Essential Together
Essential Together was designed to support the safe reintegration of Essential Care Partners into health and care settings, during COVID-19 and beyond.
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- Topics
- Patient engagement
- Health Equity
- Health workforce
- Audience
Person with lived/living experience
Point of care provider
Healthcare leader
Essential Together Change Package
Thank you for making a commitment to review your organization’s Essential Care Partner policies and working to take action to support their presence in health and care settings.
This Change Package is a guide for developing a plan that moves you to act on your commitment to the Essential Together Pledge.
Healthcare Excellence Canada has prepared a change package to support your efforts. It is intended to help partners shift existing visitor and caregiver presence policies towards person-centred care based on the three foundational principles for successful reintegration of essential care partners into health and care settings.
This resource focuses on key steps in the journey to implement meaningful organizational change. The goal of this guide is to link those who implement policy, including those who lead person- and family-centred care and patient engagement with tools and resources that support Essential Care Partner program.
How Essential Together contributed to better healthcare in Canada
The essential role of care partners became more evident throughout the COVID-19 pandemic – highlighting the importance and the benefits they bring to the care and well-being of their loved ones. We also saw that when their presence was restricted in health and care settings across the country, many unintended harms occurred that impacted the safety, experience and outcomes of those receiving care, their care partners and healthcare providers.
The Essential Together program was rapidly developed to respond to the needs and priorities of patients and their caregivers. It was designed as an open access program to ensure everyone within Canada and beyond, could access the materials and resources to enable caregiver presence to support the care of their loved ones. The program focused on guiding and impacting policies related to essential care partner presence, and the implementation of the policy guidance.
Between March 2020 and March 2023, the Essential Together program supported patients, families and caregivers, healthcare organizations and decision-makers to successfully integrate Essential Care Partners into health and care settings.
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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.”
Essential Together Resources
Organizations who have made the pledge:
Forest Dale Home Inc.
Saskatchewan Health Quality Council
St. Joseph's Health Centre Guelph
Tideview Terrace
William Osler Health System
MacEwan University
Hearthstone Manor Residential Care Facility
Sault Area Hospital
ISMP Canada
The Essential Together Pledge was created as a way for health and care organizations to show they recognize and value the role of Essential Care Partners and are committed to working together with those who are receiving care, caregivers and staff to develop and implement policies that support patient and caregiver partnership in care.
We welcome organizations to continue to access and integrate the pledge into the development of their organizations policies and programs.
"We value the role of Essential Care Partners and recognize how this role is different from a visitor. As a result, we are committed to working together with those who are receiving care, caregivers and staff to take the following actions:
We will engage with those who are receiving care, caregivers, and staff to review existing visitor and caregiver presence policies and practices.
We will work in collaboration with those who are receiving care, caregivers, and staff to develop and implement person-centred policies, practices, and programs that enable the presence of essential care partners at all times, ensuring compassion, equity, dignity, safety, and well-being for all.
We will be transparent with our caregiver presence policies and practices and ensure clear and consistent communication.
We will promote the role and benefits of essential care partners across our organization and the health system."
During the COVID‑19 pandemic, early and tight blanket restrictions were placed on “visitors” in healthcare institutions, including acute care and rehabilitation hospitals, long‑term care homes, and in other residential congregate care settings. Well into the first year of the pandemic, emerging evidence demonstrated the significant impact such restrictions had on the quality of life and physical and emotional/psychological well‑being of many people – including patients* families, caregivers, and providers. The ‘Evidence Brief’, completed in November 2020, provides a synopsis of evidence regarding the presence of caregivers as essential care partners in the following four key areas:
Benefits of family caregiver presence: Highlights the growing body of evidence that demonstrates improvements in patient safety, patient experience, patient outcomes and patient care with presence of essential care partners across a range of institutional care settings.
Better Together: family caregiver presence policies in hospitals across Canada. Results of previous CFHI programming in Better Together demonstrate shifts in family presence policies in hospitals across Canada over the past 5 years; changes in family presence policies are also noted during COVID-19 in hospitals and long-term care settings.
Transmission of COVID-19 in hospitals and long-term care: Reports on the transmission of COVID-19 within facilities during this time of pandemic.
Impacts of restrictive visiting policies during COVID-19 in hospitals and long-term care: Emerging evidence highlights the multitude of risks noted to patient care, patient safety and patient outcomes, as well as impacts on families.
