Policy Decisionmaking in Long-Term Care: Lessons from Infection Control During the COVID-19 Pandemic.

Area of Science:

• Public Health
• Gerontology
• Health Policy

Background:

• The COVID-19 pandemic highlighted deficiencies in long-term care (LTC) infection control policies.
• Policies were often created without input from residents, families, or staff, negatively impacting resident health.
• There is a critical need to reform LTC to prioritize resident and caregiver needs.

Purpose of the Study:

• To review infection control policy decisions and propose action items for inclusive decision-making in LTC.
• To lay the groundwork for cultural change in LTC policy development.
• To advocate for resident-centered approaches in long-term care.

Main Methods:

• Review of infection control policy decisions within LTC facilities.
• Guided discussions with diverse stakeholders, including residents, staff, administrators, and industry representatives.
• Analysis of proposed action items for policy improvement.

Main Results:

• Infection control policies were frequently developed without essential stakeholder involvement.
• Lack of input led to adverse effects on residents' physical and mental health.
• The study identified opportunities for more inclusive and effective policy development.

Conclusions:

• Transforming LTC culture requires prioritizing resident needs and preferences.
• Inclusive policy-making, involving residents, families, and staff, is essential.
• Strengthening facility leadership, inclusiveness, transparency, and accountability is key to improving LTC.