Client safety an association care perspective ontario home care association

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  • 1. Client  Safety  –  An  Associa1on   Perspec1ve   Ontario  Home  Care  Associa0on   for     CPSI  Pa'ent  Safety  Week   October  2013  
  • 2. Ontario  Home  Care  Associa1on   Ø Membership  organiza1on  of  those  engaged  in   and/or  suppor1ve  of  home-­‐based  health  care.   Ø Mandate  to  promote  growth  &  development   of  the  sector  through  advocacy,  knowledge   transfer,  and  member  service.   Ø   In  Ontario,  service  provider  organiza1ons   deliver  approximately  54  million  hours  of   publicly  and  privately  purchased  home  care.  
  • 3. Aim   Ø Clients  will  receive  support  to  live  safely  in  their   homes  and  will  not  be  harmed  by  the  care  they   receive.     Principle  of  the  OHCA  Standards  for  Home  Health   Care  Service  Provider  Organiza1ons  
  • 4. Context   Ø  OHCA  members  undertake  a  self-­‐assessment  of  their  performance   to  OHCA  standards  as  part  of  their  membership  renewal.   Ø  Standards  are  grouped  into  five  dimensions:   1.  2.  3.  4.  5.  Governance  &  Accountability   Service  Delivery   Finance   Quality  &  Excellence   Human  Resources   Ø  Members  assess  their  performance  as:   §  §  §  §  §  Substan1al  Compliance   Par1al  Compliance   Minimal  Compliance   Non-­‐Compliant   Not  Applicable  
  • 5. Context   Ø Performance  by  members  to  OHCA  standards  is   presented  to  the  community  using  a  Balanced   Scorecard.  (Kaplan  and  Norton)   Ø Organiza1onal  perspec1ves:   –  Customer  –  sa1sfac1on  &  client-­‐centredness   –  Internal  Business  –  efficiency  &  effec1veness   –  Financial  –  value  &  risk   –  Learning  and  Growth  –  staff  training  &  cultural   a^tudes  related  to  individual  and  organiza1onal  self-­‐ improvement  
  • 6. Safety  embedded  across  all  dimensions   Quality   Dimensions   Evidence     Governance       Engaged  in  client   safety  monitoring   and  ac1ons/   improvements   Service   Delivery   Culture  of  client   safety   Financial   Resources   dedicated  to   client  safety   S  A  F  E  T  Y   Quality     &   Excellence   Emergency   management   Human   Resources   Staffing   Ethical  Prac1ces  
  • 7. Issue   Ø Determining  provider  accountability  for  client   safety  when  the  staff  are  not  in  the  home  and   cannot  control  the  environment.   Ø Reflected  in  self  assessments  of  performance   to  OHCA  standards.   –  Comments  explaining  the  self  assessed  score   –  Concern  expressed  by  members  &  brought  to  the   Board  for  discussion  
  • 8. Interven1on   Ø  The  Plan-­‐Do-­‐Study-­‐Act  (PDSA)  cycle  allows  the  tes1ng  of   ideas  before  implemen1ng  a  full  scale  change.       Ø  From  the  Associa1on  context  the  improvement  cycles   are  longer.   Ø  Board,  members  and  staff  engage  in  the  cycle.     A S A S A S P D P D A S P D P D
  • 9. Interven1on   Ø  Ac1ons:   •  2004  –  Partnership  with  Accredita1on  Canada   •  2005    -­‐  Par1cipa1on  on  Cri1cal  Indicator  Data  Collec1on  Expert  Panel  for   MOHLTC  funded  research  –  Adverse  Events  in  Home  Care     •  2007  -­‐    Support  Peel  Senior  Link    Medica1on  Management  ini1a1ve   •  2008  –  Discussion  with  Board  by  N  Sears,  Principal  Inves1gator,  Adverse   Events    in  Home  Care     •  2009  –  Establishment  of  Pa1ent  Safety  page  within  OHCA  members  only   resources   •  2010  –  2012  Knowledge  Exchange  Broker,  Safety  at  Home:  A  Pan-­‐Canadian   Home  Care  Study,  funded  by  CPSI,  CIHR,  CHSRF   •  Ongoing  since  2008:   §  Research  Month  –  educa1onal  sessions  for  members  and  their  staffs   §  Educa1onal    webinars  such  as  Infec1on,  Preven1on  &  Control;  Mee3ng  &   Exceeding  the  Excellent  Care  for  All  Act  Expecta1ons;  Crea1ng  Befer   Value  in  Home  Care;  Understanding  RAI-­‐HC  assessments   §  Board  agenda    
  • 10. Measurement   Ø  Measurement  is  cri1cal  to  bringing  new  knowledge  into   prac1ce.   Ø  Improvement  in  OHCA’s  goal  of  ensuring  client  safety  when  in   receipt  of  home  care  service  was  achieved  through  qualita1ve   measures:   –  Reports  from  members  on  annual  their  self-­‐assessments  that  their   organiza1on  has  established  a  Client  Safety  Plan  which  aligns  to  strategy  &   quality   –  Feedback  from  members  that  client  safety  metrics  are  measured  and   descrip1on  of  metrics  used   –  Provider  discussion  at  Board  mee1ngs     Ø  Quan1ta1ve  measures  include:   –  #  of  visits  to  OHCA  member  only  client  safety  web  page   –  #  of  par1cipants  on  OHCA  webinars  related  to  client  safety  
  • 11. Contribu1on     Ø  There  is  an  important  role  for  associa1ons  to  champion  safety   in  home  care.   Ø  Based  on  the  OHCA  quality  journey,  the  Associa1on   recognizes  the  need  for  safety  as  a  dis1nct  standard  and   scorecard  perspec1ve.   Ø  A  dedicated  policy  paper  on  client  safety  in  home  care  in   Ontario  will  be  developed.  
  • 12. Lessons  Learned   Ø While  safety  issues  permeate  all  aspects  of   service  delivery,  client  safety  needs  to  be   iden1fied  as  a  strategic  priority.   Ø Associa1ons  can  enable  collabora1ve  work  to   help  educate  and  enable  sustainable  prac1ces   regarding  client  safety;  risk  management;   managing,  mi1ga1ng  or  preven1ng  harm.  
  • 13. Thank  You     Sue  VanderBent,  CEO   sue.vanderbent@homecareontario.ca           www.homecareontario.ca                                                  @HomeCareOntario