Recommended
Recommended
More Related Content
Similar to Gpc ppt for set june2012
Similar to Gpc ppt for set june2012 (20)
Recently uploaded
Recently uploaded (20)
Gpc ppt for set june2012
- 1. George Pearson Centre Renewal Senior Executive Team June 26, 2012
- 2. Story of Joy 2
- 3. Story of Guy 3
- 4. Story of Diana 4
- 5. Story of Karen 5
- 6. • Picture of GPC 6
- 7. 7
- 8. Story of Karen S 8
- 9. • Picture of GPC 9
- 10. Profile of Residents • 120 residents • Age range 21 – 87 years; average and median: 57 years • 62% male, 38% female • Approximately 19 admissions/year • Neurological conditions • Severe physical disabilities • 50% able to direct care, 50% unable to direct care • Average length of stay - 17 years • 50% of residents using power – 50% using manual wheelchair • 19 residents with tracheostomies + 20 with trachs and require ventilator • 46 residents with tube feeding • 4-6 residents move out to the community/year • 10-13 residents pass away/year 10
- 11. Profile of Staff • 240 FTEs, approx 300 staff • 20% male; 80% female • Average age – 51 years • FT staff: 67% have worked 10 years + • RNs (23%), LPNs (12%), RCAs (33%) • Allied Health Staff (9%) • 48% are from Vancouver area 11
- 12. Drivers for Change • Resident and staff feedback • Continuation of the Eden Journey • Pre-planning for GPC redevelopment • Multiple review documents with recommendations • Strong advocacy group • Media/PR concerns 12
- 13. Process for determining priorities January 2012: • Development of Steering Committee • Interview staff, residents & other stakeholders • Developed themes • Review of historical documents February 2012: • Planned details of improvement opportunities March/April 2012: • Implementation of improvement work • Conduct resident Eden Warmth survey 13
- 14. Not everything that is faced can be changed. But nothing can be changed until it is faced. James Baldwin 14
- 15. Improvement Priorities 1. Practicing all aspects of Person- Centred Approach 2. Improving basic care practices 3. Improving collaboration across nursing roles and enhancing supporting structure 4. Strategic Deployment of Lean Management 5. Developing a communication strategy 15
- 16. #1 – Practicing Person-Centered Care Approach We will achieve this by…. • Completing the Vision/Values work • Developing an education program where staff learn to improve their empathic skills and reinforce professional presence • Exploring strategies to enhance support to meet residents’ emotional needs • Holding everyone accountable to living the vision/mission/values of GPC 16
- 17. Values Respect Safety Trust Individuality Integrity Harmony 17
- 18. Our Mission Brightening each other’s 18 lives………
- 19. Vision Great place to live and work with a Passion for excellence and a Commitment to safe and respectful care Biln, 2010 19
- 20. # 2 – Enhancing Basic Care Practices We will achieve this by….. • Delivering education specific to addressing/managing behavioral issues • Ensuring that orientation is standardized • Resurrecting the one-day GPC specific orientation • Doing a needs assessment for education to develop an ongoing program 20
- 21. #3 – Improving Collaboration among Nurses We will achieve this by…… • Adjusting staffing complement • Delivering education sessions re scope of practice, roles and responsibilities of RN/LPN • Developing structure on various shifts to enhance collaboration – shift report, huddles, routines, assignment • Redesign how work is shared among RN, LPN and RCA 21
- 22. # 4 - Strategy Deployment We will achieve this by…. • Having a focus on Quality Improvement • Using Lean Management principles and tools – Daily Status Sheets – Improvement Board – K board – Breakthrough Improvement Lane – Standardized work 22
- 23. # 5 – Improving Communication We will achieve this by…. • Using Neighborhood Meetings and Resident Council to communicate changes and improvements • Using newly developed monthly staff forums • Posting all information Bulletin board to communicate improvement work • Including a Communications Leader as a member of Steering Committee • Sharing and celebrating improvement work on an ongoing basis 23