Throughout the COVID-19 pandemic, this body of evidence continues to grow. The 'Evidence Brief Addendum' adds to the initial 'Evidence Brief' by providing an updated synopsis of evidence regarding the presence of essential care partners that has emerged between the fall of 2020 and July 2021. The Addendum focuses on the following three key areas:
Caregiver presence policies that have continued to change throughout the COVID-19 pandemic across Canada: Increased understanding of COVID-19, notable impacts of restrictive policies on patients, and community transmission rates influenced the ongoing changes to provincial and territorial directives related to visitor policies throughout the pandemic. More recent directives indicate that a more balanced approach to enable the physical presence of caregivers. However, implementation of these directives remains inconsistent within provinces, territories and regions, even in times of reducing COVID-19 prevalence and increasing vaccine uptake.
Transmission of COVID-19 in hospitals and long-term care: Numerous studies conducted through the pandemic are consistent with pre-pandemic literature, which demonstrates family presence does not increase rates of COVID-19 transmission when supported and highlights the success of infection and prevention control measures that support safety and limits transmission in health and care settings.
Impact of restrictive visiting policies during COVID-19 in hospitals and long-term care: There is a significant amount of evidence that highlights the multitude of risks to the care, safety, and outcomes of patients, as well as impact on families and caregivers, health and care providers, and the health system.
Download Evidence Brief Addendum (August 2021)
Download Evidence Brief Addendum (July 2023)
These scans review the provincial and territorial government guidance for essential care partner presence and visitor policies. They provide a glimpse into the visiting guidelines and requirements at acute care and long-term care facilities across the province.
Essential Together Huddles
The COVID-19 pandemic has resulted in blanket visitor restrictions that prohibit essential care partners from accessing loved ones in health and care facilities. Although the restrictive policies were put in place with the best intentions, they bring known risks and unintended harm to patients and families and moral distress to staff. To support organizations to safely welcome back essential care partners, Healthcare Excellence Canada launched Essential Together Huddles.
Essential Together Huddles:
Connect and bring together those who create, implement or experience family presence policy during the pandemic and beyond.
Create an open, safe and supportive space for people to share with and learn from others facing similar challenges.
Enable learning across various health and care settings.
March 15, 2023
Speakers
Barbara MacLean, Executive Director
Wendy Johnstone, Director of Programs and Innovation.
Family Caregivers of BC (FCBC) proudly and compassionately supports over one million people in British Columbia who provide care and support to a family member or friend living with disease, disability or frailty due to aging. Their mission is to improve the quality of life of family and friend caregivers through support, information, education and leadership. FCBC’s health system collaboration work over the past 13 years has been focused on strengthening the voice of family caregivers and the significance of their role. As a partner in the BC Ministry of Health’s Patients as Partners Initiative, they adopted the “nothing about me without me” value of person and family centered care. This session will describe their efforts to engage with the health sector and effect systemic, structural and cultural changes at the micro, meso and macro levels so that family caregivers are valued, recognized and included as partners in care.
February 15, 2023
Speakers
Kanwal Ali, Quality and Patient Safety Specialist
Elaine Richards, Manager, Quality and Patient Safety
Michelle Samm, Director, Quality, Patient Safety, Patient Experience & Relations and IPAC
Oak Valley Health developed an Essential Caregiver Program to support the safe reintegration of families and loved ones in the patient’s care throughout their hospital journey. Essential caregivers are chosen by the patient to assist with patient care and well-being while in the hospital and are considered to be an integral part of the care team. This session will provide an overview of the development and implementation of this program.
January 18, 2023
Speaker
Liv Mendelsohn, M.A., M.Ed. (she/her), Executive Director Canadian Centre for Caregiving Excellence
Caregiving is the next frontier of public policy in Canada. Across the country, caregivers and care providers support the people we love with very little assistance from our governments. In this session, Liv Mendelsohn, Executive Director of the Canadian Centre for Caregiving Excellence (CCCE), will show how doing better is possible. CCCE recently launched Giving Care: An Approach to a Better Caregiving Landscape in Canada, a wide-ranging policy whitepaper that lays out the state of caregiving and offers policy solutions for how to make Canada the best place in the world to give and receive care. Learn how good public policy – proper income supports, improved tax credits, and accessible services, among others – can help caregivers, care providers, and care recipients.
