Over the summer of 2016, a Stakeholder Engagement and Needs Assessment was conducted by the Ontario Centres for Learning, Research and Innovation (CLRI) in Long-Term Care Program. This summary presents Sector Feedback: Results from the CLRI Stakeholder Consultation & Engagement.
Purpose and Methods:
- Gather input from key stakeholders and the broader community on the future of the Program and how to optimize its value to the long-term care sector
- Identify opportunities for the Program to facilitate capacity building and the adoption and spread of key learning, care delivery, and research innovations among Ontario long-term care homes
- Identify new and emerging learning, care delivery, and research priorities of Ontario long-term care homes
Information was gathered via:
- A literature scan
- A stakeholder engagement event involving representatives from Ontario’s long-term care homes, universities, colleges, researchers, associations, and networks within the province’s long-term care sector and follow up with stakeholders who were unable to attend
- An online survey that reached out to the sector more broadly (176 responses)
- Validation of findings with key informants
In bringing forth new projects, the Program should use innovative ways to broaden the sharing and replication of Program-developed and other resources. New projects should:
- Be evidence-based
- Be relevant and useful. in the sense that they are likely to have a high level of impact on the day-to-day lives of long-term care residents and staff
- Avoid duplication of existing projects and activities
- Be sustainable
- Use plain language
- Be co-created with sector partners from across disciplines and roles, including residents and their families
- Be evaluated
- Align with MOHLTC and home priorities and regulation
- Be accessible and affordable.
The following topics were noted as the highest priority needs in new and emerging learning, care delivery, and research practice:
- Building staff competencies including workplace skills such as leadership
- Building skills in care for specific conditions and most importantly in caring for people with Alzheimer’s or other dementias and attending appropriately to those who exhibit personal expressions
- Resident mental health
- Addressing end of life issues
- Engaging, supporting and communicating with residents and their families and promoting quality of life
- Medication use and deprescribing.
Supporting Sector Interaction:
There is a desire for a formalized learning and sharing network or community of practice to assist with the co-creation, dissemination, implementation and evaluation of tools and resources. It could provide a venue for connecting across disciplines, sectors and other homes to break down silos, share practices, jointly solve challenges and increase awareness of, and positive stories about, long-term care.
Engaging with the Program:
The most highly rated options for engaging with the CLRIs were:
- Participating in face-to-face CLRI workshops and sessions
- Developing long-term care home staff and other long-term care educator roles as trainers to deliver CLRI education programs
- Enabling student placements in long-term care homes through academic partnerships and internal capacity building
- Becoming part of a ‘Learning Innovation Network’ for long-term care
Engagement with the Program could provide homes with opportunities to:
- Play a role in shaping the long-term care sector
- Participate in culture change discussions
- Receive early access to training or resources
- Receive supportive resources such as back-fill and implementation support
- Improve resident outcomes and implement best practice guidelines
- Play a role in research or innovation at an early stage
- Provide input to ensure user-relevance
- Integrate more fully within the sector
Benefits to the sector could include:
- Improved communication among disciplines and sector divisions
- A greater openness to change and trial of new things
- Dissemination of efficiency improvements
- Greater spread of successful interventions
- Development and promotion of long-term care as a valid career path, attracting and engaging staff
- Improvement of the profile of long-term care, including the public’s perception
Benefits were also seen for the education sector, residents, and their families.
Barriers to proposed activities include:
- Resource constraints (e.g., time, money, staffing)
- Compliance with regulatory requirements that might restrict trying some new things and the burden posed by existing mandatory training requirements;
- Existing culture and resistance to change within homes and across the sector
- The difficulty in identifying and accessing appropriate innovations and programs to implement
- Igniting the interest of staff
- The burden of multiple projects, sometimes in combination with research
- The unique characteristics of northern population, smaller and rural communities and smaller homes
- A reluctance to work together and share innovations or practices that may be seen as a competitive advantage
- A lack of communication between existing inter and intra sector silos
- Inconsistent awareness of the CLRI Program itself, of how to get involved, or of the benefits and requirements of engagement
In terms of delivering resources, on-line e-learning modules promoted and delivered through existing channels are highly rated by the sector. Cross-posting and cross-promoting resources on existing CLRI and partner websites and newsletters were also well received. It was suggested that new or deeper relationships could be cultivated with an extensive list of potential partners. As is the case in all sectors, LTC stakeholders prefer to have resources that are well marketed and easy to find and access.
Considerations for the Next Phase:
In planning the future of the Program, the inclusion of the following program elements should be explored:
- Leverage existing networks, strengthen existing partnerships and explore new, and even non-traditional, partners
- Involve stakeholders in the co-creation of knowledge
- Involve diverse homes in terms of size, geography (urban and remote, southern and northern), ownership (private, not-for-profit, chain and municipal); engaged with the CLRI and new to the Program
- Address the characteristics of the various LHINs
- Roll out programs that are “ready-to-go” to create momentum, while incubating those that would follow
- Be inclusive to address the unique needs of various cultures
- Include a stronger link with the post-secondary education system in terms of training development and meaningful student placements
- Communicate awareness of the CLRI Program and the benefits of engagement
- Define clear roles for all parties among the existing and any new CLRIs and within all partnerships in the sector
- Work within the financial, human resource and regulatory realities
Key Messages from the Sector:
- The CLRI Program provides valuable support to long-term care, leading the sector as a source for state-of-the-art and evidence-based solutions and providing the capacity to enhance care, unify efforts and lead culture change.
- The Program has conducted useful research and developed innovations to meet needs; it is now time to share the results and support homes in their implementation with effective, sustainable, co-created products that would improve care, reduce duplication and optimize use of resources.
- Support needs to be relevant, evidence-based, sustainable, affordable, accessible and avoid duplication with other efforts.
- Involvement of sector partners in dissemination, communication and the co-creation of resources and programs is seen as a critical part of future activities.
- Dissemination activities should use existing channels.
- There is a strong desire for formalized networking or a Community of Practice to allow for connecting across disciplines, sectors and silos.
- Face-to-face workshops and developing trainers were the most highly rated options for engaging with the Program.
- Priority topics for new and emerging learning care delivery and research practice were identified.
- Benefits and barriers to engaging with the Program were identified.
- Homes in rural, remote and small Ontario communities face unique challenges.