Evaluation of a Regional Behavioural Support Program

Abstract

Background: Persons living with dementia may often present with responsive behaviours. Behavioural Supports Ontario (BSO) is a provincial initiative to enhance supports and services for persons living with responsive behaviours in acute care, long-term care and community care settings. Long-term care (LTC) settings use one of three BSO models, including two mobile models and one embedded model, depending on the regional health authority. A survey by Grouchy et al (2017) found the embedded model to be the most preferred in terms of service provision and impact on quality of care. The Waterloo Wellington region of Ontario uses the embedded model; however, it is unclear whether this is adequately meeting the needs of LTC residents and staff, and therefore an evaluation of program outcomes was conducted.

Methods: Guided by principles of Utilization-Focused Evaluation (Patton, 2008) and Appreciative Inquiry (Cooperrider & Whitney, 2001), an evaluation of the BSO program was conducted in consultation with BSO members from the regional health authority, family caregivers, and other LTC staff members. The evaluation utilized qualitative (individual and focus group interviews) and quantitative (survey) methods. Areas of focus included service delivery elements related to: 1) collaboration and coordination of healthcare providers; 2) importance of program outcomes; and 3) self-perceived performance of program outcomes.

Results: Qualitative interviews revealed themes related to current challenges in the LTC setting, and future directions that are important to consider for the success of the BSO program in the Waterloo Wellington region. A series of program outcomes were also identified throughout these interviews, and rated based on level of importance and performance in a quantitative survey. Generally, program outcomes were rated consistently across importance and performance by participants; however, some discrepancies could be observed.

Discussion: Aside from the work done by Grouchy et al (2017) and by Gutmanis et al (2015), there are little data available on the impact of the BSO program. This evaluation helps to fill this gap by looking at successful indicators of the program and determining which components of the embedded BSO model are most important as well as the self-reported ratings of level of performance of each of these outcomes in the LTC homes. These findings may be helpful for regions developing similar programs as well as to direct key areas of focus for future program enhancement.