Resources
Nov 16, 2022
Speakers
Lina Reid, Consultant, Patient Experience, Lakeridge Health
Marina Gaziani, Consultant, Patient Experience, Lakeridge Health
Alison Kilbourn, Project Lead, Strategic Partnerships & Innovation, The Ontario Caregiver Organization
This session will focus on the implementation journey of the Essential Partner-in-Care (EPC) program at Lakeridge Health, including why the program was developed, the various components of the program, and challenges and successes of the program roll-out so far. It will also include a brief overview of the Ontario Caregiver Organization’s Caregivers as Partners Learning Collaborative and highlight key learnings from cross-sectors partners that support the inclusion of caregivers.
Resources
October 19, 2022
Speakers
Anne MacLaurin, Senior Program Lead, Healthcare Excellence Canada
Maaike Asselbergs, Patients for Patient Safety Canada.
Improving patient safety has been a priority for more than 20 years, yet harm continues to occur an unacceptable rate. To enable safe care, we must rethink our approach. The Measuring and Monitoring of Safety (2013, Vincent, Burnett and Carthey) offers a broader, dynamic approach for creating and sustaining safer care, in which patient partnerships are integral. This session prepared and delivered in partnership with patients, will explore the questions “how safe is your care?” and “what makes you feel safe?” and illustrate actions patients, carers, healthcare providers and leaders can take to support safety though inquiry and conversations.
Resources
September 21, 2022
Speakers
Carol Fancott, Director, Patient Engagement & Partnerships, Healthcare Excellence Canada
Adrienne Zarem, Patient Partner
Engagement capable environments are environments that have incorporated the values of patient-centered and patient-partnered care as a philosophy underlying the organization's priorities. We will present co-created resources for building the capacity of patient partners, health service teams and sector leaders. This session will include information and lessons learned from ongoing efforts to bring the voices of patients and essential care to the table to improve safety and quality of care.
Resources
May 18, 2022
Speakers
Laura Williams, Senior Director, Patient Experience;
Kerseri Scane, Manager, Patient Engagement for Healthcare Improvement;
Farrah Schwartz, Patient Education & Engagement
Join the Essential Together program for a presentation from the University Health Network, Ontario, when they will discuss “Essential Care Partners Supporting Care Activities – Process and Resources for Implementation”
Resources
April 20, 2022
Speakers
Ariel Rice - Neighbourhood Manager & Volunteer Lead
Debra Boudreau - administrator / CEO
Join the Essential Together program for a Q &A with Ariel Rice from Tideview Terrrace Nursing Home, an Eden Alternative Registered facility, located in Digby, Nova Scotia. We will discuss how they have welcomed essential care partners during COVID, the barriers and facilitators, and why they have taken the Essential Together pledge.
March 16, 2022
Speakers
Jennifer Symon – Senior consultant Engagement and Patient Experience
Valrie Stewart- Consultant Patient and family Centred Care
A general discussion of the keys to success in maintaining family presence during COVID. Identification of some of the challenges of this commitment and the learnings along the way.
Jennifer is a registered nurse whose passion for family presence and PFCC grew after caring for her husband at while he battled a rare disease in hospital for a year. She now works with AHS Engagement and Patient Experience department and lives and breathes her passion for this work in all she does.
Valrie is a registered nurse with many years of nursing leadership and a special interest in patient and family centred care and family presence. She left a manger’s role in 2013 to join the South Health Campus Patient and Family Centred Care Department and subsequently the Calgary Zone Patient and Family Centred Care Team
February 16, 2022
Presenters
Angela Morin, Lead, Patient and Family Centred Care
Anne O’Riordan, Patient Family Experience Advisor
Are patient and family partners considered essential in your organization or essential with conditions? To kick off the discussion, Angela and Anne will do a brief presentation on the role of patient and family experience advisors, at the organizational and leadership levels, at Kingston Health Sciences Centre during the pandemic and their impact on family presence and the role of essential care partners. The experience of Kingston Health Sciences Centre will be shared with insights into changes that developed over the course of the pandemic and reflections about factors that fostered or challenged the role of patient and family partners at all levels of the organization.
January 19, 2022
Host
Jessie Checkley, Senior Program Lead, Patient Engagement and Partnerships, Healthcare Excellence Canada
Speaker
Jill Ritchie, Program Lead, Patient Engagement and Partnerships, Healthcare Excellence Canada
Discover the key steps to shift existing visitor and caregiver presence policies towards person- and family-centred care based on the three foundational principles for successful reintegration of essential care partners into health and care settings.
Drawing on the latest evidence, policy guidance and lessons learned through the pandemic, Healthcare Excellence Canada has developed tools and resources that support Essential Care Partner programs. This session will show participants how to use the Essential Together Change Package and create an opportunity for them to share experiences and lessons learned.
