Introduction

In response to the current COVID-19 pandemic, long-term care (LTC) and retirement homes are required to observe strict infection prevention and control measures to contain and prevent virus transmission. As a result, many residents are no longer receiving face-to-face visits with their physician or nurse practitioner (NP). There is now a tremendous need to use virtual care, which is simply the use of chat, audio and/or video, to obtain clinical advice and support from a physician / NP working offsite.

Virtual Care PDSA

St. Joseph’s Health Centre Guelph’s Waterloo Wellington Nurse-Led Outreach Team (NLOT) and Behavioural Supports (BSO) program have partnered together to support the implementation of virtual care in both LTC and retirement homes in the Waterloo Wellington LHIN (WWLHIN), through the support of St. Joseph’s Health Centre Guelph, eHealth Centre of Excellence (eCE) and the WWLHIN. The goal of the Virtual Care PDSA is to optimize resident-centred care and reduce avoidable emergency department visits during the pandemic and beyond. This will be achieved by supporting front-line staff with proactive monitoring / care planning in the home through virtual care, building capacity of staff through evidence-based nursing assessments, including behavioural assessments, and increasing access to physician, NP and specialist care.

Specific LTC and Retirement Homes have been selected to participate in the 3-month Plan-Do-Study-Act (PDSA), running from June to August 2020 (dates may vary based on date of implementation). This study includes 10 LTC and 10 retirement homes interested in implementing virtual care technology while being supported with best practices in nursing and behavioural support interventions. Each PDSA home will receive a free tablet that meets legislated privacy and encryption standards required for providing virtual care.

Each of the 20 homes will be supported by a dedicated NLOT and BSO team who will:

  • Assist in deciding which technology best fits individual home’s virtual care needs,
  • Assist in planning and communicating privacy / encryption requirements,
  • Train and support staff in virtual care implementation using nursing best practices and behaviour support interventions, and
  • Evaluate the structures, processes and outcomes involved in optimizing virtual care in their home

 

Virtual Care Resources

Original NLOT-BSO Proposal to the WWLHIN (May 8, 2020)

IHI Project Charter

Virtual Care Flowsheet (June 2020)

Virtual Care PDSA EOI

Virtual Care PDSA Expression of Interest / Application

Virtual Care PDSA Provider Information Sheet (1 page)

Virtual Care PDSA Expression of Interest Information Sheet (2 pages)

Virtual Care PDSA Onboarding Checklist

Virtual Care PDSA Tablet User Agreement

Sunnyside LTC Virtual Care Policy

ED Consultation during COVID-19 Flow Sheet

SBAR Worksheet

Virtual Care Presentation

Readiness Assessment (Canada Health Infoway)

HQO: Adopting and Integrating Virtual Visits into Care: Draft Clinical Guidance

Vimeo Video: LTC Virtual Care – How to Set Up a Virtual Visit with a Provider in VirtualCare™

Vimeo Video: LTC VirtualCare – How to Conduct a Virtual Visit with a Provider in VirtualCare™

Provider’s Guide to Using OTN in LTC and Retirement Homes

Provider’s Guide to Using LTC VirtualCare in LTC and Retirement Homes

 

How to use Virtual Care

Troubleshooting Tips

EHR Virtual Care

 

Media Coverage

Canadian Healthcare Technology (August 5, 2020): Project to implement virtual care in LTC homes

CBC KW (July 31, 2020): Virtual care could soon be part of retirement and LTC homes in Waterloo-Wellington

Wellington Advertiser (July 30, 2020): St. Joe’s Guelph bringing virtual care to long-term care and retirement homes

Partner Links

Waterloo Wellington Local Health Integration Network (WWLHIN)

eHealth Centre of Excellence (eCE)

Think Research

Ontario Telemedicine Network (OTN)

Information for Families, Caregivers and Residents

PDSA Information Sheet