- 24. Improvement Priorities 1. Practicing all aspects of Person- Centred Approach 2. Improving basic care practices 3. Improving collaboration across nursing roles and enhancing supporting structure 4. Strategic Deployment of Lean Management 5. Developing a communication strategy 24
- 25. Measurements • Eden Elder Warmth Survey • Staff Engagement and Safety Survey • Sick Time • Overtime • MSIP Injuries • Accreditation • Provincial Resident Satisfaction Survey 25
- 26. Measurements • MDS RAI • # of complaints through CARMA/Client Relations • % of complaints related to disrespectful care 26
- 27. Period 1 YTD SICK TIME Rates Measurements • # of complaints through CARMA/Client Relations • % of complaints related to disrespectful care 27
- 28. Measurements • # of complaints through CARMA/Client Relations • % of complaints related to disrespectful care 28
- 29. Eden Elder Warmth Survey Overview Total 21 questions in the survey – Satisfaction on staff (8 questions - Q2, 3, 5, 7, 8, 13, 17, 19) – Satisfaction on services (9 questions - Q1, 4, 9, 10, 11 12, 15, 16, 21) – Patients’ mood (5 questions - Q6, 14, 18, 20) 49 questionnaire have been completed Overall, 41% of residents responded with positive answers – 35.7% with positive response for staff related questions – 50.8% positively responded with satisfaction (agree or strongly agree) on facility condition & services related questions – 29.4% with positive response for psychological feeling 29
- 30. Eden Elder Warmth Survey Overview Areas we are doing well (over 50% with positive response) The administrator knows my name I feel safe I trust my physician The facility is clean I enjoy my bathing time 30
- 31. Eden Elder Warmth Survey Overview Opportunities for improvement (over 50% with negative response) I rarely see the administrator My room looks much like a room in someone’s home I am comfortable bringing my concerns to a staff member Staff members take time to talk and listen to me 31
- 32. Staff Engagement and Safety Survey 2011 32
- 33. Staff Engagement and Safety Survey 2011 Opportunities for improvement (over 50% with negative response) I rarely see the administrator My room looks much like a room in someone’s home I am comfortable bringing my concerns to a staff member Staff members take time to talk and listen to me 33
- 34. Staff Engagement and Safety Survey 2011 Opportunities for improvement (over 50% with negative response) I rarely see the administrator My room looks much like a room in someone’s home I am comfortable bringing my concerns to a staff member Staff members take time to talk and listen to me 34
- 35. We will know we have been successful when… • Residents receive care that meets their physical, medical, emotional and spiritual needs • Residents and staff feel safe living at GPC • Residents feel respected by staff and staff respected by residents • Residents and staff are living the vision, mission and values of GPC • Residents have input and control over their care decisions 35
- 36. We will know we have been successful when… • Residents feel they can raise concerns without reprisal • Residents feel that their issues are at least explored if not resolved • Residents and staff are reassured that “management” will facilitate conflict resolution • Residents and staff are informed of goings- on at GPC on a regular and ongoing basis 36
- 37. 37
Editor's Notes
- Joy was diagnosed with polio when she was 11 years old. She was at VGH for 1.5 years and then in 1956 transferred to Pearson for another 1.5 years. She then lived with her family until 1973. She has been at Pearson now for 39 years. She is now 70 years old. When asked why she doesn’t return to the community, she said that she is happy at Pearson. Her full time partner comes and visits her every night and they have dinner together. She is one of the founders of Resident Council back in the days of BC Rehab and continues to be a strong advocate for residents. Her hobbies include painting and she is in the process of writing a book about her life. When I met her in the mid-90s she wasn’t trached, but now she has a trach and requires a ventilator. Whenever I need a sounding board, I go to Joy!