December 8, 2021
Speakers
Ms. Amélie Boutin, Assistant, Support for elderly autonomy program – home care continuum)
Mr. Joël Bouchard, Senior Advisor, accommodation, harmonization, practice quality, and living environment approach)
Ms. Pascale Castonguay, regional coordinator, informal caregiving
The role and importance of informal caregivers as partners in the care and services provided to clients in public residences have continued to evolve over the past decade. However, the arrival of the COVID-19 pandemic has turned everything on its head, forcing the Direction du programme de soutien à l’autonomie des personnes âgées (Support for elderly autonomy program) to reinvent itself and come up with other ways of communicating. During this time of great uncertainty when in-person contact was no longer an option, various initiatives were introduced to maintain these important relationships. This presentation gives an overview of the issues and the solutions identified to overcome them.
November 24, 2021
Speaker
Mike Kekewich, Director of Clinical and Organizational Ethics at The Ottawa Hospital, as well as the Director for the Champlain Centre for Health Care Ethics, and the Champlain Regional MAID Network.
Recent visiting policies to health and care facilities across the countries have shown considerable change in the last few months, with some introducing vaccine mandates for staff, essential care partners and general visitors. Mike will present about the ethics and decisions involved when considering introducing vaccine mandates for essential care partners.
October 27, 2021
Panel speakers included:
Dr. Amit Arya - Palliative Care Lead at Kensington Health; Lecturer, Department of Family & Community Medicine, University of Toronto; Assistant Clinical Professor, Faculty of Health Sciences, McMaster University
Jennifer Baumbusch - Caregiver for her daughter who is medically complex, Associate Professor at the UBC School of Nursing
Jannice Kaffer - President and CEO, Hotel Dieu Grace Healthcare
Linda Moss – Patient Advocate, Ontario
Carol Fancott – Director, Patient Engagement and Partnerships, Healthcare Excellence Canada
Maggie Keresteci - Essential Care Partner, Executive Director, Canadian Association for Health Services and Policy Research
October 13, 2021
Host
Carol Fancott, Director, Patient Engagement and Partnerships, Healthcare Excellence Canada
Speakers
Maggie Keresteci, Caregiver Advocate, Executive Director CAHSPR, PCAG Co-chair
Lisa Raffoul, Patient Advocate, Hôtel-Dieu Grace Healthcare, Windsor, PCAG Member
Pamela Libralesso, RSSW, Founder, Ontario Families of Group Home Residents, PCAG Member
Serena Thompson, Vice President, Sickle Cell Association, Patient Advocate, PCAG Member
This huddle will share stories, bust myths and clarify the facts that show how essential care partners benefit care, experience, safety and outcomes, including during COVID-19. Stories written by members, colleagues and friends of the Essential Together Patient and Caregiver Advisory Group bring evidence to life and demonstrate the vital role essential care partners play in a patient’s care team.
September 23, 2021
Host
Jessie Checkley, Senior Program Lead, Patient Engagement and Partnerships
Speakers
Carol Fancott, Director, Patient Engagement and Partnerships, Healthcare Excellence Canada
Shoshana Hahn-Goldberg Senior Program Lead Representing Healthcare Excellence Canada Patient Engagement and Partnerships
This huddle will provide an overview of updated policy guidance and evidence for implementing family presence policies in health and care settings, including during the pandemic.
During 2020, policy guidance regarding family presence policies was co-developed with range of people with expertise and COVID-19 related experience, including providers, administrators, patients, families and caregivers. Using the latest evidence about the impact of restrictive policies on patient outcomes, this policy guidance has been updated to reflect the context of the COVID-19 pandemic. This session is particularly relevant for healthcare decision makers and those implementing policy that impacts on essential care partners' access to loved ones in any health and care setting.
May 6, 2021
Speakers
Chris Mayhew, Senior Consultant, Engagement and Patient Experience, Alberta Health Services
Dean Radbourne, Patient and Family Advisor, Alberta Health Services Patient and Family Advisory Group
Alberta Health Services is a province-wide health system. Their COVID-19 task force creates communication and resources to support the entire system, which covers multiple settings and patient groups. Among their tools are co-designed pamphlets that describe the roles of Designated Support Persons.
