Strengthening Specialized Geriatric Services: A Provider Experience Evaluation in Central East Ontario, Canada

Background: Central East (CE) Ontario is home to ~51,000 older adults living with complex health conditions such as frailty and dementia. Specialized Geriatric Services (SGS) providers play an important role in supporting the health and social needs of this vulnerable population. Over the last 5 years the health care system has experienced unprecedented challenges, such as the COVID-19 pandemic, the mass exodus/retirement of seasoned clinicians from Ontario’s workforce, the evolving and ever-increasing health needs of the population in general, all contributing to resource shortages and increased SGS demands.

 

These trends are having negative impacts on providers’ wellbeing. This evaluation presents an analysis of SGS providers' experience in CE Ontario and suggested action priorities at micro, meso, and system-level.

 

Approach: A mixed-methods approach was used, including the development and distribution of a comprehensive 50-question provider experience survey. The survey covered 10 distinct domains e.g., professional development, care coordination, moral distress, burnout, equity, diversity & inclusion (EDI), workplace violence, etc. Semi-structured interviews with senior leaders/executives from local and provincial organizations were also conducted. Quantitative survey data was analyzed statistically, and qualitative interview data was analyzed thematically to identify strengths, challenges and recommendations for host organizations and policy makers.

 

Results: A total of 62 survey responses were received, and five semi-structured interviews were completed. Key findings included:

Areas of strength: (1) team collaboration characterized by positive communication, mutual support, and a clear understanding of individual roles within a team; (2) providers feeling empowered to participate in decision-making processes, indicating a culture of shared responsibility; (3) self-reported confidence in delivering high-quality older adult care.

 

Areas of improvement: (1) desire for more training and development opportunities; (2) elevated levels of burnout and moral distress due to increased workload and insufficient human and financial resources; (3) discrimination from patients and caregivers.

Proposed strategies for policymakers: (1) increased investment in geriatrics; (2) expansion of structured professional training opportunities; (3) alternative funding plans to facilitate effective resources utilization; (4) development of a comprehensive older adult strategy; integrated older adult care across the continuum.

 

Implications: This evaluation provides critical insights into SGS provider experience in Central East Ontario, informing capacity planning and strategies for organizational and governmental action to improve specialized geriatric service delivery and workforce sustainability.

 

References: Provincial Geriatrics Leadership Ontario. Frailty estimates. Provincial Geriatrics Leadership Ontario; 2023.

Dong, X. & Ehsan, S. Provider Experience in Specialized Geriatric Services: Final Evaluation Report. Seniors Care Network; 2024.

Dong, X. & Ehsan, S. Provider Experience in Specialized Geriatric Services: Final Evaluation Report. Seniors Care Network; 2024.