Executive Summary

Background

In 1998, Veterans Affairs Canada (VAC) staff began interviewing veterans who reside in a Priority Access Bed (PAB) or a community long-term care bed to determine their satisfaction with services received as a means of monitoring Quality of Care. This process was guided by a Client Satisfaction Questionnaire (CSQ)designed to measure veterans level of comfort in the following ten outcome areas:

•	safety and security,

•	food quality,

•	access to clinical services,

•	medication regime,

•	access to spiritual guidance,

•	socialization/recreation,

•	activation and ambulation,

•	personal care,

•	sanitation, and

•	access to specialized services.

These are the outcome areas where research has shown a need for ongoing review. These scheduled interviews are conducted on a regular basis to provide continuous monitoring of the care provided.

The original intent at that time was for a one-time only quality assurance review. However, given the effectiveness of this review on client service and the value of the statistical data gathered, senior management determined that there was significant justification in conducting this quality assurance review on an annual basis.

VAC has 4310 priority access beds in 172 sites across the country. As well, approximately 4000 veterans reside in more than 1500 community long term care facilities. Therefore, the decision to implement the review annually presented significant workload issues to the districts. A number of internal approaches were taken to address the workload concerns, however the department was not able to sustain this level of field coverage with the existing staff complement.

The Royal Canadian Legion (The Legion)

There are many Veterans' organizations in Canada, the largest being The Royal Canadian Legion with more than 450,000 members and affiliates. The Legion is a nonprofit, dues-supported, fraternal organization with more than 1,600 branches in Canada, 21 in the United States and four in Germany.
The Legion has a long history of advocacy for Veterans and their families. The Legion is well known and respected by Veterans and their families for their tireless efforts on their behalf. With some 450,000 members located in approximately 1600 Legion Branches across the country, no other organization is so widely represented in Canada. As well, the Dominion Command of The Legion is the overarching structure which provides leadership to the Provincial Commands and all Legion Branches across Canada. With members located in cities and smaller communities, qualified Legion members are well positioned to visit with Veterans who reside in community long term care facilities across the Canada.

VAC has successfully worked with The Legion for many years to serve our joint Veteran client. This unique combination made the Legion a natural agency to assist with the client satisfaction surveys. There is no other volunteer based group with the existing relationship with Veterans and the necessary numbers to undertake this task.

Contract

The Legion was contracted to conduct the Client Satisfaction Questionnaires due to the following factors:

•	they had the membership to accomplish the task;

•	they were volunteering their services with only administrative costs to be incurred by VAC;and,

•	they have an existing relationship with veterans and are widely recognized as veteran advocates.

•

Methodology:

The CSQ that was originally developed for implementation by VAC's Area Counsellors (AC) is the instrument used by the RCL surveyors. In cases where a Veteran is unable to answer questions, then a Power of Attorney is contacted by either the RCL Surveyor. An electronic questionnaire form was introduced during the 2003/2004 survey cycle. This form is now the standard to ensure consistency through the regions.

The Objective:

The objective of these visits is to determine veterans' level of comfort and satisfaction with the services they receive in the facility where they live. These visits are part of an ongoing departmental strategy to ensure that the needs of clients who reside in long-
term care facilities are being met.

Evaluation:

Upon completion of the first year the validity of the contract was very apparent on a couple of points. The number of veterans visited had increased dramatically due to the additional man hours provided by The Legion volunteers. In addition, the contract has been so cost effective due to the volunteer surveyors, VAC was able to extend the time period by an additional year without incurring any additional costs.

Within the body of this report you will find the national overview for the visits conducted in the 2003/2004 fiscal year. The data provided is representative of 2,891 visits with either veterans or their family members. Also provided are the regional statistical documents.

National Overview

Questionnaire cycle 2003-2004

This section contains the analysis of all 2,891 responses gathered from the 5 regions (Pacific, Prairie, Ontario, Quebec and Atlantic).

Q1.	Overall, are you satisfied with the services provided here?

YES	941
NO	4
DNWA2	2

Q2. & Q3. do not contain any quantitative data.

Q4.	Generally speaking, are you treated with respect here?

YES	95
NO	1
DNWA	4

Q5.	Do you feel at home here?

