Help Me Cope and Make It Easier: A Perspective from Community Nursing.

SE Health is one of Canada's largest social enterprises, providing home and community care to Canadians since 1908. The organization's 8,000 staff make 18,000 contacts with people in their homes, per day, to deliver healthcare services. Registered nurses and registered practical nurses provide assessments and treatments and support patients and their families to remain healthy, stay safe at home, self-manage and be independent.

Commentary: Patient Safety in the Home.

In 2018, SE Health (formerly Saint Elizabeth Health Care) delivered care and support to more than 500,000 people when and where they needed it. We delivered many of these health services to Canadians in their own homes, supporting independent living and freeing up hospital beds for acute care needs. As care in one's home becomes more commonplace, it is critical that Canadians know they are safe.

Lessons on COVID-19 from Home and Community: Perspectives of Nursing Leaders at All Levels.

The initial focus of the COVID-19 pandemic was on the surge capacity of hospitals. Moving forward, however, the attention needs to shift toward keeping people healthy at home. In this paper, we discuss critical insights from the home and community care sector, which shed light on pre-pandemic fault lines that have widened. The paper, however, takes a positive look at how a better future can be built, particularly for those most vulnerable in society. We offer three key insights and analyses as well as examples of how one national homecare organization in Canada, SE Health, is facing the pandemic. We discuss the following key insights: (1) pre-pandemic systemic biases and barriers were exasperated during the pandemic, which impacted the most vulnerable; (2) nurse leaders were faced with unprecedented fear and anxiety from both patients and their staff colleagues; and (3) the pandemic provided an opportunity for significant learning, innovation and capacity development. The pandemic is far from over - we are in a marathon, not a sprint. The paper concludes with how nurse leaders can lead the way in navigating through the pandemic and build a better "new normal."

Leadership Perspective: Bringing Nursing Back to the Future Through People-Powered Care.

At a time when there is a growing interest in person- and family-centred care and integrated community-based models, the unique strengths and expertise of home care nursing is a strategic lever for change across all healthcare settings. In this paper, we explore the theme of people-powered care as a universal starting point - a new approach to health and wellness that is anchored in the strengths of people, their networks and the patterns of everyday life. Leveraging key insights from home and community care, along with broader societal shifts towards personalization and empowerment, we discuss how nurses in all areas of the system can lead the way by empowering staff, patients and their families. Finally, we look at the implications for nursing leadership including how our knowledge, skills and abilities must continue to evolve to effectively impact change and enable this vital transformation to occur.

The determinants of home and nursing home death: a systematic review and meta-analysis.

BACKGROUND: Most Canadians die in hospital, and yet, many express a preference to die at home. Place of death is the result of the interaction among sociodemographic, illness- and healthcare-related factors. Although home death is sometimes considered a potential indicator of end-of-life/palliative care quality, some determinants of place of death are more modifiable than others. The objective of this systematic review was to evaluate the determinants of home and nursing home death in adult patients diagnosed with an advanced, life-limiting illness. METHODS: A systematic literature search was performed for studies in English published from January 1, 2004 to September 24, 2013 that evaluated the determinants of home or nursing home death compared to hospital death in adult patients with an advanced, life-limiting condition. The adjusted odds ratios, relative risks, and 95% confidence intervals of each determinant were extracted from the studies. Meta-analyses were performed if appropriate. The quality of individual studies was assessed using the Newcastle-Ottawa scale and the body of evidence was assessed according to the GRADE Working Group criteria. RESULTS: Of the 5,900 citations identified, 26 retrospective cohort studies were eligible. The risk of bias in the studies identified was considered low. Factors associated with an increased likelihood of home versus hospital death included multidisciplinary home palliative care, preference for home death, cancer as opposed to other diagnoses, early referral to palliative care, not living alone, having a caregiver, and the caregiver's coping skills. CONCLUSIONS: Knowledge about the determinants of place of death can be used to inform care planning between healthcare providers, patients and family members regarding the feasibility of dying in the preferred location and may help explain the incongruence between preferred and actual place of death. Modifiable factors such as early referral to palliative care, presence of a multidisciplinary home palliative care team were identified, which may be amenable to interventions that improve the likelihood of a patient dying in the preferred location. Place of death may not be a very good indicator of the quality of end-of-life/palliative care since it is determined by multiple factors and is therefore dependent on individual circumstances.

Caring: Everybody's business.

As structures become more fluid and less constrained by traditional boundaries, the time is ripe to welcome the blurring lines between government, business, and social purpose organizations. No matter where you sit on the spectrum, organizations must learn from each other, remain grounded in their strengths, and work collectively to make the fabric of our communities richer and stronger. It is here we can realize the ideals of universality and caring at the highest level.

All aboard!

With technology and the health/wellness arena in the midst of a sea change that will revolutionize the system and allow more integration and information than ever before, this article reframes the discussion to broaden the opportunities for virtualization, enhanced information and communication and self-serve options. Considering these three consumer themes, the author explores how we can leverage current behaviours to achieve better connections with people, which will naturally lead to better uptake and help to narrow the gap between desire for and use of consumer health solutions.