Designated Supportive Living Family Experience Survey Report
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DESIGNATED SUPPORTIVE LIVING FAMILY EXPERIENCE SURVEY REPORT Provincial Results September 2020 The Health Quality Council of Alberta is a provincial agency that pursues opportunities to improve patient safety and health service quality for Albertans. It surveys Albertans on their experience with patient safety and health service quality, gathers and analyzes information, monitors the healthcare system, and collaborates with Alberta Health, Alberta Health Services, health professions, academia, and other stakeholders to drive actionable improvements. Our responsibilities are set forth in the Health Quality Council of Alberta Act. DOCUMENT COPYRIGHT The Health Quality Council of Alberta holds copyright and intellectual property rights of this document. This document is licensed under a Creative Commons “Attribution-Non-Commercial-No Derivatives 4.0 International” license: http://creativecommons.org/licenses/by-nc-nd/4.0/ You may copy, distribute, or transmit only unaltered copies of the document, and only for non- commercial purposes. Attribution is required if content from this document is used as a resource or reference in another work that is created. To reference this document, please use the following citation: Health Quality Council of Alberta. Designated Supportive Living Family Experience Survey report. Provincial results. Calgary, Alberta, Canada: Health Quality Council of Alberta; September 2020. Please contact the Health Quality Council of Alberta for more information: [email protected], 403.297.8162. TABLE OF CONTENTS 1.0 USING THE RESULTS AND OVERVIEW OF FINDINGS ....................................................... 5 1.1 A note on how to use results .............................................................................................................. 5 1.2 2019 Site results at a glance .............................................................................................................. 5 1.3 What are the actions for improvement? ........................................................................................... 14 2.0 BACKGROUND ...................................................................................................................... 17 2.1 Designated Supportive Living .......................................................................................................... 17 2.2 HQCA’s 2019 Designated Supportive Living Family Experience Survey ......................................... 20 2.3 HQCA’s 2019 Designated Supportive Living Resident Experience Survey ..................................... 20 3.0 SURVEY PROCESS AND METHODOLOGY ........................................................................ 21 3.1 The survey instrument ..................................................................................................................... 21 3.2 Survey protocol and sampling .......................................................................................................... 21 3.3 Site inclusion criteria ........................................................................................................................ 21 3.4 Family member comments ............................................................................................................... 23 4.0 2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS ................................................. 24 4.1 Overall Care Rating ......................................................................................................................... 24 4.2 Propensity to Recommend ............................................................................................................... 25 4.3 Dimension of Care: Staffing, Care of Belongings, and Environment ................................................ 26 4.4 Food Rating Scale ........................................................................................................................... 30 4.5 Dimension of Care: Providing Information and Encouraging Family Involvement ............................ 32 4.6 Dimension of Care: Kindness and Respect...................................................................................... 36 4.7 Dimension of Care: Meeting Basic Needs ....................................................................................... 39 4.8 Additional care questions ................................................................................................................. 43 4.9 Family member comments: Additional topics ................................................................................... 49 5.0 SITE CHARACTERISTICS ..................................................................................................... 53 5.1 Level of care .................................................................................................................................... 53 5.2 Site size: Number of DSL spaces .................................................................................................... 54 5.3 Operator type ................................................................................................................................... 55 5.4 Site age ............................................................................................................................................ 56 5.5 Geography: Urban versus rural ........................................................................................................ 56 6.0 LIMITATIONS .......................................................................................................................... 57 7.0 APPENDICES .......................................................................................................................... 58 APPENDIX I: FAMILY EXPERIENCE SURVEY TOOL (PAPER VERSION) ................................................. 59 APPENDIX II: SURVEY PROCESS AND METHODOLOGY ......................................................................... 66 APPENDIX III: CRITERIA FOR SITE INCLUSION IN 2019 ........................................................................... 76 APPENDIX IV: 2019 SITE RESULTS ............................................................................................................ 83 APPENDIX V: 2019 RESPONDENT AND RESIDENT CHARACTERISCTICS ........................................... 120 APPENDIX VI: SUMMARY OF 2019 PROVINCIAL AND ZONE-LEVEL RESPONSES TO INDIVIDUAL SURVEY QUESTIONS ................................................................................................................................ 128 APPENDIX VII: MODELLING SPECIFICS ................................................................................................... 143 APPENDIX VIII: DETERMINING ACTIONS FOR IMPROVEMENT............................................................. 144 1.0 USING THE RESULTS AND OVERVIEW OF FINDINGS 1.1 A note on how to use results The focus of this report is to describe the current state of designated supportive living (DSL) from the perspective of the resident’s family member. The results for each DSL site are compared amongst site peers within each AHS Zone, in addition to the previous survey iteration. Ultimately, these results are intended to guide reflection on performance and assist in identifying quality improvement opportunities. The key measures used to present the survey results include four Dimensions of Care , the Food Rating Scale, the Overall Care Rating (a measure of family members’ overall opinion of the site), and the Propensity to Recommend. The Dimensions of Care each represent a set of questions that share a similar theme; they influence the Overall Care Rating and can be used to identify areas of success and opportunities for improvement at DSL sites across Alberta. Other factors can contribute to family members’ experience at a site. Family experience alone should not be used to assess site performance in the absence of other information, such as site demographics (i.e., average age of residents and percentage male/female), level-of-need of the resident population, and other quality measures such as those derived from the interRAITM Resident Assessment Instrument (RAI), complaints and concerns, accreditation results, and compliance with Continuing Care Health Service Standards (CCHSS). One option for publicly available information is the HQCA’s FOCUS on Healthcare website. It was expanded to include designated supportive living in 2019. It features 28 interactive charts that present administrative data as well as patient experience survey data about designated supportive living. Users can compare information about designated supportive living sites or zones, and look at data presented over time. https://focus.hqca.ca/designated-supportive-living/ This report provides a single perspective of several possible interpretations of these findings. DSL owners, operators, and other stakeholders may choose to examine and interpret the findings differently. While being mindful of the limitations of the data, there are a number of ways to interpret and use the results. It is important to note that while significance testing can identify where there has been a mathematical change, this does not necessarily indicate a change in performance especially when comparing two survey cycles. In addition, results that did not show any statistically significant change or difference may still be important. 1.2 2019 Site results at a glance Among sites that did Table 1 below provides a summary of 2019 site-level results. Sites are show a statistically