YES	84
NO	10
DNWA	6

Q6.	Do you feel safe here?

YES	94
NO	2
DNWA	4

Q7.	Generally speaking, how satisfied are you with the food they serve you here?

Very Satisfied	32
Satisfied	49
Neutral	8
Dissatisfied	7
Very Dissatisfied	4
DNWA

Q8.	How satisfied are you with the professional staff here (eg. nurses, doctors)?

Very Satisfied	38
Satisfied	52
Neutral	5
Dissatisfied	3
Very Dissatisfied	2
DNWA

Q9.	a)Do you have access to specialized services such as physiotherapy, dental, etc. when you need it?

YES	82
NO	6
DNWA	12

Q9.	b) How satisfied are you with the specialized services you receive here?

Very Satisfied	27
Satisfied	54
Neutral	11
Dissatisfied	3
Very Dissatisfied	4
DNWA	1

Q10.	a) How satisfied are you with your medication?

Very Satisfied	33
Satisfied	48
Neutral	4
Dissatisfied	1
Very Dissatisfied	12
DNWA	2

Q10.	b) How satisfied are you with the treatment of any pain you might be experiencing?

Very Satisfied	30
Satisfied	52
Neutral	14
Dissatisfied
Very Dissatisfied
DNWA	4

Q11.	How satisfied are you with the access to spiritual guidance you have here?

Very Satisfied	23
Satisfied	49
Neutral	23
Dissatisfied	2
Very Dissatisfied
DNWA	3

Q12.	How satisfied are you with the recreational activities offered here?

Very Satisfied	24
Satisfied	58
Neutral	14
Dissatisfied	2
Very Dissatisfied
DNWA	2

Q13.	How satisfied are you with the personal care you receive here?

Very Satisfied	39
Satisfied	53
Neutral	5
Dissatisfied	2
Very Dissatisfied	1
DNWA

Q14.	How satisfied are you with the help you receive to get around the facility?

Very Satisfied	32
Satisfied	57
Neutral	8
Dissatisfied	2
Very Dissatisfied
DNWA	1

Q15.	How satisfied are you with the cleanliness of your room?

Very Satisfied	50
Satisfied	46
Neutral	1
Dissatisfied	2
Very Dissatisfied	1
DNWA

Q16.	How satisfied are you with the cleanliness of the facility generally?

Very Satisfied	50
Satisfied	46
Neutral	2
Dissatisfied	1
Very Dissatisfied
DNWA	1

Statistical Overview
PACIFIC REGION

- 383 respondents

Q1.	Overall, are you satisfied with the services provided here?

YES	96
NO	4
DNWA

Q2. & Q3. do not contain any quantitative data.

Q4.	Generally speaking, are you treated with respect here?

YES	99
NO	1
DNWA

Q5.	Do you feel at home here?

YES	78
NO	20
DNWA	2

Q6.	Do you feel safe here?

YES	97
NO	2
DNWA	1

Q7.	Generally speaking, how satisfied are you with the food they serve you here?

Very Satisfied	14
Satisfied	64
Neutral	11
Dissatisfied	10
Very Dissatisfied	1
DNWA

Q8.	How satisfied are you with the professional staff here (eg. nurses, doctors)?

Very Satisfied	23
Satisfied	66
Neutral	7
Dissatisfied	3
Very Dissatisfied	1
DNWA

Q9.	a)Do you have access to specialized services such as physiotherapy, dental, etc. when you need it?

YES	87
NO	3
DNWA	10

Q9.	b) How satisfied are you with the specialized services you receive here?

Very Satisfied	11
Satisfied	67
Neutral	19
Dissatisfied	2
Very Dissatisfied
DNWA	1

Q10.	a) How satisfied are you with your medication?

Very Satisfied	6
Satisfied	39
Neutral	7
Dissatisfied	2
Very Dissatisfied	46
DNWA

Q10.	b) How satisfied are you with the treatment of any pain you might be experiencing?

Very Satisfied	6
Satisfied	53
Neutral	39
Dissatisfied	1
Very Dissatisfied	1
DNWA

Q11.	How satisfied are you with the access to spiritual guidance you have here?

Very Satisfied	3
Satisfied	35
Neutral	60
Dissatisfied	2
Very Dissatisfied
DNWA

Q12.	How satisfied are you with the recreational activities offered here?

