Quality Improvement Plan 2019-2020

The Perley and Rideau Veterans’ Health Centre (Perley Rideau) is a not-for profit seniors’ care organization with 450 provincially licenced long-term care beds. While the Perley Rideau’s primary focus is on long-term care, it also actively supports the capacity of seniors to live independently. To this end, the Perley Rideau partners effectively to develop a community of care and to provide ready access to a range of clinical and therapeutic services, along with social and recreational activities.

Perley Rideau is pleased to share its 2019/20 Quality Improvement Plan (QIP). Perley Rideau’s primary focus is Excellence in Care and Service. Our commitment to quality is reflected in our mission “to achieve excellence in the health, safety and well-being of Seniors and Veterans with a focus on innovation in person centred and frailty-informed care and service" and in our supporting strategic plan, which was updated in 2017 to better reflect the evolving healthcare landscape.

Perley Rideau has entered a period of significant challenge and opportunity. The population of World War II and Korean veterans is declining. As a result, Perley Rideau’s mandate to provide long-stay residential care for veterans of World War II and Korea is evolving. Ontarians are aging and have more complex health needs. Resources are limited. The healthcare system must learn new ways of delivering higher quality care at lower cost. Perley Rideau must determine how it can continue to provide the highest value to its community.

The QIP is a roadmap to achieving excellence in care and service, while navigating challenges and opportunities in our environment. Perley Rideau’s QIP is aligned with our annual operating plan and supported by our measurement and accountability systems. This alignment allows us to effectively clarify priorities, direct resources, monitor progress and act on results.

The overall objectives of Perley Rideau's QIPs have remained largely consistent from year to year. Maintaining focus allows us to build on work completed as well as sustain and spread improvements achieved during the previous QIP cycles (2015/16 - 2018/19).

Prioritization within the QIP, targets for improvement and projected change ideas/tactics for each objective have been refined to reflect:

  • progress achieved in 2018/19;
  • the most recent performance data available from the Canadian Institute for Health Information (CIHI), resident and family experience surveys and our electronic health record;
  • emergent issues identified internally (trends in critical incidents) and/or externally
  • input from residents, families, staff, leaders and external partners, including the MOHL

 

Priorities are divided into 3 categories

 Priorities for focused action, moderate action and monitoring. Please note that targets reflect a blended average for both our community and veteran residents.

 

Priorities for Focused Action:

  1. Reduce the percentage of residents who had a worsening pressure ulcer from 3.9% to 3.0%
  2. Reduce the percentage of residents with worsening behavioural symptoms from 20.3% to 19.0%
  3. Reduce the percentage of residents who experienced worsening pain from 19.0% to 17.5%
  4. Reduce the number of staff to resident incidents of abuse/neglect that are reported to the MOHLTC from 9 to 0.

 

Priorities for Moderate Action:

  1. Reduce the percentage of residents on antipsychotics without a diagnosis of psychosis from 17.4% to 15.0%
  2. Maintain or increase the percentage of residents who would positively recommend Perley Rideau to others (currently 82%, target at or above 85%).  Target of 85% remains unchanged for 2019/20, as Perley Rideau will focus on sustaining consistently high performance in this area.

 

Priorities for Ongoing Monitoring:

  1. Reduce the percentage of residents who had a fall in the last 30 days from 20.2% to 19.5%
  2. Reduce the number of potentially avoidable ED visits per 100 residents from 13.3 to 13
  3. Reduce the use of daily physical restraints from 11.7% to 6.4%.

 

Perley Rideau continues to identify modest improvement targets in recognition that the standardized QIP indicators used for long-term care in Ontario are lagging indicators, and are calculated using a rolling four quarter average.  The baseline data used for the 2019/20 QIP reflects performance for the time period October 2017 to Sept 2018.    We have adopted a multi-year cycle for our QIP, recognizing that a phased approach to change will increase the likelihood of sustained improvement.