Registed Nurses' Association of Ontario

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Guiding better outcomes in long-term care

Long before they were “coaches,” RNAO’s long-term care (LTC) best practice co-ordinators were in the field supporting evidence-based nursing.

RNAO has a rich history of promoting best practices in LTC. The brand new LTC Best Practice Spotlight Organization (LTC-BPSO) program – and the four “coaches” who are lending their expertise to it – is just the latest evolution.

The best practice co-ordinator role was first introduced in 2005 as part of the Ontario Nursing Secretariat’s LTC Best Practices Program, a pilot project to encourage the use of best practice guidelines (BPG) in the LTC sector. In 2008, the initiative was renewed and put under RNAO’s control.

“As LTC co-ordinators, we’re the face of RNAO out in the field in LTC,” says Saima Shaikh, the co-ordinator covering the Mississauga Halton Local Health Integration Network (LHIN). Currently, there are 14 co-ordinators in Ontario, one for each LHIN.

When Shaikh came on board in 2009, she already had 17 years of experience in the LTC sector. She’d worked for multiple homes, for the ministry of health, and had taught in an RPN program. She now supports BPG implementation in 27 LTC homes within her LHIN, and 10 others in Burlington.

Shaikh and her colleagues work with staff at all levels of the LTC home, from management to point-of-care professionals.

“Every long-term care home is very unique, and our approach (to BPGs) is tailored to the culture and the needs of the (individual) home,” Shaikh says.

When visiting a home, Shaikh does an environmental scan to take stock of existing infrastructure, and to determine what is needed to harvest best practices. “I get an understanding of where the home is, and where the home wants to go,” she adds.

This can vary greatly from home to home, which means co-ordinators must be flexible. It also means they must be accessible. The Long-Term Care Homes Act, which came into effect in 2010, requires all LTC facilities to use evidence- based practice. Since then, they are accessing co-ordinators even more often.

“(We must) always be available…so they know we’re right at their fingertips,” Shaikh says, adding that she tries to contact each of her 37 homes on at least a quarterly basis. Co-ordinators can also link homes with an abundance of RNAO resources, including the online Toolkit: Implementation of Best Practice Guidelines, Second Edition.

Four of 14 co-ordinators are serving as LTC-BPSOs “coaches,” working one day per week to help guide organizations through the LTC-BPSO process. If the program expands, all co-ordinators could become coaches. This would give them the opportunity to delve deep into an individual home, and watch best practices make their mark on resident care.

“My favourite part of my job is working with LTC homes, working the staff, and seeing the outcomes and the difference it’s made for residents,” Shaikh says.

Daniel Punch is editorial assistant at RNAO.

See the photo album from the Long-Term Care Best Practice Spotlight Organization Launch.