Key resources (currently English only)
The Coordinated Care Program Evaluation: Designated Care Partner (DCP) Survey
The Coordinated Care Program Evaluation: Staff Perspective Survey
The Coordinated Care Program Evaluation: Patient Discharge Survey
The Coordinated Care Program DCP Orientation and DCP Orientation Evaluation Survey
Infection Prevention and Control training presentation for DCPs
Essential Together Learning Bundles
Identifying and Preparing Essential Care Partners (ECPs):
Develop mutual expectations of responsibilities
Establish pre-entry preparation for ECPs
Establish staff education to understand roles and safety protocols for ECPs
Establish a rapid appeals process
Supporting ECPs as they enter health and care facilities:
Establish a clearly communicated screening process
Establish caregiver IDs for ECPs
Ensure ECPs are informed about existing and updated infection prevention and control protocols
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Learning Bundles: Identify and Prepare Essential Care Partners
As part of Essential Together and to support organizations to implement policy guidance that welcomes essential care partners into health and care facilities, we have curated learning bundles. These learning bundles centralize tools and resources from organizations across the country that support the safe reintegration of essential care partners.
These tools and resources follow the respective Policy Guidance for the Reintegration of Caregivers as Essential Care Partners elements to help organizations identify and prepare essential care partners as they enter health and care facilities.
This section is about supporting health and care facilities to work with patients and patient partners to develop mutual expectations of responsibilities of staff, patients and essential care partners. It is part of the policy guidance to identify and prepare essential care partners.
Patients should be encouraged to identify their essential care partners. Once identified, a facility staff person (or people) who is designated as a point person for essential care partners ensures smooth and effective coordination of the essential care partner responsibilities, provides supportive education with information regarding infection prevention and control measures, and offers clear and consistent communication. In addition, the point person could liaise with staff to ensure they are aware of who the essential care partners are, highlight relevant policies and provide guidance in the case of any conflicts. Currently there is often no single source of information for essential care partner policies and practices, causing unnecessary confusion for patients, essential care partners and staff.
These resources provide examples of clear communication of mutual expectations and processes related to identification of essential care partners, as well as tools that can be used to formalize these expectations. Mutual expectations are often communicated clearly on websites; however, may also be reviewed during staff training and essential care partner orientation.
Goals
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.
Resources
Alberta Health Services: Alberta Health Services is a province-wide health system. Their COVID-19 task force creates communication and resources to support the entire system, which covers multiple settings and patient groups. Among their tools are co-designed pamphlets that describe the roles of Designated Support Persons.
Watch the Essential Together Huddle recording with an overview of the program via YouTube
Designated Family and Support Persons: Know your role pamphlet
Translated resources
Bruyère: Bruyère is an academic health centre with multiple sites including long-term care facilities in Ottawa, Ontario. Their Designated Carer Program welcomes essential care partners into their facilities and includes a pledge outlining their roles and responsibilities.
Bruyère website
Bruyère Designated Care Partners video via YouTube
Grey County: Grey County operates three long-term care homes across Ontario. They introduced the Designated Care Partner (DCP) program which allows for the expansion of visitors for residents whose health and overall wellbeing would benefit from a DCP.
Watch the Essential Together Huddle recording with an overview of the program via YouTube
Grey County Designated Care Partner (DCP) Program Package
Types of Visitors Chart
Perley & Rideau Veteran's Health Centre: Perley and Rideau Veteran’s Health Centre is a long-term care centre in Ontario. They have developed a program for designated caregivers including a process for designating your essential care partners.
Perley and Rideau Veteran’s Health Centre website
Nova Scotia Health Authority: Nova Scotia Health Authority has prepared a toolkit and video for essential care partners on what to expect while being with a loved one in their facilities. This includes infection control guidance:
COVID-19 Toolkit – Family/Primary Support Person(s) and Family Caregivers
What to Expect for Designated Caregivers in NSH Long Term Care Facilities
This section is about supporting health and care facilities to work with patients and patient partners to develop supportive education for essential care partners related to infection control practices. It is part of the policy guidance to identify and prepare essential care partners.
Supportive education for essential care partners related to infection control practices includes the provision and use of personal protective equipment when necessary, hand hygiene and organization/unit-specific protocols and processes. This education needs to be flexible and respond to the differing levels of health literacy, cultural and language needs of caregivers as well as differing risk profiles of patients. It should be offered in various formats and at various times/frequency. An effective education program will reduce fear for both staff and essential care partners and provide a balanced approach for the safe re-entry of essential care partners.
These resources provide examples of training programs and materials for essential care partners to learn about personal protective equipment and infection prevention and control protocols as well as the specific organizational procedures. Some organizations provide in person training to essential care partners and others provide links to online training videos. Organizations may consider providing access to staff training modules on the use of PPE and IPAC protocols, where the completion of training can be tracked. It may be helpful to provide short refresher videos at each visit and training materials in a variety of formats.
