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The Problem

Nursing homes play an increasingly vital role within the health care continuum. Over 200,000 Canadians currently reside in long-term care (LTC) homes and an additional 400,000 residents will likely require LTC beds by 2038. However, despite the increasing frailty of LTC residents over the past 20 years, the quality of care delivered to residents has remained inconsistent and sub-optimal across North America. Challenges facing medical staff in long-term care, which may include limited training, limited time to devote to residents, limited supply of geriatric specialists and general dissatisfaction with the system or remuneration model, contribute to these inconsistencies at the cost of residents' well-being.

The Question

We are conducting a study that examines staff organization within nursing homes, including: physician staff, nursing staff, and personal support workers. We hope to understand opportunities and gaps in existing care models.

Our Approach

We are describing nursing home staff organization and culture in Canada by administering practice surveys to medical directors, nursing directors, and attending physicians, using Schlegel Villages as a sample.

Quality of care outcomes are measured, including unplanned emergency department visits and practice sensitive quality care indicators.

Using these results, we will inform policy-makers and best-practice guidelines on dedicated medical staff models in nursing homes in Canada.

Our Team

Team Leads

Andrew Costa, PhD | McMaster University
Emma Scotchmer, MD Candidate | McMaster University


Graham Campbell, MA | McMaster University
Meaghan Davey, MSc | McMaster University
Kelsey Ambrose, BSc Candidate | University of Waterloo
George Heckman, MMath, MD | University of Waterloo
Paul Katz, MD, CMD | Florida State University College of Medicine
Veronique Boscart, RN, PhD | Conestoga College
Jurgis Karuza, PhD | University of Rochester