Winnipeg Regional Health Authority

  • Joe Puchniak, Regional RAI/MDS Coordinator, Personal Care Home Program, Winnipeg Regional Health Authority, Winnipeg, Manitoba
  • Cynthia Sinclair, Manager of Initiatives, Personal Care Home Program, Winnipeg Regional Health Authority, Winnipeg, Manitoba

Using RAI/MDS to Promote Continual Quality Improvement in Personal Care Homes

  • In Winnipeg we are now positioned to use Resident Assessment Instrument/Minimum Data Set (RAI/MDS) data to guide continual quality improvement and inform decision making at both the clinical and managerial levels in long term care. Joe Puchniak, Manager, RAI/MDS & Decision Support for the WRHA PCH Program, and Cynthia Sinclair, PCH Program Manager of Initiatives (currently on secondment) are leading a project which is taking the first significant step towards using the RAI information in a meaningful way at the facility and regional level.
  • Although the regional long term care antipsychotic usage rate is in line with (or slightly below) the national average, the project leads believe there is room for improvement based on the literature and the variability of usage amongst the 38 Personal Care Homes in Winnipeg.
  • The project consists of an intensive education of a dementia care model: P.I.E.C.E.S™, which stands for Physical, Intellectual, Emotional, Capabilities, Environment, and Social spheres around which health practitioners assess residents with dementia. This care model emphasizes medications as a last resort when managing challenging behavioural symptoms.
  • This is followed with weekly mentoring of clinical and leadership teams at the pilot site to promote knowledge transfer and is enhanced by the creation of an online self learning module and regular feedback from the RAI data to front line staff and managers.
  • In just six months time, the project has shown a reduction of more than 25% in antipsychotic medication use within the cohort of residents that were on the drug when the project began. This was achieved without any increase in behavioural symptoms or any increase in the use of physical restraints among this group of residents, as demonstrated using the RAI data.
  • In this facility, a paradigm shift has begun, as staff is working more collaboratively, creatively and resourcefully as they are beginning to use the data as never before, while management is now eager to continue the work of the project and look at other RAI quality indicators.
  • This project is a strong first step towards realizing the potential use for the RAI/MDS data. It also has great potential for engaging staff and families in efforts to further enhance quality of care for seniors in our long term care facilities.