Determinants of Quality in Ontario LTC Homes (2011-2014)

Walter P. Wodchis (PI), Tim Burns (Co-PI; MOHLTC), Ben Chan (Co-PI; HQO)

NEWProvincial Report - [PDF] on staff perceptions of their home's leadership practices, supervisory support, involvement in planning and practice and more!

Team Members - 2012
U of T Whitney Berta, Katherine McGilton, Kevin Walker
HQO Michelle Rey, Gail Dobell, Stephanie Soo
MOHLTC     Karen Slater
OANHSS Dan Buchanan
OLTCA Paula Neves
SHKN Larry Chambers
OARC Donna Fairley
Concerned Friends Phyllis Hymmen


What is being done to improve quality in Ontario LTC Homes?

Ontario is active in both regulatory and Quality Improvement (QI) approaches to improving quality of LTC:

  • The provincial government enacted the Long-Term Care Homes Act, 2007 that came into full force July 1, 2010.
  • Health Quality Ontario (HQO) has initiated a QI initiative called Residents First. They have also started Public Reporting of LTC quality outcomes.

Will these new initiatives improve quality in Ontario LTC Homes?

It is predicted that Homes will make changes in response to these three initiatives, an impact first felt by staff and resulting in improved resident outcomes. A research partnership, among the Seniors Health Knowledge Network (SHKN), the Ontario Association for Non-Profit Homes and Services for Seniors (OANHSS), the Ontario Long Term Care Association (OLTCA), the Ontario Association of Residents’ Councils (OARC), Concerned Friends of Ontario Citizens in Care Facilities, HQO and researchers at the University of Toronto, has embarked on a province-wide research project to explore the impacts of these new initiatives. Our study will measure changes in LTC Home leadership, support to staff and staff involvement in quality improvement and then evaluate the impact on resident clinical outcomes.

What does the research project involve?

The project is called “The Determinants of Quality in Ontario LTC Homes”. All homes will be asked to outline how they are dealing with the new initiatives. Data collection took place between November 2011 and December 2012.

  • Staff surveys were used to measure leadership practices, supervisory support, involvement in QI initiatives and the staff work experience. More than 15,000 staff members from 418 LTC Homes across the province returned surveys.
  • Administrators and Directors of Care from all of Ontario’s LTC Homes were asked to contribute by responding to an online survey about their Home’s QI activities, the availability of supports for QI activities and their need for additional supports. We will also be interviewing LTC Home leaders to understand how they are changing the way that they operate Homes.

Why is this study important?

  • This project will provide new information on the impact of regulation and QI affecting over 80,000 residents in Ontario LTC. Decision makers in Ontario will use this new information for public reporting and program evaluation purposes.
  • Participating homes have received their aggregate score from the staff survey compared to provincial and market benchmarks along with an interpretive commentary.

Study Announcement

You can share with colleagues, a copy of the Study Announcement - [PDF].

Staff Surveys

The Staff Survey - [PDF] is available for download, as is the Provincial Report - [PDF] detailing results from more than 15,000 staff from 418 LTC Homes.

Administrator and Director of Care Surveys

The Administrator - [PDF] and Director of Care - [PDF] surveys are available for download.

Previous Research on the Determinants of Quality

A similarly named research project was conducted by this research team from 2007-2010. This previous research examined the impact of internal staff supports on the quality of LTC.

For more information

A more detailed synopsis of the study can be found in the Grant Summary - [PDF].

If you have any questions or require additional information, please contact our research team at: ltcsurvey@utoronto.ca.

Funding and Partnerships




HPME  Health Quality Ontario
 OANHSS OLTCA  SHKN 
 Concerned Friend's OARC  CIHR