Spotlight on Long Term Care
29 Jun 2020
As the media spotlight hit long term-care (LTC) settings in the COVID-19 pandemic, Dr. Farinaz Havaei, an assistant professor in the UBC School of Nursing, and her team swung into action. “We already knew that over the previous decades the diluted skill-mix with fewer RNs, the burgeoning workload, and the low levels of human and physical resources made quality care in LTC settings precarious and work environments challenging for staff” said Dr. Havaei. “LTC is an underserved, under-resourced and under-studied health care sector.” With over half of Canada’s COVID-19 deaths being linked to LTC settings and over 25 COVID-19 outbreaks in LTC facilities, Dr. Havaei and her team were concerned about the impact of COVID-19 and the subsequent rapid changes to resident care delivery.
Some of the changes, including strict visitation policies, flexible sick leave, training opportunities, and use of personal protective equipment, slowed the infection rates, but the researchers were concerned about other impacts and unintended consequences of the measures. Further challenges to being able to provide quality care, exposure to stressors, fear and grief were all impacting different categories of workers inequitably. The stories coming out of long-term care were very troubling.
Dr. Havaei (Primary Investigator), in collaboration with a team of experts including Dr. David Keselman, the Chief Executive Officer, Louis Brier Home and Hospital & Weinberg Residence (https://louisbrier.com/), and Drs. Maura McPhee and Alison Phinney, professors in the School of Nursing, applied to the MSFHR COVID-19 Research Response Fund, and was one of only 10 to be successful in the first wave of funding. The study will track the impact of the rapid changes implemented in response to COVID-19.
The team is asking how changes related to COVID-19 have affected the quality and safety of care delivery for staff, residents and their families. Researchers will use a variety of methods, including administrative and survey data and interviews. “Importantly, we will include all staff including care aides, nurses, cleaning staff, and administrative personnel, so we can examine the differential impact on various categories of workers. We will look at such things as sick time, absenteeism, staff turnover and adverse events before and after COVID-19. We will conduct surveys and interviews with staff, residents, and family members to understand their perceptions of the short and longer term effects of these changes in care delivery”. The team is being guided throughout the research by a steering committee of key stakeholders, including leadership, staff, and Family and Resident Councils.
Dr. Havaei notes that evidence-based LTC practices and policies for pandemic management must be developed as soon as possible. Improving the quality of life and quality of care for staff, residents, and their families is a matter of urgency. Further, this work will set the foundation for badly-needed health services research in the LTC sector.