Moving to 3 rd floor or other unit when ready – turnover fast because of change in physical status. Keeping in the building when transferred – good staff communication of plan Now almost 1 year running the unit – Length of stay in the unit: before transfer to another floor – get an idea of flow. Reviewing affect on wait times for regular SCU Safety Learning System Reports: Medication errors, falls etc.
G2 Rapid Fire: Building on Care in the Community - S. Gilbert and F. Laity
Kiwanis Care Centre (‘KCC’) Francoise Laity, KCC Resident Care Coordinator firstname.lastname@example.org Sara Gilbert, KCC Manager email@example.com
Designing and Implementing an Effective Behavioral Support Unit - Special Care Unit (SCU) Plus
Background 2009: “Vancouver Community Project: Model of Care Framework for Vancouver Coastal Health’s SCU’s”. Pilot: Fairhaven (Vancouver): Chronic Behavior Residential Unit (CBRU) 2010: Need identified for North Vancouver and other Coastal regions.
What is the SCU Plus? Purpose: To serve individuals with moderate to severe cognitive impairment and who face behavioral challenges What is different? Environment Staffing Approach
Project Overview Project Initiation - November 2010 Planning/monitoring: Research/Lit Review Communication Construction / equipment Human Resources (Staff Changes) Staff Education Admission process/criteria Resident Transition Project Implementation – March 31, 2011 (1st admission)
Education Entire Facility Lunch and Learn Dementia: what is it and what does it mean to me? Personhood: Look at Me Communication Making a Difference: Safe Work Practices when working with Individuals with dementia 2 Day Dementia Series Non Violence Crisis Intervention Training
Referrals Kiwanis Care Centre SCU Plus Admission Checklist All items on the checklist must be completed (). Incomplete submissions will be returned. Please fax to Sophie Cole, Priority In the beginning: Access: 604-984-5806. Resident Name: _________________ Facility Name: ______________Type of Bed currently residing: ________________ Paris or MSP #: _________________ Date of Checklist Completion: _________________________ Name and Phone # of person completing the checklist: _________________________________________________ Questions YES NO () () General: Admission 1 2 What is the resident’s current level of care □ EC □ SCU □ IC3 □ Other (specify): _____________________ Please note, only IC residents will be considered at this time. The facility has exhausted all external resources available (e.g. Older Adult Mental Health (‘OAMT’), Geriatric Psychiatry Outreach Team (‘GPOT’), Seniors CNS/CNE) to determine that the present residential care setting is Criteria/Checklist not suitable. Please indicate what resources have been used: 3 The needs of the client can no longer be effectively or appropriately met with the available resources within their present residential care facility. 4 The resident is currently or in the last 6 months been living in a residential care facility, which has not been a successful setting. If the facility was not a successful setting please indicate the reasons why: Prioritization Score tool 5 6 7 The resident is stable (In the prior 7 days he/she has NOT required 2 or more PRNs per day). Current status: The resident is 60 years of age of older (if not, please indicate current age: ___) The resident has been diagnosed with moderate to severe dementia. Relevant test scores must be provided. MMSE Score: ________. Please include a copy. Review Panel Residents will not be considered unless scores are provided or if they do not have moderate to severe dementia. 8 The resident is physically strong and may cause harm to others. 9 The resident has a chronic mental illness 10 The resident is currently acutely ill (medically or acute psychosis or suicidal ideation) Tracking – non- 11 The resident has a brain injury 12 The resident has an ongoing problem of alcohol or drug addiction that is NOT manageable with the supportive interventions 13 The resident is medically complex. If yes, please describe: ambulatory 14 15 Medication compliance. Describe: Outings: Supervised/Unsupervised. Circle most appropriate. Describe: Documentation: Current 16 The resident has had a recent (in the last 4 weeks) Geriatric Psychiatrist and/or Geriatrician assessment. If no, please indicate when the last assessment was completed: 17 The resident has a care plan that contains detailed descriptions of behavioral approaches that have been successful (key phrases, distractions, 24 hr routines, triggers to challenging behavior). Behaviors: Please indicate if the resident has displayed the following behaviors in the last 3 months: 18 Socially inappropriate and/or offensive behavior (provide details): Revised process - 19 20 Aggressive: Abusive or intimidating behavior. It may be verbal like yelling or swearing at people or it may be directed at physical things like hitting or breaking objects. It is not physically directed at a person[s]). Violent: includes threatening to, attempting to, or actually physically harming someone (directed at a person[s]) streamlined 21 Extreme resistance to personal care 22 Persistent exit seeking or history of elopement 23 Poor impulse control, and/or poor insight 24 The resident displays dangerously destructive or aggressive behavior which puts others at risk (provide details):
Environment/Care Planning Social Worker/Resident Care Coordinator admission triage RCC Visit Care plan development Partnerships: Geripsychiatrist, OAMH, CNS, Priority Access, LGH (acute) Medication review
Outcomes Since initiation, only 1 hospital admit due to responsive behavior Flow at KCC Length of Stay Affect on SCU (regular) wait time Accreditation recognition (2011): Kiwanis Care Centre staff and the seniors team are commended for implementing a comprehensive new program including a secure yet home like environment for residents and extensive education and training for staff.