Research News and Views
Safety in Long Term Care Settings: Broadening the Patient Safety Agenda to Include Long Term Care Services
A recently published report, “Safety In Long-Term Care Settings: Broadening The Patient Safety Agenda to Include Long-Term Care Services” sponsored by the Canadian Patient Safety Institute (CPSI), CapitalCare, Capital Health reviewed the current scientific literature on resident safety in long term care and surveyed long term care stakeholders from across the country, including frontline staff, senior management, policy makers, researchers, and family members. The study concluded that despite the abundance of scientific literature examining quality and patient safety in long term care, there are numerous limitations with existing studies and very few have been conducted in Canada. This has left a considerable knowledge gap regarding patient safety in Canadian long term care settings.
Pressure ulcers, medication issues, falls, resident aggression and infections are concerns common to those who provide care in long term care home environments. However, the study identified staffing/human resources and communication as the top two priorities with the potential to affect safety in long-term care. With staffing/human resources, the most frequent concerns raised were that staff skills had to meet the increasing clinical complexity of residents, and the recruitment and retention of staff was a challenge. Communication concerns related to several areas: inter-disciplinary communication, family engagement, care planning, transitions in care settings, change management, disclosure of incidents/adverse events, and medication issues.
The study recommends that all long term care homes establish a concerns resolution process for patient safety issues involving management, residents and families; education for staff on appropriate disclosure; and the establishment of processes for communication that ensure continuity of care. Training and leadership development for management was highlighted as a key recommendation for the continued creation of a culture of safety in long-term care environments.
The paper was co-authored by Dr. Laura Wagner, a gerontological nursing research scientist at Baycrest Geriatric Health Care System in Toronto, and supported by many stakeholders including OLTCA who assisted on the advisory committee providing input into the interview guide, the consultation process and identifying areas for the literature review. We hope this report will be used by homes to anchor their patient safety efforts and be used to focus LTC patient safety research efforts to areas where new knowledge is required.
A summary of the report was published in the Patient Safety Papers issue of Healthcare Quarterly in early 2008 and the full report is available online at CPSI’s website at http://www.patientsafetyinstitute.ca/ltc.html . If you are having difficulty obtaining a copy of this study please contact Krista Robinson-Holt, Director of Health Planning and Research at OLTCA.
(This page houses current study reports, articles, news items, commentaries and other material relevant to research in long term care.)