Empowering Ontario's long-term care residents to shape the place they call home: a codesign protocol

Abstract

Background: Canada's long-term care (LTC) homes were founded on an institutional model that viewed residents as passive recipients of care. Many homes continue to follow this model leaving residents removed from operational decision-making within their homes. However, involving residents in the design of their LTC home's environment, programmes and operations can improve the residents' quality of life and other outcomes. This codesign project creates a toolkit/resource for LTC homes to facilitate meaningful resident engagement in their home's organisational design and governance.

Method: This three-part project consists of a scoping review, qualitative interviews, toolkit/resource development and prototyping. In part 1, we conduct a scoping review to synthesise existing knowledge on approaches to engaging LTC home residents in organisational design and governance of their LTC homes, as well as explore barriers, challenges and facilitators of engagement, considerations for diversity and cognitive change, and approaches to evaluation. In part 2, we will have interviews and focus groups with residents, team members (staff) and administrators to assess community capacity to implement and sustain a programme to engage LTC residents in organisational design and governance of their LTC homes. The third part of our project uses these findings to help codesign toolkit(s)/resource(s) to enable the engagement of LTC residents in the organisational design and governance of their LTC homes.

Ethics and dissemination: The project is conducted in partnership with the Ontario Association of Residents' Councils. We will leverage their communication to disseminate findings and support the use of the codesigned toolkit(s)/resource(S) with knowledge users. We will also publish the study results in an academic journal and present at conferences, webinars and workshops. These results can influence practices within LTC homes by inspiring an organisational culture where residents help shape the place they call home. The interviews and focus groups, conducted in part 2, have been submitted to the University Health Network Research Ethics Board.

Keywords: Aging; GERIATRIC MEDICINE; Patient-Centered Care; Quality in health care.

Figure 1

Overview of project components in alignment with the codesign steps and application of the PRISM/RE-AIM model. Step 1: ENGAGE. In this step, the research team builds relationships with OARC and their resident volunteers. Step 2: PLAN. In this step, we define the research scope, objectives and methods. The PRISM contextual factors are used as an integrated framework to guide how to plan for the creation of a toolkit/ resource. Step 3: EXPLORE: We explore existing resident engagement practices that are documented in the literature through a scoping review, as well as current practice and community readiness through interviews/ focus groups. We apply components of the PRISM/REAIM framework to analyse the scoping review questions. Steps 4–6: DEVELOP, DECIDE and CHANGE. At this step, we will iteratively cocreate and prototype a toolkit/ resource. We will apply the RE-AIM planning tool to guide the cocreation process. PRISM, Practical Robust Implementation and Sustainability Model; RE-AIM, Reach, Effectiveness, Adoption, Implementation, Maintenance.