- I was Guy’s nurse at Shaughnessy! He has a spinal cord injury from a car accident back in 1992. He has been at Pearson since 1993. He too is content living at Pearson – he has an “office” where he can do all of his techy stuff. He is basically our house IT guy! He is kept busy looking for music and burning CDs for the other residents. He owes his love for computers to a fellow resident who has since passed away. He was my mentor, Guy says. He loves the grounds of Pearson as do many other residents. Guy used to drink a lot but is now sober. Guy is 52 years old.
- Diana is 43 years old and has lived at Pearson for 2 years now after being transferred from Purdy. Diana was diagnosed with phocomelia and lymphodema from birth. Prior to living in residential care facilities, Diana lived on her own with home support. She worked at Neil Squire for 2 years and volunteered with CARMA 10 years ago. But when she got sick she had to quit work and volunteering. She is now back with CARMA – I would often see her visiting with other residents and when I chatted with her back in January, she said that she really enjoys making other residents smile, even if it’s only half a smile! Her ultimate goal is to back to the community, go to school or work and volunteer again. Our biggest challenge right now is how we can facilitate her getting up every day when we have to wrap her with an enormous compression device to decrease her systemic edema. Despite those challenges, Diana herself most always maintains a smile on her face!
- Karen has dystonia since she was 17 years old, and cannot articulate her words clearly 9dysarthric . She uses a communication board where she types what she wants to say and the words come out automatedly – alternative and augmentative communication device. She came to Pearson in 2000 and married a fellow resident Guy in 2006. Karen used to live in the community until she could no longer look after herself. She had the opportunity to move back to the community a few years back but because Guy’s condition is precarious, they decided to stay. Karen can often be seen strolling the grounds of Pearson. Right now she is sad because her husband is at VGH trach and ventilated as his medical condition became worse about 3 weeks ago.
- Need to validate with Linda/Marion
- Use nursing process as framework for assessment, planning, intervention and evaluation
- What have we faced that can be changed? Or that we decided to focus on?
- Lack of vision, mission and values specific to GPC to guide provision of care Gaps in providing emotional needs of residents Stall in implementation of Eden philosophy
- Read out statements from document for each value
- Dr. S. deRappard’s sessions Standardized orientation schedule for various roles Using competency tools at the outset for new staff Resurrecting one day GPC specific orientation Will conduct Needs Assessment from staff and develop continuing education plan
- Addition of LPNs on 2 wards Lack of consistency in operationalizing the LPN role on various shifts/wards Lack of understanding of LPN/RN responsibilities Lack of teamwork Lack of structure / standardized work
- Have RCCs start taking Lean classes starting with A3/VSM Pesentations to steering committee, interprof practice council, residents council re Lean Management and principles by Lean team Using status sheet twice weekly Introducing Improvement Board
- Lack of robust communication channels Culture of perceived non-transparency SO what have we done?
- How do we know that the changes we are making are an improvement? MDS RAI haven’t extracted data yet
- Need to consider number of staff who residents complain about staff who are not practicing patient centred care
- If we get some good 'warmth' then we can feel more confident in making changes (the people of GPC are ready and receptive for changes) Eden Alternative Warmth Surveys measure the levels of optimism, trust and generosity across an organization. This is very different from satisfaction surveys; it is more like a cultural assessment. In order to prepare an organization for change, people need to be optimistic, trusting of leaders and have a generous spirit. These surveys provide the measurements leaders need to know as they guide change on the culture change journey."
- Goal is to do more focus groups to drill down on issues especially re bringing up concerns to staff and staff taking time to talk to residents.
- N = 43 AVERAGE 3.67 for Q12 Overall satisfaction: How satisfied are you with VCH as a place to work? AVERAGE score is 4
- N = 43 AVERAGE 3.67 for Q12 Overall satisfaction: How satisfied are you with VCH as a place to work? AVERAGE score is 4
- AVERAGE score for safety: 3.38 Again, focus groups will inform us of much more regarding safety. As we know the response rate was relatively low so definitely need to hear from more staff.
- Staff feel they have input into decisions