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Exemplars in Long-Term Care during COVID-19: The Importance of Leadership. 2019冠状病毒病期间长期护理的典范:领导力的重要性。
Healthcare Policy Pub Date : 2022-06-01 DOI: 10.12927/hcpol.2022.26856
Andrea Baumann, Mary Crea-Arsenio, Mélanie Lavoie-Tremblay, Agnes Meershoek, Pat Norman, Raisa Deber
{"title":"Exemplars in Long-Term Care during COVID-19: The Importance of Leadership.","authors":"Andrea Baumann,&nbsp;Mary Crea-Arsenio,&nbsp;Mélanie Lavoie-Tremblay,&nbsp;Agnes Meershoek,&nbsp;Pat Norman,&nbsp;Raisa Deber","doi":"10.12927/hcpol.2022.26856","DOIUrl":"https://doi.org/10.12927/hcpol.2022.26856","url":null,"abstract":"<p><p>Early in the pandemic, many long-term care (LTC) homes struggled to manage resources and care for vulnerable residents. Using an appreciative inquiry approach, we analyzed exemplar homes in Ontario that remained free of COVID-19 in wave one and interviewed executive directors, directors of care and staff. Findings demonstrate the importance of leadership styles; clear, consistent communication; focusing on staff and resident safety; using a team-based approach; and adapting staff roles to meet care needs. The exemplar homes showed what works in practice. The decisions and approaches that they implemented could be used to develop standards to improve LTC and strengthen the sector.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"17 SP","pages":"27-39"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346582/pdf/policy-17-027.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9549328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Inspection Reports: The Canary in the Coal Mine. 检验报告:煤矿里的金丝雀。
Healthcare Policy Pub Date : 2022-06-01 DOI: 10.12927/hcpol.2022.26850
Mary Crea-Arsenio, Andrea Baumann, Victoria Smith
{"title":"Inspection Reports: The Canary in the Coal Mine.","authors":"Mary Crea-Arsenio,&nbsp;Andrea Baumann,&nbsp;Victoria Smith","doi":"10.12927/hcpol.2022.26850","DOIUrl":"https://doi.org/10.12927/hcpol.2022.26850","url":null,"abstract":"<p><p>Neglect in the Ontario long-term care (LTC) sector is defined under section 5 of O. Reg. 79/10 of the Long-Term Care Homes Act, 2007. Allegations are monitored and investigated via inspections. Using an exploratory descriptive design, we analyzed reports of neglect in LTC homes from 2019 to 2020. The majority were in response to critical incidents, followed by complaints from family members or staff. Thematic analysis revealed four areas of neglect: (1) failure to provide treatment; (2) failure to provide care; (3) failure to attend to or assist residents; and (4) failure to investigate allegations. Study findings demonstrate that an accountability framework that includes consequences for institutions is needed.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"17 SP","pages":"122-132"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346591/pdf/policy-17-122.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Perspectives from the Netherlands: Responses from, Strategies of and Challenges for Long-Term Care Health Personnel. 来自荷兰的观点:长期护理卫生人员的反应、策略和挑战。
Healthcare Policy Pub Date : 2022-06-01 DOI: 10.12927/hcpol.2022.26857
Agnes Meershoek, Laura Broek, Mary Crea-Arsenio
{"title":"Perspectives from the Netherlands: Responses from, Strategies of and Challenges for Long-Term Care Health Personnel.","authors":"Agnes Meershoek,&nbsp;Laura Broek,&nbsp;Mary Crea-Arsenio","doi":"10.12927/hcpol.2022.26857","DOIUrl":"https://doi.org/10.12927/hcpol.2022.26857","url":null,"abstract":"<p><p>The outbreak of the COVID-19 crisis severely afflicted the Dutch long-term care sector. To protect vulnerable residents of nursing homes the government took several measures, of which the complete nationwide visitors' ban was the most restrictive. These measures had not only a large impact on residents but they also greatly impacted nursing home personnel. Based on a descriptive review and a few interviews, this paper discusses the measures taken in the Dutch long-term care sector and the challenges healthcare personnel encountered in terms of workload and well-being. It further explores the strategies that were implemented to support personnel to cope with these challenges.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"17 SP","pages":"14-26"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346583/pdf/policy-17-014.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
What Is Old Is New Again: Global Issues Influencing Workers and Their Work in Long-Term Care. 什么是旧的又是新的:影响工人和他们在长期护理工作的全球问题。
Healthcare Policy Pub Date : 2022-06-01 DOI: 10.12927/hcpol.2022.26853
Whitney B Berta, Cal Stewart, Andrea Baumann
