Why Become a Long-Term Care Centre of Excellence?

The pandemic introduced the broader public to a shocking realization of how Long-Term Care (LTC) was operating across North America. For those working in Long Term Care homes at that time, the pandemic only reinforced long standing and well-known issues that were not being addressed. Unfortunately, since then, governments have promised sweeping change but much of that has not materialized into anything close to the promises that were made.  

True to form, however, governments have brought into practice additional regulations, increased administrative burdens, and new compliance demands. These have only magnified the existing challenges with lack of funding and staffing.  

Our healthcare consulting team worked to solve this and have delivered our Centre of Excellence Long Term Care model in multiple locations and sustainably within the existing environmental, financial, and regulatory constraints you and your colleagues work in. 

While developing a Long-Term Care home into a ‘Centre of Excellence’ is no easy task, it will deliver significant long-term rewards both for your staff and residents and the home environment.  

Why become a Long-Term Care Home Center of Excellence? 

Here are just a few of the outcomes you can expect as a model Centre of Excellence in your community:  

• Engaged teams who are empowered to “identify and own” necessary changes in their area of responsibility 

• Residents and their families feel heard as they become part of the process to “identify and problem solve” common issues  

• Reduced time is spent by nursing for medication rounds, achieved naturally through the reduction of medications residents used to need 

• Reduction in unhealthy weight loss by creating relaxed breakfast and lunch routines supporting a home like environment 

• Reduced or eliminated pressure ulcers through an increase in daily activities and movement of residents 

• Less restraints due to increased one-on-one time with residents 

• Reduced incontinence and UTIs with staff able to assist residents more with daily routines and increased fluid intake 

• Reduced number of falls through greater supervision of residents 

• Reduce number of medication due to reduced infections, falls and incontinence 

• Reduced or eliminated outbreaks by triggering the proper protocols early 

• Increased one-on-one care time for residents 
• Better quality of life for residents due to reduced acquired conditions 

• Positively engaged staff who have a more relaxed work environment and appropriate time to care for residents  

• Increased family support by involving them in solutions for their loved ones 

• Cost savings for the home 

• Less turnover due to greater staff fulfillment 

What is a LTC Centre of Excellence? 

A Centre of Excellence Home is one where all staff have worked together to solve recurring problems in order to create more time to spend with the resident’s one-on-one, when the residents need it. This high functioning home supports an environment where there is no rushing around and the quality of care has improved with reduced medical incidents becoming the norm. Leadership and staff are empowered to continually increase the quality of life for residents and their families. This is done by reducing non-value-added tasks that burden staff and prevent them from giving residents the appropriate care they require. 

A Centre of Excellence is achieved by implementing a Lean Management System.  This journey involves all stakeholders from nurses and administrators to dietary and care staff, to families and residents. Everyone in the home is brought together to work on a plan to bring about improved conditions for long-term care residents and a renewed sense of fulfillment for healthcare workers.  

How Our Centre of Excellence Model Works 

Our Long-Term Care Center of Excellence model is foundationally created using a “hub and spoke” model. What this means is one home is the Hub or connector / networker with the other LTC community homes within its cluster. This network of homes works together to solve common problems and share ideas and solutions with the other homes. The benefit of this model is that program development is accelerated, staff feel heard and are involved in the solutions and resident care is improved through wider collaboration. The Center of Excellence Home acts as the project manager or collaborator for all the homes in a specific community.  It is also the model of what a high performing home looks like in action.  

Let’s walk you through the process: 

1. The first step is to give your program an identity. Naming it might seem straightforward, but it’s a crucial internal marketing opportunity to build awareness and momentum. A thoughtful name enhances the homes brand and helps achieve buy-in from every level of the staff. Imagine having a name that resonates with the whole team, unites all the quality programs, and is tested and accepted internally before becoming a key part of the communication strategy. 

2. To transform your home, you must have a compelling reason. Change usually occurs because of a burning platform or a compelling vision. When this is known, leadership needs to craft a narrative that genuinely explains clearly why the change is necessary. This narrative will help, especially the leaders, engage everyone in discussions about the value this change will bring to the team and to the residents.  Whether through formal meetings or casual hallway chats, you want everyone to understand the purpose. 

3. To start your Lean journey, it’s important that you assess your strengths and weaknesses. Tools like a Lean Maturity Assessment will help you identify where you stand. From these insights, you’ll be able to draw an organizational roadmap that clearly lays out your focus areas for improvement. 

