Starting in January 2021, the Government of Alberta collected feedback on the facility-based continuing care system in the province. They received over 7,000 responses to their online survey on the issue.
It then hired MNP, a business advisory firm, to review the feedback and engage with stakeholders, including residents, family members, providers, operators, non-government organizations, experts, and the general public.
MNP compiled all their review into a report, which was released at the end of May. In the report, MNP included feedback on how the various stakeholder groups rated certain aspects of quality life within Alberta’s facility-based continuing care system.
I thought I’d go through that feedback.
For each aspect of that quality of life, stakeholders rated it on a scale of 0 to 10, with 10 being the highest quality.
Here’s the first chart, showing the overall perception of quality of life.
Here, we see administrators rating overall quality of life the highest, at 7.4 out of 10. The next highest rating was from staff who weren’t nurses, professional therapists, or healthcare aides, at 7.2. And the residents themselves gave the third highest rating: 6.9.
External organizations and the general public were tied for the lowest rating: 3.6. This is interesting, as their ratings were significantly lower than that of the other stakeholders. The next lowest was only 5.9, given by families and caregivers.
When you average out ratings among everyone, you end up with 5.9, but if you take out the 2 outliers, the average is actually 6.6.
I’m curious why external organizations and the general public gave such abnormally low ratings.
This time, the residents came in with the 4th highest rating, at 6.3, for the physical facilities. The external organizations and the general public both came in with the lowest ratings again, neither of which hit 4.0. No stakeholder group rated physical facilities higher than a 7.0, unlike the previous graph.
The overall average rating for physical facilities was 5.7, 6.2 if you don’t include the two lowest ratings. That’s a closer spread than we saw in the previous graph.
This graph shows less contrast than the previous charts, but there’s quite a bit more variability, with ratings in the 3’s, 4’s, 5’s, 6’s, and 7’s.
The average rating is 5.7, the first time the residents’ rating came in below the average. In fact, their rating was the third lowest. And if anyone should know about food quality, it’d be the people eating the food.
Security & safety
Again, the external stakeholders have rating significantly different from the internal stakeholders. There are nearly 2 full points between the lowest internal stakeholder group and the highest external stakeholder group.
The average rating of all groups is 6.98, which is lower than all but just one of the internal groups. It jumps to 7.6 when you exclude the two outliers.
Residents come in the middle of the pack with the 5th highest rating. However, this was the area that they gave the highest rating.
Support for families and friends
Another drastic difference between the internal and external stakeholders. The average with the stakeholders was 6.5, yet 6.9 without them.
The resident group was tied for 4th-highest ranking regarding their own connections with family and friends, which is middle of the pack if you include the external stakeholders, which once again, were outlier datapoints.
The average rating of all groups is 6.3, and it increases to 6.9 for just the internal groups.
The residents gave their facility’s ability to support connects with their family and friends a 6.9, the third highest rating. I found it interesting on this particular question that the family stakeholder group rated this metric a 6—such a difference between residents and their families on a metric that ranks their ability to connect with one another.
Relationships with staff
Here’s another chart showing residents coming in at the 5th highest ranking, tied with the professional therapies group at 7.4 out 0f 10. The average rating for all 9 groups is 7.1 and 7.7 for the top 7.
So this one is super interesting. Only 4 out of the 9 are above the 6 mark, and one of those is barely above. The average here is 6.5. If you include the 3 groups who rated dignity above 7, the average rating is only 5.4.
The average of all 9 groups is 6.5 but 7.2 if you exclude the two external stakeholder groups, who gave resident dignity unusually low ratings.
Residents rated their personal dignity a 7.1, the 4th highest rating of all 9 groups. Their families and caregivers were roughly the same, at 7.0.
In this one, residents rated their personal autonomy 7.3, which isn’t surprising given that they rated personal dignity a 7.1. Not only were they the third highest rating of all the stakeholder groups for this aspect, but their rating was the third highest rating they gave to all the aspects (see below).
The average rating for resident autonomy was 5.97, but 6.6 without the two external groups, which one again provided much lower ratings than the 7 internal groups.
Access to internet/technology
In this one, residents actually came in 4th lowest, and even gave technology access the second lowest rating of all the quality of living areas (meals was the lowest).
Surprisingly, external groups and the public gave technology the highest ratings, both tied at 6.8. This time, “other staff” were the ones with the lowest rating, at 3.7.
The average rating was 5.6, which jumped to only 5.9 when excluding the “other staff” outlier. The 5.6 was the lowest average rating of all 10 areas that stakeholders were asked to rank.
Here’s all the ratings from residents in one chart:
The top 3 ratings were for security and safety, relationships with staff, and their own autonomy. The bottom 3 ratings were meals, access to internet and technology, and recreational opportunities.
And here’s how their ratings differed from the average rating for each area:
In most cases, resident ratings were above the stakeholder average. Only 3 areas found residents rating below the average—meals, recreation, and technology–and 2 of those were only 0.1 points away from the average.
The greatest difference below the average was for meals, which was 0.4 less. The greatest difference above the average was for personal autonomy, which was 1.3 more.