“…a long-term care home is primarily the home of its residents and is to be operated so that it is a place where they may live with dignity and in security, safety and comfort and have their physical, psychological, social, spiritual and cultural needs adequately met.” 

~ Part 1, Fundamental Principle and Interpretation of the Fixing Long-Term Care Act


In recent years, the long-term care (LTC) sector in Canada has seen its fair share of scandals, public inquiries, and subsequent task forces with recommendations on how to improve conditions to enhance resident safety and quality of life. 

In 2020, the sector suffered a serious blow – the number of deaths in long-term care homes during COVID-19 was unprecedented, triggering Canadian Armed Forces staff to be deployed to some LTC homes to provide much-needed medical support. In Canada, LTC residents accounted for 3 percent of all COVID-19 cases and 43 percent of COVID-19 deaths. The pandemic highlighted systemic shortcomings in the delivery of long-term care that had been in place well before the first wave hit. 

Public Inquiry in Long-Term Care Home System 

In 2017, long before COVID was dominating the headlines, a Public Inquiry into the Safety and Security of Residents in the Long-Term Care Homes System was established as a response to the conviction of Elizabeth Wettlaufer, a nurse who intentionally injected residents in her care with overdoses of insulin, resulting in the death of eight seniors. 

The Commission’s mandate was to inquire into the events that led to the offences, as well as the circumstances and contributing factors that allowed the tragedy to happen. The overarching goal of the inquiry was to reinstate the public’s trust in Ontario’s long-term care system, as well as make recommendations on how to avoid similar tragedies in the future. 

The report, delivered in 2019, included a staggering 91 recommendations, suggesting the problem was systemic and emphasizing an improved medication management framework to keep residents in long-term care homes safe. In particular, the report suggested analyzing medication incidents and adverse drug events through a standardized and rigorous incident analysis framework. 

Furthermore, one of the Commission’s recommendations is to cultivate a “just culture” environment in long term-care homes, where human error is dealt with openly rather than punitively. This is an important step in acknowledging that culture plays an essential role in patient safety and medication error prevention. Reporting medication errors and near-miss events should be a continuous learning experience, not a blame exercise. 

To date, 31 recommendations from the report have been implemented, and another 44 are underway. In March 2021, the Ontario government announced that it would provide up to $77 million to help long-term care homes adopt technology to strengthen medication safety. The three-year Medication Safety Technology program will provide supplementary funding to help long-term care homes acquire technologies that can enhance the safety and security of their medication management.

How Pharmapod strengthens medication management through digital technologies for long-term care 

The first step in cultivating a “just culture” is leveraging data insights from measurements to improve current systems and  processes. Health information technologies in long-term care homes are shown to contribute to reductions in adverse drug events caused by medication errors, while effectively supporting safety in care settings. Furthermore, the implementation of simple digital technologies does not increase the time nurses spend on medication rounds. 

One way to keep your residents safe is by identifying systemic issues, enhancing internal processes and having a robust, yet easy-to-use system to measure, monitor and analyze medication incidents and near-miss events.

Pharmapod’s cloud-based solution makes it simple for care home and pharmacy teams to monitor the quality of their medication management system practices, proactively identify areas of potential risk, collaborate across sectors, and implement action plans to improve safety and quality in both care home and pharmacy practice.

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Learn how the Pharmapod platform can improve resident safety and medication management in your long-term care home – book your demo today

Related: Learn more about common causes of medication errors and how regular reporting of incidents and near-miss events can improve patient safety. Watch our on-demand webinar, Mission Impossible: Can Reporting Medication Incidents and Learning from Data be Easier?


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