Resources: Client Centred Care
The following resource is designed to assist Long-Term Care (LTC) homes with the implementation of the Client Centred Care Best Practice Guideline. Documents found in this resource are evidence-based, but it is not a program plan. Each LTC home is unique and each home is in various stages of guideline implementation. LTC homes are advised to use the resource at their discretion. For those resources that have copyright notations, it is recommended that LTC homes obtain permission from the primary author prior to implementing them within their setting. The Toolkit is a dynamic resource, and is being updated and revised on a regular basis by the LTC Best Practices Initiative team. Visit this site often to see what's new!
The word client, patient, resident and person will be used interchangeably so that the resources can be used in any practice setting. In certain circumstances the resident substitute decision maker may be involved in the process.
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References for Client Centred Care
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| Resource | Link |
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RNAO Client Centred Care Best Practice Guideline (BPG) |  |
RNAO Client Centred Care Best Practice Guideline (BPG) Supplement | |
RNAO Soins axés sur les besoins du client RNAO Lignes directrices sur les pratiques exemplaires en soins infirmiers. | |
RNAO Client Centred Care PDA Guideline Condensed version of the Client Centred Care BPG viewable on Personal Digital Assistants (PDAs) or mobile phones. |  |
RNAO Soins axés sur les besoins du client PDA | |
Client Centred Care Gap Analysis | |
Client Centred Care Gap Analysis Worksheet |  |
Congregate living and the law as it affects older adults Read more... | |
RNAO Client Centred Care - French Supplement Soins axés sur les besoins du client Supplément. | |
Resident's Bill of Rights The resident bill of rights can be found in the Nursing Homes Act, R.S.O. 1990, c. N.7. Source: http://www.acelaw.ca/appimages/file/Residents_Rights_Insert.pdf | |
Resident's Bill of Rights: Aphasia Institute Pictoral Version The pictographic version of the Ontario Resident's Bill of Rights was designed by the Aphasia Institute and funded by the Ontario Ministry of Health and Long-Term Care through the Seniors Health Research Transfer Network (SHRTN) initiative. | |
Resident’s Bill of Rights: "Every Resident" Advocacy Centre for the Elderly (ACE) and Community Legal Education Ontario (CLEO) An education booklet designed to explain the Bill of Rights that pertains to every resident living in long-term care in Ontario. | |
College of Nurses of Ontario (CNO) Practice Standards and Client Centered Care This resource includes the most applicable CNO Standards reflecting client centered care concepts. | |
Sunnybrook Nursing Standards: A Framework for Practice Comparison of College of Nursing Standards and Sunnybrook Health Sciences Centre Nursing Standards for the Nurse-Person Process including 6Rs (Really listening, Responding to Concerns, Respecting Choices, Reporting, Recording, and Reviewing Feedback) | |
| Resource | Link |
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Sample of Report Card A tool to demonstrate areas of strengths and areas for improvement. | |
Sample of Resident Questions to Evaluate Client Centred Care A compilation of questions to measure client centered care and services in long-term care home setting. | |
Tools and Practical Suggestions to create your own survey at less cost Tools and practical suggestions for resident satisfaction surveys are featured in this article by written by Dr. Emma Stodel for the Manrex Educational Series: A reprinted document from Long Term Care Magazine. | |
Picker Patient Centred Care Institute This comprehensive guide was developed for care homes in the United States by two non-profit organizations the Planetree Foundation and the Picker Institute with input from residents, families staff and management. | |
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RNAO Toolkit: Implementation of clinical practice guidelines This Toolkit was designed to assist health care settings in maximizing the potential of Clinical Practice Guidelines through systematic and well-planned implementation. It was also designed to accompany the Nursing Best Practice Guidelines (NBPGs) developed by the Registered Nurses' Association of Ontario (RNAO) in order to facilitate their implementation. | |
RNAO Trousse sur la marche à suivre Mise en place des lignes directrices pour la pratique Clinique. | |
Toolkit Resources Includes: | |
RNAO Toolkit: Stakeholder Assessment Worksheet Worksheet from RNAO Toolkit: Implementation of Clinical Practice Guidelines. Assesses stakeholder influence and support and looks at strategies for engagement (page 32 of Chapter 2). | |
