Report on Quality in Long-term Care Homes September 2009- Several initiatives aimed at evaluating and/or improving the quality of care in long-term care (LTC) homes are underway in the province of Ontario. Concerned Friends tries to keep our readers informed by reporting on these efforts in our newsletter. Current initiatives are projects to improve the Performance and Compliance of long-term care homes, and the recent report on Quality in Long-term Care Homes by the Ontario Health Quality Council. The Ontario Health Quality Council (OHQC) is an independent agency funded by the government of Ontario to monitor the quality of the health system, highlights what is working, notes what could be improved, and supports quality improvements across the system. The agency recently released a report which focused on eight aspects of long-term care in Ontario. 1. Waiting for a Bed in a Long-term Care Home The OHQC found that overall waits for places in LTC Homes doubled in the past 2 years – from an average of 49 days to 106 days. The wait is consistently longer for people in their homes than for those waiting in acute care hospitals. The findings also indicate that only 41% of those who move into LTC are in their first choice of home. The OHQC does not suggest that we need more LTC beds in Ontario . Rather, it notes that University of Toronto researchers estimate that many of those currently in LTC Homes could live independently with more supports. Concerned Friends has long supported the view that we need alternatives to long-term care, including more and better Home Care and Supportive Housing. 2. Drug Safety in LTC The OHQC found that approximately one-quarter of seniors, whether in the community or in LTC Homes, are taking prescription drugs that have potential serious side effects for elderly people. These drugs are identified on the Beers list that was developed n 1991 by a group of clinicians specializing in geriatrics. Although the rate of use of these drugs among seniors is decreasing, it is still a serious concern. 3. Avoiding Emergency Department Visits The OHQC determined that residents of LTC Homes often end up in emergency departments of hospitals for problems that could be prevented or looked after in the Home. The report notes that more could be done to avoid unnecessary visits. A program in Sault Ste. Marie significantly reduces visits to hospital by ambulance from LTC Homes by having a Nurse Practitioner in the homes to treat residents before they are sent to hospital and to handle minor emergencies on their own. The Nurse Practitioner helped homes deal with common problems such as minor falls, bladder infections, and caring for wounds. Concerned Friends strongly supports increased use of Nurse Practitioners in long-term care homes. 4. Falls Falls are especially dangerous for seniors. The OHQC believes that more can be done to reduce falls in LTC homes. For example, homes can help residents get more exercise, avoid drugs with serious side effects, treat osteoporosis properly, reduce clutter, improve lighting, etc. 5. Prevent Pressure Ulcers The OHQC reports that one out of every 13 LTC residents has pressure ulcers, and recommends more be done to prevent them. Suggestions include – using special mattresses or padding for those most susceptible, regular repositioning and better diet. Some LTC homes have implemented successful programs to eliminate pressure ulcers. Concerned Friends believes all LTC homes should be required to have similar programs and should be evaluated on their success in reducing the prevalence of these painful ulcers. 6. Resident Satisfaction The OHQC surveyed residents and their families to measure satisfaction with the care. Nine out of ten residents rated the overall quality of care they receive as good to excellent. One-third of the residents surveyed stated that they were not encouraged to participate in decisions and felt that staff did not answer their calls promptly. While Concerned Friends has some reservations about the materials currently used to survey resident satisfaction, this disturbing finding suggests that some homes have difficulty caring respectfully for residents as individuals. 7. Keeping Residents Healthy OHQC found that 27% of LTC residents show signs of increasing depression and one in five has lost some ability to function independently over 3 months. The report suggests that there are ways homes can slow this process, such as offering physical or occupational therapy programs, as well as choice of recreational and social activities. 8. Worker Safety The report states that the injury rate for LTC workers is almost double the rate in hospitals. More and better training and proper equipment is suggested to keep staff healthy. Concerned Friends believes a better staff to resident ratio would also help. The report concludes with three valuable tips for residents and their families:
Concerned Friends is pleased that the OHQC is monitoring LTC Homes. We are encouraged that as of November 09 it will begin to report to the public on the quality of care in individual homes through its website. Within 3 years the council expects to include information on all publicly funded homes. This has the potential to be could be an invaluable source of information for seniors and their families . It could also be a major support for our efforts to improve the overall quality of care of residents in long term care homes! For more information about the Ontario Health Quality Council and their report, call 416-323-6866 or 1-866-623-6868, or check the website at www.ohqc.ca. |
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