EDIB Champion Coaching Enrollment - Ontario Centres for Learning, Research, and Innovation in Long-Term Care

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Equity, Diversity, Inclusion and Belonging (EDIB) Champion Coaching Program – Year 2 Application Form

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Thank you for your interest in the Equity, Diversity, Inclusion and Belonging (EDIB) Champion Coaching Program, offered by the Ontario CLRI at Bruyère Health with support from CLRI at the RIA through the PSW Education Fund.

We’re excited to offer this opportunity, now in its second year, to individuals who have completed the Creating a Culture of Belonging workshop and are ready to take the next step in advancing inclusive and affirming care in their long-term care homes. Applicants must be working in an Ontario-based long-term care home.

Each LTC home may apply for up to two (2) EDIB Champions** to participate in this coaching program. This program will run from November 2026 to March 2027, and involves seven (7) two-hour coaching sessions, where champions will receive coaching, tools and peer support to strengthen EDIB efforts within their home. Each session consists of:

90 minutes (1:00-2:30 pm) live on Zoom with an EDIB facilitator.
30 minutes (2:30-3:00 pm) of independent post-session learning/reflection time.

**Champions who participated in Cohort 1 (2025-26) are welcome to apply again. However, priority will be given to new applicants. Returning Champions will be offered a space only if one remains after new applicants have been placed.

Backfill funding is available for participants through the PSW Fund.

Please complete the form below to submit your LTC homes application. If you have any questions, please don’t hesitate to contact us at edi@bruyere.org or 613-562-6262 ext. 1990.

Active Participation

A Coaching Program is most successful if the participants are:

Able to attend ALL seven sessions; and
Willing to share and learn from one another.

Active participation is vital for participants to get the most out of every session, and the program as a whole.

Confidentiality Notice

We respect your privacy. Your responses are confidential and will not be shared with anyone outside the Ontario CLRI project team. The information you provide on this form will be used only for the purpose of selecting participants to join the EDIB Champion Coaching Program. Anonymous and aggregated application data will also be used to inform our project evaluation and planning in order to improve future program delivery.

Section 1: Long-Term Care Home Information

What is the name of the LTC home you are affiliated with?*

If you are unable to select your LTC Home from the list, please contact pswfund@the-ria.ca before continuing.

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Home Name

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Address Line 1

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Address Line 2

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City

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Province

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Postal Code

Lead Contact Name*

First Last

Email*

Enter Email Confirm Email

Phone*

Country Phone Number

Phone Ext

Job title*

Does participation in the EDIB Champion Coaching Program have the support of your senior leadership (e.g., Administrator, Executive Director, Director of Care)?

Yes

No

Not sure

If you selected “No” or “Not sure,” please briefly explain your situation:

Does your organization have a formal strategy to promote and protect EDI in your organization?

Not started

Planning phase

Drafting phase

Finalized plan

Finalized and implemented

Does your organization have an EDIB committee or similar working group?

No committee or working group at this time

Informal group or staff resource group

Integrated into another committee (e.g., Quality Improvement)

Formal, dedicated EDIB Committee

Not sure

Has your LTC home done any training related to EDIB?

Yes

No

I don’t know

Please share a little bit about the topic(s) covered in the EDIB-related training.

Briefly explain why your home is interested in participating in the EDIB Champion Coaching Program.

How do you envision EDIB Champion(s) contributing to your home’s EDIB initiatives following the coaching program?

What questions would you like to see answered through the EDIB Champion Coaching Program?

Section 2: EDIB Champion Nominee(s)

Each LTC home may nominate one or two Champions.

Nominated Champion #1 Information

Name*

First Last

Job Title*

Role*

Personal Support Worker (PSW, Health Care Aide, Care Aide)

Nursing (RN, RPN)

Formal leader (Administrator, DOC/ADOC, department manager, etc.)

