Table 1 Description of systems level research projects

1. Health Human Resources Forecasting Model

- Approximately three-quarters of direct care staff in Ontario’s long-term care (LTC) sector are Personal Support Workers (PSWs) - Despite their importance, relatively little is known about them

To create a dynamic forecasting model to outline the current and future use of PSWs and nurses in the LTC sector

- Through three phases, build and validate a forecasting model that brings together demand and supply data for PSWs and nurses

Phase 1: 2014 Phase 2: 2015 Phase 3: 2015–2017 (Ongoing)

- Knowing how many nurses and PSWs will be required, as well as the projected supply, will assist provincial planning

2. Improving Wait Times and Transitions in Care

- Concern about the huge (alternate level care) numbers of patients in hospitals - Backlogs exist while patients wait in one facility for a bed to become available in another facility

To provide a queuing model that maps how patients move through a network of post-acute services (including LTC) in order to better understand the necessary capacity at each node in the network

- Development of a network queuing model with blocking, development of a simulation model, comparison of the simulation results with current performance metrics, optimisation and testing of the model

2013–2015

- Provide insight as to the average build-up of clients waiting at each facility and what alternative facility they are seeking to enter - Determine optimal capacity and resource allocation for the various facilities that minimises blocking at each stage

3. Understanding Health Care Use and Cost for LTC and End-of-Life

- Better understanding of the major population drivers of LTC admissions and outcomes, as well as the cost drivers for LTC services required

To examine factors that influence healthcare use and cost, and reporting on indicators that measure the performance of the healthcare system at the end‐of‐life and in LTC

- A retrospective, 12-month analysis of several variables for all deaths in Ontario in 2011 and 2012 (177,817 deaths)

2013–2015

- Understand the role of socio-demographic variables, co-morbidity, health system variables and acute healthcare events on healthcare use and costs at the end-of-life and in LTC

4. Specialised Units in LTC Homes

- Despite the potential of Specialised Units and the well-documented gaps in the current care system, the number of designated Specialised Units remains low

To create a toolkit for LTC Homes interested in establishing a Specialised Unit; explore capacity planning aspects of LTC Specialised Units in Ontario; and assist interested LTC Homes with their application for a Specialised Unit

- Review existing literature and other information on providing specialised care to LTC residents - Province-wide consultation with stakeholders about their experience with Specialised Units

2014–2017 (Data analysis ongoing)

- Better understanding of the facilitators and challenges for Specialised Units - Multi-stakeholder toolkit to support the designation process

5. Framework for Case Costing in Long-Term Care

- Case costing is critical to plan for efficient models of care delivery and for decision-making; although it is common in other healthcare sectors, it is not practiced in LTC

To develop a case costing framework for the LTC sector and to generate an approximation of resident-specific costs in two LTC homes

- As a first step, review the literature to identify (1) case costing frameworks in LTC and/or other sectors, and (2) nursing workload proxies for LTC; consult with experts in the field

2013–2015

- Enhanced decision-making for resource allocation and staffing based on the actual resource requirements by residents, not purely based on historical staffing models