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Structures and Outcomes of Home-Based Care in Ontario: From Knowledge to Action

This knowledge-to-action forum was held on March 11, 2016 and brought together individuals and stakeholders from home care service provider organizations, home and community care associations and government to validate study results as well as to discuss the impact of these findings on the future direction of community-based care.

In this study we identified how home-based patient care is structured for long-term maintenance clients by examining the roles of Registered Nurses, Registered Practical Nurses and personal support workers in the planning, management and delivery of home-based nursing care. In Canada, a large proportion of home care services for long-term/maintenance clients are provided by unregulated care providers, also known as personal support workers. Within Ontario, approximately 34,000 PSWs work in home health care under the direction of RNs and RPNs. As such, this study focused on the provision of patient care activities by PSWs and the role of nurses in assigning, delegating, and supervising these activities.

Opening remarks and first presentation, “Developing a Picture of the Home Care Team: Roles of Care Team Members.” click here for PDF slides.

This presentation provides background information on the study design, methods and research outputs of the Government of Ontario funded study The Impact of Home Care Nurse Staffing, Work Environments and Collaboration on Patient Outcomes. Presentation 1 describes the roles of home care team members with a specific focus on the role of the personal support worker (PSW). Communication structures between team members are also outlined. Finally, challenges to the safe integration of PSWs in home-based care are discussed.

Second presentation, “Understanding Care Structures and Patient Outcomes in Home Based here for PDF slides.

This presentation builds on the Knowledge to Action’s first presentation and describes the structures of home-based care including an in-depth look at documentation, service patterns, continuity of care and the delivery of added skills. Additionally, event rates for the 10 outcomes examined in the study are reported and some issues related to outcomes reporting are discussed.