Healthcare Areas

In a survey conducted in 2022-23, the HQCA asked family members of residents living in continuing care homes – type B (formerly called designated supportive living):

In the last three months, how often was your family member cared for by the same team of staff?

Family members could choose “Never / Sometimes / Usually / Always”

If a resident is consistently cared for by the same staff, they often experience relationship continuity. Relationship continuity often indicates a trusting relationship with a care provider. How often family members feel their loved one is cared for by the same staff can impact the experience of care from the family member’s perspective. Family member comments from the HQCA survey indicate that when their loved one is not being cared for by the same staff over time, care and treatment plans are inconsistently followed.

There are a number of factors providers and leaders can consider to better understand and improve family member experiences with continuity. Before taking action, consider the following:

• How important is consistency of staff to family members?
• How are staff encouraged and supported to develop ongoing relationships with family members?
• How might family member experiences with relationship continuity between staff and their loved one differ from the resident’s experience?
• Can existing staff resources be used in different ways to improve this measure? What are sites with better results doing differently?
• What are the reasons why staff change? How could these changes be managed to support both relationship continuity and operations? How might this be shared with family members?
• Which 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 (e.g., engage the resident and family council)? 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 continuity are embraced by all staff?

For information about the HQCA’s Facility-based Continuing Care Survey, please visit the HQCA website.

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 performance in these dimensions of quality: Acceptability, Appropriateness, Effectiveness, Efficiency, and Safety.

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