Patient Centered Measurement: The Office of the Seniors Advocate’s (OSA) Long-Term Care (LTC) 2016/17 Survey

Description

The 2016/17 Office of the Seniors Advocate’s (OSA) Long-Term Residential Care Survey asked residents and their most frequent visitors about their health-related quality of life and their experiences with the quality of the care and services received as a resident in one of 292 long-term care facilities in BC.

The survey was piloted in May and June 2016 and was in field from September 2016 to September 2017. The survey was completed by 9812 residents and 10049 most frequent visitors (MFVs) of residents as a matched sample.

The Survey included items from the following Patient Experience Reported Measures (PREMs) and Patient Outcome Reported Measures (PROMs).

View a video presentation on these data below:

PREMs

• Topics include: Personal Control, Social Life, Staff Responsiveness, Caring Staff, Food, Hand Hygiene, Physician Care, Medications, Physical Environment, Health and Well-Being, Family Council, Overall Experience.

• Two versions:

  • interRAI Long-Term Care Resident Quality of Life Survey (103 questions)
  • interRAI LTC Family Survey (104 questions)
• “Made-in-BC” Questions & Modules

PROMs

• Veteran’s Rand 12 (VR-12) Item Health Survey and Long-Term Residential Care Version (VR-12LTRC)
  • Includes 12 items that can be scored to provide measures of physical and mental health status as well as 8 health domains: general health perceptions, physical functioning, role limitations due to physical problems, role limitations due to emotional problems, bodily pain, energy-fatigue, social functioning, and mental health.
  • A Long-Term Residential Care version of the generic VR-12 was tested for the OSA’s survey via in a side by side study.

Inclusions

• The 2016/17 OSA Long-term Residential Care survey was conducted through two processes for the residents and most frequent visitors’ survey.

• Five health authorities in BC provide residential care services to primarily frail older adults with or without cognitive impairment through both health authority owned and operated locations and contracted care facilities that operate either as not for profit or for profit. All locations in British Columbia with publicly funded beds were included in the OSA’s survey.
• Comment boxes were placed at the end of each section of the questionnaire for trained volunteers to record any additional comments the residents made during the interview. Residents and MFV was also asked to respond to the question at the end of the survey, “Is there anything else you would like to tell us about your experience living here?”
• For the purposes of the 2016/17 OSA Long-term Residential Care survey, opentext comments were transcribed verbatim for the resident survey completed in person and were entered exactly as written for the MFV mail or online survey. All comments appear verbatim in the data set, with no corrections for grammar or content, although any personal identifiers are masked (XXXX). The survey vendor then coded each comment into predefined themes (e.g., Privacy, Food/Meal, Comfort, Autonomy, Respect, Activities, Safety). For each theme, valence codes were assigned depending on whether the theme-specific comment was positive, negative, neutral, or both positive and negative.
• Open-text comments serve as a rich source of qualitative data to compliment the quantitative results of the survey. Open-text comments can be used to illustrate the human face of the data, to provide additional insight into what the survey results are demonstrating, and to point to areas not addressed in the survey that may be important to patients.

Exclusions

TBC

Quality/accuracy of information/field coding source

• The 2016/17 OSA Long-term Residential Care survey was conducted through two processes, 1) for the residents and 2) most frequent visitors’ survey. Trained volunteers completed an in-person interview with residents and most frequent visitors completed a mail-in or online survey. 
• The overall response rate for the 2016/17 OSA Long-term Residential Care Resident survey was 44.6%.
• The overall response rate for the 2016/17 OSA Long-term Residential Care Most Frequent Visitor survey was 48.8%.

• Further information on the response rate and margin of error are available in the OSA Long-Term Care Survey 2016-17 HealthIdeas Toolkit for Data Users.

Important additional information

• Since 2003, the BC Patient-Centred Working Group (PCMWG) has led BC's strategy for patient-centred measurement, using scientifically rigorous survey instruments that give people who use BC's health care services the opportunity to assess the quality and safety of the health care system from their perspective. Patients’ self-reports of their experiences (and more recently, since 2016, their health related quality of life/health care outcomes) are solicited using PREMS (patient reported experience measures) and PROMS (patient reported outcome measures).
• To date, province-wide coordinated sector surveys have been conducted in the Emergency Department sector, Long Term Care sector, Acute (inpatient) sector, Outpatient Cancer Care sector, and Mental Health and Substance Use sector. The results of past surveys are publicly available. These are large scale surveys with all locations where services are provided in BC included.
• The release of the Acute Inpatient 2016/17 survey is the first time researchers will have access to the results of the PCM surveys conducted between 2003 and 2018. The "raw" survey data will be available via Population Data BC to conduct secondary analyses and inform patient-oriented research. Data from the Acute IP 2016/17 survey has been released first, followed by data from the Emergency Department 2018 survey. The release of data from each sector will occur in conjunction with the availability of support materials.
• The Office of PCM wants to support researchers who are interested in exploring and using the PCM data. Researchers may contact Ben Chou at: bchou@providencehealth.bc.ca with questions, or if interested in receiving more information.

Data collection process

For the OSA Long-Term Care 2016/17 survey, data was collected via the following process:

Data submission: HAs/affiliates sent residents records and lists of identified MFVs to the data collection vendor, NRC Health. NRC Health prepared a list of eligible residents for trained volunteers to conduct survey interviews with residents. MFV was sent a survey package with the option to complete the survey on paper or online. A census approach was used for the eligible residents and their MFV. The total population of LTC residents approached for an interview was 22,162 across 292 care homes in the province. The number of completed surveys for the resident survey was 9,812. The number of MFV surveys sent out was 21,334 and the number of returned MFV surveys was 10,049. Interview welcome package: Information required to conduct the interviews were included in a welcome package mailed to each facility. The welcome package contained an introduction letter, resident list, resident survey, and postage paid envelopes.

Further information on the data collection process is available in the OSA Long Term Care 2016-17 HealthIdeas Toolkit for Data Users.

• Survey administration: Notification signage was posted in every facility one month prior to surveying began. Trained volunteer interviewers conducted structured interviews with residents in the long-term care homes using standardized scripts and prompts. MFV completed the survey on paper or online.
• Data Collection: Survey responses were entered into a secure database and collated by the survey vendor.

Additional resources

• OSA Long-Term Care Survey 2016-17 CheatSheet
• OSA Long-Term Care Survey 2016-17 Data Users Guide
• OSA Long-Term Care Survey 2016-17 Technical Report
• OSA Long-Term Care Survey 2016-17 HealthIdeas Toolkit for Data Users

If you have a question about the data or metadata, please contact Benedito Chou at: beneditochou@gmail.com or Rob Cowan-Douglas at: rob.cowandouglas@gov.bc.ca