Physician / Medical Director

Educator/Instructor

Social Worker/Social Service Worker (SW/SSW)

Recreational Therapist/Recreation Professional

Physiotherapist

Occupational Therapist

Music Therapist

Dietitian

Chaplain/Spiritual Care Coordinator

Coordinator/Operations Support

Administrative support (HR, scheduling, payroll, reception)

Food Service Worker

Environmental Service Worker

Other

Email*

Enter Email Confirm Email

Phone

Country Phone Number

Phone extension

Has the nominee completed the Creating a Culture of Belonging: From Awareness to Action workshop?*

Yes

No

I don’t know

Did this Champion participate in Cohort 1 (2025-26) of the EDIB Champion Coaching Program?*

Returning Champions are welcome to apply. Priority is given to new applicants, and returning Champions will be offered a space only if one remains available.

Yes

No

Unsure

Please note that completion of the Creating a Culture of Belonging workshop is a prerequisite for participation in the EDIB Champion Coaching Program. If this nominee has not yet completed the workshop, we encourage you to consider nominating another team member who has successfully completed the workshop.

There will be two tracks of EDIB Champions (up to 25 in each).

Tuesday Track:

Session 1: Grounding in Purpose: The Role of an EDIB Champion
Tuesday, November 10, 2026
Session 2: Building the Committee: Structure, Start-Up, and Staying Power
Tuesday, November 24, 2026
Session 3: Planning Education That Sticks: Needs, Delivery, Adaptation
Tuesday, December 8, 2026
Session 4: Sustaining the Work: Boundaries and a Mid-Program Check-In
Tuesday, January 12, 2027
Session 5: Embedding EDIB in Policy and Practice
Tuesday, January 26, 2027
Session 6: Advocating with Confidence: Navigating Difficult Conversations
Tuesday, February 23, 2027
Session 7: Consolidating the Work: Impact, Commitment, Next Steps
Tuesday, March 9, 2027

Thursday Track:

Session 1: Grounding in Purpose: The Role of an EDIB Champion
Thursday, November 12, 2026
Session 2: Building the Committee: Structure, Start-Up, and Staying Power
Thursday, November 26, 2026
Session 3: Planning Education That Sticks: Needs, Delivery, Adaptation
Thursday, December 10, 2026
Session 4: Sustaining the Work: Boundaries and a Mid-Program Check-In
Thursday, January 14, 2027
Session 5: Embedding EDIB in Policy and Practice
Thursday, January 28, 2027
Session 6: Advocating with Confidence: Navigating Difficult Conversations
Thursday, February 25, 2027
Session 7: Consolidating the Work: Impact, Commitment, Next Steps
Thursday, March 11, 2027

Please select the nominee’s preferred stream:*

Tuesday Track

Thursday Track

Either track is fine

Do you require accessibility accommodations to support a barrier-free learning experience?

Please include any needs such as a sign language interpreter, large-print materials, assistive technology, or other supports.

Would this Champion like to opt in to a peer connection list?

This list will share your name, email, and LTC home with other Champions who also opt in for peer networking purposes. This is separate from the confidentiality notice above, which covers your application responses.

Yes

No

Do you wish to nominate a second Champion?*

Yes

No

Nominated Champion #2 Information

Name*

First Last

Job Title*

Role*

Personal Support Worker (PSW, Health Care Aide, Care Aide)

Nursing (RN, RPN)

Formal leader (Administrator, DOC/ADOC, department manager, etc.)

Physician / Medical Director

Educator/Instructor

Social Worker/Social Service Worker (SW/SSW)

Recreational Therapist/Recreation Professional

Physiotherapist

Occupational Therapist

Music Therapist

Dietitian

Chaplain/Spiritual Care Coordinator

Coordinator/Operations Support

Administrative support (HR, scheduling, payroll, reception)

Food Service Worker

Environmental Service Worker

Other

Email*

Enter Email Confirm Email

Phone

Phone Extension

Has the nominee completed the Creating a Culture of Belonging: From Awareness to Action workshop?*

Yes

No

I don’t know

Did this Champion participate in Cohort 1 (2025-26) of the EDIB Champion Coaching Program?*

Returning Champions are welcome to apply. Priority is given to new applicants, and returning Champions will be offered a space only if one remains available.

