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 Quality Improvement (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 to build on the Fundamental Principle and the Resdients’ Bill of Rights.
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 Ministry of Health and Long-Term Care (MOHLTC) in order to reduce Alternate Level of Care (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 (Behavioural Supports Ontario - 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.