“There was essentially an abrupt mass ‘layoff’ of caregivers – which is very difficult because they could no longer monitor the pulse of care while it flatlined in their absence.”
In a blog post in late September, Dr. Sammy Winemaker, a palliative care physician in Hamilton, ON used these words to eloquently describe what happened in the first stages of the COVID-19 pandemic when Essential Care Partners[1] were banned from healthcare institutions where their loved ones resided or were hospitalized.
While these restrictions were introduced with best intent at a time when little was known about the virus and personal protective equipment supplies were scarce, extended restrictions impact patient safety, care, and wellbeing. That’s why the theme of this year’s Canadian Patient Safety Week is Who Knows? Essential Care Partners Do.
Prior to COVID-19, almost three-quarters of hospitals surveyed across Canada had policies to accommodate family members and other Essential Care Partners. When surveyed again in March/April 2020 after the outbreak of COVID-19, these policies had disappeared at all hospitals polled. The move reversed a positive trend to acknowledge that Essential Care Partners are not just visitors but are important members of the care team. While recent policies tend to have a more balanced approach, safe re-entry of essential care partners remains inconsistent across jurisdictions and organizations.
Like many other families across the country and around the world, a relative of mine died alone during an early wave of the pandemic. Another’s dementia symptoms and mobility worsened when family were not allowed to come into the long-term care home where she lives.
Consistent with our family’s experience, there is evidence that Essential Care Partners can improve patient safety, in both direct and indirect ways. For example, data show:
- Adopting family presence policies in hospitals, concurrent with other interventions, reduces patient falls and injuries sustained by falls.
- Family caregivers’ participation in the care process can reduce patient anxiety and dissatisfaction.
- Patients in medically vulnerable situations (e.g. intensive care units, older adult patients) are more likely to experience a medical error, costly non-essential care, physical and/or emotional harm, social isolation and inconsistencies in care when families and caregivers are not able to participate actively in care.
- For patients with acute heart failure, higher levels of social support (i.e. family and friends) were associated with increased medication adherence.
- Hospital staff tend to experience more gaps in vital information in the absence of family caregivers.
By focusing Canadian Patient Safety Week on Essential Care Partners, we hope to reinforce the importance of the lived experience of patients, families and caregivers guiding pandemic recovery and future resilience broadly, just as it is a touchstone for Healthcare Excellence Canada’s work. It is now more than six months since we launched the organization, bringing together the Canadian Patient Safety Institute and Canadian Foundation for Healthcare Improvement.
Our organization was born of a belief that everyone in Canada wants and deserves excellent healthcare. That’s why it was important for us to select a theme for our first Patient Safety Week that reflects the vital role of Essential Care Partners in patient safety and healthcare quality. I hope that you’ll join us to prompt their safe re-integration in health and care settings across the country.
Learn more about building your Essential Care Partner program by participating in Canadian Patient Safety Week 2021 at PatientSafetyWeek.ca.
[1] Essential Care Partners (ECPs) are different from general visitors; they are identified and designated by patients. Throughout the care journey, they play a significant role in patient safety and provide physical, psychological and emotional support, including support in decision-making, care coordination, and continuity of care. ECPs can include family members, close friends, caregivers or any person identified by the patient.
