Entre Nous - Special Edition

Our accomplishments - together! 

Bruyère Continuing Care is preparing for its accreditation visit which will take place from April 1-5 2019. Some of our accomplishments highlighted in this special newsletter align with required organizational practices and accreditation standards. We look forward to sharing our successes with the Accreditation Canada surveyors. The surveyors may talk to anyone within our homes, including families and residents. Please share your experience and our accomplishments! If you are not able to answer their questions, just let them know that you will find someone who can help them out.

Antipsychotic Usage 

Bruyère’s LTC homes are part of the Seniors Quality LEAP initiative(SQLI), a strong community of practice with over a dozen member organizations and nine strategic partners from across North America. At the most recent SQLI meeting, Bruyère presented its work on decreasing inappropriate antipsychotic usage as it was the most improved organization for this indicator. We have worked hard on decreasing antipsychotics internally and are part of the Canadian Foundation for Healthcare Improvement initiative on appropriate usage of antipsychotics.

Congratulations to our staff of both homes on the great work!

Falls & pressure ulcer prevention brochure

It is important that residents and families be able to participate optimally in their care, and have easy access to relevant information on important topics. To address this, we have developed brochures this year on;

• Falls Prevention
• Pressure Ulcer Prevention 

These are available on the Bruyère website and in our Resident and Family Handbook.

Always Practices

We have had a lot of fun this year engaging employees, residents, families and other stakeholders in developing ten “Always Practices” for LTC. These “Always Practices” are behaviours expected to make our LTC homes an even greater working and living environment. For example, one of these practices is “Concentrate on the solution, not the problem.”

As we launch our Always Practices, keep an eye out for our teams, residents and families illustrating (in photographs) how we live these practices, every day, in our homes.

Introduce yourself, smile and be positive!

Tub room enhancements

At the Saint-Louis Residence, we have worked diligently with our teams to improve the bathing experience for both residents and employees. Our project, which has now been funded by the Eldercare Foundation, allows for the innovative use of a LEAN quality approach that mobilizes residents, families and staff to enable enhanced processes for quality of life, bathing experience and safety.

Purchases made through the grant include: wheeled units for the storage of supplies and equipment, wall-mounted documentation stations, artwork and music players.

Enhanced move-in process

The decision to move into an LTC home can be very stressful for both families and residents. We have taken steps to enhance our move-in day processes. This has included:

• Developing a pre move-in and move-in day checklist with clear roles for each team member;
• Ensuring the resident and family are welcomed and toured on the unit to meet others in the home area;
• Changing the order of assessments to ensure a better flow of the day and priority areas to be covered early such as the dietary assessment and medication orders;
• Offering the family some munchies and drinks . . . it can be a long day;
• A welcome card from the RSL team;
• A reminder sheet with information they should retain (ex: how to reach the home area, nurses names, physician, room number, etc.);
• A follow-up phone call or visit 2 weeks after move-in day to check on how things are going and to see if any questions can be answered or information provided. 

Innovative resident-centered education

For the first time this year, we involved residents in our education sessions on residents’ rights following the Through Our Eyes framework created by the Ontario Association of Resident Councils. Residents helped to develop and teach the education sessions in person, and through video statements about their lives, preferences and feelings. At Residence Elisabeth Bruyère, two personal support workers educated their peers using the Excellence in Resident Centered Care Program offered through Conestoga College in partnership with the Schlegel-UW Research Institute for Aging. This program uses a train-the-trainer format to build practical skills using a person-centered approach.

Labelling and lost items

Labelling and management of lost items is very complex in an organization with hundreds of residents and employees. Items to track include clothing, glasses, dentures, mobility equipment, personal items, etc.

We have created a labelling guide with new and innovative ways of labelling each of these types of items. Look out for some of the new labelling techniques!

We have also updated lost & found processes and launched Lost and Found Item Days (2 held so far) to help reunite the lost objects and their owners.

Infusion pump training

Did you know that infusion pumps are used in long-term care?

• For enteral feeding
• For intravenous antibiotic administration
• For some pain medicines 

We have done a full review of all pumps, education mechanisms, operating manuals, etc. This ensures optimal employee competency and resident safety.

Care planning enhancements

The resident’s care plan is a complex and living document. It allows our interprofessional care team to know how best to care for each resident.

We have an ongoing quality project that aims to improve the process from the resident's move into ongoing provision of care.

The team completed a full review of the current process involving our front-line staff as well as residents and families. This process included not only our clinical staff, but also our therapeutic support staff, therapists, the administration and the Centre for Learning, Research and Innovation in LTC team.  This has led to:

• Enhancements to our move-in process
• An overhaul of our care plan library and assessments
• The creation of standard interventions (expected of all)
• The inception of care plan binders on each unit that include “what matters to me” information for each resident...coming soon! 

New and exciting activities!

At Bruyère Continuing Care, it is very important to us that residents be able to participate in meaningful activities. Over the past year, we have introduced many new activities such as;

• The Java Music Club, a weekly peer support group for residents, designed to decrease rates of depression and loneliness.
• The Java Memory Care program which combines peer support, reminiscing, and music.
  