Best Practice Guideline Implementation: Project Plan This project plan is intended to be used as an example in organizations wishing to develop an implementation strategy of their own. The project plan demonstrates how and when implementation of the RNAO BPG will occur, by showing the major milestones of the project, and the activities and resources required to meet these goals. | |
Sustainability of Best Practice Guideline Implementation Objectives: | |
Implementation Strategies for Client Centred Care Page 5 of the RNAO Client Centred Care supplement outlines implementation strategies for client centred care. | |
RNAO Best Practice Champion Network RNAO provides free training and networking opportunities to nurture skills in implementing best practice guidelines for individuals and teams. | |
ABCs for BPGs A workbook designed to introduce nurses in Long-Term Care to the basics of best practice guideline implementation. | |
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Health Quality Ontario: Quality Improvement Guide for Long-Term Care (English) This guide is intended as a jumping off point in the LTC QI journey, and provides foundational knowledge necessary to start improvement projects. | |
Health Quality Ontario: Quality Improvement Guide for Long-Term Care (French) Guide pour l’amélioration de la qualité - des soins de longue durée. | |
Health Quality Ontario: Tools for QI Teams This website provides links to downloadable information to help with project accessibility and efficiency through the use of quality improvement tools. | |
Institute for Healthcare Improvement (IHI): Model for Improvement Developed by Associates in Process Improvement. A simple tool for accelerating improvement. The model does not replace change models currently used in the organizations. | |
PDSA Worksheet The Plan-Do-Study-Act (PDSA) or Deming Cycle worksheet is a quality management planning tools. | |
PDSA Cycle Log Worksheet The Plan-Do-Study-Act (PDSA) or Deming Cycle worksheet is a quality management planning tools. | |
Health Quality Ontario: Creating a Mini Survey Mini-surveys show improvement on a small scale, and provide data for the ‘Study’ part of the Plan-Do-Study-Act cycles. Steps on administering a mini survey and generic sample templates are made available through the website. | |
Health Quality Ontario: Implementing and Testing Change Provides descriptions and samples of PDSA cycles, PDSA ramps and run charts, typically used to test and implement change and improvement. | |
Health Quality Ontario: Analyzing your system Provides descriptions and samples of tools to analyze your project, including process mapping, pareto charts, and root cause analysis. | |
IHI (Institute for Healthcare Improvement) Interactive Tools This area of Workspace features interactive tools to help you in your improvement work. Just enter your data and the interactive tool will automatically calculate and graph the appropriate measures for you. The first two interactive tools we are introducing are powerful tools to help organizations make their processes safer: The Trigger Tool for Measuring Adverse Drug Events (ADEs) and the Failure Modes and Effects Analysis (FMEA) Tool. NOTE: Registration is required to be able to use the tools on this site. | |
The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement The Breakthrough Series model is based on a collaborative approach and used by many organizations worldwide to improve the delivery of patient care. Institute for Healthcare Improvement. IHI Innovation Series white paper. The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. Boston, Massachusetts: Institute for Healthcare Improvement; 2003 | |
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Resident Centered Care Policy This is a sample of a client centred care policy from Essex Long Term Care Best Practice Workgroup entitled Resident Centred Resource Kit (pages 4 to 7). Other policies related to Client Centred Care may be: | |
| Resource | Link |
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Client Centered Care Plan Fact Sheet Practice recommendations and MOHLTC Resident Assessment Instrument/Minimum Data Set (RAI- MDS) Education recommendations related to Resident Assessment Protocols (RAPS) and Care Planning. Care Plan prompts and examples of generic vs. client centered care planning statements are also included. | |
Family Involvement in Care for Persons with Dementia in Long-Term Care Facilities Pamphlet and Family Staff partnership Activities Agreement This pamphlet outlines Family Involvement in Care (FIC) and provides a template for establishing expectations and negotiating a partnership agreement between staff and the family. Some of the benefits outlined include: improved attitudes about families, decreased family caregiver guilt and increased therapeutic and diversional activities for the person with dementia. | |
Documentation: Provider-driven vs. Client-centered These are sample of progress notes demonstrating the contrast between provider (staff) driven vs. client centred documentation. Source: Sunnybrook Health Sciences Centre. | |