{"title":"What Is Old Is New Again: Global Issues Influencing Workers and Their Work in Long-Term Care.","authors":"Whitney B Berta,&nbsp;Cal Stewart,&nbsp;Andrea Baumann","doi":"10.12927/hcpol.2022.26853","DOIUrl":"https://doi.org/10.12927/hcpol.2022.26853","url":null,"abstract":"<p><p>We offer a broad understanding of contemporary issues relevant to the long-term care (LTC) sector and its workers, globally, and the concurrent evolution and involution of these workers' roles, their work and policy environments. While contemporary, most issues are also longstanding and fall into two broad categories: issues relating to the work environments in LTC, including resource availability and worker support, and issues relating to the changing nature of LTC work. We identify five key challenges that relate to the system structures of the LTC sector.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"17 SP","pages":"66-90"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346581/pdf/policy-17-066.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Rights versus Risks: The Impact of Isolation on Residents and Families in Long-Term Care. 权利与风险:隔离对长期护理的居民和家庭的影响。
Healthcare Policy Pub Date : 2022-06-01 DOI: 10.12927/hcpol.2022.26849
Andrea Baumann, Mary Crea-Arsenio
{"title":"Rights versus Risks: The Impact of Isolation on Residents and Families in Long-Term Care.","authors":"Andrea Baumann,&nbsp;Mary Crea-Arsenio","doi":"10.12927/hcpol.2022.26849","DOIUrl":"https://doi.org/10.12927/hcpol.2022.26849","url":null,"abstract":"<p><p>Early in the COVID-19 pandemic, the Ontario government created directives for long-term care (LTC) homes. As a result, residents were isolated in their rooms and visitors were banned. This commentary examines these practices and their impact on LTC residents and their families. A review of relevant documents showed the practices were unnecessary and physically and psychologically detrimental. Moving forward, family should be recognized as essential members of residents' care teams and allowed in LTC homes during outbreaks. This would entail providing them with the necessary protective equipment and adequate training to ensure infection prevention protocols are maintained.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"17 SP","pages":"133-144"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346585/pdf/policy-17-133.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Forecasting Staffing Needs for Ontario's Long-Term Care Sector. 预测安大略省长期护理部门的人员需求。
Healthcare Policy Pub Date : 2022-06-01 DOI: 10.12927/hcpol.2022.26852
Adrian Rohit Dass, Raisa Deber, Audrey Laporte
{"title":"Forecasting Staffing Needs for Ontario's Long-Term Care Sector.","authors":"Adrian Rohit Dass,&nbsp;Raisa Deber,&nbsp;Audrey Laporte","doi":"10.12927/hcpol.2022.26852","DOIUrl":"https://doi.org/10.12927/hcpol.2022.26852","url":null,"abstract":"<p><p>This paper presents a forecasting model for personal support workers (PSWs) and nurses (registered nurses [RNs] and registered practical nurses [RPNs]) for Ontario's long-term care (LTC) sector. In the base-case scenario, the model projects a shortfall in the supply of full-time equivalent (FTE) workers required to meet the expected demand for care for all workers by 2035, which would require an estimated increase of 11,632 FTE PSWs, 6,031 FTE RNs and 10,178 FTE RPNs entering the market by 2035. The results of this paper may have important implications for health human resources policy planning in Ontario's LTC sector.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"17 SP","pages":"91-106"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346590/pdf/policy-17-091.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Lessons from Long-Term Care Facilities without COVID-19 Outbreaks. 没有COVID-19疫情的长期护理机构的经验教训。
Healthcare Policy Pub Date : 2022-06-01 DOI: 10.12927/hcpol.2022.26855
Mélanie Lavoie-Tremblay, Guylaine Cyr, Thalia Aubé, GenevièVe Lavigne
{"title":"Lessons from Long-Term Care Facilities without COVID-19 Outbreaks.","authors":"Mélanie Lavoie-Tremblay,&nbsp;Guylaine Cyr,&nbsp;Thalia Aubé,&nbsp;GenevièVe Lavigne","doi":"10.12927/hcpol.2022.26855","DOIUrl":"https://doi.org/10.12927/hcpol.2022.26855","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 crisis in long-term care (LTC) homes was devastating for residents and front-line workers. Recent reports have detailed what went wrong in LTC facilities, including equipment shortages, lack of preparedness, underestimation of COVID-19's virulence and bans on caregiver visits. Less is known about what went well in some facilities.</p><p><strong>Purpose: </strong>To describe nurses' and other staff members' experiences and lessons learned in two LTC facilities in Quebec that reported no COVID-19 outbreaks during the first wave of the pandemic.</p><p><strong>Methods: </strong>Methods: A case study design guided by appreciative inquiry was conducted, in which a case was defined as a LTC facility without COVID-19 outbreaks; two cases were included. Twenty-three healthcare team members from the two sites were recruited and interviewed between October and November, 2020.