Changing Roles of Care Team Members within New Models of Care Delivery in Residential Care Facilities: Implications for the Delivery of Quality of Care
- quality of care; long term care; health human resources; older adults; mixed methods; Canada
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Providing quality of care (QoC) to older adults in residential care settings is an ongoing challenge given the increasingly complex needs of this population and the escalating economic constraints within which health authorities operate. While the implementation of the residential care delivery model in a Western Canadian health authority has contributed to some improvements in QoC, it has also highlighted key challenges that are both interpersonal and organizational in nature; specifically, gaps in leadership, teamwork, mentorship, and communication, as well as staffing mix, staffing consistency, resident complexity, and competing policy and program initiatives and directives. The implementation of a major change in care delivery impacts residents, families, and staff and may, in turn, impact their perceptions of change in QoC. When evaluating a model, therefore, it is important to examine both qualitative and quantitative outcomes: stories from those most affected in their everyday lives and trends in QoC indicator data.
2. Harrington, C., Choiniere, J., Goldmann, M., Jacobsen, F.F., Lloyd, L., McGregor, M., Stamatopoulos, V., & Szebehely, M. (2012). Nursing Home Staffing Standards and Staffing Levels in Six Countries. Journal of Nursing Scholarship, 44(1), 88-98.
3. Canadian Nurses Association. (2004). Nursing Staff Mix: A Literature Review, Ottawa: ON.
4. Wilson, D. M., Brow, R. R., & Playfair, R. (2017). What Is The “Right” Number of Nursing Home Beds For Population Needs? An Indicator Development Project. Jour Nursing Home Res, 3, 16-21.
5. McGregor, M., Baumbusch, J., Abu-Laban, R., McGrail, K., Andrusiek, D., Globerman, J., Berg, S., Cox, M., Salomons, K., Volker, J., & Ronald, L. (2011). A Survey of Nursing Home Organizational Characteristics Associated with Potentially Avoidable Hospital Transfers and Care Quality in One Large British Columbia Health Region. Canadian Journal on Aging, 30(4), 551-561.
6. Aiken, L., Sloane, D., Van den Heede, Griffiths, P., Busse, R., Diomidous, M., Kinnunen, J., Kozka, M., Lesaffre, E., McHugh, M., Moreno-Casbas, M., Rafferty, A., Schwendimann, R., Scott, P., Tishelman, C., van Achterberg & Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. The Lancet, 383(9931), 1824-1830.
7. Spilsbury, K., Hewitt, C., Stirk, L., & Bowman, C. (2011). The relationship between nurse staffing and quality of care in nursing homes: A systematic review. International Journal of Nursing Studies, 48(6), 732-750.
8. McGregor, M., & Ronald, L. (2011). Residential Long-Term Care for Canadian Seniors: Nonprofit, For-Profit or Does it Matter? IRPP Study, No. 14, Montreal: Institute for Research on Public Policy.
9. Office of the Seniors Advocate. (2015). Seniors Housing in BC.
10. Estabrooks, C., Knopp-Sihota, J., & Norton, P. (2013). Practice sensitive quality indicators in RAI-MDS 2.0 nursing home data. BMC Research Notes, 6(1), 460.
11. Donald, F., Martin-Misener, R., Carter, N., Donald, E., Kaasalainen, S., Wickson-Griffiths, A., Lioyd, M., Akhtar-Danesh, N., & DiCenso, A. (2013). A systematic review of the effectiveness of advanced practice nurses in long-term care. Journal of Advanced Nursing, 69(10), 2148-2161.
12. Richards, L. (1999). Data alive! The thinking behind NVivo, Qualitative Health Research, 9, 412–28.
13. Trastek, V., Hamilton, N., & Niles, E. (2014). Leadership Models in Health Care – A Case for Servant Leadership. Mayo Clinic Proceedings, 89(3), 374-381.
14. Kontos, P., Miller, K., & Mitchell, G. (2009). Neglecting the importance of the decision making and care regimes of personal support workers: A critique of standardization of care planning through the RAI/MDS. The Gerontologist, 50 (3), 352-36