Spread, participant experience, and implementation of Pallium Canada's Palliative Care ECHO project: a mixed methods study.

Background: Pallium Canada's Palliative Care Extension for Community (ECHO) Project (PC ECHO) is a five-year national initiative (launched April 2021) to support continuous professional development and to facilitate the integration of palliative care across different care settings. PC ECHO includes a superhub (Pallium Canada) and several partner hubs. The goal of this formative evaluation study is to explore the project's early spread and the experiences of hub partners and participants from April 2021 to September 2023.

Methods: A mixed-methods approach was used. Webinar and participant demographic information was collected by Pallium Canada's online learning management system and by partner hubs. Participants' experience feedback was collected through a standardized online evaluation form. Project leads at the superhub and three inaugural partners were interviewed and transcriptions subjected to a thematic analysis.

Results: A total of 301 sessions were delivered during the study period; 155 (51%) by Pallium Canada and 146 (49%) by nine partner hubs. Of these, 125 (42%) were standalone-type sessions and 176 (58%) were community of practice (COP)- or series-type sessions. A total of 7648 individuals - representing over 17 professions - participated across the 301 sessions; the nursing professions were the largest group (36.8%). There was a total of 17,467 participations across the 301 sessions, with participants from across Canada and 31% from rural or small population centres. 5105 evaluations of sessions were received (response rate 29%). Of these, 90% stated they "Agreed" or "Strongly Agreed" that the sessions were good learning experiences, and 93% indicated that they would recommend the session to colleagues. Project strengths and facilitators included accelerating partners' palliative care mandates, increased connections to other partners and resources, flexibility with the ECHO model, and funding received.

Conclusion: The intended outcomes of the PC ECHO Project are materializing, including utility for participants and helping partner hubs accelerate their palliative care mandates. There is evidence of significant spread, over a relatively short period of time. Future studies should include further exploration of the respective roles and impact of different session types (standalone versus communities of practice and series) and impact at higher patient and health system levels.