Registed Nurses' Association of Ontario

Evidence Booster: Impact of Communities of Practice: Collaborations and partnerships for evidence-informed resident care

Ontario long-term care (LTC) homes are required by legislation to have evidence-based clinical programs. To support the implementation of evidence-informed clinical programs, Shaila Aranha, the LTC best practice coordinator in the Waterloo Wellington (WW) region designed and facilitated Communities of Practice (CoP). A CoP is a group of people with a shared interest who engage together in collective learning to support practice change (Wenger, McDermott & Snyder, 2002). These CoPs assisted LTC homes implement evidenced-based practices through the use of RNAO best practice guidelines (BPG) by using the Toolkit: Implementation of Best Practice Guidelines (2012).

This evidence booster focuses on LTC homes who participated in CoPs over the years from 2015-2018, demonstrating levels of impact on participants and the adoption of recommendations from the two falls prevention BPGs (2011[revised], 2017).

Practice Change
The first two CoPs focused on the clinical programs, therefore, the foci of each CoP team varied. In 2017-18, each clinical program was separated into a different CoP.  In Figure 1 outer circle denotes focus on falls and inner circle denotes the focus on clinical programs.
The CoPs allowed LTC homes to share experiences with implementation strategies and development of tools.
A standardized process was used to assist LTC homes with implementing BPGs as follows:

  • completion of gap analysis
  • prioritization of gaps
  • development of a sustainability action plan
  • establishment of monitoring indicators
  • sharing their journey of improvement including: plans for improvement, change ideas, challenges and successes.

Impact

The CoP allowed for the development of numerous  relationships, helping to eliminate the professional isolation for the LTC teams. As a result, 57 per cent of WW LTC homes engaged in CoPs over time. In addition 70 per cent of the time was focused on fall prevention.

There was an average 34 per cent decrease in the number of residents who fell per month after participation in the CoP and the implementation of fall prevention strategies (range 12.5 – 45 per cent)