Goals
Ensure consistent and ongoing information and education for essential care partners regarding safety protocols required for entry.
Resources
Alberta Health Services
Alberta Health Services is a province-wide health system with a Designated Support Persons program. Their COVID-19 task force creates communication and resources to support the entire system, which covers multiple settings and patient groups. They have co-created material to ensure Designated Support People understand their risks when entering health and care facilities during the pandemic.
Watch the Essential Together Huddle recording with an overview of the program via YouTube
Know Your Risk During COVID-19 (For Designated Support Persons)
Centre intégré de santé et de services sociaux de Laval (CISSS de Laval)
The CISSS de Laval has established procedures for its long-term care homes (CHSLDs) to admit caregivers who had been regularly providing support to meet a loved one’s needs with safety measures in place that comply with all infection prevention and control directives. The CISSS de Laval web page for caregivers includes a training video.
Hôtel-Dieu Grace Healthcare
Hôtel-Dieu Grace Healthcare’s Coordinated Care Program enables Designated Care Partners (DCP) to provide specific aspects of the care plan as agreed by the patient and care team in a carefully planned and coordinated approach.
Watch the Essential Together Huddle recording with an overview of the program via YouTube and view the presentation slides
The Coordinated Care Program Evaluation: DCP Survey (English only)
The Coordinated Care Program Evaluation: Patient Discharge Survey (English only)
The Coordinated Care Program DCP Orientation and DCP Orientation Evaluation Survey (English only)
Infection Prevention and Control training presentation for DCPs (English only)
McGill University Health Centre
The McGill University Health Centre in Montreal, Quebec has prepared a short video that reviews infection prevention and control measures that essential care partners watch at their first visit.
McMaster University
McMaster University Continuing Education has developed a short online course called Infection Prevention and Control for Caregivers and Families. The course is free and self-paced, meaning that you can complete it on your own time. It takes approximately five to six hours to complete all the course elements. If you are successful on the quizzes in the course, there is a printable certificate provided
SafeCare BC
SafeCare BC is a not for profit organization aimed at creating supports for those working in continuing care in British Columbia. Their online learning space includes a free course for essential care partners called COVID-19 Social Visitation Essentials and includes on COVID-19 and how to stay safe while in healthcare facilities.
The Ottawa Hospital
The Ottawa Hospital is a learning and research hospital in Ontario and affiliated with the University of Ottawa. The Ottawa Hospital has created online training materials for essential care partners.
This section is about supporting health and care facilities to work with patients and patient partners to establish staff education to understand roles and safety protocols for essential care partners. It is part of the policy guidance to identify and prepare essential care partners.
There was and is a great deal of anxiety among healthcare providers and staff, and in some cases, patients and caregivers, about contracting COVID-19. There are concerns that additional individuals in healthcare facilities may increase sources of infection. In line with fostering an organizational philosophy that embraces principles of patient- and family-centred and partnered care, it is important for leaders and staff to continue to recognize the widely accepted role and benefits of caregiver presence and welcome their physical presence as essential care partners. Staff concerns or fears may be alleviated through appropriate education and communication strategies to ensure that essential care partners are properly and methodically identified, screened, educated in facility specific COVID-19 safety protocols.
These resources provide examples of training and education available to help staff to implement essential care partner policies. Generally, essential care partner reintegration is reviewed with staff during huddles and the importance of the role of essential care partners is reinforced through stories shared on the intranet or by having patients and families share stories at town halls. Other supports for staff can include posters and conversation guides. Although not specific to COVID-19, general training related to patient- and family-partnered care is also helpful.
Goals
Ensure there is education and clear communication for staff regarding the role and value of essential care partners and their safe re-entry.
Resources
Department of Family Medicine - University of Alberta Faculty of Medicine and Dentistry
Caregiver Centered Care is a Program of Applied Research & Innovation in Health Services Delivery in Family Caregiving. This work is funded by Centre for Aging and Brain Health Innovation’s Spark Program. There are two training programs available: A foundational course and one specific to supporting caregivers during COVID-19. Certificates for competition are provided.
Grey County
Grey County operates three long-term care homes across Ontario. They introduced the Designated Care Partner (DCP) program which allows for the expansion of visitors for residents whose health and overall wellbeing would benefit from a DCP.
