(OTTAWA) A Canadian organization that develops health care standards has released draft new guidelines on long-term care that the authors hope will fundamentally change the way such facilities are accredited and inspected in the country.
Posted at 6:44 p.m.
Written in response to the thousands of resident deaths related to COVID-19 in 2020, the new standards are designed to prevent such tragedies in the future, said the Dr Samir Sinha, chair of the Health Standards Organization technical committee that drafted the new document.
The pandemic has exposed serious and long-standing shortcomings in long-term care, including poor working conditions for staff.
These poor conditions caused staffing shortages which, when COVID-19 broke out in early 2020, fueled the spread of infections as attendants and nurses moved from home to home. Meanwhile, residents were sometimes barred from going out and cut off from loved ones, Dr Sinha said.
According to the Canadian Institute for Health Information, COVID-19 has, as of August 15, 2021, killed 14,000 residents of long-term care homes in Canada, representing approximately 43% of all coronavirus deaths. so far.
The Dr Sinha, who is director of the geriatrics department at Sinai Health in Toronto, believes several new criteria in the proposed standards would have saved thousands of lives in long-term care homes during the pandemic.
Although the federal government has called for new standards, it remains unclear how it intends to implement them, since long-term care falls under provincial and territorial jurisdiction. Premier François Legault, for example, repeats that Quebec rather expects to receive “recurring money” in health care from Ottawa, unconditionally, and not national standards.
Like in hospitals
The standards focus on care delivery and quality of life for residents, as well as an attractive work environment. This includes offering fair compensation and benefits, as well as sufficient staff. It would also be recommended to align infection prevention and control measures in homes with those in effect in hospitals, said the Dr Sinha.
The standards also reflect the right of residents to live with a certain level of risk, if they wish, which may mean that people who are prone to falls could avoid restraints, or that certain visitors would be allowed to come and see them. even during outbreaks.
“We need to strike that balance by allowing residents to live with certain risks and respecting their right to manage them, while balancing (that right) with the safety of everyone living in the home,” Dr Sinha said.
The previous standards were developed by the Health Standards Organization in 2012 and have been updated over the years. These standards are currently used to accredit about 68% of long-term homes in Canada, according to Dr. Sinha.
While the current standards include 35 criteria for providing quality long-term care, the new draft includes 183. The standards cover resident care plans, quality of care, disaster procedures, protection whistleblowers and staff qualification.
These standards also provide for the collection of workforce data and the assessment of the quality of life, health and well-being of residents, in order to promote improvements in homes.
The Health Standards Organization is now asking for public comment on the draft, over the next 60 days; these comments will be collected and used to develop the final draft. The new national standards should be finalized and published by the end of the year.
Provincial agreement
The proposed new standards were developed in conjunction with CSA Group, formerly known as the Canadian Standards Association (CSA), which will focus on more “physical” elements of long-term care, such as building design. , air filtration and infection prevention and control. CSA Group’s draft of the new standards is expected to be released for public review next month.
Prime Minister Justin Trudeau’s government has pledged $3 billion over five years to support the implementation of the new standards, but ultimately this national initiative will need to secure agreement from provinces and territories.
Trudeau also gave Health Minister Jean-Yves Duclos a mandate to “develop national standards and legislation for safe long-term care,” although no details have yet been released. .
The Dr Sinha considers the standards used to inform every cog in long-term care, from legislation to accreditation, and from inspections to staff training programs. He adds that governments will also need to put some teeth into these standards, so that they can be enforced and homes held accountable for meeting them.
“My God, I hope this is a clear plan that can truly empower provinces, territories and the federal government to bring long-term care to where all Canadians want it. »
Note to readers: In the version of this text transmitted on January 27, The Canadian Press incorrectly reported that the standards currently used to accredit approximately 61% of long-term homes in Canada, according to Dr. Sinha. In fact, this percentage is around 68%.