Lessons from long-term care can inform innovation across Canada’s healthcare system

By Jennifer Zelmer and Tanya MacDonald

Jennifer Zelmer is President and CEO, and Tanya MacDonald is Director, Innovations and Strategic Development, at Healthcare Excellence Canada.  


The past two years have tested Canada’s health systems and the people working in them to the limit. We learned how to innovate fast.

High-profile innovations like virtual care and vaccines emerged when other options simply weren’t available. And sharing ingenious emerging solutions has also been essential to address new challenges, including in long-term care.

The pandemic has had a profound impact on those who live and work in long-term care, and their families. Care home residents accounted for more than two-thirds of Canada’s COVID-19 deaths between March 1, 2020 and February 15, 2021, according to a report by the Canadian Institute for Health Information. Harm in long-term care rapidly became the single biggest patient safety issue in the country.

Long-term care homes faced many challenges at the same time: pandemic prevention and response; COVID-19 and non-COVID-19 care; staffing shortages and worker safety; and the safe presence of family and essential care partners. Organizations had to respond rapidly, seeking practical solutions to support people and save lives.

Working in partnership to rise to these challenges made all the difference.

At Healthcare Excellence Canada (HEC), we saw this first-hand. More than 1,500 homes caring for over 180,000 residents came together in response to the pandemic, under the name LTC+.

Together we shared experiences and best practices, and HEC provided coaching, virtual learning opportunities and seed funding to implement action plans and help long-term care organizations strengthen their response as they moved through the pandemic.

In partnership, we were able to face challenges head-on, thinking innovatively while sharing solutions to help others across Canada.

Organizations shared improvements on bolstering capacity for staff training and education, ensuring access to appropriate personal protective equipment and hiring staff to support implementation of policy directives like screeners at entry points.

Other participants made changes to infection prevention and control policies and procedures, pandemic and outbreak plans, and visitation policies and practices for essential care partners, who provide important physical, psychological and emotional support.

More than half of the teams involved in this partnership noted improvements in care experiences and outcomes. Staff felt supported and better prepared to handle challenges, with nearly half of LTC+ teams noting work life improvements.

A common theme emerged: sharing knowledge helped identify gaps, benchmark approaches and improve practices.

Need for high-quality care for older adults will grow

Sharing knowledge across broad teams is progress, but there is much more to do in long-term care as the pandemic evolves and beyond. Teams tell us that workforce support, retention and mental health programming are needed to address worrying trends in staff burnout. There is also a need to refocus on person-centred care.

The need for safe, high-quality care for older adults with health and social needs will continue to grow in the years ahead. More people in Canada are living to 85 and beyond than ever before — and there will be slightly less than 2.7 million people, or 5.7 per cent of the Canada’s population, aged 85 and older by 2051, according a report by Statistics Canada.

While nearly one in three people aged 85 and older currently lives in a collective dwelling such as a long-term care or retirement home, most older adults have indicated a strong preference to age in place.

Health systems across the country are echoing the need to shift towards supporting aging in place. For instance, a report by the Health Accord for Newfoundland & Labrador task force, and the Yukon’s Aging in Place Action Plan, both call for a commitment to aging in place, rooted in family and community supports and supported by both home and long-term care.

As we continue moving through the pandemic, the long-term care sector teaches us that many challenges can be eased by working together. And such partnering in innovation should not be limited to long-term care. We must now apply this same approach across our healthcare system to fix what ails it.

Jennifer Zelmer is President and CEO, and Tanya MacDonald is Director, Innovations and Strategic Development, at Healthcare Excellence Canada