Watch the Essential Together Huddle recording with an overview of the program via YouTube
Grey County DCP Program Package with policies and education material (English only)
Hôtel-Dieu Grace Healthcare
Hôtel-Dieu Grace Healthcare’s Coordinated Care Program enables Designated Care Partners to provide specific aspects of the care plan as agreed by the patient and care team in a carefully planned and coordinated approach.
Watch the Essential Together Huddle recording with an overview of the program via YouTube
The Coordinated Care Program Evaluation: Staff Perspective Survey (English only)
L'Appui
L'Appui is an organization representing and supporting caregivers in Quebec. They have prepared a video that highlights the importance of essential care partners.
View L'Appui video via YouTube (only available in French)
Ontario Caregiver Organization
The Ontario Caregiver Organization (OCO) supports caregivers across Ontario. They have developed several training modules for healthcare providers looking to support caregivers as partners in care.
Saskatchewan Health Authority
The Saskatchewan Health Authority supports health organizations across Saskatchewan. Their Family Presence Expert Panel and support team have created many resources and supports for staff, so they can successfully support essential care partners
This section is about supporting organizations to work with patients and patient partners to establish a rapid and transparent appeals process. It is part of the policy guidance to identify and prepare essential care partners.
Health and care facilities should ensure patients and essential care partners have access to a transparent and timely appeal or dispute resolution process to resolve disagreements about essential care partner access. This process needs to allow for regional flexibility based on risk. The appeals process should be lean and publicly available so caregivers can understand the decisions related to access. A clear and transparent process will help reduce potential conflicts and avoid putting essential care partners or staff in untenable positions.
These resources provide examples of clear communication and execution of rapid appeals processes. Predominantly, these are initiated by the patient and family who want an essential care partner to support them, but can also be initiated by the organization, if they feel an essential care partner is not following agreed protocols.
Goals
Communicate a clear and transparent appeals process to patients and essential care partners so concerns can be quickly raised and addressed.
Current resources
The tools and resources are open source, which means you can use and adapt them to fit your local context. We will continue to add to these learning bundles. If you would like to be notified when we have new material, please let us know.
Baycrest
Baycrest is a hospital and long-term care facility for older adults in Toronto, Ontario. Their detailed appeals process is explained on their website.
Fraser Health
Fraser Health delivers hospital and community-based care from Burnaby to Fraser Canyon in British Columbia. Their website includes the process of what to do if patients or essential care partners have any questions or concerns.
Northwest Territories Health and Social Services Authority
The Northwest Territories Health and Social Services Authority designs and delivers health and social services across the territory. Their webpage for visitors includes a clear process and submission for requesting visitor exemptions.
Saskatchewan Health Authority
The Saskatchewan Health Authority supports health organizations across Saskatchewan. Their appeals process is run through quality of care coordinators and is supported by a newly created family presence support team.
Sinai Health
Sinai Health is a multi-site academic health science centre in Toronto, Ontario. Their rapid appeals process at the hospital is run through their patient relations team and responds to appeals within 48 hours.
Learning Bundles: Supporting Essential Care Partners as they Enter Health and Care Facilities
As part of Essential Together and to support organizations to implement policy guidance that welcomes essential care partners into health and care facilities, we have curated learning bundles. These learning bundles centralize tools and resources from organizations across the country that support the safe reintegration of essential care partners.
These tools and resources are arranged into seven learning bundles that follow the respective Policy Guidance for the Reintegration of Caregivers as Essential Care Partners elements to help organizations support essential care partners as they enter health and care facilities.
This section is about supporting organizations to work with patients and patient partners to establish clearly communicated screening processes. It’s part of the policy guidance to support essential care partners as they enter health and care facilities.
It is paramount to reduce vectors of transmission when entering an environment with medically vulnerable people, especially during a pandemic. Screening processes ensure everyone – including healthcare providers, administrators, staff and essential care partners – entering a healthcare facility is symptom free. Contact information needs to be collected for tracing purposes as per public health guidelines.
There should also be clarity in the different ways screening may be done, such as self-screening prior to arriving at the facility and/or in person at the time of entry. Consistency is important so screeners at the facility are methodical with everyone entering. Screening provides an opportunity for essential care partners to identify themselves, which in some cases can be with the patient as they are enter the facility.
These resources provide examples of various methods and tools for screening essential care partners.
Goals
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.
Resources
Alberta Health Services
Alberta Health Services is a province-wide health system. Their COVID-19 task force creates communication and resources to support the entire system, which covers multiple settings and patient groups. Among their tools is a communication friendly screening tool.
