1) The document discusses using data to drive improvements in resident quality of life at Providence Health Care's residential care homes. It summarizes Providence's current residential care program and facilities. 2) It describes the Seniors Quality Leap Initiative (SQLI), a consortium of long-term care organizations that works to improve clinical quality and safety for seniors through benchmarking, testing improvement ideas, and disseminating best practices. Providence is a member of SQLI. 3) Providence has been working to improve residents' quality of life, as measured by an internationally-used survey, by identifying opportunities through SQLI like enhancing social engagement and testing various changes in its homes.

1. COLLABORATING FOR EXCELLENCE
USING DATA TO DRIVE IMPROVEMENTS IN
RESIDENT QUALITY OF LIFE
Jo-Ann Tait, MScN, BHSc (PN), RPN
Program Director, Elder Care and Palliative Services - Providence Health Care
Adjunct Professor, School of Nursing – University of British Columbia
BC CARE PROVIDERS ASSOCIATION CONFERENCE
May 2017
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2. DISCLOSURES
No actual or potential conflicts of interest in relation to this presentation.
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3. PROVIDENCE HEALTH CARE – CURRENT STATE
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• Seven Community Dialysis Clinics
• Providence Crosstown Clinic
• Granville Youth Health Centre
• Management of Little Mountain Place/Court
• Management of St. Michael’s Centre

4. PROVIDENCE POPULATIONS OF EMPHASIS
CARDIO
PULMONARY
RENAL
SENIORS
HIV/AIDS
MENTAL HEALTH
URBAN HEALTH
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5. ELDER CARE PROGRAM & PALLIATIVE SERVICES
Residential Care:
Brock Fahrni (148)
Holy Family (142)
Mount Saint Joseph (100)
Langara (197)
Youville (42)
Assisted Living:
Honoria Conway (60)
Palliative Care:
SPH Acute Unit (12)
Rehabilitation:
Holy Family Inpatient (60)
Holy Family Outpatient
Tertiary Mental Health – Older
Adult:
Parkview (32)
Geriatric Medicine:
MSJ 4East (22)
Geriatric Consult and
Outreach Team
(GCOT)
Geriatric Psychiatry
and Outreach Team
(GPOT)
Palliative Outreach
and Consult Team
(POCT)
Elder Care
Ambulatory Services
SPH and MSJ
Community – Residential Care – Acute Services – Transitional Services - Home
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Hospice Care:
St. John’s Hospice (14)

