Quality of Work Life in Long-Term Care

Project funded from April 2023 – March 2027


Long-term care (LTC) is an essential component of the health system, yet often undervalued. Before the pandemic, concerns existed about care staff’s high risk of burnout, poor physical and mental health and low job satisfaction. The pandemic placed additional stress on this workforce, leading to serious staff shortages and increasing concerns about staff health and well-being. Our study seeks to understand how the conditions of work in LTC may affect the conditions of care of the residents. We will be assessing how work environment impacts the quality of work life (QWL) of staff in LTC and ultimately, resident quality of care outcomes in Atlantic Canada.
This study is being led by Dr. Janice Keefe, Mount Saint Vincent University, and co-led by Dr. Rick Audas, Dr. Carole Estabrooks, Dr. Rose McCloskey, and Dr. Gail Tomblin-Murphy with participation of co-investigators from different university and disciplines and sector and decision maker collaborators. Keefe and colleagues were awarded a $2.1 million CIHR project grant for the multi-site study.



This project is an Atlantic Canadian research collaboration to build evidence to understand, support and manage the LTC workforce.  We will conduct a survey about staff’s physical and mental health, and key features about their work environment. We will examine the relationship between staff QWL and resident outcomes by linking staff survey results with resident assessment data. Linking data will help us understand if or how the working environment affects the quality of care received by LTC residents.




This project extends research happening in Western Canada through the Translating Research in Elder Care (TREC) program. Research will take place in the four Atlantic Canadian provinces – Nova Scotia (NS), New Brunswick (NB), Prince Edward Island (PEI), and Newfoundland and Labrador (NL). We will survey 25% of eligible homes in each province with over sampling in NL and PEI to obtain a minimum of 8 homes per province. We will hear from a mix of staff including care aids, nurses, allied health, and managers.



This project is funded from April 2023 to March 2027. Data collection with staff working in LTC will take place October 2023 – June 2024. InterRAI data will also be collected to be linked to staff working conditions to understand the relationship of work environment on resident quality of care. After data collection is complete, data will be cleaned and analyzed. Dissemination activities for the project include publishing in academic journals, presentations at scholarly conferences, and webinars. Throughout the project there will be frequent knowledge translation and engagement opportunities to share findings and invite feedback including summary findings shared to each LTC home, webinar presentations, workshops, and a regional summit.

Project Activities:


The Atlantic region currently has limited data to understand LTC staff quality of work life and what can be done to support these staff. The results from this study will help employers and government better support the overall health and well-being of LTC staff. Ultimately, our project will provide evidence to support improvements for LTC staff, by enabling knowledge users to consider tangible interventions to improve staff QWL, their work environment and ultimately, the quality of care for residents.


Paula Richardson, Atlantic Region Project Manager
Email: arcltc@msvu.ca
Telephone: 902-457-6235

Emily Hubley, Nova Scotia and Prince Edward Island HUB Coordinator
Email: Emily.Hubley1@msvu.ca

Marlene Robichaud, New Brunswick HUB Manager
email: marlene.robichaud@unb.ca

Colin Walsh, Newfoundland & Labrador HUB Manager

Our Thanks

This study is funded by Canadian Institutes of Health Research (CIHR) with partner funding from Research Nova Scotia (RNS), Newfoundland and Labrador Center of Applied Research (NLCAHR), Health PEI, Research New Brunswick and Nova Scotia Health.

Research Team

Dr. Janice Keefe, MSVU

Dr. Rick Audas, NLCAHR at MUN

Dr. Carole Estabrooks, UofA

Dr. Rose McCloskey, UNB

Dr. Gail Tomblin-Murphy, NSHealth


Dr. Marilyn Hodgins, UNB

Dr. Adrian MacKenzie, NS Dept Health

Dr. Caitlin McArthur, Dal

Dr. Kathleen Norman, NSHealth

Dr. Lori Weeks, Dal

Dr. Robert Wilson, MUN

NS Health, PEI Health, NL Health & Community Services, NL Eastern Health, NS Seniors & LTC, NS Department of Health and Wellness, Nursing Homes of Nova Scotia Association, New Brunswick Association of Nursing Homes, PEI Long-Term Care

Atlantic Region Manager: Paula Richardson

Nova Scotia/Prince Edward Island HUB: Emily Hubley, Field Survey Coordinator, Amber Duynisveld, Research Assistant

NB HUB: Marlene Robichaud, Manager, Katie Edgar, Field Survey Coordinator

NL HUB: Colin Walsh, Manager