Ottawa Decision Support Framework The Ottawa Decision Support Framework is an evidence-based, practical, mid-range theory for guiding patients making health or social decisions. It uses a three-step process to: | |
Ottawa Decision Support Framework Tools Tools that were used to operationalize the variables in the Ottawa Decision Support Framework are listed in the website link. A sample of each tool is provided, along with a User Manual describing the tool's properties, scoring and directions for administration. | |
| Resource | Link |
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| Self Learning and PowerPoint Presentations | |
Client Centred Care e-Learning Course This is an interactive computer based self-learning tool designed to build on existing knowledge, skills and experience of all health care providers and to help integrate evidence-based recommendations into practice. | |
Consent, Capacity and Substitute Decision-Making The Basics Mental Capacity in law is issue or task specific. A resident is not globally incapable just because they have been admitted to long term care, this document helps the reader to understand consent, capacity and substitution decision-making. | |
Resident Created Profile: Persons living in LTC sharing their life Sample profile created by residents themselves. It is suggested that homes create a similar set with their own residents. This profile can be used for orientation and education. Source: Sunnybrook Health Sciences Centre. | |
Client Centred Care PowerPoint Presentation Created by the RNAO Long-Term Care Best Practice Coordinators to provide an overview of client centred care. | |
Resident Created Profile: A Personal view of waiting Sample profile created by residents themselves. It is suggested that homes create a similar set with their own residents. This profile can be used for orientation and education. Source: Sunnybrook Health Sciences Centre. | |
Resident Centred Care in Long-Term Care: A Self Learning Package This self-directed learning package is designed to support the implementation of the RNAO BPG Client Centred Care in the long-term care sector. The main objective of the package is to help nurses begin to think about the principles of resident centred care, and the ways that they can improve the provision of care to residents in the long-term care home. | |
Resident Created Profile: A personal view of living with early onset Alzheimer’s Disease Sample profile created by residents themselves. It is suggested that homes create a similar set with their own residents. This profile can be used for orientation and education. Source: Sunnybrook Health Sciences Centre. | |
| Charts | |
| Fact Sheets / Pamplets / Pocket Cards / Logos | |
RNAO Health Education Fact Sheet: Putting Patients First This fact sheet is targeted towards patients to help them better understand the role and responsibility of a nurse within the health care system. | |
RNAO Placer les patients à l’avant-plan RNAO Fiche de renseignements pour la sensibilisation en matière de santé. | |
Title: Integrating eHealth in Your practice A fact sheet prepared by RNAO’s e-Health initiative. Suggestions help to keep the focus on the resident/client when using technology. | |
What is a Healthy Healthcare Organization A RNAO Healthy Work Environments fact sheet for residents/”patients” and family on what a healthy health care organization is, how they will know it is healthy and what they as a “patient” can help to do to contribute to a healthy organization. Healthy work environments go hand and hand with providing client centred care. | |
Pocket Cards Patient centred care questions for initiating discussion. Created by Sunnybrook Health Sciences Centre. | |
| Videos | |
UHN Video Clip: "What Patient Centred Care Means To Me" A video clip from nine individuals discussing what inspires them to care for patients and families. Each story brings the unique perspective of the individuals based on their past experiences. Run time is 10:40 min. Source: University Health Network (UHN): /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} http://www.uhn.ca/about_uhn/nursing/site/practice/pcc/video_series/index.html | |
Video Listing from Sunnybrook This is a listing of client centred care audiovisual resources from Sunnybrook Health Sciences Centre. | |
MAREP Video Resources This is a listing of client centred care audiovisual resources from MAREP (Murray Alzheimer Research & Education Program), University of Waterloo. | |
Strategies for Leadership : Patient- and Family-Centred Care A video and toolkit prepared by AHA partnered with the Institute for Family-Centered Care, a non-profit organization that serves as a resource for consumers, practitioners and policymakers who want to advance the practice of family-centered care. Source: http://www.aha.org/aha/issues/Quality-and-Patient-Safety/strategies-patientcentered.html. | |
| Websites | |
