Quality Improvement Initiatives at Sunnyside Home

Residents First

Sunnyside Home participates in a provincial initiative that promotes quality improvement within long-term care homes. The vision and mission statements of the Residents First initiative are as follows:

Residents First Vision:

That each resident enjoys safe, effective and responsive care to help them achieve the highest potential of quality of life.

Residents First Mission:

To grow our capacity for quality improvement, so that the quality of each resident's care in Ontario is the best in Canada and comparable to leading jurisdictions the world over.

For more information, please visit the Residents First website:
Residents First


Annual Quality Improvement Plan

Seniors' Services produces an annual Quality Improvement Plan that outlines the projects that will be undertaken to improve the quality of care provided to the residents of Sunnyside Home.

The 2012 Quality Improvement Plan includes actions to address the following focus areas:

  • Preventing falls
  • Preventing pressure ulcers
  • Continence care
  • Supporting continuity of relationship with residents

Public Reporting

The Health Quality Ontario website features quality indicator results for falls, pressure ulcers, incontinence, and restraints for nearly 300 individual long-term care homes - including Sunnyside Home. To view this information, click on the following link:


Sunnyside Home public reporting results and interventions

The following results are displayed on the Quality Ontario LTC Public Reporting website:

Indicator Name1

Risk-Adjusted2 Sunnyside Home April 2009-March 2010

Provincial data March 2010

 Risk-Adjusted Sunnyside Home April 2010-March 2011

Provincial data March 2011

% residents who had a recent fall3





% residents with worsening bladder control





% residents who had a pressure ulcer that recently became worse





% residents with physical restraints 






Notes: 1 All data is self-reported by long-term care homes across the province.
2 Results are risk-adjusted which is a statistical technique to increase the comparability between long-term care homes. For example, if a home that has a higher percentage of frail Residents than other homes they are more likely to have higher rates of falls and incontinence.
3 Percentages for this variable may include falls that happened prior to admission to a long-term care home.
Source: Retrieved on 2012 04 23 from the Health Quality Ontario Website:


Quality Plan Interventions

In order to continuously improve quality of care for the residents, Sunnyside Home has developed interventions to address each of the four quality indicators. The interventions are part of the annual quality plan.


Indicator: Percentage of residents who had a recent fall

In 2011, the Fall Prevention Team had been successful in reducing the number of injuries from falls. The team will build on this success by further decreasing the overall number of falls while promoting independence and dignity.


Two home areas where the number of falls was higher have been selected to review the fall prevention program. The front line staff members, alongside their team leader and manager, have developed strategies to address the number of falls on the two home areas. These include reviewing each resident's foot wear, reviewing resident's involvement in activities, using funding from Behavioural Support Ontario (BSO) to allocate extra PSWs and RNs hours with extra training on predictable behaviours on the two home areas, establishing individualized and practical plans of care, reviewing the fall risk assessment process, and continuing to ensure an interdisciplinary approach to fall prevention.

Indicator: Percentage of residents with worsening bladder control

Sunnyside Home has an established Continence Management Team which will focus this year on residents whose bladder control has worsened and establish individualized toileting plans.


Two home areas have been selected to implement a Continence Management Program. The Continence Management Team will utilize Residents First quality initiatives change packages to initiate changes on the two home areas. This team will analyze root causes and will review Best Practices Guidelines and implement changes. The team will reassess residents with worsening bladder control, develop individualized interventions (e.g. toileting plan, review medications), review their care plans and evaluate interventions.

Indicator: Percentage of residents who had a pressure ulcer that recently became worse

The Skin and Wound Team will continue to work diligently in the prevention and treatment of pressure ulcers based on Best Practices Guidelines. The percentage of pressure ulcers that have recently gotten worse indicates residents who were identified with stage 2 to 4 pressure ulcers on one or more previous assessments and whose pressure ulcers have worsened over a three-month period. A pressure ulcer refers to an area of the skin that breaks down when constant pressure is placed against the skin.


Sunnyside Home will maintain the established interdisciplinary Wound Care Team and will continue to ensure weekly wound assessment by registered staff. Sunnyside Home will continue to offer education for in-house wound care nurses on prevention and treatment of pressure ulcers.

Indicator: Percentage of residents who were physically restrained

At Sunnyside Home, the only devices that are classified as physical restraints are lap belts, tilt chairs, recliner chairs, bed rails and table tops. A physical restraint is any device that restricts or prevents movement and cannot easily be removed by the resident. The use of a tilt chair, lap belt or table top is occasionally prescribed to a resident to maintain proper positioning, to promote comfort and to promote independence (e.g. use of a table top for activities or meals).


One home area has been selected to assess, develop and initiate changes using Residents First tools and resources. All residents will then be reassessed by the interdisciplinary team to ensure the proper use of a device that could have a restraining effect. Sunnyside will provide education opportunities to all staff, residents and family on restraint use. Sunnyside has also purchased new 1/4 sized bed rails that will allow the residents to use the bed rail for self-positioning without having a restraining effect. The Sunnyside team will be installing these new bed rails based on the individual needs of the residents.

For more information on any of the items listed on this page, please contact Marie Bélanger, Coordinator Quality and Risk Management, Seniors' Services at 519-893-8494 ext.6336.