6. OUR HOMES: 721 PEOPLE
Brock Fahrni Holy Family Langara Mount Saint
Joseph
Youville Honoria
Conway
Current
Resident Care
Capacity
148
Current
Resident Care
Capacity
143
Current
Resident Care
Capacity
196
Current
Resident Care
Capacity
100
Current
Resident Care
Capacity
42 / 32
Current Tenant
Capacity
60
Year
Constructed
1983
Year
Constructed
1953
Year
Constructed
1990
Year
Constructed
1944 & 1976
Year
Constructed
1969
Renovated
1980’s
Year
Constructed
2008
Current Bed Distributions
Primarily three and
four bed rooms;
limited private
bathrooms;
communal shower
rooms
Primarily three and
four bed rooms;
limited private
bathrooms;
communal shower
rooms
Primarily three and
four bed rooms;
limited private
bathrooms;
communal shower
rooms
Primarily three and
four bed rooms;
limited private
bathrooms;
communal shower
rooms
All single rooms;
communal shower
rooms
Private suites
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7. SQLI HISTORY
The Seniors Quality Leap Initiative (SQLI) was
established by North America’s leading Long Term
Care organizations in 2010 out of their collective
desire improve clinical quality and safety for seniors.
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8. THE SENIORS QUALITY LEAP INITIATIVE
Vision
To become North America’s
leading post-acute and long-
term care provider
consortium for benchmarking
clinical quality standards that
reflect advancing innovative
change ideas to raise the bar
for excellence throughout our
industry.
Mission
To enhance the quality of life
and quality of care for seniors
by utilizing a structured
approach to quality and
performance improvement
and disseminating
recommendations to the
broader post-acute and long-
term care sector.
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9. THE SQLI MEMBER ORGANIZATIONS
1. Baycrest (Canada)
2. CapitalCare Group Inc. (Canada)
3. Donald Berman Maimonides Geriatric Centre (Canada)
4. Hebrew SeniorLife (USA)
5. Perley and Rideau Veterans Health Centre (Canada)
6. Presbyterian Senior Living (USA)
7. Providence Health Care (Canada)
8. Schlegel Villages (Canada)
9. Bruyère Continuing Care (Canada)
10. The Jewish Home of San Francisco (USA)
11. Westminster Communities of Florida (USA)
12. York Care Centre (Canada)
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10. SQLI MEMBERS AND STRATEGIC PARTNERS
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11. THE SQLI STRATEGIC PARTNERS
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12. OBJECTIVES
1. Exchange and benchmark performance data as it relates to quality of care and
quality of life for seniors
2. Test, design and adopt a collaboratively derived approach for performance
improvement
3. Identify and undertake initiatives designed to make improvements in quality of
care and quality of life for seniors using evidence-based practices
4. Broadly disseminate SQLI consensus-based recommendations for
improvement across the post-acute and long-term care sector
5. Support a culture of innovation that consistently seeks to identify, test,
evaluate and develop innovative solutions that have the potential for
significant healthcare and economic impact through partnership with the
Canadian Centre for Aging and Brain Health Innovation (CC-ABHI)
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13. PHC QOL SURVEY BACKGROUND JOURNEY
While we thought our clinical indicators were strong,
our Quality of Life indicators shone a light on areas
that we needed to pay attention to.
In 2012/13, our results were humbling.
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14. UNDERSTANDING RESIDENT QUALITY OF LIFE (QOL) SURVEY
InterRAI Quality of Life (QoL) Survey
Validated instrument to determine how persons served in long term care experience
day-to-day life and assess the services they receive
Used nationally and internationally
Administered to clients with Cognitive Performance Scale (CPS) 0-3
50 question survey that measures 5 domains of resident quality of life
• Staff responsiveness
• Caring staff
• Social life
• Food
• Personal Control
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15. SQLI IMPROVEMENT OPPORTUNITY
As a sector, the international benchmark (20th – 80th percentile) is quite low
Opportunities to make improvements in social life
Together with our SQLI partners, we are delving into social engagement:
✓ What are our collective strengths?
✓ Where do we face similar challenges?
✓ What can we learn from top performing organizations?
✓ How can we get input from residents to improve their social life
(empathy mapping)?
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16. AS PART OF SQLI WE ARE COMMITTED TO:
Conducting ongoing quality of life surveys
Members of SQLI submit their data to the University of
Waterloo for reporting and analysis at least annually
International benchmarks updated as more surveys are
completed
Identifying new innovative practices for social engagement
(with the support from the Canadian Centre for Aging and
Brain Health Innovation)
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17. The RCfM and Redevelopment Journey
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18. PHC Residential Redevelopment Conceptual Plan
33rd Avenue and Heather Street – Saint Vincent’s Heather – Urban Neighbourhood
May 23, 2017 18

19. EMOTIONAL CONNECTIONS: BEFORE
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20. OUR VISION OF LIFE: IN PHC RESIDENTIAL CARE
Emotional Connections
Matter Most
Residents Direct Each
Moment
Home is not a Place, it is a
Feeling
People won't remember what you
said or did, they will remember
how you made them feel.
Time is not measured by a clock ,
but by moments.
Home feels friendly, relaxing,
secure, familiar.
1. Emotional connections are
social and positive
2. I know who is supporting me
and my family in each moment
3. Your relationship with my
family matters
4. I have a friend who cares
about me
5. People around me know what
brings me comfort and joy
(and they may be risky)
1. RCAs and RAs are empowered
to make decisions with me
2. Meals are an enjoyable and
social experience
3. Moments in my day are not
always predictable.
4. I can get outside whenever I
want
5. I can get health services when
I need them
1. This is my home
2. I live in a smaller household
(of about 10 people)
3. My environment engages me