Yes

No

Unsure

Please note that completion of the Creating a Culture of Belonging workshop is a prerequisite for participation in the EDIB Champion Coaching Program. If this nominee has not yet completed the workshop, we encourage you to consider nominating another team member who has successfully completed the workshop.

There will be two tracks of EDIB Champions (up to 25 in each).

Tuesday Track:

Session 1: Grounding in Purpose: The Role of an EDIB Champion
Tuesday, November 10, 2026
Session 2: Building the Committee: Structure, Start-Up, and Staying Power
Tuesday, November 24, 2026
Session 3: Planning Education That Sticks: Needs, Delivery, Adaptation
Tuesday, December 8, 2026
Session 4: Sustaining the Work: Boundaries and a Mid-Program Check-In
Tuesday, January 12, 2027
Session 5: Embedding EDIB in Policy and Practice
Tuesday, January 26, 2027
Session 6: Advocating with Confidence: Navigating Difficult Conversations
Tuesday, February 23, 2027
Session 7: Consolidating the Work: Impact, Commitment, Next Steps
Tuesday, March 9, 2027

Thursday Track:

Session 1: Grounding in Purpose: The Role of an EDIB Champion
Thursday, November 12, 2026
Session 2: Building the Committee: Structure, Start-Up, and Staying Power
Thursday, November 26, 2026
Session 3: Planning Education That Sticks: Needs, Delivery, Adaptation
Thursday, December 10, 2026
Session 4: Sustaining the Work: Boundaries and a Mid-Program Check-In
Thursday, January 14, 2027
Session 5: Embedding EDIB in Policy and Practice
Thursday, January 28, 2027
Session 6: Advocating with Confidence: Navigating Difficult Conversations
Thursday, February 25, 2027
Session 7: Consolidating the Work: Impact, Commitment, Next Steps
Thursday, March 11, 2027

Please select the nominee’s preferred stream:*

Tuesday Track

Thursday Track

Either track is fine

Do you require accessibility accommodations to support a barrier-free learning experience?

Please include any needs such as a sign language interpreter, large-print materials, assistive technology, or other supports.

Would this Champion like to opt in to a peer connection list?

This list will share your name, email, and LTC home with other Champions who also opt in for peer networking purposes. This is separate from the confidentiality notice above, which covers your application responses.

Yes

No

Section 3: Organizational Commitment

Acknowledgment*

Acknowledgement for using backfill funding*

I acknowledge that backfill funding is provided to our organization to bring in staff support for the home while Champion(s) attend the coaching sessions. For questions about backfill funding, please contact pswfund@the-ria.ca.

Acknowledgment*

Acknowledgement to Use EDI Champion Coaching Spot(s)*

I acknowledge that a limited number of EDI Champion coaching spots are available to LTC homes, and that our nominated Champion(s) are committed to attending ALL 7 coaching sessions as part of this program. I understand that full participation is required to receive a final, full certificate of completion. I will notify the Ontario CLRI at Bruyère Health team if we are unable to fulfill this commitment.

Acknowledgment*

Acknowledgement to provide access to computer, internet, Zoom*

I commit to supporting Champion(s) to attend the virtual coaching sessions by providing the necessary equipment (e.g., ensuring each learner has their own device—ideally a computer—to engage fully in the various learning components), or supporting their attendance in the coaching from home.

By submitting this application, you confirm that your home supports participation in this EDIB Champion Coaching Program, including time and backfill funding for nominated Champions.

The Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI) strengthen the quality of life and care for residents across the province. The Ontario CLRI is mandated by the Ministry of Health and the Ministry of Long-Term Care to be a resource for the sector by providing education and sharing research and innovations to enhance the health and well-being of people who live and work in long-term care.

Visit the Ontario CLRI

The Schlegel-UW Research Institute for Aging (RIA) is a charitable, non-profit organization dedicated to enhancing the quality of life and care of older adults. The RIA tackles some of the biggest issues facing an aging population by driving research and innovation to improve education and practice. The RIA develops and shares solutions that make a difference to benefit older adults everywhere.

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