</p><p><strong>Results: </strong>Several common themes were identified: being informed and respecting outbreak protocols; the presence of key outbreak protocols, which allowed for stable teams; a clear action plan; and access to materials and resources. Key management themes included team support and reward, ongoing communication and providing compassionate care to residents.</p><p><strong>Conclusion: </strong>This study highlights several lessons learned that have the potential to strengthen the LTC health system.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"17 SP","pages":"40-52"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346588/pdf/policy-17-040.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Frequency of Neglect and Its Effect on Mortality in Long-Term Care before and during the COVID-19 Pandemic. COVID-19大流行之前和期间长期护理人员被忽视的频率及其对死亡率的影响
Healthcare Policy Pub Date : 2022-06-01 DOI: 10.12927/hcpol.2022.26851
Noori Akhtar-Danesh, Andrea Baumann, Mary Crea-Arsenio, Valentina Antonipillai
{"title":"Frequency of Neglect and Its Effect on Mortality in Long-Term Care before and during the COVID-19 Pandemic.","authors":"Noori Akhtar-Danesh,&nbsp;Andrea Baumann,&nbsp;Mary Crea-Arsenio,&nbsp;Valentina Antonipillai","doi":"10.12927/hcpol.2022.26851","DOIUrl":"https://doi.org/10.12927/hcpol.2022.26851","url":null,"abstract":"<p><p>Neglect of vulnerable adults living in long-term care (LTC) homes has been well documented. It often presents first in the physical symptoms of decubitus ulcers, dehydration and urinary tract infections (UTIs). A retrospective cohort study was conducted to examine the relationship between neglect and 90-day mortality among LTC residents in Ontario. An index of neglect was created. Of 106,765 residents, more than one-quarter were found to have at least one indicator of neglect: 13.1% had decubitus ulcers, 13.5% had dehydration, 6.2% had a UTI. Residents who exhibited clinical signs of neglect had higher risks of death within 90 days, both before and during the COVID-19 pandemic.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"17 SP","pages":"107-121"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346587/pdf/policy-17-107.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
COVID-19 Issues in Long-Term Care in Ontario: A Document Analysis. 安大略省长期护理中的COVID-19问题:文献分析
Healthcare Policy Pub Date : 2022-06-01 DOI: 10.12927/hcpol.2022.26854
David Oldenburger, Andrea Baumann, Mary Crea-Arsenio, Raisa Deber, Vishwanath Baba
{"title":"COVID-19 Issues in Long-Term Care in Ontario: A Document Analysis.","authors":"David Oldenburger,&nbsp;Andrea Baumann,&nbsp;Mary Crea-Arsenio,&nbsp;Raisa Deber,&nbsp;Vishwanath Baba","doi":"10.12927/hcpol.2022.26854","DOIUrl":"https://doi.org/10.12927/hcpol.2022.26854","url":null,"abstract":"<p><p>The COVID-19 crisis in long-term care in Canada has been characterized as a crisis upon a crisis. This study examines recent documents on the crisis in long-term care in Ontario, using document and thematic analysis to synthesize issues and recommendations from the perspectives of different groups and organizations. Thirty-three documents from 20 organizations were analysed and six thematic areas were identified: resident care; human resources; governance, leadership and management; financing; physical infrastructure and supplies; and training and preparation. The six common themes, as perceived by different perspectives, can inform policy makers on long-term care issues.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"17 SP","pages":"53-65"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346589/pdf/policy-17-053.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
New Spending Programs and Old Frustrations: Where Is the Vision? 新的支出计划和旧的挫折:愿景在哪里?
Healthcare Policy Pub Date : 2022-05-01 DOI: 10.12927/hcpol.2022.26831
Jason M Sutherland
{"title":"New Spending Programs and Old Frustrations: Where Is the Vision?","authors":"Jason M Sutherland","doi":"10.12927/hcpol.2022.26831","DOIUrl":"https://doi.org/10.12927/hcpol.2022.26831","url":null,"abstract":"<p><p>The spring has ushered in an unexpected number of major health policy announcements compared with the last 10 years. They are led by the federal government's outlines of a national pharmacare program, an unexpected dental care program (Prime Minister of Canada Justin Trudeau 2022), plus \"top-up\" funding for clearing provincial surgical and imaging backlogs. These announcements are on top of the voices expressing concerns about COVID-19-related healthcare expenditure trends (Bailey 2022). Without a doubt, taxpayer money is flowing freely into healthcare (Labby 2020).</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"17 4","pages":"6-14"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9170053/pdf/policy-17-006.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9748274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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