Pursuing excellence in the long-term care sector
Par Family Councils Ontario
Long-term care (LTC) is an essential aspect of the healthcare system and is also a home to over 77,000 Ontarians. Over 80,000 staff provide 24/7 care to people living with complex health issues, including physical, cognitive, and mental health challenges. LTC is a system with both great challenges and incredible opportunities. One of the greatest opportunities and approaches to resolving challenges is to pursue excellence.
We firmly believe that long-term care has the possibility to be truly excellent in every way. Pursuing excellence has different meanings to different people and organizations. These are our ideas for pursuing excellence in long-term care.
Develop a vison of excellence
Like any other pursuit or goal, we must know what we are trying to achieve. What does your vision of excellence look like? How does that vision differ from the current state? What is the same? In your desired state of excellence, what roles, tasks and activities will people carry out? How will they behave? What processes and systems will be in place to drive and maintain excellence? By answering these questions, you can start to visualize what you mean by a state of excellence. Ensure that everyone involved understands and shares the vision of excellence so they can actively support activities to achieve the vision.
Centre the voices of people most directly involved and impacted
In any system or setting that involves caring for and with people, it is essential to centre the voices of the people who are most directly involved in and impacted by the system. Long-term care is no exception. To achieve excellence, we need to centre the voices of residents, families, and front-line staff. Residents are the recipients of care and their experiences, needs, wants, and opinions should be the centre of work being done to improve the LTC sector. Families bring rich, diverse, unique perspectives by virtue of being main care partners and system clients. Front-line staff bring to the table their professional and lived experiences. These are the voices that need to inform what excellence looks like and how we achieve our desired state. Centring these voices does not mean that we discount or ignore the other perspectives. It means that we place resident, family, and front-line staff voices at the forefront of the discussions that affect them. After all, they are usually the people most directly impacted by the long-term care sector.
Prioritize diversity, inclusion, and equity
In addition to centring the voices of people most directly involved and impacted in pursuing excellence, it is essential to prioritize diversity, inclusion, and equity in our pursuit. In order to have the greatest odds of success, we need to have diverse perspectives contribute. This means including people from diverse racial, economic, social, language, gender identity, gender expression, sexual orientation, age, ability, and all other aspects of diversity. Keeping diversity top-of-mind as we pursue excellence in long-term care helps us to get as wide a range of insights and perspectives as possible and contributes to the richness of discussion and quality of our ideas. It also helps to reduce or eliminate bias and broadens our perspectives. Diversity will enhance and strengthen what we do.
Inclusion is about valuing all individuals and understanding that everyone has something to contribute. Miller and Katz (2002) defined inclusion as “a sense of belonging: feeling respected, valued for who you are; feeling a level of supportive energy and commitment from others so that you can do your best.”1 When we pursue excellence in an inclusive manner, we support people to play a role in our work and value their contributions.
Equity removes systematic and local barriers to active participation. These barriers could be language-based, physical, geographical, logistical, or cognitive. Equity means that residents with cognitive impairments and non-native English speaking families are given support to engage meaningfully in discussions and work being done. It can also mean utilizing technology to enable people from remote locations to participate in meetings. Equity enables active participation from all participants and is a core aspect of achieving excellence. We can’t move forward in our work if we ignore barriers people face in participation.
Share knowledge and information widely
Across the Ontario long-term care sector, there are people, teams, and organizations doing incredible work that advance the quality of care and life for people living, working, volunteering, and visiting in long-term care homes. While not all of these initiatives can be spread or scaled due to the local nature of the problem solved or need met, many are transferrable to other homes and communities. Seek partnerships with people and organizations outside of your home and share what you have learned. It is by working together that we will improve our homes and communities. No one wants to reinvent the wheel, so let’s work together.
Utilize evidence-based information and critically analyze media reports
In order to make good decisions that advance our pursuit of excellence, we need good, evidence-based information. Whether that is qualitative or quantitative data, we need to ensure that it is evidence-based and reliable. Consider the possibility of bias and non-disclosed motivations in information you come across and verify your sources. Good information makes for good decision making.
Long-term care is often in the media. Unfortunately, it is rarely the positive stories that are reported. While it is important for the public to be kept abreast of issues in long-term care, media reports may not tell the whole story. When you read a media report or story about long-term care- or any other topic- consider if it is reporting the whole story and is factually correct. If an organization or person is referred to or quoted in the article, verify the accuracy of the quote or information. The media is an important source of information, but information published should not be accepted as fact without verification.
The Centre for Media Literacy has resource and information to help you develop and deepen your media literacy. Visit them online at https://www.medialit.org/
Think beyond what you have to do to also consider what you can do
In Ontario, the Long-Term Care Homes Act, compliance inspections, home satisfaction surveys, performance indicators, and Quality Improvement Plans (QIPs) are all essential for pursuing and achieve high-quality resident care. The legislation and quality improvement initiatives are all things that must be done in long-term care, for good reason. They are necessary. To pursue and achieve excellence, we need to take into account all of that and also look at the possibilities of what we can do. Compliance inspections, satisfaction surveys, and QIPs tell us if we have met certain standards but don’t tell the whole story of a long-term care home, the long-term care sector, or what is possible. For example, legislation can’t compel people to smile to one another. Think beyond the minimum or baseline of performance and never stop striving for excellence. Our long-term care residents, their families, home staff, and Ontarians as a whole deserve no less.
Long-term care is a complex sector serving over 75,000 residents with complex health and social needs. Much work has been done and is continuing to be done to improve resident care and safety, family engagement in care, and the experiences of home staff. As we continue working to improve the sector, let’s make our goal excellence. As an active partner in the LTC sector, FCO is committed to the pursuit of excellence and working with you to make that happen. We believe in the potential of excellence in all aspects of the long-term care sector.
References
1. Miller, F.A., and Katz, J.H. (2002). The Inclusion Breakthrough.