November 27-29, 2017
Westin Harbour Castle, Toronto
Call for Abstracts – The Ontario Long Term Care Association’s (OLTCA) This is Long Term Care 2017 conference profiles emerging research and innovation and successful quality initiatives in a unique forum designed for learning, networking and information sharing. It provides an unparalleled opportunity for our members to hear about cutting edge ideas as well as existing best practice programs that have tools, resources, policies and procedures which can be implemented across the sector.
CLICK HERE to review application criteria or to apply online.
The need to support Indigenous culture & cultural diversity in Ontario Long-Term Care homes
Canada’s population is getting more diverse. As our population ages, Long-Term Care homes will be expected to meet the growing needs of a culturally-diverse population.
Culture is ingrained in individual identity and affects life and health care practices, traditions, values and decision-making. In particular, Canada’s Indigenous people have unique cultural requirements. A legacy of colonization, historical trauma, racism, distrust of western medicine and ways, and sometimes geographic isolation, impact Indigenous people more than other segments of seniors. Respect for treaty rights and jurisdictional issues needs to be considered in planning for care and supporting the culture of this population.
Starting an inclusive, sector-wide reflection
As providers of person-centred care, Long-Term Care homes need to recognize and support the culture of their residents. This can sometimes be challenging, especially at a time when a resident’s health and mental capacity are declining. To help the sector learn about the approaches homes have used, and to understand the types of challenges homes have faced, Ontario’s CLRI Program spent several months in the past year gathering evidence and experiences from around the province.
We worked closely with multiple stakeholders and two Advisory Groups, and conducted a literature review. Our learnings will inform future work around developing tools and resources to support Indigenous culture and cultural diversity in Long-Term Care, and to scale-up existing, successful practices. Stakeholders underlined that any future activity must be in collaboration with various cultural and Indigenous groups, and with a broad range of healthcare providers.
Behavioural Supports Ontario (BSO) & brainXchange released a new report, Environmental Scan of Ontario’s Behavioural Support Transition Units (BSTUs). The report presents general information about the BSTUs for the purposes of learning, knowledge sharing, and quality improvement.
In 2016, the Bruyère CLRI joined the BSTU Collaborative, which is part of Ontario’s Best Practice Exchange. The Collaborative designed and facilitated the environmental scan of Ontario’s BSTUs. Click here to learn more about the BSTU Collaborative and to access the report.
To contribute to the Collaborative, the Bruyère CLRI team drew on one of its past projects, Meeting Future Need Through Specialization in Long-Term Care Homes. This project focused on existing designated specialized units in Ontario’s long-term care homes. The designated units either wrap higher intensity care around residents with complex responsive behaviours, which are frequently related to dementia (BSTUs), or support the needs of residents who require dialysis.
To learn more about specialized units visit http://clri-ltc.ca/resource-category/specialized-units/ or read the article, Designated Specialized Units: How Ontario’s long-term care homes fill a gap in care, which was published in Healthcare Management Forum (October 2016).
Videos from the March 2017 Culture Change Exchange are now online! Sessions from this event feature internationally-renowned speakers and presenters from Ontario’s long-term care sector, sharing how they’re enhancing the culture in their long-term care home or organization by building relationships and supporting people living with dementia.
For more information, visit the Research Institute for Aging website.
The Bruyère Centre for Learning, Research and Innovation in Long-Term Care is proudly collaborating with La Cité’s Dental Hygiene Program and Saint-Louis Residence. Together, these organizations are creating educational opportunities to enhance the skills of dental hygiene students and long-term care home staff, as well as improve the quality of oral health care for long-term care residents.
To learn more about this exciting partnership, please visit the Bruyère Continuing Care website.
Last month, the CLRI team engaged with a large group of Extendicare leaders from across Canada. The focus was on how tools developed through the CLRI program can help long-term care homes improve care and embrace innovation.
The three Ontario CLRIs were invited to present at the Extendicare National Business Conference and Trade Show, in Toronto, on April 26, 2017. Entitled, “Ten Innovations to Help You Transform Your Home,” the presentation featured a variety of CLRI-developed approaches and free web-based resources to support the transformation of long-term care homes in the areas of culture change, learning, and staff engagement. The CLRIs shared the session with Charlene Chu from AGE-WELL and the Toronto Rehabilitation Institute.
The CLRI team also hosted an interactive booth to further showcase the work of the Ontario CLRI Program.
