Grant: Doctoral Research Award: Canada Graduate Scholarships

Although the global COVID-19 pandemic has disproportionately affected the health of older adults, Canada's long-term care (LTC) sector has been particularly hard hit. Nearly 70% of COVID-19-related deaths in Canada have occurred in LTC homes and retirement home residences compared to the international average of 41%. Although it might appear that quality of care during the pandemic impacted this tragic outcome, the reality is that poor quality care has challenged Canadian LTC homes for decades. How care is organized and delivered - the model of care delivery (MoCD) - directly affects LTC residents' quality of life and quality of care they receive. Canada is in urgent need of extensive LTC MoCD reform for one of our most vulnerable populations-frail seniors with complex needs. The first phase of this realist methods study, a realist review, will be used to systematically gather evidence about the characteristics of Canadian LTC homes associated with improved resident quality of life and safe, quality care delivery. The phase one outcome will be a testable, hypothetical LTC MoCD. The second phase will be a realist evaluation using different data sources, including administrative data and interviews, to test the hypothetical MoCD in LTC settings in Canada. The final outcome will be a tested, refined MoCD to serve as a standard for Canadian LTC homes. From the inception of the study to its conclusion, key knowledge users will be integrated into every phase of the research (using integrated knowledge translation methods). Key knowledge users will include healthcare leaders, healthcare staff, residents, and family members. An advisory group of these key knowledge users will be integral to insuring uptake, application and sustainability of outcomes for this study. Planned knowledge translation deliverables include a co-designed toolkit for knowledge users, evidence briefs and scholarly publications and conference presentations.