Family experience with sharing concerns 

How family members rated their comfort with sharing concerns with staff. (see data dictionary)

What do you think?

  • Why does understanding family member comfort with sharing concerns matter?
  • Are there differences between zones? Between providers? Between mainly rural and urban zones or sites? What factors could account for these differences?
  • How are family experience results around sharing concerns different in designated supportive living?

Whether you’re a resident, family member, provider, or health system administrator, thinking about why these differences might exist can start or inform conversations and lead to solutions for improved quality of healthcare.

Understanding “family experience with sharing concerns”

In a survey conducted from May to October 2017, the HQCA asked family members of residents living in long term care:

In the last six months, did you ever stop yourself from talking to any nursing home staff about your concerns because you thought they would take it out on your family member?

Family members could choose “Yes / No”

At times, family members do not feel comfortable speaking up about concerns related to their loved one’s care. One reason may be a fear of retribution or retaliation, and that by sharing concerns, their loved one’s care experiences might be negatively impacted or even become unsafe.

Considerations when viewing the results:

There are a number of factors providers and leaders can consider to better understand and improve family member confidence to share concerns. Before taking action, consider the following:

  • If family members are not comfortable expressing concerns, how might this impact their loved one’s quality of life or safety?
  • What are some of the reasons why a family member may fear retribution or retaliation? How might the process to address concerns be improved to help family members feel safe to share concerns?
  • How might embracing the key principles of a Just Culture, as it relates to family concerns, impact this result?
  • How might the presence of a resident and family council impact this result? How could a resident and family council be engaged to better understand this result and help make improvements?
  • If family members do not feel safe to speak freely, how might this impact the site or organization’s ability to learn about opportunities for improvement?
  • Which Long Term Care Accommodation Standard(s) does this question help inform, if any?
  • Which Continuing Care Health Service Standard(s) does this question help inform, if any?
  • Who should be involved in discussions to improve these results? How could residents and/or family members be engaged to develop solutions (e.g., engage the resident and family council)? What other collaboration might be required to make improvements in this area?

For information about the HQCA’s long term care family experience survey, please visit the HQCA website.

The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. This measure can be used as input to assess long-term care’s performance in these dimensions of quality:


Dimensions of Quality

  • Acceptability 
  • Accessibility 
  • Appropriateness 
  • Effectiveness 
  • Efficiency 
  • Safety