This study is a quality improvement (QI) study. Unfortunately, due to differing provincial legislation concerning quality improvement studies across Canada we cannot provide clear national guidance as to whether collaborators can receive a QI exemption from research ethics board (REB) review, or not. For example, according to Ontario legislation, one cannot share patient data across institutions for the purpose of QI. For this reason, we have received Clinical Trials Ontario provincial REB approval (or separate institutional REB approval) for all Ontario sites. Each collaborating site will need to contact their local REBs to confirm if this project can proceed as a quality improvement study at their institution or require traditional REB approval. We are happy to support any new national collaborating institutions with their REB exemptions/approvals. Please see our Study Design Document. If you require further information or other protocol documents please contact COVIDRegistry@virtualhospice.ca.