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No more half measures: A blueprint to fundamentally reorganize long-term care in Quebec

December 8, 2021 Print

New IRPP research calls for the creation of a Qualité Québec agency to bring lasting improvements to seniors’ care, including in CHSLDs

Montreal — In the wake of the preventable death and suffering that occurred in Quebec’s Centres d’hébergement de soins de longue durée (CHSLDs) during the COVID-19 pandemic, a new study from the Institute for Research on Public Policy calls on the Quebec government to commit to a major overhaul of long-term care focused on care recipients’ needs and quality improvement.

In the paper, authors Yves Couturier, Maxime Guillette and David Lanneville argue that the failure of prior health care reforms to resolve long-standing problems in Quebec’s CHSLDs stems from many well-known causes, including chronic underinvestment, a refusal to prepare for the effects of an aging population, inadequate management of change and difficulties attracting and retaining staff.

To ensure that any new reforms result in lasting improvements to care, the authors stress the need to develop the system’s capacity for innovation, evaluation and adaptation. They recommend a three-pronged approach aimed at increasing satisfaction among care recipients and health care personnel, improving clinical outcomes and achieving more effective public spending. They call on the Quebec government to implement the following measures:

  1. Re-evaluate the needs of older adults across the full continuum of care and invest in institutional-, home- and community-care settings accordingly.
  2. Review the governance and organization of CHSLDs to bring them up to 21st-century standards. Governance structures should be community-based and focused on living environments rather than overseeing vast geographic regions.
  3. Create a “Qualité Québec” agency that would give decision-makers access to clinical data so that they can make evidence-informed changes to policies in a timely fashion.

The proposed agency is key to improving the capacity for change and adaptation throughout the health care system, the authors say. Its goal would be to help implement clinical and managerial processes to enable learning and innovation based on a continuous evaluation of policies, practices and clinical outcomes.

“Our proposals provide a clear roadmap for positive change. The window of opportunity to reform long-term care in Quebec will not be open forever,” says Yves Couturier, the study’s lead author. “The time for decisive action is now.”


Réorganiser les soins de longue durée à la lumière de la pandémie can be downloaded from the IRPP’s website (irpp.org).

The Institute for Research on Public Policy is an independent, national, bilingual, not-for-profit organization based in Montreal. To receive updates from the IRPP, please subscribe to our e‑mail list.

Media contact: Cléa Desjardins, tel. 514-245-2139 cdesjardins@nullirpp.org

Réorganiser les soins de longue durée à la lumière de la pandémie

Réorganiser les soins de longue durée à la lumière de la pandémie

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Media Contact

Cléa Desjardins
Communications Director
Tel. 514-245-2139 • cdesjardins@irpp.org