Speaker
Description
Objective/Background: Transitioning into long-term care is a complex and often stressful experience for residents, care partners, and the staff supporting the move. Recognizing the need to enhance our move-in process, we aligned our approach with the RNAO BPG on Transitions in Care and Services and Resident- and Family-Centered Care.
Methods: Gap analyses were conducted to evaluate existing processes against RNAO guideline recommendations using the LTC Best Practices Toolkit. Guided by the Knowledge-to-Action Framework, we developed and implemented a structured transition support process.
Results: The John M. Parrott Centre implemented a standardized transition support process spanning pre-admission to the first two weeks post-admission. Key components include early communication with residents/care partners/families, enhanced information gathering, and preparation of the resident’s environment prior to move-in. A Pre-Move In Assessment in the resident EHR was created for pre-admission information, resulting in a more organized/prepared transition starting on the day of move-in. Move-In day processes were redesigned to emphasize a warm welcome, orientating information, and completion of a comprehensive assessment to inform individualized care planning. A comprehensive social history is shared with all staff to support internal community awareness that supports social connections within the Home. The initial two-week transition period focuses on relationship-building, ongoing assessment, and individualized care plan adjustments. Follow-up by the Resident & Family Liaison supports continuity, communication, and partnership.
Conclusion Key lessons learned include the importance of a structured pre-admission process which improved information sharing and staff readiness. The Admission Clinical Pathway and BPG supported personalized, resident-focused care from move-in. The introduction of scheduled check-ins enhanced communication, relationships, feedback, and continuous improvement, creating a sustainable, person-centered transition model. These check-ins strengthened our ability to gather feedback and support ongoing quality improvement. Our new process demonstrates a sustainable, person-centered model that can inform best practices for transitions into long-term care.
Author(s) Credentials and Title
Emily Sarley BScN, RN, MON, BPSO Lead
Melissa Boot RPN, BPSO Co-Lead
What RNAO BPG or tool/toolkit is your abstract related to?
Transitions in Care & Services and Person Centered Care
| Organization Name | The John M. Parrott Centre |
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