For a copy of the presentation slides, or if you have any questions related to free, web-based resources developed by the CLRIs, please contact us at email@example.com.
The Bruyère CLRI was proud to present our work on plan of care compliance at the recent AdvantAge Ontario Conference. We jointly delivered with Wellington Terrace, a long-term care home in Fergus, which has consistently focused on care planning as an integral part of high quality care delivery. The many questions from a packed room ensured a dynamic session and confirmed the relevance of this topic.
Since 2015, the Bruyère CLRI has been working in close partnership with AdvantAge Ontario and the Ontario Long Term Care Association to better understand the facilitators and challenges related to compliance with the plan of care regulations of the Long-Term Care Homes Act. During the presentation, we shared our findings from interviewing those homes that have consistently demonstrated – through resident quality inspections – the highest degree of compliance with plan of care regulations. To guide these interviews, we conducted a literature review on the challenges and solutions to implementing optimal evidence-informed care planning for long-term care residents.
For a copy of the presentation or the literature review, please contact us at firstname.lastname@example.org.
The Bruyère CLRI is pleased to announce the publication of the article, “Clinical Nursing Leadership Education in Long-Term Care: Intervention Design and Evaluation,” in the Journal of Gerontological Nursing. Click here to access a free download of the full article.
The main objective of the current case study was to investigate the perceived leadership learning needs and feasibility of delivering leadership education to registered staff involved in direct care in long-term care (LTC) homes. The study was conducted in Ontario, Canada, and participants included RNs, registered practical nurses, and nursing administrators. Phase 1 bilingual web-based survey and bilingual focus group needs assessment data supported a preference for external training along with in-house mentoring to support sustainability. An intervention designed using insights gained from Phase 1 data was delivered via a 2-day, in-person workshop. Phases 2 and 3 evaluation survey data identified aspects of leadership training for LTC that require ongoing refinement. Findings suggest that communication skills and managing day-to-day nursing demands in the context of regulatory frameworks were areas of particular interest for leadership training in the LTC setting.
The Bruyère CLRI is pleased to announce that the original article, “Level of Need, Divertibility, and Outcomes of Newly Admitted Nursing Home Residents”, is currently in Press. The article is available for free download from The Journal of The American Medical Directors Association (JAMDA) website.
Objectives: To describe the level of need and divertibility of newly admitted nursing home residents, describe the factors that drive need, and describe the outcomes of residents across different levels of need.
Design: Retrospective cohort study.
Setting: A total of 640 publicly funded nursing homes (also known as long-term care facilities) in Ontario, Canada.
Participants: All newly admitted residents between January 1, 2010 and March 1, 2012.
Measurements: We categorized residents into 36 groups based on different levels of (1) cognitive impairment, (2) difficulty in activities of daily living (ADL), (3) difficulty in instrumental ADLs, and (4) whether or not they had a caregiver at home. Residents were then categorized as having low, intermediate, or high needs; applying results from previous “Balance of Care” studies, we also captured the proportion who could have been cost-effectively diverted into the community. We then contrasted the characteristics of residents across the needs and divertible groupings, and compared 4 outcomes among these groups: hospital admissions, emergency department visits, mortality, and return to home.
Results: A population-level cohort of 64,105 incident admissions was captured. About two-thirds had great difficulty performing ADLs (65%) and had mild to severe cognitive impairment (66%); over 90% had great difficulty with instrumental ADLs. Just less than 50% of the new admissions were considered to be residents with high care needs (cognitively impaired with great ADL difficulty), while only 4.5% (2880 residents) had low care needs (cognition and ADL intact). Those with dementia (71.0%) and previous stroke (21.5%) were over-represented in the high needs group. Those that cannot be divertible to anywhere else but an institution with 24 hour nursing care comprised 41.3% (n ¼ 26,502) of residents. Only 5.4% (n ¼ 3483), based on community resources available, could potentially be cost-effectively diverted to the community. Those at higher needs experienced higher rates of mortality, higher total cost across all health sectors, and lower rates of return to home.
Conclusions: The majority of those admitted into nursing homes have high levels of need (driven largely by dementia and stroke) and could not have their needs met cost-effectively elsewhere, suggesting that the system is at capacity. Caring for the long-term care needs of the aging population should consider the balance of investments in institution and community settings.
The Ontario Centres for Learning, Research and Innovation (CLRI) in Long-Term Care have created a brief overview of the CLRI Program’s achievements over the past fiscal year (2016-2017). Click on the image to download the one-page document.