Family experience with staffing

How family members rated their experience with the amount of staff available to support their loved one. (see data dictionary)

What do you think?

  • Why does the family member experience with the amount of staff available matter?
  • Are there differences between zones? Between providers? Between mainly rural and urban zones or sites? What factors could account for these differences?
  • How is this result related to family experience with continuity of staff?
  • How are family experience results around staffing levels different in long term care?

Whether you’re a resident, family member, provider, or health system administrator, thinking about why these differences might exist can start or inform conversations and lead to solutions for improved quality of healthcare.

Understanding “family experience with staffing”

In a survey conducted from May to October 2016, the HQCA asked family members of residents living in designated supportive living:

In the last six months, how often did you feel that there were enough nurses and aides in the supportive living facility?

Family members could answer either “Never / Sometimes / Usually / Always.”

When family members feel that there is enough staff to support the needs of their loved one, there is an increased likelihood of a positive experience with care and services. Aspects of staffing and relationships with staff have a strong influence on the overall experience of care from the family member’s perspective.

Considerations when viewing the results:            

There are a number of factors providers and leaders can consider if looking to improve family members’ overall experience of care. Before taking action, consider the following:

  • What expectations do family members have about staffing? Family member perspectives may differ in the degree to which they feel there are “enough” staff at a site and how often staff need to be present.
  • How might family member experiences with staffing differ from the resident?
  • Residents in designated supportive living may be more independent than residents in long term care. How might this impact the family members’ perceptions of staffing?
  • How can overall funding impact family member perception of staffing? Staffing is linked to acuity, or intensity of care required, and not a simple staff-to-resident ratio (e.g., one staff member for every five residents). The activities a site needs to offer in order to meet a resident’s assessed needs is typically determined by the overall acuity of the residents at each site. This means that when a higher volume and higher intensity of activities or care is required, the site’s funding reflects this. A site with an overall higher acuity population of residents are funded for things like more staff relative to a site with an overall lower acuity population of residents.
      – How is this staffing formula communicated to residents and family members, to help understand why some sites might appear to be staffed differently than others?
    • – Why are some sites performing better? How are those doing better managing resources differently? What types of staffing and staffing arrangements foster better experiences?
  • 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 (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 improve this result?

For information about the HQCA’s designated supportive living family experience 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 designated supportive living’s performance in these dimensions of quality:
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Dimensions of Quality

  • Acceptability 
  • Accessibility 
  • Appropriateness 
  • Effectiveness 
  • Efficiency 
  • Safety