Barriers and facilitators to data-informed care planning in long-term care in Nova Scotia, Canada: a qualitative study

Long-term care (LTC) homes in Canada provide essential care for individuals requiring ongoing support. While data-informed care planning is increasingly advocated for, its implementation remains inconsistent, limiting its potential to enhance resident-centered care. The interRAI long-term care facilities assessment (LTCF) and real-time location systems (RTLS) are two sources of routinely collected data that can inform care planning. However, how they are currently used to inform care planning and what hinders or supports their use remains unclear. We describe the current use of routinely collected data in LTC and identify barriers and facilitators to informing care planning from the perspectives of staff, residents, and family caregivers in Nova Scotia, Canada. We employed Sally Thorne’s Interpretive Description qualitative design with purposeful sampling: 10 LTC residents, 14 family members, and 22 staff (12 nurses, 2 nursing assistants, 2 physiotherapy/occupational therapy assistants, plus one administrator, one recreational/music therapist, and one dietitian). Data collection occurred in two stages: initial interviews (individual or focus group) followed by care observations, with additional interviews as needed after observation. Each session, lasting for one hour, was audio recorded, transcribe verbatim for analysis. Data were analyzed using thematic analysis by multiple coders. Findings revealed that while interRAI LTCF and RTLS data were available, their integration into care planning was inconsistent due to outdated admission records, data interpretation challenges, communication gaps, and staff shortages. Residents and families often lacked awareness of care plans, limiting their engagement in decision-making. However, facilitators such as incorporating residents’ social histories, leveraging RTLS to track activity patterns, ensuring regular data updates, and fostering interdisciplinary collaboration improved data utilization. Enhanced training, structured implementation strategies, and tailored communication methods were identified as essential to strengthening data-informed care planning. Although routinely collected data have the potential to enhance resident-centered care planning, systemic barriers hinder their effective use in LTC settings. Addressing these challenges through targeted interventions, improved staff training, and knowledge user engagement can optimize data-driven decision-making and improve resident outcomes. Future efforts should focus on integrating digital health tools and structured implementation frameworks to maximize the benefits of data-informed care planning in LTC homes. Not applicable.