Essential Together

The COVID-19 pandemic has resulted in substantial shifts in healthcare practices and policies, including the implementation of blanket visitor restrictionsBlanket visitor restrictions refers to restrictions that extend to all “visitors” entering a facility, often without exceptions, including essential care partners. that prohibit essential care partners accessing loved ones in health and care facilities.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. The restrictive policies have best intentions, but also bring known risks and unintended harm to patientsPatients include residents and clients. and families and moral distress to staff.1

Essential care partners are different to 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. 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. There is clear evidence that the presence of essential care partners benefits care, experience, safety and outcomes.2

The newly amalgamated organization that brings together the Canadian Foundation for Healthcare Improvement and Canadian Patient Safety Institute launched Essential Together – a program to support policy makers, policy implementers and those who experience policy relating to family presenceOpen family presence policies support the presence of family caregivers to be at the patient bedside at any time, and not restricted by “visiting hours.” during the pandemic and beyond.

The program builds on a former CFHI program – Better Together – and is based on co-created policy guidance that supports the reintegration of essential care partners during the pandemic. The guidance consists of seven key elements to help organizations identify and prepare essential care partners and then support them as they enter health and care facilities.

In the first phase of the program we are supporting policy implementers across health and care settings to reintegrate, welcome and support essential care partners as part of care teams during COVID-19 and beyond. Learning bundles with tools and resources that can be adapted to implement the policy guidance are available to anyone interested. Organizations that join the program also have access to peer learning and coaching.

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 support you.

As part of registering, we encourage you and your team to collaborate with patients and patient partners 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. 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@cfhi-fcass.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 do not feel comfortable sharing your tool, you can still participate in the program.

Download the Essential Together Tool

Register to 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 are here for you. Take advantage of dedicated coaching and peer to peer learning opportunities. The coaching support can provide you with expertise in change management, co-design and patient- and family partnered care, and other expertise to help you take action and implement the policy guidance. Peer-to-peer support gives you and colleagues a shared space for mutual support, empathy, and guidance.

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 is intended to be flexible and you can draw on what components of the program you feel you need.

Essential Together will continue to grow and evolve over the coming months. Let us know if you would like to be notified when updates are made to this program.

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 that support the reintegration of essential care partners from organizations across the country. These tools and resources are organized 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. 

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 send us an email via Essential.Together@cfhi-fcass.ca.

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.

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 family caregivers to be at the patient bedside at any time, and not restricted by “visiting hours.”

1 Canadian Foundation for Healthcare Improvement, Canadian Patient Safety Institute. “EVIDENCE BRIEF: Caregivers as Essential 2 Care Partners.” (2020)
 
2 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.