Our 78,000 long- term- care residents need protection
The Toronto Star is right: Enough is enough. We need decisive action to protect those most vulnerable to COVID19: Ontario’s 78,000 long- termcare residents. They deserve nothing less.
More homes across the province are currently in outbreak than at any point in the pandemic. And the number of outbreaks keeps escalating.
Once COVID- 19 enters a long- termcare home, the risk to residents is horrifying, and we have seen all too often the tragic loss of lives. This is because COVID19 is a uniquely virulent and deadly disease, especially for frail seniors. But it is also because structural issues in our long- term- care system, built up over decades of neglect by successive governments, further increase the risk to residents’ lives.
The answers aren’t new, or secret, or even very controversial. They just require resources, commitment and common purpose. While any home with many vulnerable people is at high risk from COVID- 19, we also know that its toll is greatest in older homes that were built with multi- resident rooms, in regions with high rates of community spread, and where we have critical staffing challenges.
That is why we welcome the call of Torstar’s Paul Rivett and Jordan Bitove for immediate investments and changes to our long- term care system, and for supports for our most vulnerable seniors.
The Star has called for immediate action on five recommendations:
Immediate rapid testing and vaccinations in long- term care;
Enhanced inspections and mandatory reporting on infections, supplies and staffing, as well as on access to other levels of care; á Emergency funding from provincial and federal governments to address staffing issues;
> A rapid response task force of infection control workers;
> The creation of independent federal and provincial ombuds with a national regulatory authority.
We agree, vaccines must be administered as quickly and safely as possible — this requires an education campaign to increase uptake.
Rapid testing, with the support of partners like hospitals, is critical to keep COVID- 19 out of homes.
Both immediate and long- term action on the staffing crisis is vital. This means major, long- overdue investment from government, enhanced staffing levels and flexibility for new approaches to build our workforce, including rapid training and credentialing.
Enhanced infection prevention and control ( IPAC) measures are essential. We have long advocated for dedicated IPAC staff in each home, complemented by hospital partnerships. Further, as soon as any home begins to struggle with aCOVID- 19 outbreak, Ontario must deploy emergency external supports.
We agree that there must be clear accountability and transparency, so we can identify issues quickly, and address them urgently. Clear accountability includes knowing who is in charge; any ambiguity about which roles are federal and which are provincial would obscure accountability rather than enhancing it.
The reason we want accountability and transparency is because they contribute to excellence in quality and safety for residents. Top performing healthcare organizations have embraced continuous quality improvement; indeed, the Ontario government requires by law that all hospitals have “quality improvement plans,” even if they already have excellent results.
Inspections are a tool to achieve this. They must identify problems and risks, and hold accountable anyone who does not take appropriate steps to ensure safe, high- quality care.
Critically, this means fostering and supporting quality improvementand the innovation that enables it. Past inspection regimes have been least effective when they stifled evidence- based improvement by enforcing rigid adherence to arbitrary processes with no real connection to safe, high- quality care.
Finally, it is past time to rebuild the province’s older long- term- care homes with multi- resident rooms, which carry inherently higher risk for infectious disease. There is a long history of failed attempts to create a provincial capital funding program that works.
Recent improvements by government will allow more homes to rebuild, but too many operators are still waiting for an approval process that is far too complex. The province must fix that process, and approve rebuilds with the urgency our residents deserve.
Our seniors built the society we enjoy today. Everyone in Ontario shares a responsibility to care for them. Those of us on the front lines of care, and of the battle against COVID, believe change cannot come fast enough. We join the Star’s call to action.
The reason we want accountability and transparency is because they contribute to excellence in quality and safety for residents