21. MEGAMORPHOSIS: TESTS OF CHANGE
Emotional Connections Matter Most:
1.Staff name tages/buttons
2.Care Aprons
3.Buddy Program
4.Decorate Resident Rooms
5.Find Me Lights
6.AM/PM care is calm and social
7.Meal time is social and engaging
8.Move Rehab out of Basement
9.Food Services and Housekeeping are part of the
team
10.Yes! I can help you! Approach
11.Break times
12.Language and labels
13.Resident/Family directed Care conference
14.Volunteers
15.Staff rate their interactions
Resident Directed Care:
1.2 Dining Rooms
2.Continental breakfast
3.3 things that bring comfort and joy
4.Remove staff signs from resident space
5.Colours, textures and interactive items fill the
space
6.Resident “rummaging” is encouraged
7.Staff space is invisible
8.RCA lead shift (handover) report
9.Shift away from residents days in bed
10.RN support medically complex people
11.TV use is meaningful to residents
12.RA and RCA lead 1145 Huddle/Cuddle
13.Create a vibrant garden patio
14.I go to things outside my home
15.Volunteers
16.Support resident risk

22. MEGAMORPHOSIS: TESTS OF CHANGE
Emotional Connections Matter Most:
1.Staff name tages/buttons
2.Care Aprons
3.Buddy Program
4.Decorate Resident Rooms
5.Find Me Lights
6.AM/PM care is calm and social
7.Meal time is social and engaging
8.Move Rehab out of Basement
9.Food Services and Housekeeping are part of the
team
10.Yes! I can help you! Approach
11.Break times
12.Language and labels
13.Resident/Family directed Care conference
14.Volunteers
15.Staff rate their interactions
16.Staff Community Tree
17.“Treasure Room”
18.Improve Spa Room – fix/remove tub
19.Meal time: plate to person
20.Plan recreation programs together
21.SNARF Scarf
22.All Hands on Deck
Resident Directed Care:
1.2 Dining Rooms
2.Continental breakfast
3.3 things that bring comfort and joy
4.Remove staff signs from resident space
5.Colours, textures and interactive items fill the
space
6.Resident “rummaging” is encouraged
7.Staff space is invisible
8.RCA lead shift (handover) report
9.Shift away from residents days in bed
10.RN support medically complex people
11.TV use is meaningful to residents
12.RA and RCA lead 1145 Huddle/Cuddle
13.Create a vibrant garden patio
14.I go to things outside my home
15.Volunteers
16.Support resident risk
17.Resident diet textures – one page in public view
18.Keys avail for patio, bathroom and stove
19.Freedom of movement: Wanderguard disabled
20.Lighting is calming
21.Ideas and hesitations notebook
22.Create craft space
23.Main floor cafe

23. MARGUERITE PLACE: BEFORE
Staff Space for Shift Report, Breaks, MeetingsStaff Pre-Work Experiences

24. ENGAGEMENT: FEELING LIKE HOME

25. RESIDENTS, FAMILY AND STAFF INVOLVEMENT

26. SPONTANEITY AND GOING WITH THE FLOW

27. STAFF PRESENCE ON THE NEIGHBOURHOOD

28. TESTING NEW IDEAS EVERYDAY…

29. EMOTIONAL CONNECTIONS: BEFORE
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30. EMOTIONAL CONNECTIONS: AFTER
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25
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5
1
0
0
5
10
15
20
25
30
Positive and Social Positive Neutral Negative Protective Negative Restrictive
NumberofObservations
Emotional Connectedness Observations
Marguerite Place, February 23, 2017
n = 56

31. VIDEO: PHC’S RESIDENTIAL CARE FOR ME
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32. 32