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Clear supported long-term care homes in BC to provide person-centred care for residents with the behavioural and psychological symptoms of dementia (BPSD).

Clear was a clinical quality improvement initiative guided by Choosing Wisely’s recommendation on using antipsychotic medications to treat BPSD in cases where nonpharmacologic measures have failed, and where the symptoms either cause significant suffering, distress and/or pose an imminent threat to the patient or others.

Wave 3 supported care homes across the province whose use of antipsychotics (without a diagnosis of psychosis) is higher than the BC average of 25%. This included both affiliated and health authority owned-and-operated care homes and represents the most care homes to ever participate in Clear.

Participating care homes worked together with other teams, our Clear team, clinical faculty, guest speakers and care homes that previously participated in Clear.

The initiative began in December 2017 with a series of leadership preparation webinars to help clinical leaders and directors of care build their Action & Improvement Teams. Five regional Kick-Off Workshops in the Spring of 2018 and five Regional Workshops in the Fall of 2018 brought the teams together to connect and share learning. Regular monthly webinars provided education and tools to support emergent challenges. Clear Wave 3 ended May 2019.

Clear Resources

Wave 3 Technical Report

This technical report outlines in detail the evaluation results of Wave 3 which spanned from December 2017 to May 2019.

Download the Report

Wave 3 Summary Report

The aim of Clear Wave 3 was to reduce the rate of antipsychotic use in residents without a diagnosis of psychosis from baseline to the national average by April 30, 2019. 33 participating care homes across BC completed the collaborative. This summary report contains an overview of the evaluation results from Wave 3 which spanned from December 2017 to May 2019.

Download the Report

Wave 3 Resource Page

We’ve developed and gathered a number of resources to help Clear’s Action & Improvement teams, in a new and revamped Resources Page for Teams, Physicians and Families & Caregivers.

See and download all of the resources

Wave 2 Report

Forty care homes participated in Wave 2 of Clear, from September 2015 through December 2016. Collectively, they made a tremendous impact – reducing or discontinuing antipsychotics prescriptions for 1,001 residents.

These results – and many more – are captured in a commissioned evaluation of Wave 2.

Download the report

Clear Faculty were clinical experts from throughout the province who have knowledge and expertise in many aspects of this initiative. They provided expert advice, coaching and mentorship to participating teams. This was done in several ways: local workshops, provincial webinars, email and team or individual calls.

Anita Wahl, Clinical Nurse Specialist, Fraser Health
Ann Marie Leijen, Consultant, Rebalance Rehab
Ashok Krishnamoorthy, Geriatric Psychiatrist, Vancouver Coastal Health
Carol Ward, Geriatric Psychiatrist, Interior Health
Dacia Reid, Manager Program Practice and Education, Island Health
Jasjit Gill, PIECES Representative and Educator, Vancouver Coastal Health
Johanna Trimble, Patient Partner, Patient Voices Network
Judy Macdonald, Clinical Pharmacist
Katharine McKeen, Family Physician (Victoria)
Marcia Bertschi, Quality Advisor, Northern Health
Zainab Diesta, Director of Care, George Derby Centre

The Partnership Alliance represents key stakeholders in the field of dementia care, who provided overall guidance to Clear and identify opportunities for alignment between partners and Clear.

Alzheimer’s Society of BC
BC Care Providers Association
BC College of Family Physicians
BC Psychogeriatric Association
College of Pharmacists of BC
Denominational Health Association
Division of Geriatric Psychiatry at UBC
Ministry of Health
Office of the Seniors Advocate
Public Guardians and Trustee of BC
SafeCare BC
Worksafe BC

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CLEAR Wave 3 Technical Report

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  1. Adjusted rate for potentially inappropriate use of antipsychotics in long-term care, 2016-17 Q4. Source: Canadian Institute for Health Information