Maimonides Geriatric Centre – Strategic Plan, 2007–2012

Maimonides Geriatric Centre

Strategic Plan, 2007–2012

Preamble

The aim of Maimonides Geriatric Centre, a McGill-affiliated long-term care facility, is to provide excellent care while offering the best possible quality of daily life experience to residents throughout the Maimonides network: whether in accredited homes, intermediate resources, day care, or our long-term care facility.

Our focus is on providing care, mainly to the elderly Jewish population of Montreal, in a welcoming, secure and homelike environment tailored to individual needs. Our fundamental commitment to well-being and safety – shared by all staff and volunteers, as well as by each resident’s family – underlies all our policies and practices, and also the design of our physical environment.We engage families as partners in care so that – even when they live at a distance – they feel welcome and included in the life of the Centre.

Over the next five years, the Centre will face both strategic and operational challenges. Strategic initiatives of the past five years, strengthened and consolidated, will pass into the operational arena. New strategic directions will strengthen our position as a leader in long term care. These will be supported through re-allocation of human and financial resources, and as always, we are privileged to have the support of the Maimonides Geriatric Centre Foundation for special programs and services.

Our strategy in moving forward recognizes six basic truths about our residents:

  1. Once admitted, they are in our care for the remainder of their lives.
  2. They enter this new phase of life with their individual personalities, histories, culture, interests, abilities and limitations, concerns, and family relationships;
  3. Our residents require a certain level of nursing support, which will likely intensify over time;
  4. Their needs are not limited to nursing care, but include other physical, social, cultural, affective and spiritual dimensions;
  5. Their families continue to be an integral part of their lives and are actively involved in ensuring their well-being, in situations that introduce new dynamics to long-standing relationships;
  6. In caring for our residents, staff are entrusted with supporting the whole person, and thereby also with supporting the family, to the extent that this promotes the well-being of the resident.

Mission

The core mission of Maimonides Geriatric Centre, a McGill-affiliated long-term care facility, is to provide service to aging members of the QuebecJewish community who are no longer able to function independently. They are entrusted to our care by their families, with whom we are allied in values and purpose. Our mandate is founded on a strong heritage of Jewish values and community support. We provide a continuum of high-quality care through our integrated network, which includes the Helen and SamSteinbergDayHospital, short-term respite care, community-based homes and a variety of long-term care accommodations. In line with our mission, the Centre serves as a training ground for professionals and conducts research into issues related to geriatric medicine and care of the elderly.

In recent years, at the behest of the government, we have taken on the additional responsibility of managing the Jewish Eldercare Centre, a 320-bed long-term care facility and day centre located approximately 5 km. from Maimonides. This mandate is aligned with our mission but resource-intensive, as we strive to ensure the highest quality standards of care at both centres. Maimonides receives its mandate and operating budget from government and is generously supported by its Foundation for special programs, research, equipment and other needs.

“More than care”

Our strategic focus for the next five years will be on supporting and enhancing the quality of care for residents and for their families. This focus on the quality of care and of the resident’s and family’s experience at Maimonides, which we refer to as “More than care”, is a core theme which will:

  • position Maimonides as a centre of excellence in long term care;
  • serve as a model for care delivery, teaching and research;
  • build upon the strategic work of the past five years;
  • strengthen the Centre’s role in the community and within the CSSS network;
  • be a leader in the health system in responding to emerging trends; and
  • attract the human and financial resources needed to ensure the Centre’s continued vitality and growth.

The following sections present strategic actions to be carried out over the next five years by management, professionals, staff, and lay leadership (Corporation / Centre / Foundation / Auxiliary) to achieve this new vision. They are grouped into the following main areas:

  1. Care to residents that is respectful, supportive, and personalized;
  2. Partnerships with families that encourage and support their involvement in care;
  3. Research that uncovers new knowledge, promotes expertise in long-term care, with a“More than care”focus, and actively engages in knowledge transfer;
  4. Teaching that issupportive of staff, families and the community;
  5. Public relations and communications that strengthen our position with clear, coordinated and consistent messages;
  6. Environments that are secure, homelike, and welcoming for residents and supportive of the work of the staff;
  7. Government and network relationships that build upon a spirit of collaboration and leadership;
  8. Resources and support services that support strategic initiatives, including the“More than care”model.