OLTCA Photo Exhibit and Irene Borins Ash Irene Borins Ash is a Toronto social worker and photographer. Her website features photographs and stories on aging through the perspective of long-term care residents. Based on her interviews with long-term care residents, she had collected 25 images with text exhibit that exposes myths about aging and long term care. | |
| Education Resources | |
Lesson/Workshop Planning: Education Program 2 Day Agendas for 2 day long workshops (offered one month apart). Many of the activities are found in the tools following this agenda). Source: Sunnybrook Health Sciences Centre. | |
Lesson/Workshop Planning: Education Program 8 Week Course outline for an 8 week client centred care course offered in 2 hour sessions. Many of the activities are found in the tools following this agenda). Source: Sunnybrook Health Sciences Centre. | |
Lesson/Workshop Planning: Course confirmation notice Source: Sunnybrook Health Sciences Centre. | |
Lesson/Workshop Planning: Course Checklist for Facilitator Source: Sunnybrook Health Sciences Centre. | |
Workshop Presentation #1 Day 1 PowerPoint presentation to assist a facilitator(s) in guiding the focus for 2-full day workshops on client centred care. The recommended number of participants is 25 working in groups of 5. From Sunnybrook Health Sciences Centre. | |
Workshop Presentation #2 Day 2 PowerPoint presentation to assist a facilitator(s) in guiding the focus for 2-full day workshops on client centred care. The recommended number of participants is 25 working in groups of 5. From Sunnybrook Health Sciences Centre. | |
Icebreaker: Getting to Know You Getting to Know You is an activity for participants to get to know each other. Source: Nadine Janes, RN; PhD, Manager, Professional Practice & Advanced Practice Nurse, Extended Practice, West Park Healthcare Centre, Toronto. | |
Icebreaker: Knowing and Engaging Participants Knowing and Engaging Participants is an activity for participants to get to know each other. Source: J. Hollett, PCC Project Manager, UHN, Toronto. | |
Icebreaker: Shield Activity Shield activity an exercise to uncover personal values in the participants work. Source: Sunnybrook Health Sciences Centre. | |
Values Resources – Values Exercise The value exercise is an activity to demonstrate where client/family, management, and staff stand in regards to the certain values. Source: Pillemer, Karl & Meador, Rhoda (1997). Partners in Caregiving: Cooperative Communication Between Families and Nursing Homes, Cornell University, Ithaca, NY. | |
Listening Resources – Communication: Guided Imagery Guided Imagery is an exercise to experience being listened to. Developed by J. Hollett, RN; MSc; Patient Centred Care Manager, University Health Network, Toronto. | |
Listening Resources – Communication: The art of listening The 5 Rs of the Nurse-Person Process are Really listening, Responding to concerns, Respecting choices, Reporting and Recording. Developed by Ferrer, Erlinda (2005). Really Listening. Nursing Voice (Summer), p. 10. Sunnybrook Health Sciences Centre. | |
Dialogue Resources: Communication: Dialogue Analysis This is a collection of resources/worksheets to introduce client centred dialogue in class and as assignments between classes. Source: Contributing Authors: M. E. Nicholson, RN, MSc. PhD(c)., Sunnybrook Health Sciences Centre. | |
Dialogue Resources: Communication: Exercise/Dialogue Sheets This is a collection of resources/worksheets to introduce client centred dialogue in class and as assignments between classes. Source: Contributing Authors: M. E. Nicholson, RN, MSc. PhD(c)., Sunnybrook Health Sciences Centre. | |
Dialogue Resources: Communication: 4 A’s of CCC This is a collection of resources/worksheets to introduce client centred dialogue in class and as assignments between classes. Source: Contributing Authors: Janice Beitel, RN, BSN, MScN, CNCC(c), CNN(c) Professional Practice Leader Trillium Gift of Life Network, and Jane Hollett, RN, MSc. PCC Project Manager, University Health Network, Toronto. | |
Dialogue Resources: Communication - Getting to Know the Person This is a collection of resources/worksheets to introduce client centred dialogue in class and as assignments between classes. Source: Source: Nadine Janes, RN; PhD, Manager, Professional Practice & Advanced Practice Nurse, Extended Practice, West Park Healthcare Centre, Toronto. | |
Dialogue Resources: Communication - Dialogue with a partner exercise This is a collection of resources/worksheets to introduce client centred dialogue in class and as assignments between classes. Source: J. Hollett, RN, APN, MSc. PCC Project Manager, University Health Network, Toronto. | |
Dialogue Resources: Communication - Sample questions according to 4 core processes This is a collection of resources/worksheets to introduce client centred dialogue in class and as assignments between classes. Source: Sunnybrook Health Sciences Centre. | |
