The President's 2010/2011 Report to the Annual General Meeting November 16, 2011 The Latvian Canadian Cultural Centre 4 Credit Union Drive Toronto, Ontario It is a new era in long-term care. We have a new Long-Term Care Homes Act, new regulations, and a completely transformed inspection system with new inspection protocols. Concerned Friends has been very much a part of all these initiatives. With all that has taken place, our focus has turned from reforming the system to now advocating for the improvement in the quality of care and life in Ontario's long-term care homes. Over the past year, we have seen successes, continued relevant partnerships, and identified challenges. We want to help residents and families to have the right home, with the right staff and with the right care. Concerned Friends sees evidence of success in the quality of long-term care from a recent obituary for a long-term care resident. It reads ”Peacefully at his home,” and followed by the name of a long-term care home. In the obituary the family expresses gratitude to the “caring staff members” who cared for him in his “home.” The new Act emphasizes that the long-term care facility is the resident's home. We have seen success in our support of family members who have called or emailed Concerned Friends. One message came from a family member who was concerned about approaching the staff of a home in an upcoming case conference. After conversations with our advocate she wrote: “You certainly made some good suggestions and took a lot of time to talk to me. I was able to go to the care conference with a lot more confidence.” However, we are also aware that there are still challenges about the quality of care when a July headline of a Toronto newspaper was, “Nursing Home gave Tylenol to resident with broken leg.” This was an appalling situation that led to the death of this resident. The daughter of this resident was referred to us by the Ombudsman's office. Our advocate was able to provide her with information about obtaining the medical and care plan records, as well as giving her help in contacting the appropriate Coroners' office. The Coroner has been reviewing the case, and an inquest could be the result. This review is in addition to a Ministry of Health and Long-Term Care (MOHLTC) inspection, and the MOHLTC Compliance orders that the Home was given. Partnerships Family Councils' Program (FCP) Our partnership continues with the Self-Help Resource Centre in the operation the Family Councils' Program. In the new Act, there is legal provision for a Family Council to request the Licensee to appoint a Family Council Assistant who is acceptable to the Family Council. It sets out the reporting process for the Assistant and the requirements for confidentiality. As a result of the FCP partnership, we have been able to work co-operatively and successfully with the Performance Improvement and Compliance Branch of the Ministry of Health and Long-Term Care on a Statement of Clarification for the term “Family Council Assistant” and activities the Assistant would undertake. The Statement of Clarification clarifies the term “Family Council Assistant” from one used earlier in FCP resource material. The statement also outlines the powers that a Family Council has under the Act, and emphasizes a cooperative process with the Home's management in detailing the Assistant's activities to fit the needs of that Family Council. Ministry of Health and Long-Term Care Compliance Transformation Advisory Group Over the past year, Concerned Friends continued to be an active member of the Compliance Transformation Advisory Group. Now, the transformation of the inspection process is complete, we will be part of a new Ministry of Health and Long-Term Care Advisory Group to advise on the new system now in force. The Group is currently refining its terms of reference. We have also maintained close contact with the MOHLTC Senior Managers of Compliance on specific issues of concern. This has involved not only Concerned Friends contacting these Managers, but also the Managers contacting us. Health Quality Ontario (HQO) (formerly Ontario Health Quality Council) We continue to be a partner in HQO's Residents First Quality Improvement initiatives, and sit as a member of its Steering Committee. As a partner, our logo appears on all Residents First printed material and the HQO website. We were actively involved in a project called “The Resident's Voice.” One objective of The Resident's Voice is to increase staff's/resident's/family member's understanding of the resident's experience and views. In Part 1 of this series of five digital stories, a resident or family member describes his/her experience with either falls, visits to the emergency department, incontinence, consistency of personal support worker assignment or pressure ulcers, and tell what they would like staff to know. The objective is to influence the review of care practices by staff after they have heard the suggestions in the stories. Part 2, ”Quality of Life at the End of Life,” has six stories where residents and a family member describe their view of quality of life at the end of life. The family member describes the responsibility of quality of life decisions for someone who can no longer do so. Distinct themes emerge from these stories. Again the objective is to help the understanding of other residents, family members and staff about quality of life at the end of life after listening to the six perspectives. A discussion guide is also being finalized with Concerned Friends having direct involvement. This project is complete, and Terms of Reference for The Resident's Voice Working Group were recently accepted by the Residents First Steering Committee. The Working Group will