Strategic Actions, 2007–2012

  1. Care to Residents

Maimonides Geriatric Centre is a leader in long-term care, fully accredited, and winner of many awards for excellence. Over recent years, we have expanded our outreach into the community, particularly in the area of respite care. We are widely recognized for our best practices and for the safe, homelike environment we provide. Our strategic goal is to make Maimonides the resource of choice for elders of our community.

Objectives:

To adopt a respectful, supportive and personalized approach to care for each resident

To continue developing new approaches to creating a safe, homelike environment tailored to individual needs

To provide much-needed respite services to persons who are not yet residents of the Centre

1.1Within the coming year, we will formally adopt a“More than care”model as the defining vision which will permeate all our activities: care, research, teaching, outreach, as well as relations with staff, volunteers, benefactors, and others.

To define the vision, we will study examples of best practices in long-term care across North America and elsewhere and identify the core principles that will guide our model.

We will select and adopt the model that best serves our vision, working closely with staff to explore opportunities for introducing these principles into the daily life of the Centre.

1.2To support “More than care” in care delivery, we will continue to work in partnership with ASSTSAS (Association paritaire pour la santé et la sécurité du travail du secteur affaires sociales) to implement the relation-centred care approach (approche relationnelle de soins) in Nursing, aimed at providing more direct personal interaction between staff and residents.

We will clearly define the principles underlying the approach and communicate them widely to staff, residents, families, network partners, other institutions, professional organizations and journals.

We will continue the implementation of the approach to encompass all units.

As we proceed, we will develop training manuals, communication tools and other materials. Over the next five years, our aim is to become a resource to other long-term care facilities across Canada.

1.3We will continue to be leaders in developing efficient and effective approaches to care that ensure the safety of all residents while promoting individual autonomy.

1.4 We willprovide end-of-life services that correspond to best practices and are based on a whole-person approach and respect for personal dignity.

1.5 We will assess the need for respite beds among the elderly Jewish population and, if needed, will work with the Agence de la santé et des services sociaux de Montréal to increase the number of respite beds year-round to accommodate families who require this support.

  1. Partnerships with Families

At MGC, honouring the Jewish tradition of the importance of families, we make every effort to work hand-in-hand with families to ensure the comfort, security and dignity of all residents. This partnership begins prior to admission, with facility tours, and extends to including families in our satisfaction surveys and accreditation teams. We provide annual report cards to families about how their loved one is doing, and through activities such as the Life Biography Project, we work with families to educate staff about each resident’s life experiences. Our goal is to strengthen that connection and improve the hospitality aspect of the Centre further over the coming years.

Objectives:

To integrate families into the overall functioning of the Centre

To respect the multiplicity of families’ needs for information and support

To support the families of elderly persons in the community who may not yet be residents of long-term care facilities

2.1We will extend the relation-centred care approach to include families in a meaningful role. Staff will work with families to explain the approach and the implications for them and their loved ones.

After the approach has been implemented among all the staff, we will explore the possibility of offering the training to family members who wish to improve their skills in supporting their loved ones.

2.2 We will improve processes for intake and follow-up with families, to ensure they clearly understand policies, decision-making procedures, communications systems, and overall organization.

We will improve pre-admission communications with residents and families to reduce anxiety and confusion on the day of admission, using tours, printed materials, videos, web site, and a contact person designated to respond to questions during the waiting period.

We will analyze the various steps of the admission process, with feedback from families, and will modify processes and environments to make the experience more welcoming to families. We will assess the success of the changes with follow-up studies and questionnaires.

We will implement programs of ongoing support to families of new residents, whether in groups or individually, as required.

2.3 We will support families through the experience of losing a loved one by providing the information they need and accompanying them through a peaceful grieving process.

2.4We will make it easier for residents and families to communicate needs and concerns to the staff, and for staff to communicate with families.

We will survey families to assess needs for support and to invite ideas for the most effective means of providing it. We will follow up the survey with a plan to implement ideas that are feasible and affordable, with the help of our Foundation as required.

We will assess needs for ongoing support of families of specific clienteles (e.g. Alzheimer’s, Parkinson’s, stroke, Holocaust survivors, multiple sclerosis, etc.) and put in place systems either to connect them with existing resources in the community, or, where appropriate, to create support groups at the Centre.

