How long-term care can harness research to improve quality

Number 7, 2006

Long-term care organizations have not traditionally been partners in applied health services research. This is unfortunate, since a number of key challenges in long-term care are in fact highly researchable questions.

Take the issue of falls, for instance. They are the most common adverse event reported in long-term care homes, often triggering a domino effect of medical, economic, and psychological consequences for seniors. Knowing how to better prevent falls would improve the lives of residents and reduce the burden on staff as well.

“Our members want to provide the best services they can, and they know research is another tool in the toolbox,” says Krista Robinson-Holt, director of health planning and research for the Ontario Long Term Care Association. “Research, however, is not deeply embedded in the culture of long-term care homes. And by the same token, long-term care has not traditionally attracted much attention from the research community.”

The association represents 427 long-term care homes in Ontario, accounting for 94 percent of the province’s nursing homes. Member organizations hesitate to get engaged   in research for a number of reasons, including shortages of time and resources and the fact the process is not necessarily responsive to their needs. In addition, researchers don’t always understand the context of long-term care, and some are frustrated by lack of access to sites or lack of interest and co-operation from staff.

“The issue had arisen from time to time,” notes Ms. Robinson-Holt, “but the penny really dropped one day while talking with a researcher about how her project had missed several factors relevant to the long-term care home setting. That’s when I realized we needed to establish relationships between our members and the research community.”

To promote this kind of research and establish linkage and exchange between the research community and long-term care homes, the association formed an applied research committee including its members and representatives from the research community.

Since April 2005, the committee has worked to dismantle barriers and build linkages to support relationships between association members and the research community.

“We’ve definitely raised the profile of research with our members,” says Ms. Robinson-Holt, “and we are starting to form close working relationships with the research community.”

Simple, practical actions have had unforeseen positive impacts. For example, long-term care homes recruited as potential research sites are providing researchers with valuable feedback on their proposed research approach. In turn, the involvement of association member homes in research projects has made them more interested in the results.

“It’s really moved the yardstick for our association,” says Karen Sullivan, executive director of the association. “We are now in a position to better disseminate research findings and encourage their uptake.”

Perhaps the most visible demonstration of the association’s success in promoting health services research is the fact that it is now a producer of research. Remember the issue of falls? In partnership with one of its members the association sought and received funding for a study on falls in long-term care. Research is underway and the results should be available in spring 2007.

For more information, please visit www.oltca.com or contact Krista Robinson-Holt at krobinson-holt@oltca.com.