The Prescott and Russell Residence therefore has a strategic plan for 2017-2020. This plan identifies several goals and objectives for improving the quality of care and the safety of residents, particularly in such a way as to adapt the offer to the needs of the community, to optimize governance, various resources, and the operation of the organization, to improve internal and external communications, and to continue the implementation and maintenance of the Quality Improvement Program, while having as a backdrop high-quality certification from Accreditation Canada. In partnership with the residents, families, partners, employees, and members of the Board of Directors, the Residence is working this year to reinitialize its strategic plan.
Firstly, the safety of the residents, risk management, and quality improvement are the priority elements of the Residence’s strategic framework.
Secondly, the involvement of residents and families is critical to residents’ care planning. It is also necessary in order to focus on an effective communication process to assess the satisfaction of residents and families through surveys, interdisciplinary meetings, educational workshops, various committees, or others in order to improve quality.
Thirdly, the participation of partners and interdisciplinary teams allows the Residence to perfect communication internally with residents and families and externally with the community and partners. This communication process ensures the implementation of a Quality Improvement Plan based on the real and changing needs of the clientele and on the satisfaction of residents, families, and the community.
Several quality indicators are at the core of the Residence’s policies and procedures. Since the last year, these indicators have allowed us to see simultaneously the reduction of pressure ulcers, the reduction of restraints and falls, and the reduction of antipsychotic administration at the Residence. We have also noticed an increase in the satisfaction of residents, families, and employees, generally following the results obtained through safety and satisfaction surveys. Residents and families feel that they are safe, can express their opinions without fear of consequences, and are very satisfied with their life experience at the Residence.
The Residence also faces certain challenges, notably with regard to the recruitment and retention of qualified personnel, particularly in the nursing field. The quality and safety of the care provided are based on an organizational structure that must provide sufficient human resources in compliance with the Act. The building’s structure also poses some challenges in terms of the limitations it imposes on us, which creates additional human resource needs. That being said, this constraint brings up questions about the management of financial resources.
Since we are always looking for opportunities to ensure good care, at the right time, in the right place, and in the most efficient way possible according to the residents’ needs, we remain on the lookout to continue to improve the range of specialized services on-site to reduce transfers to the emergency and keep our resident in their home environment.
Finally, we used the results obtained as part of our latest Quality Plan, comparable statistical data, the results of various quality and safety surveys, comments, suggestions, and feedback from our residents, families, and employees to focus on a future Quality Plan geared towards resident safety.
Organization’s greatest QI achievements from the past year
Several activities and programs have been put in place to build a safe living environment for residents and a satisfying living environment for employees.
A strong interdisciplinary structure is in place to ensure the safety of residents. Follow-ups are conducted quarterly and as needed to focus on best practices and effective improvement plans.
Quality and safety surveys were distributed to residents, families, and employees to plan to ensure and improve everyone’s satisfaction.
Several care programs, policies, and procedures were implemented and/or revised to ensure the success of our accreditation process with Accreditation Canada, Qmentum level.
A quality improvement chart has been installed and better communicates the results achieved with regard to quality indicators.
A Quality Improvement Committee was set up and reviews the recommendations of the various Interdisciplinary Committees
All quality indicators were met or have exceeded the intended target.
An electronic medical prescription system was initiated.
Resident, Patient, Client Engagement
Engagement of employees, medical team members, external partners, families, residents, Family Council and Residents’ Committee representative to the Quality Improvement, Safety, and Risk Management Interdisciplinary Committee. Transparent communication process with regard to projects, successes, desired objectives, quality indicators with employees, residents, and families. Commit to publishing the successes, events, and completed projects regularly on the Residence’s website in the coming year.
Collaboration and Integration
Collaboration with the Mental Health and Addiction Centre on-site to ensure the well-being and care of residents as the need arises.
Participation in the “Through our eyes” program with the Ontario Association of Resident’s Council.
Measures in place to allow the Residence’s medical team to approve on-site interventions to avoid transfers.
Proposal to increase the number of beds at the Residence following the announcement of the MOHLTC in order to reduce ALC placement beds at the Hospital and also shorten the waiting list of people in the community.
Training and education of employees to be better equipped to deal with residents with disruptive and reactive behaviours (BSO) and to put in place the right prevention and intervention measures and avoid transfers to the hospital.
Engagement of Clinicians, Leadership & Staff
The establishment of a Quality Improvement Committee consolidates the engagement. The membership is interdisciplinary and includes employees from each service sector, family members, volunteers, as well as Residents’ Committee and the Family Council representatives. The Quality Improvement objectives results are reviewed, and graphs of statistics are presented for subsequent internal and external communication. A training video on evacuation procedures was prepared with the participation of employees, the management team, residents and is presented during new employee hiring orientation, is viewed annually on a mandatory basis, and is available on the Residence website. Interdisciplinary Committees are well established and the colossal process of setting up and revising policies and procedures is nearing completion in anticipation of a visit by Accreditation Canada representatives in June. A transparent communication process is in place with the Family Council and the Residents’ Committee.
Population Health and Equity Considerations
Our residence offers care and services in both official languages. The menus can be modified so that the food can meet the needs of the residents according to their culture. We have access to pastoral services in the community to meet the residents’ religious needs and spiritual beliefs. A palliative care program was established for the needs of residents and their families. We adapt the purchase of equipment and our work procedures according to the specific needs of each resident. A wide range of specialized services is on-site to avoid moving the residents and reduce the financial impact. A significant reduction in transfers to the emergency was noted in the past year, and this, beyond our goal.
Access to the Right Level of Care - Addressing problems
Under the recommendation and approval of the Medical Management, a process was put in place to ensure the consistency of internal procedures, based on effective evaluation and interventions. In consultation with the attending Physician, the follow-up of the resident’s condition is carried out rigorously in order to avoid and reduce transfers to the emergency and to keep the resident in their own environment until the very end. We can thus see the success of the measures put in place by the reduction in the number of transfers to the emergency. As a result, the objective set in our Quality Plan last year was met and has been exceeded. In that respect, the resident can therefore continue to benefit from good care, in the right place, and at the right time, through a multidisciplinary and medical team at the Residence and in their living environment.
Opioid Prescribing for the Treatment of Pain and Opioid Use Disorder
A pharmaceutical committee with the participation of the pharmacist and the medical director, reviews the medication of each resident according to individual needs. A Quality, Safety and Risk Management Improvement Committee reviews the recommendations of the pharmaceutical committee and makes recommendations as needed.
Workplace Violence Prevention
The health and safety element of individuals particularly residents, employees, and visitors is one of the objectives included in the Residence’s Strategic Plan and aims to manage the risks associated with the individual’s integrity. Any occurrence dealing with assault, incidents, or violence is reported to the relevant Interdisciplinary Committees, the Quality Improvement, Safety, and Risk Committee, and the Residence Administration Committee. Several initiatives aimed at a healthy and safe workplace were implemented:
- Yearly training offered to all employees and volunteers by the Prescott and Russell Residence to promote zero tolerance for abuse and neglect of residents.
- A safety survey was conducted with all employees in 2017.
- Training offered by the Corporation of the United Counties of Prescott and Russell on the Policy on violence in the workplace, harassment, and discrimination (PER 006).
- Each floor has posters, in both official languages, on zero tolerance containing the following text:
- “This public building operates in an environment of courtesy and respect. We are committed to maintaining a safe workplace free of harassment for our employees, volunteers, elected officials, and visitors. Aggressive behaviour or abusive language will not be tolerated.”
- Incident statistics including incidents involving assaults are posted on the Health and Safety boards. Joint Workplace Health and Safety Committee meetings are held quarterly.