Excellence through Quality Improvement Project (E-QIP)

Transcription

1 Excellence through Quality Improvement Project (E-QIP) SW LHIN KE March 22, 2017 #EqipON

2 Agenda Overview of E-QIP Organizing Frameworks Work to Date E-QIP Project Profiles Questions & Discussion

3 E-QIP

4 The Excellence through Quality Improvement Project (E-QIP) E-QIP is an 18-month partnership project between Addictions & Mental Health Ontario, Canadian Mental Health Association, Ontario & Health Quality Ontario to promote and support quality improvement (QI) in the community mental health and addictions sector. E-QIP is based on the sectors existing commitment to providing high quality, person-centered care to individuals and families.

5 Mission increasing the understanding of quality in mental health and addictions care, working towards improvement in key domains of quality, increasing sector-wide QI learning and mentorship, highlighting promising quality improvement practices, and building readiness within the sector to embrace the Excellent Care for All Act (ECFAA) principles

6 Mental Health & Addictions Leadership Advisory Council Nov Mental Health and Addictions Leadership Advisory Council Members represent diverse sectors that work on mental health and addictions issues The Council has five working groups Community Funding Reform Youth Addictions System Alignment and Capacity Prevention, Promotion and Early Intervention Supportive Housing In December 2015, the Council released their first annual report titled Better Mental Health Means Better Health For more information about the Council: 6

7 High Performing Mental Health & Addictions System for Ontario 7

8 Organizing Frameworks

9 Model Areas Goals Safe Equitable Effective Individual Timely Personcentred Efficient Model for Improvement HQO Quality Domains Quadruple AIM

10 Organizational Factors Culture Leadership Strategy & Policy Structure Resources Information Communication Skills Training Baker et al., 2008

11 Work to Date

12 Engagement & Alignment

13 Organizations are at different stages of QI Readiness (n=67) Data System for QI 56 QI Committee 53 Dedicated QI Staff Formal Policies % of Organizations 22 QI Model Dedicated time for QI

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15 Provincial QI Readiness

16 What can E-QIP do? Indicators and benchmarks for MHA QI training QI coaching Community of Practice Mentorship opportunities Tools and templates including models and QIPs Data analytics support Identify best practices Common language

17 Training & Education

18 Training and Education Completed 2016 In Progress 2017 (As of March 21) Training N Training N Influencing Change (2) 58 IDEAS (9 Regional Sessions) 72 Leadership (1) 106 IDEAS (Organizational sessions) IDEAS (7 Regional Sessions) 100 Experience-based Co-design 62 Webinars (3) 176 Webinars 112

19 QI STAGE & TOOLS/CONCEPTS MODEL FOR IMPROVEMENT Preparing for QI Model for Improvement Project charter Problem statement: 5W2H Defining the Problem Process Map Fishbone & 5 Why Pareto Chart Aim statement What are we trying to accomplish? Measuring & Understanding Your System Driver diagram Measures & Data Collection Run charts How will we know that a change is an improvement? Creating Change Concepts Developing & Planning Solutions Impact Effort Grid What changes can we make that will result in improvement? Testing & Implementing Change PDSA Tool Sustainability & Spread Seven Spreadly Sins Spread Planner

20 IDEAS Training Feedback % Agreed IDEAS Training increased understanding: QI diagnostic tools and processes (90.8%) The Model for Improvement (89.2%) How to develop a QI project (87.7%) and General QI (86.2%) Very helpful tools and information will be used to process change in our changing environment I have enjoyed this learning experience and plan to incorporate what I have learned into my work I will be able to apply what I learned to my work Strongly Disagree Neither Disagree Agree nor Disagree Agree Strongly Agree Missing

21 #EqipON E-QIP Webinar Series Webinar 1: Introduction to E-QIP Webinar 2: E-QIP Supporting You in Quality Improvement Webinar 3: Supporting a QI Culture Webinar 4: The Use of OCAN in Quality Improvement Webinar 5: Quality Improvement and the OPOC Tool UPCOMING: Date: March 29 from 12:00 1:30 pm Webinar 6: The Role of Data in the QI Process Future webinars will be coming up. To get on our mailing list to learn about these opportunities, please quality@e-qip.ca

22 E-QIP Coaching

23 Coaching Coaching applications accepted: 32 Organizations supported to date: 48 Domain of Quality Number Example Safe 3 Improve hand hygiene compliance Client Centered 7 Improve client engagement in recovery planning Effective 5 Increase the completion of OCAN clinical assessment Efficient 1 Improve transitions between adult and youth crisis services Timely 7 Improve access to OTN clinics Equitable 0 N/A All/ General 5 Organizational support and develop of QIP frameworks Total 28 (out of 32 applications)

24 Coaching 1. Traditional QI project coaching using the Model for Improvement 2. Agencies receiving more general QI and Data coaching support focusing on the factors supporting QI readiness (Baker et al, 2008) 24

