From Pilot to Program
The Algoma Ontario Health Team (AOHT) identified early on in the COVID-19 pandemic that with visitor restrictions in place, the exclusion of caregivers had numerous unintended consequences, and that their most vulnerable patients needed the emotional and physical support of their families.
In the fall of 2020, the AOHT embarked on a pilot of the Caregiver ID Program, which launched in one unit at Sault Area Hospital in January 2021 (SAH is a core partner of the AOHT) . The program quickly expanded to other units across the hospital. The project team, led by SAH's Transformation Department, included membership from staff, leaders, Patient and Family Advisors, and other AOHT partner organizations. Project implementation involved updating essential caregiver policies, formalizing caregiver roles, providing caregivers with a visual identification card, and providing training and resources on topics such as infection prevention and control.
Meaningful Partnerships
Laura Tenhagen (Project Lead, SAH) explains that the meaningful engagement of caregivers was key: "Two patient and family advisors have been involved in the co-design of the project and they helped to shape future direction a lot, especially around supporting the role of caregivers." In addition, working with the Ontario Caregiver Organization (OCO) as a participant in the Partners in Care/Caregiver ID Learning Collaborative was instrumental to the success of the AOHT's program, allowing project staff to use previously developed tools and look to other hospitals for what worked.
Key Success Factors
Prior to onboarding the first essential caregivers in January 2021, SAH began communicating to staff about what to expect on the floor. "There was some initial hesitation and confusion around differentiating visitors and essential caregivers, but the process was clarified both for staff and caregivers. We used huddles, posters, and OCO's e-learning modules, which highlighted the importance of working with caregivers and demonstrated that this was not an 'extra step' that staff had to do, and that caregivers are a huge asset to the team and can improve patient outcomes along the way" explains Tenhagen.
One of the key success factors has been ensuring the program is not too prescriptive for patients and caregivers. As Danielle Florio (Patient Care Supervisor, SAH) explains, "Allowing flexibility and the ability for the care team to adapt can be a bit scary at first for staff because we were concerned it would 'go off the rails', but it worked. Broadening the spectrum made it more successful."
Program Impact
The impact of the program on patients, caregivers and staff has also turned some challenging situations into positive ones. Florio notes that for one particular patient, once their essential caregiver was onboarded, "Anxiety and anger melted away and the individual's care started to be positively affected by support from their family caregiver." The program has been very well-received by SAH's staff, physicians, patients and families alike.
Looking Ahead
Now that the Caregiver ID pilot has been successfully completed at SAH, the project team is working to ultimately roll out the standardized Caregiver ID program more broadly across SAH and regionally to other AOHT partner sites, such as long-term care. The project has been developed in a way that makes the inclusion and recognition of caregivers easy for health and social service providers across Algoma and already lots of interest and initial steps are being taken by organizations looking to formally recognize the important work of essential caregivers.
At a system level, we hope that if an essential caregiver is identified by a health partner, they will maintain that role as they seamlessly transition across the continuum of care throughout the community.