Redesigning Long-term Care Policy for an Aging Population Using Systems Thinking in the Post-Pandemic Era

Author Information

Peter Tsasis, York University, Canada
Joachim P. Sturmberg, University of Newcastle, Australia
Grace Liu, York University, Canada

Abstract

The COVID-19 pandemic highlighted critical issues in health services and public policy, particularly in long-term care facilities across Canada. The failures in these facilities underscore the need to rethink health service interventions, especially considering varying implementation contexts. Using systems thinking to understand interconnections and interdependencies across multiple intervention levels can improve health outcomes. The Ontario Long-Term Care COVID-19 Commission Final Report pointed to long-standing systemic issues in government policies and governance as the primary causes of the sector’s failures. Our aim is to synthesize evidence showing that addressing systemic problems in long-term care begins with adopting a systems-thinking approach. A literature review was conducted to explore the issues in light of the Ontario Long-Term Care COVID-19 Commission Final Report. The long-term care crisis in Canada cannot be solved by more privatization, regulation, or efficiency measures, as these have contributed to the problem’s root causes. Governments must lead the redesign of a systemic policy framework that addresses the interdependencies, values, and priorities of all stakeholders. A shared vision for a new relational model of responsibility is essential for improving long-term care outcomes. This redesign should be patient-centered and focus on public involvement, with lessons that can inform improvements in other jurisdictions.

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