TRANSLATING RESEARCH IN ELDER CARE (TREC) is a pan-Canadian health services research program that aims to produce knowledge to improve elder care through a partnership of researchers, knowledge users, policy makers and those most affected – residents and their families. This partnership ensures that the research meets the needs of everyone in the residential long-term care sector.
TREC aims to improve the lives of vulnerable nursing home residents by creating solutions in the areas of:
· Enriching the daily lives of residents
· Improving quality of work life for staff
· Assisting managers, administrators, owners and policy makers with evidence-informed decision making
Evidence-based
The TREC Measurement System
The TREC Measurement System (TMS) is a research technology that includes data from over 90 nursing homes across British Columbia, Alberta, Saskatchewan and Manitoba, and collected in some regions for more than a decade. We have a representative sample of nursing homes that includes facilities of different sizes and owner-operator models (public, voluntary and private).
The TMS is the largest longitudinal database of its kind in Canada and the only one collecting resident (patient) and care provider data at the unit (microsystem) level, where the care happens between professional care providers and the residents.
The TMS enables us to leverage data for intervention studies, facility and regional level tailored feedback, pilot studies, system projects, trainee projects and to form working groups to tackle specific questions. Using the TMS, we can explore the strength of linkages between work environment, work life quality, best practice use and resident outcomes.
What We Study
· Burnout Among Care Aides in Nursing Homes
Predictors of burnout. Does staff burnout influence resident outcomes?
· Health of Care Providers
The physical and mental health of care providers. Does the workplace influence health? Are these health measures linked to modifiable resident outcomes, such as pain, behavioural problems, depression or use of physical restraints?
· Resident Length of Stay
How long residents live in nursing homes. Has this changed over time? How does it vary between different health regions? How do provincial policies influence length of stay?
· Health of Nursing Home Residents
Quality indicators, such as resident falls, pressure ulcers and pain. Understanding the extent of pain as residents near end-of-life and best practices in managing pain once it is identified.
· Responsive Behaviours of Residents with Dementia
Aspects of nursing home work environments that contribute to responsive and sometimes aggressive behaviours among residents.
· Varying Clinical Profiles of Residents by Region
Effects of different numbers of nursing home beds per capita in each province. How do differing clinical complexity profiles influence admitting practices?
· Regulated Staff
Demographic characteristics and health and work-related outcomes for regulated staff (nurses, occupational therapists, physiotherapists) in nursing homes.
· Assessing Work Environment
Nursing home work environment at the unit and facility level. How does the work context influence quality of resident care, quality of resident life and quality of work life for staff?
Major Projects Include
· Clinical Trials:
o Improving Nursing Home Care Through Feedback on Performance Data (INFORM): Comparing two tailored feedback approaches designed to support managers to measurably improve their work context.
o Safer Care for Older Persons (in Residential) Environments (SCOPE): Are care aide led quality initiatives at the local (microsystem) level effective in improving work-life and resident care quality? Are tailored (to support change) leadership training programs effective in supporting “bottom up” quality initiatives?
· Networks Among Nursing Homes in Canada:
o Advice-seeking networks in long-term care: Who are the opinion leaders and opinion leading organizations within the informal advice seeking nursing networks and what leaders and organizations bridge between networks?
· Major Leveraged Studies:
START on Mobility (Sustaining Transfers through Affordable Research Translation): Cluster of randomized controlled trials investigating the contextual and environmental factors that influence the uptake of simple innovations intended to enhance the well-being of frail older adults.
o Older Persons’ Transitions in Care (OPTIC): Care transitions for residents between nursing homes and emergency departments.
o Seniors Adding Life to Years (SALTY): A pan-Canadian CIHR team asking: How can we improve end of life care for older adults living in nursing homes? How can we support families and other caregivers at the end of life?
TREC Partnerships
· TREC’s 36 researchers and 13 trainees are based at 13 Canadian, 3 U.S. and 2 International universities working in co-operation
· University of Alberta is the primary hub of TREC activities
· TREC’s Funding History (to 2018):
o Peer Reviewed = $10,319,555
o Partner Contributions (including provincial, health authorities, etc.) = $13,050,000
Learn more at https://trecresearch.ca/
