increased success and sustainability2 


Definition of Rural Several definitions and considerations related to ‘rural’ and ‘rural health’ exist, however no standard definition exists. Therefore, for the purpose of the Rural HPC CoP, the definition for ‘rural’ to guide ongoing discussions addressing issues in rural communities was adopted from the Ministry of Health and Long Term Care: ‘Rural’ communities in Ontario are those with a population of less than 30,000 that are greater than 30 minutes away in travel time from a community with a population of more than 30,000.3 

Why is a Rural Hospice Palliative Care Community of Practice needed? It is known that rural Ontario has a higher proportion of seniors per capita as compared to urban settings and the projections are signalling that this trend will be increasing in the coming years.

When delivering hospice palliative care across rural areas, most providers face similar key challenges. The most challenging issues identified by rural hospice directors fell into six categories4:
  • Financial issues, such as reimbursement issues and low volumes
  • General rural issues, such as culture and distance/travel
  • Regulatory and policy requirements
  • Workforce issues, including challenges in recruiting staff and maintaining staff
  • Relationships with other organizations, including competition for resources and patients
  • Technology issues, including the lack of available broadband and cell service 

Rural providers also identified the following additional challenges in meeting their service goals5:
  • Assuring access to hospice and palliative care-trained physicians;
  • Assuring access to qualified social workers;
  • Creating access to specialized medical expertise and consultation, including such specialties as oncology, neurology or hemato

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* 1. Your contact information:

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* 2. About You:

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* 3. Is the organization you work/volunteer for accredited?

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* 4. Your Workplace Setting(s) (please check all that apply)

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* 5. Please describe your interest in the Rural HPC CoP:

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* 6. Please provide a summary of your skills/experience that will benefit it the Rural HPC CoP in a Leadership Role: