Ajoc presentation dundalk sept 2014
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This document outlines a project called "A Journey of Change" which aims to build a community of residential care centres dedicated to improving end of life care. It describes three levels - Building Excellence, Growing Excellence, and Strengthening Excellence - which residential care centres can join to access resources, training, and support to facilitate continuous review and improvement of end of life care. The ultimate goal is for centres to reflect on and develop their own vision for end of life care while implementing tailored change projects with support from the Irish Hospice Foundation over a two year pilot period.
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Ajoc presentation dundalk sept 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’ • Build on work already undertaken, both in the RCC and in EoLC nationally. • Provide RCCs with the tools and skills needed to conduct continuous review and reflection on EOLC after the death of a resident. • Identifies what is being done well and areas where further development needed. • 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.
- 5. How does it work? Building Excellence Growing Excellence Strengthening Excellence
- 6. Building Excellence • Become part of a community supported by the on-line learning and 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 EOLC 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. “Small things make a big difference” A Good Death: A Reflection on Ombudsman Complaints about End of Life Care in Irish Hospitals, 2014
- 10. Next Steps • Two year pilot project. • Level 3 piloted in 4 geographical areas 2014/2015: Mid-West, South West, Midlands and Dublin. • Anna de Siún; Anna.desiun@hospicefoundation.ie 087 6310667
Editor's Notes
- RCCs networking and sharing practice initiatives, policies, ect nationwide via conferences/online support network/ face to face meets. Online support will include guidelines for best current practice will serve as a depository for information on EOL education & resources, as well as members sharing successes, learning and information. Face to face networking within mid west, meeting several times per year. Another option would be regional meetings via teleconferencing, with web cams provided in resource packs.
- 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, hence the need to be flexible ….
- We wanted this to be a strengths based initiative, one that would take account of, and weave together all the strands of work already undertaken in EoLC. We felt it was important that we recognise that many RCCs have done fantastic work in EoLC, while others are just beginning their journey, so we needed an initiative that would engage with RCCs in a meaningful way where-ever they are on their journey. We also wanted the initiative to take into account the excellent resources and education being developed both nationally and internationally, and be flexible enough to capitalise on this work. As we’ve seen good EoLC needs to be responsive, as each death is individual to the person – therefore it is necessary to continually look at our practices around end of life care in order to continually grow and evolve. This process not only allows a care centre to identify areas they wish to develop or improve, but also identifies what is being done well, affirming for people what they are getting right. One of the biggest areas we wanted to address with this initiative was the challenge of making sustainable effective change. Our learning from the end of life audit and review was that while people are generally very good at identifying areas that need improvement, or things they would like to do differently, actually making the step to changing practice, or changing culture is not an easy one, and it’s the place where many enthusiastic projects falter. So we wanted to embed change management skills into this initiative. Finally, it’s a reality that RCCs have a limited pool of resources, so we wanted to be sure that this approach was going to give RCCs the knowledge they need to ensure that their limited money and resources are put to best use.