4. Once your team commits to the Lean Management System, leadership training becomes indispensable. As leaders, you all need to learn project-based techniques and how to lead a Lean organization strategically. Courses like the Executive Green Belt training program are important for those leading impactful change.  You need to identify your leadership team, create standardized materials, and develop an internal lean certification process. 

5. Communication within your organization is paramount. Your communication plan must be comprehensive and sequentially deployed, ensuring everyone is in the loop about the program’s goals, key milestones, and upcoming training. By using various media and focusing on consistency, your leadership can ensure clarity and transparency through the various communication channels. 

6. Having the right infrastructure to support the development of your Centre of Excellence is also essential. Simple yet comprehensive tools and templates like ‘visibility walls’ and ‘daily huddle boards’ will support and sustain the Lean program. Getting these components in place within the first few months is crucial to keeping the team on track. 

7. Leadership’s role is to ensure your program’s structure supports its strategic priorities and complementary quality programs. Leadership should set up a ‘Center of Excellence’ by defining their True North and Break Through Metrics and creating a framework for governance. These steps will guide the quality management focus, with the True North Metric serving as the single foundational measure for the whole team. Break Through Metrics will need to be tailored to specific departments and neighborhoods. 

8. A Lean Management System is vital for developing and maintaining a Center of Excellence (CoE). Staffed by knowledgeable Black Belts, it will oversee the various components, ensuring they are integrated effectively. 

9. Project selection needs to be systematic and aligned with your strategic plan. Your Black Belt who is leading your Centre of Excellence will categorize projects into: 

a. "Just Do It,"  

b. 5S Events,  

c. Kaizen Events, and  

d. larger Rapid Improvement Events 

A decision matrix will help you score and select the right projects, ensuring they meet your  

organizational goals. 

10. Training and mentoring are equally important. Through a structured process, you will identify suitable candidates and provide both in-house and external training to build Lean knowledge. Eventually, you will aim to deliver your own training programs, promoting independence and incorporating your organizational specifics into the curriculum. Mentor support will be crucial to guide your trainees as they apply their skills to each project. 

11. As leaders, you must show commitment through standardized work, setting an example for the organization. This includes participating in quality board huddles, sponsoring projects, and supporting the twenty diamonds. The twenty diamonds are a step-by-step sequenced approach to implementing a Lean management system. 

12. Consistent measurement and tracking of savings and project progress will keep everyone informed and ensure that all gains are monitored. A standardized savings calculator and project tracking process will help the team keep everything on track, addressing any roadblocks promptly.  This method also keeps everyone informed of progress and helps to build buy-in. 

13. Reporting structures will need to be established.  Those assigned will provide regular updates on Lean progress to their leadership. Dashboards will highlight key metrics, project statuses, and Lean facilitator training candidate selection updates, and will support transparency and stakeholder engagement. 

14. Networking both internally and externally with peers will facilitate knowledge sharing and continuous improvement. Establishing regular touch base meetings and in-person networking opportunities for your internal network, while relationships with other organizations will provide valuable external insights.

15. Finally, having a sensei or advisor who has "been there, done that" would be invaluable. This external advisory role will continue guiding, as needed, through the early stages of Lean implementation and provides ongoing strategic advice, ensuring the Lean Management System remains robust and evolves effectively. 

By approaching this as a complete team, naming the program, establishing the reasons for change, assessing your starting point, investing in leadership training, ensuring robust communication, completing meaningful projects, and setting up essential infrastructure, the team can successfully navigate this transformative journey.  

Timing: 

Creating a Long-Term care Center of Excellence typically takes eighteen to twenty-four months. The timeline is the same regardless of the size of the home.  

Creating this level of sweeping change, staff engagement, and family and resident involvement is a dramatic change to normal operations that will reap significant results.  As you focus on consistency of messaging and determine your compelling vision of ‘resident focused care’ improving the standard to a high quality of life, you will find the quality management infrastructure, perspective and methodology will lead to new thinking as “the new way we do business”.  

Need Help? 

Our lean and healthcare experience is a driving force in developing and executing models that demand results and create value for our stakeholders by meeting their goals.  If you want to lead the charge in achieving excellence for your home, enhance your team’s working environment, improve the quality of care for your residents and support your long-term care community > let us help you get started.