Essential Care Partner Cathie McDowell and her Father

From Ideas to Action 

After the onset of the COVID-19 pandemic and understanding the negative impact of visiting restrictions during wave one, Niagara Health partnered with Niagara Health Engagement Network and Patient Partners to implement change. The concept of Caregiver ID and caregivers as part of the care team was part of their long-term plan. After the challenges of the first and second wave of the pandemic, however, Niagara Health's executive leadership recommended 'fast forwarding' those plans and implementing an essential caregiver program as soon as possible. "We are committed to authentic partnership and listening to the needs of our community, which is why the essential care partner program was developed" explained Lynn Guerriero (President and CEO, Niagara Health) and Linda Boich (Executive Vice President, Quality, Mental Health and Addictions and Executive Lead Integrated Care).

Partner Involvement

Niagara Health looked to the Ontario Caregiver Organization for support and was connected with early adopters Hôtel-Dieu Grace Healthcare (HDGH) and Bruyère to learn from their experiences and adapt existing tools. A cross-functional team was pulled together with representation from five sites, and included managers, directors, screeners, communications, IT, and most importantly, Patient Partners. As Sonia Pagura (Director of Quality, Safety, Risk, Patient Partnership and Relations) notes, "we took a co-design approach because we knew it needed to be adapted to Niagara's unique needs and population." Pagura credits Patient Partner involvement as a key success factor in the development of the program. Maia Greig, one of the Patient Partners who participated in the process reflected that she "was consistently supported throughout the journey and was made to feel included. I believe the most meaningful contribution I made as a Patient Partner was the importance of including emotional support as a critical component of an essential care partner".

Accelerated Implementation

Niagara Health's essential care partner program planning began in December 2020 and went live just six weeks later on January 24, 2021. The program was embedded in the nursing assessment and incorporated into the electronic platform with an automated trigger across their five sites to ensure there was no additional clinical burden for staff. In preparation, simulations were conducted to test the system and a LEAN event was completed shortly after the launch to further streamline the process.

At Niagara Health, each essential care partner is issued a printed badge. Pagura explains that "the badge is an acknowledgement of the essential care partner role. It's a visual management piece for staff to understand that they an integral part of the care team and their presence is encouraged, including on a 24/7 basis."

Program Impact

The impact of the essential care partner program has created positive ripple effects on both patients and caregivers. In one instance, Cathie, an essential care partner for her father, actually extended her role to include her father's hospital roommate when she realized there was a need: "Dad shared a room with an 86-year-old gentleman for a couple of weeks and we all became quite friendly. His roommate had expected to be in the hospital for a day or two and when we met, he had been there about 3 weeks (which turned out to be 4 months!)  He eventually moved to another ward before Dad was discharged and I was able to have my ECP extended to visit and take him coffee/supplies in the other ward. The most important thing one needs is a personal connection and we became the connection because his family lives out of town. That wonderful connection continues to this day."  

Moving Forward

After its launch over ten months ago, over 2000 essential care partners have been on-boarded and trained at Niagara Health. Next steps will be a focus on evaluating the program and continued plans for sustainability. As Pagura notes, "It is critical that this is a forever program and that we continuously identify care partners and include them as part of the care team, as their wisdom and support contribute to positive health outcomes."