Essential Together

Essential Together

Through Essential Together, we’re working with health and care organizations to support them to re-integrate, welcome and engage essential care partners as part of care teams, during COVID-19 and beyond.

The COVID-19 pandemic led to blanket visitor restrictions that prohibit essential care partners from being with loved ones in health and care settings. Although the restrictive policies were put in place with the best intentions, they have contributed to other risks and unintended harm to patients and families, as well as moral distress to staff.

Healthcare Excellence Canada launched Essential Together – a program to support policy makers, policy implementers and those who experience policy relating to family presence during the pandemic and beyond.

We’re calling on health and care organizations across the country to join Essential Together and implement co-created policy guidance so that essential care partners can continue being active members of care teams that benefits patient care, patient safety and outcomes, including during COVID-19.

 Essential Together takes a balanced approach to support the safe re-integration of essential care partners. The program offers:

  • Learning bundles with tools and resources that can be adapted to implement the policy guidance (available to anyone interested).
  • Essential Together Huddles that create an open and safe supportive space for people to learn from and connect with others who are facing similar challenges (available to anyone interested).
  • Access to dedicated coaching and other support (for organizations that formally join the program).
  • Ongoing peer learning and connections.

Essential care partners are different from general visitors. While visitors have an important social role, they are not active partners in care. Essential care partners provide physical, psychological and emotional support, as deemed important by the patient. There is clear evidence that the presence of essential care partners benefits care, experience, safety and outcomes.

Join Essential Together

Join Essential Together

In this first phase of the program, individuals or teams of people that implement policy and are dedicated to improving family presence policies can formally join Essential Together.

Step 1: As part of joining Essential Together, we ask you to commit to the call to action:

  • As leaders, providers and staff within health and care facilities, we value and support the role of essential care partners within our organization.
  • We support patients to identify essential care partners.
  • We are committed to welcoming back and supporting essential care partners to safely participate as part of care teams.

Step 2: Complete a simple registration form that will provide us with some information about how we can best work with you.

As part of registering, we encourage you and your team to collaborate with patients and patient partners and use the Essential Together Tool to identify strengths and areas for improvement within your organization. If you feel comfortable sharing your completed tool with us, you can either email the completed PDF to Essential.Together@HEC-ESC.ca or complete an online version. We will aggregate the data for our evaluation purposes and the information you share will remain confidential. If you don’t feel comfortable sharing your tool, you can still participate in the program.

Join Essential Together

Step 3: Reflecting on your completed Essential Together tool, review and implement the seven policy guidance elements together with patients and patient partners. The implementation of the guidance should be based on the local context of your facility. We have seen many innovative examples of organizations leading the way in family presence during the pandemic and have developed seven online learning bundles with growing lists of tools and resources for you to draw on.

Step 4: You are not alone! We know these are challenging times and we’re here for you. Take advantage of dedicated coaching and peer to peer learning opportunities through Essential Together Huddles. Once you register, we will reach out with further details. Coaching can provide you with expertise in change management, co-design, patient- and family-partnered care (and more) to help you take action and implement the policy guidance. Our National Huddles give you and your colleagues a shared space for mutual support, advice and empathy.

Essential Together has been designed together with policy makers, implementers and those with lived experience to ensure the it meets the needs of many people and organizations across the country. It’s intended to be flexible and you can draw on the components of the program you need.

Please note, if you are a team participating in LTC+ Acting on Pandemic Learning Together, you can still join Essential Together (and are encouraged to do so, especially if you have identified presence of family as a key focus area).

Learning Bundles

We have curated tools and resources from organizations across the country that support the reintegration of essential care partners. These tools and resources are arranged into seven learning bundles that follow the respective policy guidance elements. The tools and resources are open source, which means you can use and adapt them to fit your local context.

Identification and preparation of essential care partners

 

Develop mutual expectations of responsibilities

·Ensure patients understand what an essential care partner is and are welcomed to identify their own essential care partners

·Establish process and roles to connect essential care partners with a staff point-person for consistent coordination

 

Establish pre-entry preparation for essential care partners

·Ensure consistent and ongoing information and education for essential care partners regarding safety protocols required for entry 

 

Establish staff education to understand roles and safety protocols for essential care partners

·Ensure there is education and clear communication for staff regarding the role and value of essential care partners and their safe re-entry

 

Establish a rapid appeals process

·Communicate a clear and transparent appeals process to patients and essential care partners so concerns can be quickly raised and addressed

Entry into facility

 

Establish a clearly communicated screening process

·Implement a consistent screening process with relevant, evidence-informed protocols and questions

·Ensure clear communication regarding what is expected at screening

·Create an opportunity for different methods of pre-entry screening (for example online in advance) and provide information on expected safety protocols

 

Establish caregiver IDs for essential care partners

·Institute processes that clearly identify essential care partners

·Connect these processes with supportive education for safety protocols and PPE processes

 

Ensure essential care partners are informed about existing and updated infection prevention and control protocols

·Provide an opportunity for ongoing updates to ensure essential care partners are aware of recent safety protocols and processes

We’ll continue to add to these learning bundles. If you would like to be notified when we have new material, please let us know.

If you know of other tools and resources to contribute to these learning bundles, or if there is something specific you are looking for, please reach out via Essential.Together@HEC-ESC.ca.

Other related material

We know there is different language and terminology used across the country, but to make sure we provide as much clarity as possible, in this context:

Blanket visitor restrictions refer to restrictions that extend to all “visitors” entering a facility, often without exceptions, including essential care partners.

Essential care partners provide physical, psychological and emotional support, as deemed important by the patient. This care can include support in decision making, care coordination and continuity of care. Essential care partners are identified by the patient (or substitute decision maker) and can include family members, close friends or other caregivers.

Patients includes residents and clients.

Patient partners include patients, residents, clients, families, caregivers and care partners, and others with lived experience who are working together with teams to improve the quality and safety of healthcare.

Health and care facilities refers to hospitals, long-term care/residential care/nursing homes and other congregate care settings as well as primary care and outpatient care settings.

Open family presence policies support the presence of essential care partners at patient bedside at any time and not restricted by “visiting hours.”

Supporting partners

Alberta Health Services BC Patient Safety and Quality Council
Health Quality Council of Alberta Canada Health Infoway
Institute for Patient- and Family-Centered Care Imagine Citizens Collaborating for Health
Mental Health Commission of Canada Manitoba Institute for Patient Safety
Saskatchewan Health Authority Saskatchewan Health Quality Council
The Ontario Caregiver Organization  

[i] Farmanova, Elina, Maria Judd, Christine Maika, and Graeme Wilkes. “Much More Than Just a Visit: A Review of Visiting Policies in Select Canadian Acute Care Hospitals.” Canadian Foundation for Healthcare Improvement (2016), https://www.cfhi-fcass.ca/docs/default-source/itr/tools-and-resources/better-together-baseline-report.pdf .