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21 Implementing virtual care planning with resident/family: A Canadian COVID long-term care experience
  1. Melissa Babcock3,
  2. Denise Connelly1,
  3. Cherie Furlan-Craievich3,
  4. Harrison Gao1,
  5. Anna Garnett1,
  6. Pam Hamilton7,
  7. Melissa Hay1,
  8. Lillian Hung2,
  9. Jacqueline Ripley4,
  10. Samantha Salatino6,
  11. Lori Schindel Martin5,
  12. Shannon Snelgrove4,
  13. Nancy Snobelen6
  1. 1Western University, London, Canada
  2. 2University of British Columbia, Vancouver, Canada
  3. 3Vision 74, Sarnia, Canada
  4. 4Copper Terrace, Chatham-Kent, Canada
  5. 5Ryerson University, Toronto, Canada
  6. 6WeRPN, Toronto, Canada
  7. 7PIECES Canada, Toronto, Canada


Background COVID-19 imposed extreme constraints on Canadian long-term care (LTC) homes, leading to intense isolation for residents, restricted family visits, and staff shortages. Consequently, these challenges negatively impacted the mental and physical health of residents, family, and interdisciplinary workforce in LTC homes.


  1. To describe how two LTC homes addressed promising practices – Presence of family, People in the workforce, and Future COVID–19 and non-COVID–19 care with implementation science.

  2. To understand the enablers, barriers and outcomes to the implementation of an innovative re-engineered intervention – P.I.E.C.E.S.™ (PIECES), designed to include families virtually for team-based resident care planning, and empower Registered Practical Nurses (RPNs) to build resilience and wellbeing.

Methods An interdisciplinary team (residents and family, nurses, and academic researchers), guided by the Consolidated Framework for Implementation Research, employed a mixed-method design to investigate implementation processes, determinants, and outcomes. Interviews with residents/families and staff focus groups provided insight into enablers and challenges. Pre- and post-intervention results of the Connor Davidson Resilience Scale, Resilience at Work, and Assessment of Interprofessional Team Collaboration Scale informed understandings of personal, professional and organizational resilience outcomes.

Results Findings highlighted how implementation of virtual PIECES helped sustain enhanced person-centered care through more comprehensive, collaborative, efficient and effective teams, leading to better outcomes for residents. Moreover, results suggested improved resilience, wellbeing, and communication between LTC home staff and family. New learnings improved preparedness for future outbreaks. Providing a plan for adapting, embedding, and sustaining the intervention based on implementation science will accelerate the spread of high-quality actionable research evidence.

Conclusions This is the first study to explore implementation processes of a virtually delivered PIECES intervention with meaningful engagement of multiple stakeholders (residents, family, RPNs). Findings provide evidence supporting important healthcare improvements, future spread of virtual interventions, and practice and policy changes for the LTC home sector.

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