CISSS de la Montérégie-Ouest
CISSS de la Montérégie-Ouest’s website includes information for individuals in the care of intermediate and family-type resources (IR-FTRs), and residents of private seniors’ residences (PSRs). Among other resources are tools and guidelines for staff at the facility entrances and screening logs.
Perley and Rideau Veteran’s Health Centre
Perley and Rideau Veteran’s Health Centre is a long-term care centre in Ontario. They have launched an online screening app for designated caregivers.
Saskatchewan Health Authority
The Saskatchewan Health Authority supports health organizations across Saskatchewan. Their Family Presence expert panel and support team have created many resources to support screening.
Windsor Regional Hospital
Windsor Regional Hospital supports Windsor and Essex Country in Ontario. The hospital has both online and print options for patients and essential care partners to use before coming to the facility.
This section is about supporting organizations to work with patients and patient partners to establish caregiver identification (ID) for essential care partners. It is part of the policy guidance to support essential care partners as they enter health and care facilities.
Before COVID-19, some organizations had already instituted formal caregiver ID programs. ID processes remain relevant during the pandemic so staff can identify who is in the facility/on the unit and part of the care team. The provision of an ID badge or another visible icon can be linked to other processes, such as the designation of essential care partner(s) by the patient, cleared pre-entry screening and essential care partner education. This process may promote the acceptance of the role of essential care partners and alleviate staff fears as they can be confident essential care partners have been designated by patients, understand the safety protocols and are prepared to be on the unit as part of the care team.
These resources provide examples of essential care partner ID when they are on site. They can be helpful for enabling easy access into facilities and are important for tracking and safety.
Goals
Institute processes that clearly identify essential care partners.
Connect these processes with supportive education for safety protocols and personal protective equipment processes.
Resources
Bruyère
Bruyère is an academic health centre with multiple sites including long-term care facilities in Ottawa, Ontario. Their Designated Carer Program welcomes essential care partners into their facilities and provides them with DCP ID badges.
Grey County
Grey County operates three long-term care homes across Ontario. They introduced the Designated Care Partner (DCP) program which allows for the expansion of visitors for residents whose health and overall wellbeing would benefit from a DCP.
Watch the Essential Together Huddle recording with an overview of the program via YouTube
DCP Badge example and supporting communication material (English only)
Ontario Caregiver Organization
The Ontario Caregiver Organization supports caregivers across Ontario. They have developed several training modules for healthcare providers looking to support caregivers as essential care partners.
McGill University Health Centre
The McGill University Health Centre in Montreal, Quebec explains on their webpage for essential care partners that they will be given a green bracelet to wear to identify them as a designated visitor.
This section is about supporting organizations to work with patients and patient partners to ensure essential care partners are informed about existing and updated infection prevention and control protocols. It is part of the policy guidance to support essential care partners as they enter health and care facilities.
Connecting essential care partners with a staff point-person as they enter a facility provides an opportunity for essential care partners to receive updates on relevant infection control and prevention practices and ask questions or clarify details on protocols. This additional touchpoint contributes to ensuring safety protocols are understood and applied.
These resources provide examples of making sure essential care partners have updated information they need in their role as essential care partner.
Goals
Provide an opportunity for ongoing updates to ensure essential care partners are aware of current safety protocols and processes.
Current resources
The tools and resources are open source, which means you can use and adapt them to fit your local context. We will continue to add to these learning bundles. If you would like to be notified when we have new material, please let us know.
Alberta Health Services
Alberta Health Services is a province-wide health system. Their COVID-19 task force creates communication and resources to support the entire system, which covers multiple settings and patient groups. Their website is updated frequently and the date of update is noted clearly on the page.
Baycrest
Baycrest is a hospital and long-term care facility for older adults in Toronto, Ontario. Their detailed appeals process is explained on their website. They have a webpage with up to date information and people can subscribe to be kept up to date via email.
CIUSSS de l'Est-de-l'Île-de-Montréal
The CIUSSS de l'Est-de-l'Île-de-Montréal has several hospitals and CHSLDs. The CHSLDs have Facebook pages to keep families updated
CISSS Chaudière-Appalaches
The Centre intégré de santé et des services sociaux de la Chaudière-Appalaches has a range of ways available to keep essential care partners up-to-date including regular check ins from a dedicated staff member at the CHSLD.
Loch Lomond Villa
Loch Lomond Villa is a long-term care home in New Brunswick with a program supporting and welcoming essential care partners. They communicate about any changes to the program through notices to all their clients.
Our partners
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[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)
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