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The impact of home care nurse staffing, work environments & collaboration on patient outcomes.

Increasingly, nursing care is delegated and provided by unregulated care providers such as Personal Support Workers (PSW). Little is known about the provision of nursing care activities by PSWs and the role of the nurse in assigning, delegating, teaching and supervising these activities in home care. This study will examine current structures of home care provision, the roles of RNs, RPNs and PSWs and the relationship between structures of nursing care and home care client outcomes.


Knowledge Translation

Literature Review: A scoping review related to the structures and outcomes of home-based nursing care. Summary

Jurisdictional Scan: Review and synthesis of provincial/territorial legislation and policy documents influencing structures of home-based nursing care. Summary

Policy Analysis: Analysis and application of the scoping literature review and jurisdictional scan. Summary

Final Report: Final report providing overall summary of study findings and outlining findings of each study research question.

Posters & Presentations

Provision of complex care activities by unregulated care providers in home care: The right care in the right place? 2018 interRAI Canada Conference, Calgary, AB

Impact of Continuity of Care on Outcomes for Community-based Seniors with Dementia 2016 World interRAI Conference, Toronto, ON.

Understanding the Structures of Home-Based Care Delivery 2016 Invited webinar for Home Care Ontario

Understanding the Structures of Home-Based Care Delivery 2015 Invited presentation for the Ontario Renal Network

Understanding the Structures of Home-Based Care Delivery: Developing A Picture of the Home Care Team 2015 Canadian Home Care Association Home Care Summit, Ottawa, ON

Understanding the Evolving Role of the Personal Support Worker: Task Shifting in Home-Based Care 2015 Ontario Community Support Association Conference, Markham ON

Task-shifting: Unregulated Care Providers’ Expanded Role in the Care of Complex Patients in Home Care 2015 Canadian Association on Gerontology Conference, Calgary, AB

Structures and Outcomes of Home-based Care in Ontario: From Knowledge to Action
This forum brought together individuals and stakeholders from home care service provider organizations, home and community care associations and government to validate study results and to discuss the impact of study findings on the future direction of community-based care. To read more and view presentations, click here.


A portion of the Ministry of Health and Long-Term Care funding for this project has been allocated to address Applied Health Research Questions (AHRQs) identified by health system providers and policy makers. The aim of the AHRQ process is to build research evidence to inform policy and practice benefiting the broader Ontario health care system. Open Here

Study Partners and Collaborators

Hamilton Niagara Haldimand Brant CCAC
Mississauga Halton CCAC







Featured Publication

Work-related factors influencing home care nurse intention to remain employed

Health care is increasingly moving from hospitals to community settings. In Ontario, home care organizations continue to experience challenges recruiting and retaining nurses. However, factors influencing home care nurse retention are largely unexplored. This study aims to test and refine a model that identifies which factors are related to home care nurse intentions to remain employed for the next 5 years.


Dr. Ann Tourangeau

Dr. Ann Tourangeau’s research is within the broad field of nursing health systems. Her research program focuses on nursing-related determinants of health care outcomes and explores causes and other influencing factors affecting patient safety, nurse, and nurse work environment outcomes.


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