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Clear is supporting 50 long-term care homes in BC to provide person-centered care for residents with the behavioural and psychological symptoms of dementia (BPSD).


It is 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 is supporting care homes across the province whose use of antipsychotics (without a diagnosis of psychosis) is higher than the BC average of 25%. This includes both affiliated and health authority owned-and-operated care homes and represents the most care homes to ever participate in Clear. We’re excited to see what they accomplish together!

Each care home that is participating in Clear has an Action & Improvement Team that is leading its work in the initiative. Over the next year they will work together, learning from our 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. We then hosted five regional Kick-Off Workshops that brought the teams together; feedback at the workshops guided the topic for the teams’ first monthly webinar, on physician engagement, which was hosted in March 2018.

Currently the Action & Improvement teams are beginning to collect data, test change ideas, and receive support from our improvement advisors.


Key Resources

Measurement Resources

Clear’s Action and Improvement Teams are collecting data every month as part of their improvement work so that they can learn and understand what change ideas and processes will achieve their aims and bring about improvement. We’ve created a series of resources to help them do so.

Download measurement resources

Wave 3 Resources

We’ve developed and gathered a number of resources to help Clear’s Action & Improvement teams, including:

  • Driver Diagram
  • High Impact Changes
  • Stakeholder Engagement Planning Form
  • PDSA Testing Ideas Worksheet
See and download all of the resources

Webinar Recordings

Action & Improvement Teams attend webinars to learn about topics related to their work, such as communication, physician engagement, and data collection.

View webinar recordings

Wave 2 Report

Recently, 40 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

Follow Clear’s Progress

Registration for Action & Improvement teams is closed, but you can still join as a Supporter to receive its newsletters and access most of its resources.

Faculty & Partnership Alliance

Clear is guided by a Faculty which includes many clinical experts in seniors care and dementia, as well as a Partnership Alliance which ensures Clear aligns with similar initiatives.

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

Anita Wahl, Clinical Nurse Specialist, Fraser Health
Ann Marie Leijen, Director of Care, Cheam Village Care Centre
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, Administrator, New Vista Society

 

The Partnership Alliance represents key stakeholders in the field of dementia care. It provides overall guidance to Clear and identifies 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


References

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

Key Contact

Shari McKeown
Director, Learning & Capability Development
smckeown@bcpsqc.ca