Each year, staff at Health Quality Ontario read the Quality Improvement Plans (QIPs) submitted by Ontario hospitals, primary care organizations, long-term care homes, and local health integration networks (which administer home care). We identified some stand-out examples from the 2017/18 QIPs showing how organizations have engaged patients or residents and their families and caregivers, and reached out to the people involved to find out more about their experiences.
Here, we spoke with Elizabeth Bartley, the activities director, and Charleen Bennett, a resident, from Cambridge Country Manor Long-Term Care Home. Their home was involved in the “Through Our Eyes”pilot, which was led by the Ontario Association of Residents’ Councils and is meant to guide teams of staff and residents in long-term care homes to co-develop and co-facilitate education sessions about the Residents’ Bill of Rights.
This photo shows the courtyard of Cambridge Country
Manor, a favourite place for residents and their loved ones.
Can you give us a bit of background on this initiative?
Elizabeth: The Through Our Eyes pilot was created by the Ontario Association of Residents’ Councils and is a tool to bring alive the Bill of Rights. Even though we had been reviewing the Bill of Rights at Resident Council on a regular basis, we found that sometimes there was a disconnect between residents’ knowledge of the Bill of Rights and the application of the Bill of Rights in their own lives. By participating, our goal was to improve residents’ overall understanding of the Bill of Rights, improve staff awareness of resident experience, and ultimately to make the Residents’ Bill of Rights come alive through staff and resident collaboration.
The Ontario Association of Residents’ Councils provided us a workbook to work through. The team consisted of me, Charleen, and Heather Richardson (our administrator). Initially we held several meetings over a month or two where we watched videos to guide us, and used exercises to get to know one another and identify what areas of the home to improve or which areas of the Bill of Rights we would like to be the focus for our resident meetings. From there we held our first Bill of Rights discussion meeting with residents and chose two Bill of Rights to focus on.
What are your memories of the first meeting you held with the residents to discuss the Bill of Rights?
Charleen: At first, most of the residents were not terribly interested in the Bill of Rights. But as the meeting went on, they got a little more involved and more open with expressing what they felt needed improvement. Residents participated more as trust was built and the residents realized that the facilitators were sincere.
Elizabeth: The Bill of Rights sessions gave residents the opportunity to really focus on their experiences and to connect with co-residents in a more normative way like two friends would over coffee. By the end of the first discussion, residents were offering all sorts of insights into what they liked about the staff, and the home, what could be improved, and sharing insight into their personal lives and loved ones.
What changes have you seen after participating in this process?
Elizabeth: We noticed that even in Residents’ Council meetings, residents’ department feedback was increasing as the Through Our Eyes project empowered residents to take on more of an ownership of the Home. We plan to continue holding these meetings monthly.
One specific change that came out of this was improved communication. A point that came up during the resident lead staff meeting was that residents liked when staff prioritized who needed assistance and communicated this effectively to residents. Staff feel a responsibility to assist residents right away, although not all needs are urgent, so their response is sometimes that they will “be there in just a minute”. Charleen pointed out to staff that although their intent is to help all residents right away, residents want staff to prioritize who needs assistance first and to provide a more realistic timeline to residents.
Charleen, could you tell us about your experience working with this as a leader for the residents?
Charleen: I think that the residents feel that I am one of them and approachable – they feel that they can bring things to me and bring things up and nothing bad will happen to them. Even with Elizabeth or Heather there, they still feel comfortable. I did not feel confident or capable going in – I just did not know a lot about the Bill of Rights. But Heather and the others did a wonderful job solving that.
Elizabeth: Charleen brought a lot of good insight into these meetings because she was a nurse herself, so she had a good insight into the other piece of the puzzle – staff day to day. In the meetings, Charleen has a way of refocusing residents back to the discussion when we get off topic. The residents see the Bill of Rights discussions as a safe place and occasionally, a resident might share something upsetting about their personal life, unrelated to the Home, and Charleen does an amazing job comforting her co-residents. Charleen and I also hosted a few meetings for staff focused on the Bill of Rights. These meetings allow staff to hear the resident experience from a resident and provide us all the opportunity to collaborate on ways to improve the Home and hear positive feedback.
If another long-term care home wanted to get involved in the pilot, what would you tell them?
Elizabeth: It is a wonderful process to go through. The book offers a lot of worksheets and exercises that you can do at the Bill of Rights meetings – we recommend doing some, but at our Home the Bill of Right discussions have developed into more of an open platform where residents can speak up about anything that is important to them.
Do you work in long-term care?
You may be interested in our quality improvement stories featuring the work of long-term care homes across Ontario.