We will develop systems for improved communication between staff and family members using a variety of means, including web-based services.

  1. Research

MGC initiated the Collaborative Research Network ten years ago in association with the Division of Geriatric Medicine at the Sir Mortimer B. Davis Jewish General Hospital and McGillUniversity. A combined research team was formed and jointly engaged a research coordinator. The team has completed numerous research projects, often in collaboration with other institutions and universities. To date, we have completed over 15 peer reviewed papers, 50 scientific presentations and poster presentations and received visits from other institutions interested in learning more about our specific research programs.

Objectives:

To position Maimonides Geriatric Centre as a centre of expertise in long-term care

To study the impacts of a “MORE THAN CARE” approach on the well-being of residents and staff

To actively engage in knowledge transfer for improved practice and policies

3.1We will focus on “More than care” as a rich source of opportunities for interdisciplinary research.

We will develop a plan to identify and investigate “More than care”-based research topics and to assemble the required staff and funding.

To ensure the realization of this plan, we will hire a full-time Research Coordinator to be based at Maimonides.

3.2We will capitalize on the multi-campus responsibility of MGC as an opportunity for comparative research projects, not only in long-term care, but also in intermediate resources and accredited homes, to determine how the principles of “More than care” may be applied in settings across the continuum of services.

3.3 Building upon the collaborative research program, we will pursue the creation of an endowed Chair in Long-Term Care, in collaboration with McGillUniversity’s Division of Geriatric Medicine and School of Nursing, to support research carried out at Maimonides as well as knowledge transfer initiatives.

Within the first year, we will establish the parameters of an endowed Chair in long-term care.

Over the following years, we will work in partnership with the Foundation to obtain the financial support required to endow the Chair.

Once the above are in place, we will recruit the Chair and associated staff, and will locate and prepare the physical space needed to accommodate them.

We will develop and implement processes for transferring knowledge to other researchers, institutions, government and decision-makers to continually improve long-term care practice and to positively influence public policies.

3.4Over the coming years, we will prepare the foundation for a Centre for Long-term Care Studies that will be the locus for innovative research into clinical practice in long-term care. Our aim is to inaugurate the Centre by the year 2012.

We will undertake discussions with McGillUniversity, the Ministry of Health and Social Services, and other relevant organizations, to define the parameters of the Centre for Long-term Care Studies and the steps to be taken for its realization.

  1. Teaching

Maimonides Geriatric Centre has been a McGill-affiliated teaching establishment for more than 20 years. The Centre receives more than 400 students each year, from a wide range of professions: nursing, medicine, social services, occupational therapy, physical therapy, dietetics, and others. Over the years we have also forged links with CEGEP and high school programs across Montreal, serving as a site for technical training. We currently offer monthly education sessions open to all health care professionals in the city, as well as occasional programs for the wider community. Our goal in the coming years is to expand our role as teachers to families and the public at large.

Objectives:

To educate families and the community about health issues facing the elderly

To support staff in integrating “More than care”principles into care practices

To share our expertise with other health care professionals

4.1To complete the implementation of the relation-centred care approach over the next two years, we will provide intensive training and follow-up to all staff involved in the care of residents.

4.2Recognizing the essential role of education in enhancing the quality of care, as well as in encouraging the involvement of families, we will create an Office of Education to oversee the planning and implementation of education programs for staff, residents, families, and the community at large, as well as the development of all materials and training tools.

We will create an Office of Education with at least one full-time coordinator, and we will define additional needs for staffing and funding to be added over time as new education programs are developed.

The Office will also pursue the recognition of teaching materials and programs developed in-house as the intellectual property of the Centre, for eventual commercial distribution.

4.3We will establish education programs for the community, as well as for health care professionals from other institutions, under the direction of the Office of Education. Our goal will be to position Maimonides Geriatric Centre as the primary locus of expertise in long term care in Quebec.

We will develop and promote a roster of education programs that can be carried to a variety of locations, both within and outside the Centre. We will support staff in providing this service, and will invite outside speakers as appropriate.

To educate the public on matters within our areas of expertise, we will use a variety of media and venues including newspapers, brochures, television, radio, video, libraries, booths at fairs and conferences, and others.