Bruyère Continuing Care
Bruyère Continuing Care provides a wide range of vital programs and services, and specializes in compassionate health care for some of the most vulnerable people in the community: the elderly, people with chronic and terminal illness. Founded in 1845 by Mother Élisabeth Bruyère, the organization has earned great recognition for being the champion of the aging population and those requiring continuing care.
In a bilingual and caring environment, Bruyère provides holistic care based on their values of respect, collaboration, accountability, learning and compassion. Rather than simply treating a disease or injury, they focus on inclusive care that encompasses both a patient’s medical and human needs. Bruyère achieves this by providing compassionate and quality care through their ongoing commitment to advancing teaching, education and research. They have long term care as well as primary care and care of the elderly programs which range all the way from being able to look after the rehabilitative needs of seniors to help them optimize their level of function and overall quality of life. We enhance lives and transform care.
“While there are certain programs that we are well known for and we work for solutions for vulnerable populations, there are two areas of the environment around us that we’re particularly focusing on which is the increasingly complex need for senior Canadians as well the increasing tendency for patients with multiple chronic conditions that require care that is below the level of care required in an acute care hospital but above the level of care that long-term care or the community is able to provide,” says Bernie Blais, CEO, Bruyère Continuing Care. Bruyere has the array of services that are geared towards finding those solutions with their programs and include: complex continuing care, palliative care , rehabilitation care , care of the elderly , long-term care , research for care and family medicine care .
Housing accommodation of seniors was identified years ago as an area of particular need where the type of accommodation that was available was not necessarily supportive of keeping families together or having multiples types of care available on one campus. Bruyère Continuing Care has developed “Bruyère Village”, a concept that’s an innovative development building with an array of housing options for seniors. Another area that was identified in need of solution focus was in longer complex continuing care environments. Through grants provided by the Canadian Foundation for Healthcare Innovation staff and physicians are working diligently to increase patient engagement.
“At Saint Vincent Hospital we are focused on increasing patient engagement which is innovative and solicits patient input early on in our care processes. We are adapting and customizing the care we provide to each patient,” says Blais.
Bruyère is one of the largest organizations of its kind in Canada. They describe themselves as solution oriented. Everything they do puts the patients first. Overall most patients want to remain independent for as long as possible. With evidence provided by their very own Bruyère Research Institute they are able to customize care for individual patients and get many of them back to the community where they want to be.
“People may end up in institutional care, when other options are available instead,” says Dr. Shaun McGuire.
“Home care has grown exponentially in the last 10-15 years but that wasn’t the case before. We’ve realized that a lot of seniors can continue to live independently with some support.”
The “Bruyere Village” was built to meet an emerging need with our growing senior’s population. It has been a major investment for Bruyere, having 227 beds; 78 for living independently and 149 are in assisted living.
“This is a solution that’s quite practical and in partnership with the City of Ottawa that provides subsidized housing for 48 of these units for seniors on a fixed income or who live in poverty,” says Dr. McGuire.
Bruyère is presently involved in a major study, called the Canadian Longitudinal Study on Aging, funded by the government with 10 other research hospitals across the country. They are doing a 20 year study involving about 50,000 individuals between the ages of 45 and 85. “Each site also has highly specialized labs and equipment that’s been funded to assess the aging of these groups,” says Blais. “If you want to get ahead of the curve, you have to start analyzing what interventions have the greatest impact and what we can do sooner.”
All of Bruyère’s patient care units have unit based quality teams. To support those teams, they have developed and trained “Quality Improvement Facilitators” through a partnership with Health Quality Ontario to be better able to bring their knowledge to the bedside. They have also trained about 20 “Lean Six Sigma Green and Yellow Belts” through a partnership with Algonquin College. Care at Bruyère is provided by a multitude of different therapeutic disciplines and different regulated health professions.
“The emphasis is weighted towards the team helping patients to regain as much of their level of quality of life as possible,” says Dr. McGuire.
“Like other hospitals, we have information systems that provide us with metrics or score cards which are an important first step, to understand how we’re doing. Bruyère uses this feedback to make substantive changes that impact how patients perceive their quality of care.
Over the past decade, more patients that are in the acute care environment are coming out with multiple chronic conditions that require care.
Part of Bruyère’s current strategic focus, is looking at the inpatient environment for the complex continuing care.
“We’ve developed particular programs overtime to look after some these complicated patient needs, where it is not a question of one particular illness grouping that’s affecting a patient,” says Blais.
Bruyère has initiated the research concept of “rapid review”. They are able to capitalize on the power inherent in having an attached research institute to review things for best practice by instilling the information and bringing it to the bedside as quickly as possible. “Giving a greater voice to the patients is the primary vehicle of communication and collaboration for the team and reflects patient and family input,” says Blais.
Bruyère is anticipating that there is going to be continuing pressure to develop programs not just for specific populations around rehabilitation like seniors but for more generalized patients who are impacted by other chronic conditions.
“The shift for Bruyère for the coming 5 years is exponential. There will be a need to help patients who have an acute care event and multiple chronic complexities. Our goal is to help them get to a care environment as close to home as possible,” says Dr. McGuire. “We need to develop the care capacity for a variety of patient populations coming through our doors.”
Historically, the long term care sector has never had specialized services as most conditions were dealt with in acute care. Since Bruyère is known for specialization in complex populations, in November 2013, Bruyère established a partnership with The Ottawa Hospital; the majority, 92% of Bruyère’s patients is coming from there.
Bruyère is one of only three “Centers of Learning, Research and Innovation” in long term care in Ontario.
This provides Bruyère with an incredible opportunity to be a center of excellence focusing on a series of initiatives in this area to explore solutions they can offer to enhance the quality of life for individuals in long term care.
“This is an area we are doing well in and we share information with our counterparts across the country. The Bruyère research institute is the corner stone of everything we do and we look to them for solutions.”
Bruyère being a teaching and research hospital certainly drives innovation, as there is a high degree of expectation from future practitioners that come from universities. “They always keep us in check with the questions they ask,” says Dr. McGuire. The academic environment itself is a constant reflection and encourages dialogue around how training becomes an integral part of academic development.
“Being academic isn’t just teaching, it’s also research,” says Blais. “It’s about knowing what questions to ask as there has been an explosion in healthcare knowledge and information. It becomes more difficult for practitioners to necessarily know everything about everything all the time.
It’s a vital as a supporting tool to have an infrastructure in place that helps us stay on top of this information pragmatically that we can use on a daily basis.”
By 2031, the seniors’ population, those 65 years of age and over will more than double to over 10 million.
Given that life expectancy will be prolonged, part of Bruyère’s objectives is to be leaders in “care closer to home”. Technology offers us one of the greatest opportunities to help support and sustain care in their own communities and homes, says Blais. “Ongoing, we are also assessing emerging technologies such as virtual rehabilitation or virtual treatment.” There is an inevitability and realization that Bruyère’s services are much needed. The community knows and responds to Bruyère in its support to insure it remains a strong and vibrant community.