Very Satisfied	7
Satisfied	70
Neutral	20
Dissatisfied	2
Very Dissatisfied
DNWA	1

Q13.	How satisfied are you with the personal care you receive here?

Very Satisfied	16
Satisfied	75
Neutral	7
Dissatisfied	2
Very Dissatisfied
DNWA

Q14.	How satisfied are you with the help you receive to get around the facility?

Very Satisfied	11
Satisfied	66
Neutral	23
Dissatisfied
Very Dissatisfied
DNWA

Q15.	How satisfied are you with the cleanliness of your room?

Very Satisfied	30
Satisfied	68
Neutral
Dissatisfied	2
Very Dissatisfied
DNWA

Q16.	How satisfied are you with the cleanliness of the facility generally?

Very Satisfied	27
Satisfied	71
Neutral	2
Dissatisfied
Very Dissatisfied
DNWA

Statistical Overview

Prairie Region

757 respondents

Q1.	Overall, are you satisfied with the services provided here?

YES	94
NO	5
DNWA	1

Q2. & Q3. do not contain any quantitative data.

Q4.	Generally speaking, are you treated with respect here?

YES	97
NO	2
DNWA	1

Q5.	Do you feel at home here?

YES	90
NO	8
DNWA	2

Q6.	Do you feel safe here?

YES	96
NO	2
DNWA	2

Q7.	Generally speaking, how satisfied are you with the food they serve you here?

Very Satisfied	35
Satisfied	47
Neutral	8
Dissatisfied	8
Very Dissatisfied	1
DNWA	1

Q8.	How satisfied are you with the professional staff here (eg. nurses, doctors)?

Very Satisfied	38
Satisfied	52
Neutral	5
Dissatisfied	3
Very Dissatisfied	1
DNWA	1

Q9.	a)Do you have access to specialized services such as physiotherapy, dental, etc. when you need it?

YES	87
NO	5
DNWA	8

Q9.	b) How satisfied are you with the specialized services you receive here?

Very Satisfied	26
Satisfied	56
Neutral	10
Dissatisfied	3
Very Dissatisfied	3
DNWA	2

Q10.	a) How satisfied are you with your medication?

Very Satisfied	39
Satisfied	48
Neutral	4
Dissatisfied	1
Very Dissatisfied	7
DNWA	1

Q10.	b) How satisfied are you with the treatment of any pain you might be experiencing?

Very Satisfied	32
Satisfied	52
Neutral	12
Dissatisfied	1
Very Dissatisfied	1
DNWA	2

Q11.	How satisfied are you with the access to spiritual guidance you have here?

Very Satisfied	23
Satisfied	52
Neutral	19
Dissatisfied	1
Very Dissatisfied
DNWA	5

Q12.	How satisfied are you with the recreational activities offered here?

Very Satisfied	22
Satisfied	58
Neutral	15
Dissatisfied	3
Very Dissatisfied	1
DNWA	1

Q13.	How satisfied are you with the personal care you receive here?

Very Satisfied	43
Satisfied	48
Neutral	5
Dissatisfied	3
Very Dissatisfied	1
DNWA

Q14.	How satisfied are you with the help you receive to get around the facility?

Very Satisfied	36
Satisfied	57
Neutral	4
Dissatisfied	2
Very Dissatisfied	1
DNWA

Q15.	How satisfied are you with the cleanliness of your room?

Very Satisfied	54
Satisfied	42
Neutral	1
Dissatisfied	2
Very Dissatisfied	1
DNWA

Q16.	How satisfied are you with the cleanliness of the facility generally?

Very Satisfied	55
Satisfied	41
Neutral	2
Dissatisfied	1
Very Dissatisfied	1
DNWA

Regional Statistical Overview

ONTARIO

Q = 1,107

Q1.	Overall, are you satisfied with the services provided here?

YES	95
NO	3
DNWA	2

Q2. & Q3. do not contain any quantitative data.

Q4.	Generally speaking, are you treated with respect here?

YES	97
NO	2
DNWA	1

Q5.	Do you feel at home here?

YES	83
NO	12
DNWA	5

Q6.	Do you feel safe here?