Blocks to Communication Examples of communication blocks and its definition as opposed to a client centred communication. Developed by: Sunnybrook Health Sciences Centre and University Health Network, Toronto. | |
Blocks to Communication Resources: Communication - 7 Hard to break Habits "Hard to break habits" are reflection exercises to raise awareness of common blocks to communication. Sample document of blocks of communication and alternatives are included as well as a blank form to identify blocks to communication and client centred alternatives. Based on article by J. Beitel (1998). Illuminations File: Illuminations Newsletter of the International Consortium of Parse Scholars, 7(3), 3-5. Source: Sunnybrook Health Sciences Centre. | |
Resources for discussion and reflection: Myths and Challenges - Debunking Client Centred Care Myths & Misconceptions Developed by: Sunnybrook Health Sciences Centre, Toronto. | |
Resources for discussion and reflection: Haiku Poem Exercise Developed by J. Hollett, RN, APN, MSc. PCC Project Manager, University Health Network, Toronto. | |
Resources for discussion and reflection: Keeping the CCC Flame Burning - Ideas to Integrate PCC into Clinical Staff Meeting Agendas Source: J. Hollett, RN, APN, MSc. PCC Project Manager, University Health Network, Toronto. | |
Evaluation of Learning Experiences: Workshop Evaluation Tools Sample of workshop evaluation tools. Source: J. Hollett, RN, APN, MSc. PCC Project Manager, University Health Network, Toronto. | |
Evaluation of Learning Experiences: Workshop Evaluation Tools Sample of workshop evaluation tool. Source: Sunnybrook Health Sciences Centre. | |
Evaluation of Learning Experiences: Jeopardy Game Sample The sample Jeopardy Game illustrates a fun way to evaluate learning. Source: Sunnybrook Health Sciences Centre. | |
Evaluation of Learning Experiences: Blank Jeopardy Template This is a blank template where you can make your own Jeopardy Game. Source: http://www.jmu.edu/madison/teacher/menu.htm. | |
| Other Resources | |
What we heard: Long Term Care Quality Consultation 2008 A synthesis of a consultation process hosted by the MOHLTC (Ministry of Health and Long Term Care) and SHRTN (Seniors Health Research Transfer Network) in 2008. Over 600 participants from LTC. Five common themes identified. | |
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Evaluating Your Success From RNAO’s Toolkit: Implementation of Clinical Practice Guidelines, Chapter 5, pages 57-64. | |
A Person/Family Survey: Knowing the person questionnaire This is an evaluation form designed to interview clients about their experience as recipients of client centred care. Source: Sunnybrook Health Sciences Centre. | |
A Chart Review for client centred care This is a 2-part Chart Review. Part 1 evaluates nursing documentation from a client centred care perspective and Part 2 evaluates pain management from a client centred care perspective. Source: Sunnybrook Health Sciences Centre. | |
Program Evaluation: The basics The Public Health Agency of Canada – Agence de la Santé Publique du Canada toolkit for evaluation of programs particularly as it considers constraints in human resources and finances. En haut de la page principale il y a un hyperlien pour la version française de ce document. The whole toolkit can be accessed at: http://www.phac-aspc.gc.ca/php-psp/toolkit-eng.php. | |
The Evaluation Center – Western Michigan University This contains checklists and tools for planning your evaluation. | |
Ontario Injury Prevention Resource Centre. There is a link to the stages of evaluation. This website provides access to a toolkit of evaluation methods and measures. | |
Public Health Agency of Canada - A Guide to Project Evaluation: A participatory approach This evaluation guide provides an easy-to-use comprehensive framework for project evaluation. | |
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Does your care plan tell my story? Coker, E. (1998). Documenting aspects of personhood in Long Term Care. Journal of Holistic Nursing, 16(4), 435-452 | |
Figuring it Out in the Moment: A Theory of Unregulated Care Providers' Knowledge Utilization in Dementia Care Settings Authors: Janes, Nadine1; Sidani, Souraya2; Cott, Cheryl3; Rappolt, Susan4 | |
You Are Words (Dementia Poems) (1997) – Edited by John Killick . London UK: Hawker Publications Ltd. This is a citation for Dementia Poems. It may be available in some Alzheimer’s Society Library Resources. This is a compilation of poems related to client centred care. It can be used to enhance educational programs. | |
Creative Training Openers and Energizers: Book order information This website provides a link to the information for purchasing additional references for icebreakers/openers. The book entitled, 50 Creative Training Openers and Energizers Innovative Ways to Start your training with a BANG! Bob Pike CSP,CPAE; Lynn Solem (2000). Jossey-Bass/Pfeiffer & Creative Training Techniques Press. San Francisco, CA, includes actual tools for facilitators to use. | |