TREC Measurement System (TMS)

What is the TREC Measurement System?

The TREC Measurement System (TMS) is a platform technology that enables us to leverage data for intervention studies, facility and regional level feedback, pilot studies, system projects, trainee projects and to form working groups to tackle specific questions. It is the largest longitudinal database of its kind in Canada and the only one collecting data at the unit (microsystem) level.

What is involved?

Graph showing red and green homes

The TREC Measurement System is a longitudinal study that explores the strength of linkages between work environment, best practice use and resident outcomes using staff survey data and the Resident Assessment Instrument – Minimum Data set 2.0 (RAI-MDS 2.0) data. The study takes place in over 90 nursing homes across British Columbia, Alberta and Manitoba. We have a representative sample of nursing homes that includes facilities of different sizes and owner-operator models (public, voluntary and private).

Data is collected from facilities in three waves spaced approximately 18 months apart. It includes surveys on facilities and units, and from regulated and unregulated staff. Participating facilities will play an important role in building the first longitudinal database of which we are aware of in Canada or elsewhere. We will work closely with Facility Managers, Administrator and Directors of Care to ensure that these data are collected with minimal impact on resident care.

Why is it important?

The TMS database is a rich data source that can be used to provide evidence contributing to system level changes being implemented.

A unique aspect of TMS is its definition and use of the clinical microsystem (i.e., working units) within nursing homes. This level of focus and analysis allows us to demonstrate the benefit of targeting change at the microsystem level as well as the broader levels of care (facility, region, etc.).

These data are combined with RAI-MDS 2.0 outcome data, and further analysis conducted to identify factors (not usually captured) that affect resident outcomes – providing facilities with new knowledge to improve resident quality of care and quality of life.

Progress update: Where are we now?

We collected Wave 1 data between September 2014 and April 2015 from over 4,000 care aides, 1,000 regulated staff, unit/facility managers, and 40,000 residents. We will analyze staff data for important relationships among modifiable elements of work environments, best practice use, and staff health/well-being. Staff data will be combined with RAI-MDS 2.0 data to identify factors that affect resident outcomes and will provide your facility with new knowledge to improve resident quality of care and quality of life.

Wave 2 began in May 2017 and will involve the collection of similar data. We continue to work closely with Facility Managers, Administrators and Directors of Care to ensure that surveys are collected with minimal impact on resident care.

Benefits to the participating facilities

  • Access to a rich source of data that links context, staff and resident data
  • Individualized feedback reports for sites and different levels of staff
  • Opportunity to share and discuss findings and strategies at Regional Summits
  • Participation in projects aligned with regional and provincial priorities
  • Opportunity for involvement in other TREC projects such as SCOPE & INFORM



BC: Interior and Fraser Health Authorities
Alberta: Edmonton, Calgary AHS Zones
Manitoba: Winnipeg Regional Health Authority

Facilities involved

91 long term care facilities (a randomly chosen sample, stratified on public, voluntary and private ownership models and facility size) 

Length of project

2007 to 2018 (longer pending funding)

Data collection

Surveys are collected in waves, spaced at 18-24 month intervals