YES	96
NO	2
DNWA	2

Q7.	Generally speaking, how satisfied are you with the food they serve you here?

Very Satisfied	30
Satisfied	47
Neutral	10
Dissatisfied	6
Very Dissatisfied	7
DNWA

Q8.	How satisfied are you with the professional staff here (eg. nurses, doctors)?

Very Satisfied	37
Satisfied	52
Neutral	5
Dissatisfied	3
Very Dissatisfied	2
DNWA	1

Q9.	a)Do you have access to specialized services such as physiotherapy, dental, etc. when you need it?

YES	82
NO	5
DNWA	13

Q9.	b) How satisfied are you with the specialized services you receive here?

Very Satisfied	26
Satisfied	51
Neutral	10
Dissatisfied	3
Very Dissatisfied	6
DNWA	4

Q10.	a) How satisfied are you with your medication?

Very Satisfied	28
Satisfied	56
Neutral	3
Dissatisfied	2
Very Dissatisfied	9
DNWA	2

Q10.	b) How satisfied are you with the treatment of any pain you might be experiencing?2

Very Satisfied	30
Satisfied	55
Neutral	10
Dissatisfied	2
Very Dissatisfied	1
DNWA	2

Q11.	How satisfied are you with the access to spiritual guidance you have here?

Very Satisfied	22
Satisfied	52
Neutral	17
Dissatisfied	2
Very Dissatisfied	2
DNWA	5

Q12.	How satisfied are you with the recreational activities offered here?

Very Satisfied	29
Satisfied	54
Neutral	12
Dissatisfied	2
Very Dissatisfied
DNWA	3

Q13.	How satisfied are you with the personal care you receive here?

Very Satisfied	37
Satisfied	54
Neutral	4
Dissatisfied	3
Very Dissatisfied	1
DNWA	1

Q14.	How satisfied are you with the help you receive to get around the facility?

Very Satisfied	33
Satisfied	57
Neutral	6
Dissatisfied	2
Very Dissatisfied	1
DNWA	1

Q15.	How satisfied are you with the cleanliness of your room?

Very Satisfied	48
Satisfied	47
Neutral	2
Dissatisfied	1
Very Dissatisfied	1
DNWA	1

Q16.	How satisfied are you with the cleanliness of the facility generally?

Very Satisfied	49
Satisfied	45
Neutral	2
Dissatisfied	1
Very Dissatisfied	1
DNWA	2

Aperçu statistique

Quebec Regional Overview

100 Répondants

Q1.	En général, êtes-vous satisfait(e) des services offerts par l'établissement?

OUI	100
NON
Pas de réponse

Les questions 2 et 3 ne fournissent pas de données quantitatives.

Q4.	En général, êtes-vous traité(e) avec respect?

OUI	100
NON
Pas de réponse

Q5.	Vous sentez-vous chez vous ici?

OUI	95
NON	2
Pas de réponse	3

Q6.	Vous sentez-vous en sécurité ici?

OUI	97
NON
Pas de réponse	3

Q7.	En général, êtes-vous satisfait(e) de la nourriture qu'on vous sert?

Très satisfait	31
Satisfait	61
Neutre	3
Insatisfait	3
Très insatisfait	2
Pas de réponse

Q8.	Êtes-vous satisfait(e) du personnel professionnel (infirmières, médecins, etc.)?

Très satisfait	35
Satisfait	61
Neutre	2
Insatisfait	2
Très insatisfait
Pas de réponse

Q9.	a) Au besoin, avez-vous accès à des services spécialisés tels que la physiothérapie, les soins dentaires, etc.?

OUI	43
NON	50
Pas de réponse	7

Q9.	b) Êtes-vous satisfait(e) des services spécialisés que vous recevez?

Très satisfait	19
Satisfait	59
Neutre	14
Insatisfait	6
Très insatisfait	2
Pas de réponse

Q10.	a) Avez-vous des préoccupations à l'égard de vos médicaments?

Très satisfait	22
Satisfait	52
Neutre	23
Insatisfait
Très insatisfait	1
Pas de réponse	2

Q10. b) Étes-vous satisfait(e) du traitement de la douleur dont vous souffrez peut-être?

