The Omaha System Helps Find Meaning in Despair (Using the Omaha System to document disaster recovery efforts)
Finding Meaning in Despair Using the Omaha System todocument disaster recovery efforts Kay Poulsen, BA, MBA, DipSecTchg, PRINCE2 Practitioner HINZ, 25 November 2011
A Tale of Two Cities• Setting the scene and the links to HINZ• The Omaha System• Beyond 22/2/11• The public health warning
How did we get here? A Timeline• HINZ November 2009“To ensure that correct decision making occurs atthe right time, at the right place, and that servicesprovided are at the right level in aconsistent, coordinated way, this clinicalinformation must be valid, reliable, but most of allpresent”.Brent McGrath (1960 – 2010)Changing the way nurses and allied health professionals document and communicatecare in community clinical practice : a community care clinical data set.
Unique features of Omaha System• Problems at family or community level• Potential problems• Opportunities for health promotion• Evaluation of problem rating over time: – Knowledge –do they understand the problem? – Behaviour – are they compliant with the plan? – Status – are signs/symptoms present?
• Holistic evaluation of problems in the setting of a person’s life• Measure the impact of interventions on consumer awareness and consumer engagement as well as clinical outcomes. www.omahasystem.org
Checkpoint 2010: Where are we?• Omaha System• CADI data dictionary• Project GAIN• PLAIN WORDS taxonomy• IT architecture• International partnerships
Delivering the vision• HINZ, November 2010 – Sheree East“The key thing is, understanding thelandscape in which you are operatingis constantly shifting. And when theground shifts beneath you – systemsneed to be flexible and sustainable.
• “We are now ready to embark upon the trial and implementation of the dataset using 21st century documentation and communication technology” (Sheree East, HINZ November 2010)Transforming Clinical Practice through Terminology
The Help4U timeline• Stocktake of agencies• Set up a Facebook page• Linked student welfare division with existing agencies• Commenced coordinating suburban welfare enquiries• Earthquake services A-Z• The lightbulb project
Immediate Aftermath • 100 tertiary care beds • 600 residential care beds • 122 NGO health groups
Student Volunteer Army• Established a ‘welfare division’• Lodged a request for help on Facebook
Social Media• Facebook here: – Red Cross – CDHB – Plunket – Christchurch City Council – St John – City Mission• And overseas – Katrina experiences – Omaha System colleagues
Problems encountered 35 Nutrition 03 Residence 02 Sanitation 38 Personal care06 Communication with community resources 12 Mental Health 41 Health care supervision 07 Social contact 04 Neighbourhood/ Workplace safety % of all cases 01 Income % of all requests 42 Medication regimen 36 Sleep and rest patterns 14 Caretaking/parenting 27 Neuro-musculo-skeletal function 11 Grief 30 Digestion-hydration 09 Interpersonal relationship 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Case Studies• A solo mum, recovering alcoholic, who had been given a bottle of wine in a food parcel• Elderly couple (one dementia, one hearing impaired, both with mobility issues), hadn’t seen anyone for 3 weeks, no portaloo in street, had food laid out on floor and were rationing it• Teenage boy, living alone in condemned house while parents were in Wellington with daughter who had leg amputated at hip due to quake injury. Auntie (mother’s sister) died at CTV.• ‘The Rat Problem’
Where to from here?• TotalCare service – Hospital in the Home• Nurse Practitioner service – Older Persons’ Health• AESOP clinical documentation tool
Hospital in the Home Baseline Rating Substance use Residence Healthcare supervision Physical activity Urinary function Status Social contact Behaviour Nutrition Knowledge Oral healthInterpersonal relationships Personal care Medication regimen 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5