Every month the Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI) are sharing the stories of long-term care homes and the work they do in partnership with the Ontario CLRI.
If it takes a village to raise a child, the same community approach might be useful in caring for the needs of senior citizens as they age. Imagine it — a team of clinical professionals, talented health care managers, industrious support services staff, and dedicated volunteers all working together to provide quality, dignified care to some of the community’s most vulnerable members.
A handful of such teams exist across Ontario. For example, Bruyère Continuing Care supports the complex medical needs of the community through evidence-informed care. This bilingual organization was established in 1845 by Mother Élisabeth Bruyère, a Grey Nun of Montréal. Today, this Eastern Ontario-based, Catholic health care organization operates two hospitals, a pair of family medicine centres, two long-term care (LTC) residences, a variety of outpatient and community support services, and its own research institute.
And, oh yes, it also manages Bruyère Village, an innovative clustering of independent and assisted living apartments, villas, and affordable housing overlooking the Ottawa River in Ottawa’s east end. The comprehensive Bruyère Village is designed to meet the needs of an aging population, perhaps before any LTC services are required at the adjacent Saint-Louis Residence (home to 198 residents), or at the sister home, Élisabeth Bruyère Residence(71 residents) in Ottawa’s historic ByWard Market neighbourhood.
The executive director for the two LTC homes is Melissa Donskov, a seasoned Bruyère health care management professional who holds a master’s degree in health administration and an undergraduate degree in physiotherapy from the University of Ottawa. For Donskov, Bruyère’s success is due to residents enjoying a continuous stream of care in the same community of family, friends, and care workers, as residents move through the stages of care services they require as they age. “We work hard to continue the legacy of the Sisters and Catholic health care in providing holistic and dignified care for the most vulnerable in our society,” says Donskov.
The oversight of the structures and initiatives that guide the quality of care, communications, and strategy at the two residences can be demanding, but Donskov still makes time to visit with residents, staff, and families every day. Her physiotherapy background helps Donskov better understand the clinical decision-making and daily challenges the care teams manage.
“We don’t have a large management team, so I like it that I can be hands-on, and see the direct impact of what we are doing.,” explains Donskov. “The nurses and personal support workers work very hard, and we have families who stay on to volunteer, so it’s a big team effort.”
A unique feature of the Saint-Louis Residence is that a team of educators and researchers is work directly in the building. Just down the hallway from Donskov’s office are the offices of the Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI), a provincially funded program hosted at Bruyère, Baycrest Health Sciences and the Schlegel-UW Research Institute for Aging. The Ontario CLRI trains the current and future LTC workforce by creating and evaluating educational resources and leading practices, which are shared with Ontario LTC homes.
As the director of operations for the Ontario CLRI at Bruyère from 2012 to 2016, Donskov saw first-hand the benefits of hosting the Ontario CLRI on-site and how effective the partnership could be in developing projects aimed at enhancing the quality of care for LTC residents.
Ontario is a bit of a front-runner when it comes to the teaching nursing home model,” says Donskov. “The Ontario CLRI has a provincial mandate, but because their Bruyère team is embedded here in Saint-Louis Residence, we are a perfect pilot zone for many of their initiatives.”
One of the big initiatives Donskov says she will be rolling out over the next year is “focused rounding.” These regular, structured and proactive check-ins with residents can help to detect any pain and other clinical needs early. The check-ins can also help residents feel their needs are being met. Early results are very promising: better interaction between staff and residents means the call bells are ringing less often.
“We are caring for residents whose needs are becoming more complex and acute,” Donskov says. “The way we did things 10 years ago, and even the status quo, aren’t good enough. We need to continue to push the envelope, and I am hugely grateful for the help that the Ontario CLRI provides to Bruyère by sharing evidence-informed practices and experiences.”
Through the Ontario CLRI, the provincial government is advancing the quality of care all across Ontario’s LTC sector.
“Our challenges are similar to everybody else’s, so if they can understand our problems, they can also help other long-term care homes tailor their approach and initiatives. There’s nice synergy. I love coming to work because I know that what we are doing is making a difference.”