Resident experience with decision-making | HQCA Focus

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Designated Supported Living

Resident experience with decision-making

How residents rated their involvement in decisions about their care, in a 2019 survey. (see data dictionary)

*Alberta Health Services, Emergency Medical Services, System Performance and Innovation. “EMS Computer Assisted Dispatch (CAD) data.” (2020) [Data showing median and 90th percentile results for the length of time patients experiencing a life-threatening medical event wait for EMS staff to arrive, from when the 9-1-1 call is received by AHS EMS dispatch to when the first ambulance arrives at the scene of the incident, by zone, geographic area, month, and quarter].

What do you think?

  • Why does resident involvement in decision-making matter? What aspects of care might be impacted by this element of resident experience?
  • Are there differences between zones? Between providers? Between mainly rural and urban zones or sites? What factors could account for these differences?
  • How are resident experience results around decision-making different than family members’ in designated supportive living?

Understanding “resident experience with decision-making”

In a survey conducted in 2019, the HQCA asked residents living in designated supportive living:

Are you involved in making decisions about your care? (Such as planning your daily activities, choosing medical treatments or medication schedule)

Residents could choose “Yes, always / Yes, sometimes / No, hardly ever / No, never”

Resident overall experience of care is likely better when they feel they have a say in or are empowered to make choices about their care.

Considerations when viewing the results:

There are a number of factors providers and leaders can consider to better understand and improve resident experiences with decision-making about their care. Before taking action, consider the following:

  • How are residents engaged in making decisions about their care? Which decisions are residents typically involved in? How are expectations about care set together? How do staff work together to meet those expectations?
  • What are possible barriers residents face to being involved in decisions about their care? Which barriers could a site help overcome?
  • What approaches could be taken to help residents choose to be more actively involved in decisions regarding their care, if they have not previously chosen to be engaged?
  • Which Supportive Living Accommodation Standard(s) does this question help inform, if any?
  • Which Continuing Care Health Service Standard(s) does this question help inform, if any?
  • Who should be involved in discussions to improve these results? How could residents and/or family members be engaged to develop solutions? What other collaboration might be required to make improvements in this area?
  • A site may only be directly accountable for one type of staff. For example, in designated supportive living, case management and sometimes nursing care are delivered by Alberta Health Services, while other services like care aides and housekeeping are managed by a housing provider or site operator. How can providers collaborate to make sure improvements related to improving resident involvement in decision-making are embraced by all staff?

For information about the HQCA’s designated supportive living resident experience survey, please visit the HQCA website.

Alberta Quality Matrix for Health

The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. This measure can be used as input to assess supported living’s performance in these dimensions of quality: Acceptability, Appropriateness, and Safety.