• The Motiview program combines safe physical activity with beautiful videos of bike paths or roadways from the Ottawa area, across Canada, and around the world. 
• Cycling Without Age has been a huge success at both LTC homes. This allows residents to enjoy a bike ride on a 3 wheeled carriage. In its inaugural season, it provided 193 people at Saint-Louis Residence and the Bruyère Village with the outdoor cycling experience. More than 1,500 km were travelled. To find out more about our activities please contact Therapeutic Support Services.  

Shared aspiration workshop

On January 18, 2018, Saint-Louis Residence held the kick-off to a beautiful journey! More than 70 people came together for the Shared Aspirations in Long-Term Care workshop. This very special event brought together residents, family members, nurses, auxiliary services and food services staff, physicians, volunteers, researchers, managers, partners and board members. Their goal was to identify and explore our strengths and positive core and to think about what the care and services in our long-term care homes might look like in the future. This workshop launched our 5-year transformation journey with 4 key themes: a) resident and family-centred care, b) meaningful activities and reducing isolation, c) employee recognition and development and d) safe and secure environment. Our transformation advisory team continues to meet quarterly and our next full workshop will likely be held in January 2020.

Bed system optimization

Have you noticed new beds on our units? Many of our residents are now sleeping in new bed systems specially designed for long-term care!
We have evaluated each of the residents to determine which safe bed system would best respond to their needs. The teams have worked very hard on this project which aimed to protect particularly vulnerable residents when it comes to bed-related injuries like getting stuck in or around the bed. In long-term care, bed rails are perceived as equipment to help keep residents safe. However, in some situations, bed rails pose risks, one of which is bed entrapment. This means that a resident could become trapped in the spaces around or between the bed rails, mattress and/or bed frame.

Suicide prevention and interventions

Suicide prevention has become an important topic for everyone in our communities. This year, we launched and educated employees on our new Suicide Prevention and Interventions policy, including tools for screening and assessment of suicide risk. Employees are now empowered with tools and processes to help them intervene and help protect residents who might be experiencing suicidal ideation. The focus of our program is on understanding the resident holistically to try and address the areas of need and tailor an individualized care plan

Focused rounding

A new focused rounding project is being implemented at Saint-Louis residence in the spring. Focused rounding will enhance the way we work by moving us towards a more proactive, rather than reactive, approach in meeting residents’ needs. One of the goals is to enhance the satisfaction of all by proactively addressing resident and family concerns, and enhancing communication and relationships. Other main goals include the reduction of falls, pain, pressure ulcers and call bells, and the enhancement of employee satisfaction. Other similar health care institutions have implemented focused rounding and have had huge successes! Following our pilot on the 3rd floor at RSL, this project will be spread across our LTC homes. 

Dignified goodbye 

The passing of a resident is a difficult time for the family, staff and the other residents. At Saint-Louis Residence, we are optimizing our end-of-life rituals, starting with providing a dignified and peaceful exit for our deceased residents and their family members. This includes:

• A symbolic chime and a moment of silence
• The deceased, covered by a dignity quilt, accompanied by staff, exiting through the front door of our Residence.

We have also created a sympathy card that is placed at the dining room table where the deceased resident used to sit with a beautiful butterfly light. Everyone is welcome to write a word of sympathy for the family members of the deceased resident. In addition, we have designed a beautiful wreath that is hung on the deceased resident’s door to let others know this person has left us.

Finally, we have prepared a brochure to help families cope with the difficult end-of-life period. It is available on the Bruyère website and in our Resident and Family Handbook.

Many of our PSWs are also benefiting from the Communication at End-of-Life education program developed by Algonquin College and the Bruyère Centre for Learning, Research and Innovation in LTC.

RNAO BPSO designation

In May 2015, SLR was the first long-term care home in the Champlain Region and the first Francophone long-term care home in Ontario to be designated as a Best Practice Spotlight Organization (BPSO) candidate by the Registered Nurses’ Association of Ontario (RNAO).

On April 19, 2018, SLR proudly received their full BPSO designation. SLR is committed to sustaining its efforts as it utilizes the framework and strategies to continue to implement more best-practice guidelines and enhance the quality of care for long-term care residents.

Congratulations to our teams at SLR! Their efforts and dedication to enhancing the lives of our residents is being recognized.

Our current focus is on implementing the Resident and Family Centred Care Best Practice Guideline.

New Practice Support Nurse role

We are very pleased to announce the appointment of Maggy Célestin (SLR) and Mariem Ben Amor (ÉBR) into their roles as registered nurses working in a practice support nurse role (PSN).

These new positions are funded through the MOHLTC. These funds were provided to LTC homes to use solely for a new full-time registered nurse position in order to enhance resident care.

We are confident that these new positions will help us to build capacity within the homes, enhance care to residents and allow us to continue our best practice implementation efforts.

Do you have a funny, touching, story that is worth sharing? Send it to sld-ltc@bruyere.org.