Impact of the single site order in LTC: exacerbation of an overburdened system
Abstract Background The long-term care (LTC) sector has been at the epicentre of COVID-19 in Canada. This study aimed to understand the impact that the Single Site Order (SSO) had on staff and leadership in four LTC homes in the Lower Mainland of British Columbia, Canada. Methods A mixed method stud...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09670-7 |
| _version_ | 1797795760837754880 |
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| author | Farinaz Havaei Joanie Sims-Gould Sabina Staempfli Thea Franke Minjeong Park Andy Ma Megan Kaulius |
| author_facet | Farinaz Havaei Joanie Sims-Gould Sabina Staempfli Thea Franke Minjeong Park Andy Ma Megan Kaulius |
| author_sort | Farinaz Havaei |
| collection | DOAJ |
| description | Abstract Background The long-term care (LTC) sector has been at the epicentre of COVID-19 in Canada. This study aimed to understand the impact that the Single Site Order (SSO) had on staff and leadership in four LTC homes in the Lower Mainland of British Columbia, Canada. Methods A mixed method study was conducted by analyzing administrative staffing data. Overtime, turnover, and job vacancy data were extracted and analyzed from four quarters before (April 2019 – March 2020) and four quarters during the pandemic (April 2020 – March 2021) using scatterplots and two-part linear trendlines across total direct care nursing staff and by designation (i.e., registered nurses (RNs), licenced practical nurses (LPNs) and care aids (CAs)). Virtual interviews were conducted with a purposive sample of leadership (10) and staff (18) from each of the four partner care homes (n = 28). Transcripts were analyzed in NVivo 12 using thematic analysis. Results Quantitative data indicated that the total overtime rate increased from before to during the pandemic, with RNs demonstrating the steepest rate increase. Additionally, while rates of voluntary turnover showed an upward trend before the pandemic for all direct care nursing staff, the rate for LPNs and, most drastically, for RNs was higher during the pandemic, while this rate decreased for CAs. Qualitative analysis identified two main themes and sub-themes: (1) overtime (loss of staff, mental health, and sick leave) and (2) staff turnover (the need to train new staff, and gender/race) as the most notable impacts associated with the SSO. Conclusions The results of this study indicate that the outcomes due to COVID-19 and the SSO are not equal across nursing designations, with the RN shortage in the LTC sector highly evident. Quantitative and qualitative data underscore the substantial impact the pandemic and associated policies have on the LTC sector, namely, that staff are over-worked and care homes are understaffed. |
| first_indexed | 2024-03-13T03:22:54Z |
| format | Article |
| id | doaj.art-19200206df0241cfa1d1fb8233601acc |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-13T03:22:54Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-19200206df0241cfa1d1fb8233601acc2023-06-25T11:12:47ZengBMCBMC Health Services Research1472-69632023-06-0123111310.1186/s12913-023-09670-7Impact of the single site order in LTC: exacerbation of an overburdened systemFarinaz Havaei0Joanie Sims-Gould1Sabina Staempfli2Thea Franke3Minjeong Park4Andy Ma5Megan Kaulius6School of Nursing, University of British ColumbiaCenter for Hip Health and Mobility, University of British ColumbiaSchool of Nursing, University of British ColumbiaCenter for Hip Health and Mobility, University of British ColumbiaSimon Fraser University, 8888 University DrSchool of Nursing, University of British ColumbiaSchool of Nursing, University of British ColumbiaAbstract Background The long-term care (LTC) sector has been at the epicentre of COVID-19 in Canada. This study aimed to understand the impact that the Single Site Order (SSO) had on staff and leadership in four LTC homes in the Lower Mainland of British Columbia, Canada. Methods A mixed method study was conducted by analyzing administrative staffing data. Overtime, turnover, and job vacancy data were extracted and analyzed from four quarters before (April 2019 – March 2020) and four quarters during the pandemic (April 2020 – March 2021) using scatterplots and two-part linear trendlines across total direct care nursing staff and by designation (i.e., registered nurses (RNs), licenced practical nurses (LPNs) and care aids (CAs)). Virtual interviews were conducted with a purposive sample of leadership (10) and staff (18) from each of the four partner care homes (n = 28). Transcripts were analyzed in NVivo 12 using thematic analysis. Results Quantitative data indicated that the total overtime rate increased from before to during the pandemic, with RNs demonstrating the steepest rate increase. Additionally, while rates of voluntary turnover showed an upward trend before the pandemic for all direct care nursing staff, the rate for LPNs and, most drastically, for RNs was higher during the pandemic, while this rate decreased for CAs. Qualitative analysis identified two main themes and sub-themes: (1) overtime (loss of staff, mental health, and sick leave) and (2) staff turnover (the need to train new staff, and gender/race) as the most notable impacts associated with the SSO. Conclusions The results of this study indicate that the outcomes due to COVID-19 and the SSO are not equal across nursing designations, with the RN shortage in the LTC sector highly evident. Quantitative and qualitative data underscore the substantial impact the pandemic and associated policies have on the LTC sector, namely, that staff are over-worked and care homes are understaffed.https://doi.org/10.1186/s12913-023-09670-7Single site policyImpactCOVID-19Nursing human resourcesMixed-methods |
| spellingShingle | Farinaz Havaei Joanie Sims-Gould Sabina Staempfli Thea Franke Minjeong Park Andy Ma Megan Kaulius Impact of the single site order in LTC: exacerbation of an overburdened system BMC Health Services Research Single site policy Impact COVID-19 Nursing human resources Mixed-methods |
| title | Impact of the single site order in LTC: exacerbation of an overburdened system |
| title_full | Impact of the single site order in LTC: exacerbation of an overburdened system |
| title_fullStr | Impact of the single site order in LTC: exacerbation of an overburdened system |
| title_full_unstemmed | Impact of the single site order in LTC: exacerbation of an overburdened system |
| title_short | Impact of the single site order in LTC: exacerbation of an overburdened system |
| title_sort | impact of the single site order in ltc exacerbation of an overburdened system |
| topic | Single site policy Impact COVID-19 Nursing human resources Mixed-methods |
| url | https://doi.org/10.1186/s12913-023-09670-7 |
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