develop The Resident's Voice as the Residents First initiatives move into quality improvement with a focus on behaviour and medication. I have continued to represent Concerned Friends on the HQO Public Reporting Working Group and at various meetings concerned with the indicators that are used to report quality in long-term care homes. The challenge here is to respect the highly technical and clinical aspects of the indicators, while ensuring that members of the general public, residents and family members are able to understand and interpret the results. The results are listed on the HQO public reporting website and in its annual Quality Monitor report on Ontario's health system. To that end I have been working with the Project Leader for HQO Public Reporting on the development of a user guide. Ontario Seniors Secretariat Long-Term Care Advisory Committee While recent meetings of this Committee have been postponed, I was able to arrange for Eileen Patterson, HQO Vice President, Quality Improvement, to make a presentation on quality improvement in long-term care homes under the Residents First Initiative. Members of this Advisory Committee focus on care in the home, and the avoidance, or at least the delay, of placement in long-term care. Committee members were most appreciative of Eileen's presentation. Ontario Long-Term Care Association (OLTCA) Advisory Panel for Long-term Care Sector Education Concerned Friends was invited to be a member of an OLTCA panel advising on the development of e-learning tools webcasts to profile key elements of the Long-Term Care Homes Act (2007). I was a member of this panel, and the webcasts are now posted on the OTCA website and provide information on key areas such consent and the use of restraints. Residents and family members are included in these webcasts. McMaster School of Nursing LTC Pain Management Toolkit Advisory Board On the recommendation of Health Quality Ontario, I was invited to be a member of this Advisory Board. The challenge is to bring the voice of the resident and/or family member into a cooperative management of a resident's pain. The toolkit is being developed from a grant from the Canadian Institute for Health Research. I was able to bring to the Advisory Board's attention examples where pain was not at all managed in a long-term care home, as well as the requirements for pain management in the regulations and the compliance reports that resulted from complaints. University of Toronto Determinants of Quality in Long-Term Care On the recommendations of Health Quality Ontario and the Ministry of Health and Long-Term Care, I was invited to sit on the research advisory committee for this project. Again, the challenge is to give input into making the highly technical aspects and the results of this research project easily understood and useful to all long-term care stakeholders. Ontario Trillium Foundation Grant With the assistance of our Project Coordinator, Marlynn Jolliffee, and our Resource Development Planner Manny Wong, we have been working very hard on meeting the targets that were set for our Ontario Trillium Grant. We now have a new logo that has been much complimented. We have developed and printed a new and colourful Concerned Friends brochure which describes the voices that we have for long-term care. Our grant allowed for the purchase of a LED projector to be used at meetings and presentations and two computers to be used by board members in analyzing the compliance reports we receive and for presentations using Powerpoint. We have sent out letters to all our members in an effort to meet our target for new members. Our challenge is not only recruiting new members but sustaining the existing membership. Presentations We have met and exceeded our Trillium Grant targets for presentations. In these presentations we take the opportunity to explain the advocacy work of Concerned Friends, and to make points that focus on the continued improvement of along-term care system that meets the needs of residents, families and staff. Sheila Elson has made presentations to Senior's groups in the London area. I made presentations at: • Elder Connections Networking Breakfast Board of Directors We have been greatly saddened by the loss of Sharon Clark who served as a Director and as a conscientious reviewer of Compliance Reports. She continued to review these reports even when she was very ill and knew that she had little time left. Sharon honoured Concerned Friends by asking that memorial donations for her be made to Concerned Friends, and to the LTC home where she volunteered. We have welcomed three new Board Members, Sheila Elston, who represents South Western Ontario on the Board, Kathy Pearsall, who manages our website and coordinates our newsletter, and Jackie Porter, who brings a strong interest in seniors to the board. I sincerely thank all members of the Concerned Friends Board of Directors for their work as team over the past year and for making the development of our new logo and brochure a successful team effort. On the Board's behalf, I would also like to thank Sheila Latimer for the contribution she made as a member of the Concerned Friends Board of Directors and as a Compliance Report review. I also thank to our Treasurer, Peter Harris. Peter will leave the Board at the end of this Annual General meeting, and we so appreciate his years as a Concerned Friends volunteer, and as Treasurer. We thank Lorna Snelling, who helps us so much by processing all our mail, membership applications and banking. We also extend our thanks to SPRINT, and its executive director Stacy Landau for the office and meeting space that they so generously donate to us. —Phyllis Hymmen, President |
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