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 partnered together to support the implementation of virtual care in both LTC and retirement homes in the Waterloo Wellington area, 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 (PDF, 164KB) was to optimize resident-centred care and reduce avoidable emergency department visits during the pandemic and beyond. This was 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

The following documents were developed through the PDSA and are available as a resource for other organizations undertaking similar work. We only ask that you reference St. Joseph’s Health Centre Guelph if using these materials.

PDSA Study Materials

Original NLOT-BSO Proposal to the WWLHIN (May 8, 2020) (PDF, 3.31MB)

IHI Project Charter (PDF, 823KB)

Virtual Care PDSA Expression of Interest / Application (PDF, 306KB)

Virtual Care PDSA Provider Information Sheet (1-pager) (PDF, 158KB)

Virtual Care PDSA Provider Information Sheet (2-pager) (PDF, 164KB)

Virtual Care PDSA Resident and Family Information Sheet (1-pager) (PDF, 130KB)

Virtual Care PDSA Tablet User Agreement (MS Word, 99KB)

Virtual Care PDSA Onboarding Checklist (MS Word, 106KB)

Troubleshooting Tips (PDF, 318KB)

Virtual Care Readiness Assessment (adapted from Canada Health Infoway) (PDF, 156KB)

Virtual Care PDSA Presentation (September 17, 2020) (MS PowerPoint, 203KB)

Virtual Care PDSA Final Presentation (December 9, 2020) (PDF, 2.74MB)


Virtual Care PDSA Developed Resources

Virtual Care Flowsheet (June 2020) (PDF, 690KB)

Sunnyside LTC Virtual Care Policy (PDF, 204KB)

ED Consultation during COVID-19 Flow Sheet (PDF, 765KB)

Supporting Effective Access to ED MD Consultation in LTC (PDF, 990KB)

Supporting Effective Access to ED MD Consultation in Community Setting (PDF, 992KB)

Provider’s Guide to Using OTN in LTC and Retirement Homes (PDF, 406KB)

Provider’s Guide to Using LTC Virtual Care in LTC and Retirement Homes (PDF, 369KB)


Other Resources

St. Joseph’s Health Centre Guelph SBAR Worksheet (PDF, 507KB)

HQO: Adopting and Integrating Virtual Visits into Care: Draft Clinical Guidance (PDF, 566KB)

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

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

Using your LTC Electronic Health Record for Virtual Care (Dr. Evelyn Williams, MD, CCFP (COE), FCFP, MHSc) (PDF, 214KB)


Media Coverage

Canadian Healthcare Technologies (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 & Resources

Waterloo Wellington Local Health Integration Network (WWLHIN)

eHealth Centre of Excellence (eCE)

Ontario Telemedicine Network (OTN)

Think Research Corporation (TRC)