Très satisfait	25
Satisfait	65
Neutre	9
Insatisfait
Très insatisfait
Pas de réponse	1

Q11.	À quel point êtes-vous satisfait(e) des conseils spirituels que vous recevez?

Très satisfait	22
Satisfait	67
Neutre	8
Insatisfait	1
Très insatisfait
Pas de réponse	2

Q12.	Êtes-vous satisfait(e) des activités de loisirs offertes?

Très satisfait	23
Satisfait	72
Neutre	3
Insatisfait
Très insatisfait	1
Pas de réponse	1

Q13.	Êtes-vous satisfait(e) des soins personnels que vous recevez?

Très satisfait	29
Satisfait	54
Neutre	14
Insatisfait	2
Très insatisfait
Pas de réponse	1
Q14.	Êtes-vous satisfait(e) de l'aide que vous recevez en ce qui a trait aux activités quotidiennes?

Très satisfait	17
Satisfait	61
Neutre	20
Insatisfait	1
Très insatisfait
Pas de réponse	1
Q15.	Êtes-vous satisfait(e) de la propreté de votre chambre?

Très satisfait	43
Satisfait	56
Neutre	1
Insatisfait
Très insatisfait
Pas de réponse

Q 16. Étes-vous satisfait(e) de la propreté de l'établissement en général?

Très satisfait	45
Satisfait	54
Neutre	1
Insatisfait
Très insatisfait
Pas de réponse

Statistical Overview

Atlantic Region Overview

544 Respondents

Q1.	Overall, are you satisfied with the services provided here?

YES	92
NO	6
DNWA	2

Q2. & Q3. do not contain any quantitative data.

Q4.	Generally speaking, are you treated with respect here?

YES	86
NO	1
DNWA	13

Q5.	Do you feel at home here?

YES	80
NO	5
DNWA	15

Q6.	Do you feel safe here?

YES	85
NO	1
DNWA	14

Q7.	Generally speaking, how satisfied are you with the food they serve you here?

Very Satisfied	43
Satisfied	42
Neutral	6
Dissatisfied	4
Very Dissatisfied	4
DNWA	1

Q8.	How satisfied are you with the professional staff here (eg. nurses, doctors)?

Very Satisfied	51
Satisfied	42
Neutral	3
Dissatisfied	1
Very Dissatisfied	2
DNWA	1

Q9.	a)Do you have access to specialized services such as physiotherapy, dental, etc. when you need it?

YES	76
NO	2
DNWA	22

Q9.	b) How satisfied are you with the specialized services you receive here?

Very Satisfied	40
Satisfied	45
Neutral	7
Dissatisfied	2
Very Dissatisfied	3
DNWA	3

Q10.	a) How satisfied are you with your medication?

Very Satisfied	55
Satisfied	40
Neutral	2
Dissatisfied	1
Very Dissatisfied	1
DNWA	1

Q10.	b) How satisfied are you with the treatment of any pain you might be experiencing?

Very Satisfied	45
Satisfied	43
Neutral	8
Dissatisfied	1
Very Dissatisfied	1
DNWA	2

Q11.	How satisfied are you with the access to spiritual guidance you have here?

Very Satisfied	38
Satisfied	46
Neutral	12
Dissatisfied
Very Dissatisfied	1
DNWA	3

Q12.	How satisfied are you with the recreational activities offered here?

Very Satisfied	31
Satisfied	52
Neutral	12
Dissatisfied	2
Very Dissatisfied	1
DNWA	2

Q13.	How satisfied are you with the personal care you receive here?

Very Satisfied	55
Satisfied	39
Neutral	2
Dissatisfied	1
Very Dissatisfied	2
DNWA	1

Q14.	How satisfied are you with the help you receive to get around the facility?

Very Satisfied	43
Satisfied	49
Neutral	3
Dissatisfied	2
Very Dissatisfied	2
DNWA	1

Q15.	How satisfied are you with the cleanliness of your room?

Very Satisfied	64
Satisfied	31
Neutral	1
Dissatisfied	2
Very Dissatisfied	2
DNWA

Q16.	How satisfied are you with the cleanliness of the facility generally?

Very Satisfied	65
Satisfied	32
Neutral	1
Dissatisfied
Very Dissatisfied	1
DNWA	1