Ajoc inecma presentation oct 2014
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Outline of quality improvement initiative for residential care settings in Ireland - promoting excellence in end of life care for people with dementia
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Ajoc inecma presentation oct 2014
- 1. A Journey of Change Anna de Siún, National Development Co-ordinator, Residential Care
- 2. Our Vision: Building a community of residential care centres dedicated to continuous quality improvement in end of life care
- 3. “Good end-of-life care is flexible, contemplative and responsive to residents needs in order to capture the uncertainty associated with increasing dependency, dying and death” HIQA, 2013
- 4. Developing ‘A Journey of Change’ • A wealth of resources, education and training on end-of-life care. • Provide staff with the tools and skills needed to conduct continuous review and reflection on EoLC after the death of a resident. • Recognising the challenge of change. • Giving staff the skills and knowledge to implement effective change. • Facilitate RCCs to identify and access the resources most appropriate to their needs. • Differing needs.
- 5. How does it work? Building Excellence Growing Excellence Strengthening Excellence
- 6. Building Excellence • Become part of a community supported by the on-line support network. • Regional On-line Meetings. • Regular bulletins regarding best practice in EOLC. • Webinars. • Depository of up-to-date information on EOL education and resources. • Receive the EOLC Toolkit for RCCs. • Communication with a person who has dementia, care planning, assessment, care after death, bereavement support. • Receive an EOLC Resource Pack. • EoL symbol, DVD, posters, bereavement leaflets • Cost: €250. • Annual membership to network, €250 per annum thereafter.
- 7. Growing Excellence • Receive the EoLC Toolkit and Resource Pack. • Training on facilitating structured review meetings after the death of a resident. • Training on change management and utilising the EoLC toolkit. • Guidance on accessing and using resources and tools necessary to meet identified EOLC needs. • Receive phone and e-mail support. • Receive discounted What Matters to Me staff development workshops. • Membership to the on-line learning and support network. • Cost: €500 • Annual membership to network, €250 per annum thereafter.
- 8. Strengthening Excellence • An entire continuous quality improvement cycle supported each step with on-site facilitation from IHF. • Opportunity to reflect on what EoL means to everyone in the care centre and developing their own vision for EoLC. • Facilitated retrospective review after death. • Support to develop and implement individually tailored change projects. • Optimum use of resources to meet their unique EoLC needs. • New set of transferable skills in change management/CQI. • Platform to share learning and best practice. • Cost: 1,000 • Annual membership to network, €250 per annum thereafter.
- 9. Next Steps • Two year pilot project. • Currently engaging with RCCs in the Mid- West, Dublin and North West. • Further information available at stand or by e-mailing: ajourneyofchange@hospicefoundation.ie
Editor's Notes
- Use the terms RCC to capture public and private nursing homes, community hospitals and long stay units.
- What do I need to change? I don’t know – it will depend on your situation There are a number of elements that are necessary to ensure good eolc, but eolc is not one single concrete thing, it is made up of a myriad of elements, which is one reason why there are so many different resources and education programmes that either directly or indirectly, deal with end of life care.
- In developing this programme, we recognised that there is a wealth of resources currently available, and a number of additional education programmes addressing end-of-life care, palliative care and dementia care are currently being developed. We didn’t want to develop something that would compete with what is already out there – we wanted to develop something that would weave together everything that was currently available and coming on stream. We wanted to give RCCs a range of end-of-life resources, but also give them the tools and skills necessary to identify what their own unique needs around end of life care are. In order to identify those needs, it is necessary for each RCC to continually review and reflect on its own end-of life care practices and culture. Therefore this programme provides staff with … This ensures that end of life care does not become a single destination, but continually grows and reacts to new learning. Of course identifying what you would like to change or develop is only one step in the journey – one of the cornerstones of this initiative is recognising the challenge of change. This is a learning we took from our experience of the hospice friendly hospitals programme, whereby it became apparent that people are very good at identifying what they want to change, but actually making effective, sustainable change is difficult. So in this programme we are offering to give staff change management knowledge and skills. This process will allow effective change to occur, and guide centres to identify whether they need additional resources to make those changes, and if so which resources are most appropriate to their needs. Finally, we recognised that no two RCCs are alike, and all will have differing needs. Some have been investing a lot of time in EoLC, while others have been investing time in other care areas – so we wanted to develop a programme that would offer a range of options to best suit the needs and resources of individual RCCs – thus we came up with a three level model.
- The first level is building excellence, and this is aimed at RCCs who wish to develop their EoLC practices, but perhaps are not in a position to dedicate a huge amount of time and resources at this moment. Centres engaging at this level will receive a range of EoLC resources, and membership to the on-line support network, which I will speak more about in a moment. The second level, growing excellence, provides the resources and network membership in building excellence, but also includes two additional workshops, giving staff skills in conducting review meetings after the death of a resident and change management. This level gives staff the skills and knowledge necessary for continuous quality improvement, but leaves them to implement that new knowledge themselves. The third level is strengthening excellence. This is aimed at RCCs who have passed HIQA, and are looking to further develop their EoLC practices. At this level, the centre has an entire continuous quality improvement cycle, facilitated on-site by the IHF. So I’m just going to run through some more of what is involved at each level.