Perley Health's Quality Improvement Plan (QIP)

A QIP is a formal statement of goals, along with the proposed actions and initiatives designed to fulfill them. Perley Health has prepared a QIP in each of the last ten years. Since 2016, legislation has required all healthcare organizations in Ontario to develop and submit QIPs to the Government of Ontario. QIPs must align with provincial priorities for improvement; at Perley Health, they also align with corporate priorities and are driven by indicators for quality of care and other performance measures. By formalizing the process of establishing goals and reporting on progress, QIPs help to inspire improvements not only in quality of care, but also in quality of life. A compelling example at Perley Health is wound care.

Among LTC residents, pressure injuries (some are also known as bedsores) are quite common due to a number of factors, such as reduced mobility and altered skin integrity. Pressure injuries are often quite painful and can significantly diminish a resident's quality of life. However, research studies show that proper nursing care can prevent pressure injuries from occurring and from worsening.

Perley Health tracks the incidence of pressure injuries among residents, along with whether existing injuries worsen over time. In 2016, our QIP began to include measures to better track and prevent pressure injuries. Since that time, the percentage of pressure injuries that worsen has decreased significantly: from a little over 5% to less than 2%.

During the last year, Perley Health analyzed the specific actions that led to these remarkable results and developed a six-step strategy to share with other homes. In October, members of Perley Health's wound-team presented the strategy at the Ontario Long-Term Care Association's annual conference, and work is now underway to create a guide to share this knowledge. The lessons learned at Perley Health now benefit residents of other LTC homes.

Highlights of QIP 2023–2024

The QIP aligns with Ontario Health's Quadruple Aim framework and is informed by corporate priorities set by the Perley Health Board of Directors. The QIP establishes specific goals for a series of focused and moderate actions; the performance measures for many of these goals are based on the results of surveys.

Focused action:

• Improve the staff experience by continuing to implement People First initiatives.
• Improve the experience of residents by focusing on meaningful activities and mealtimes.

Moderate action:

• Reduce the percentage of residents taking antipsychotic medications.
• Reduce the percentage of residents experiencing symptoms of depression.
• Reduce the percentage of residents experiencing pain.
• Improve end-of-life care planning.

Work on the QIP involves broad collaboration and follows an incremental approach. The Quality Council establishes preliminary priorities and presents them for review to a series of groups, including the Family and Friends Council, Perley Health's leadership team, both resident councils, and the Quality of Life and Safety Committee. Responsibility for final approval rests with the Board of Directors.