Minimum Staffing Guidelines for cystic fibrosis clinics in Canada

Cystic Fibrosis Canada, in collaboration with Canadian cystic fibrosis (CF) clinicians across all CF disciplines (i.e. nursing, social work, pharmacy, physiotherapy, dietitian, CF physicians), developed Minimum Staffing Guidelines for Canadian cystic fibrosis clinics. These guidelines are to help ensure that all Canadians living with cystic fibrosis (CF) and their families receive the best care possible.  

Why are these guidelines important? 

Each person living with CF has a unique journey as they navigate their health. With the introduction of new life-changing medications, such as CF modulators like Trikafta, the experiences with CF continue to evolve. Although it is positive that individuals with CF are living much healthier and longer lives, they are also potentially facing different age-related health challenges, such as heart disease, and CF-related diabetes, that were otherwise rarely seen. As individuals living with CF navigate new care journeys, clinic staff requirements need to reflect these new experiences.  

The guidelines are intended to be utilized by CF clinic/ hospital leadership as a benchmarking tool for working towards adequate staffing levels within every CF clinic in Canada on an ongoing basis, and thereby ensuring equitable care for every Canadian living with CF.  

What are these guidelines? 

The minimum staffing guidelines: 

• Outline the minimum staffing standards required for Canadian CF clinics to operate with adequate personnel resources available to meet the needs of the population being served, regardless of city or province.    
• Provide a minimum standard for staffing models within Canadian CF clinics based on clinic size and clinic type, keeping in mind current and anticipated changes in CF care.  
• Clinic size is identified by: Large clinics (greater than 125 patients annually), medium clinics (between 50-124 patients annually), and small clinics (less than 50 patients annually).  
• Clinic type may be adult, pediatric, or combined. 
• Will align with the new CF standards of care that are currently in development. 

What happens if my clinic doesn’t meet the recommendations? 

Over the past several years Cystic Fibrosis Canada has monitored increasingly positive health outcomes for people in Canada with cystic fibrosis through our annual data report, these positive outcomes are a testament to the world class healthcare our community already receives. If your  Canadian CF clinic does not yet have the recommended staffing positions in place, please know that you are still receiving quality care.  

This document includes new and evolving staff guidelines based on current evidence and taking into consideration the recent introduction of  life-saving treatments for most people living with CF (e.g., Trikafta). Canadian CF clinics may not yet have the recommended staffing positions in place and staffing needs will continue to change over time based on many factors that are unique to each clinic and their population. It is important to have open and honest discussions with your CF team about the guidelines as they can provide insight into how they are working to meet the minimum recommendations and if there are ways you as a patient/caregiver can support this work. 

What is my role as a person living with CF or a caregiver/family/support person to advocate for more staffing resources within my clinic?  

The many ways in which you can support increasing staffing resources at your clinic include: 

• Engaging with your clinic by asking what steps are being taken to reach the recommended levels.  
• Building rapport with your clinic staff to help ensure that you are comfortable discussing concerns and recommendations. 
• Becoming informed by asking your clinic staff how they meet the staffing guideline recommendations. 
• Advocating by joining hospital patient advisory groups to share relevant stories from the CF clinics and about the importance of these guidelines. 
• Focusing on the positives while trying to address gaps in staffing (if relevant) 

Across the country, CF clinics are dedicated to providing excellent, comprehensive care to people living with CF. Clinicians are working hard to ensure appropriate staffing for their clinics to deliver this care. By continuing discussions and being part of the conversation, together, the CF community can advocate for change. While your clinic may not currently meet the recommendations, the guidelines are a tool that clinic leadership can use to advocate for the personnel resources required to provide excellent patient care. 

Should you have any questions about these guidelines, please reach out to Jana Kocourek, Director of Healthcare programs at Cystic Fibrosis Canada at jkocourek@cysticfibrosis.ca