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26 Applications by Geography 26

27 LHIN 2 CMHA Huron-Perth Salvation Army Centre of Hope CMHA Middlesex

28 LHIN 1 House of Sophrosyne LHIN 2 CMHA Huron-Perth Salvation Army Centre of Hope CMHA Middlesex LHIN 4 CMHA Niagara Oak Centre LHIN 5 CMHA Peel LHIN 6 STRIDE TEACH- Enhancing Peer Support Initiative Applications by Geography LHIN 7 Jean Tweed Street Health Fred Victor Centre St.Stephen s Community House Madison Community Services St. Jude Community Homes LHIN 9 CMHA Haliburton Kawartha Pine Ridge LHIN 10 Youth Habilitation LHIN 11 McKay Manor Ottawa Salus LHIN 12 Chigamik Community Health Centre CMHA Simcoe County LHIN 13 Monarch Recovery Services Jubilee Centre DeNovo Treatment Centre South Cochrane Addictions Services CMHA Cochrane- Timiskaming CMHA Nipissing CMHA Sudbury LHIN 14 CMHA Kenora Changes Recovery Groups: - Residential Treatment Community of Practice - Toronto Mental Health and Addictions Supportive Housing Network 28

29 E-QIP Project Profile: CMHA Nipissing 29

30 Serves North East LHIN 12 Volunteers 43 Staff 30

31 Programs and Services Social Rehabilitation Case Management Outreach Trusteeship Developmental Disabilities Services Youth Mental Health Diversion Court Support Mental Health Diversion Housing Outreach Release from Custody Transitional Case Management..and more! 31

32 Safe Problem: The length of time an individual waits between first point of contact and notification of acceptance or non acceptance into the Housing Outreach, Trusteeship and 416 Lakeshore Services. Equitable Individual Effective Aim: By March 31, 2017, we will reduce the number of days waiting for individuals between the submission of referral and notification of a decision by 20%. Timely Personcentred Efficient 32

33 Intake Process Map 33

34 CMHA Nipissing Regional Branch Fishbone Diagram for: Improving Client Referral to Decision Notification Process for Bridges Program Applicant Staff Process/ Procedures Lack of trained intake staff Lack of forms uploaded to CRMS Lack of Accountability Lack of understanding Lack of specialized staff to address complex applicant needs (ex. Dual diagnosis, Addictions, ABI) Lack of defined program criteria Lack of clear terminology with CRMS Lack of support to manage complex needs of applicant Lack of clarity regarding clear criteria for program acceptance/non-acceptance Lack of staff training regarding proper use of CRMS system Lack of coverage when staff performing intake duties is away Lack of knowledge/understanding regarding program capabilities/limits Lack of models of reference as program is unique Lack of access to capacity assessments Lack of funds for training Lack of process for informing reception about acceptance/nonacceptance/status of referrals Lack of defined process regarding data entry into CRMS & expected timelines Shortage of dedicated interview/assessment space Inadequate technology set up to allow immediate data entry with client during assessment The length of time an individual waits between the agency receiving the referral and notification of acceptance or non acceptance into the Housing Outreach Service of CMHA Nipissing Regional Branch is too long. Potential applicants are having to wait longer than 20 days to receive notification of decision. Policies External Factors Equipment/Space

35 # days waiting between submission of referral and notification of a decision Aim Statement By AUGUST 31, 2017, we will reduce the median number of days waiting for individuals between the submission of referral and notification of a decision by 20%. Primary Drivers Secondary Drivers Change Concepts/Ideas Process Measures Increased Program consistency Increasing Awareness Capitalizing on available staff time Define program criteria Internal knowledge External Knowledge Develop training module for new staff orientation to intake Set daily hours to work on intake /assessment Set timeline standard for accountability ( Finalize List of Inclusionary criteria (ex. Primary Dx is AXIS 1) Bi-annual program updates to all staff re: any changes/updates Display visual metrics in the office (ex. On vision board)???? In service OR newsletter re: program updates (use Connex) # days staff reported utilization of 2 hours of dedicated time between 10am-2pm # days staff reported utilization of 2 hours of dedicated time outside 10am-2pm # of referrals that the timeline standard was applied to # of inappropriate referrals received Improved data (accuracy, consistency) Increase use of technology Reduce duplication of e-file and hardcopy CRMS Training-specifically re: inputting data at receipt of referral. Place computer with internet access in meeting space (small meeting room) Have assessment forms available in CRMS Explore paperless consents & E- signature on tablet # staff trained in CRMS data input # of times assessment form was filled in CRMS (once we have developed the embedded form)

36 By improving the quality of our intake process, we hope to ameliorate the client experience from the time that they walk through our front door. We are hopeful that this process will assist us with keeping applicants informed about their status within the organization, and allow us to more efficiently redirect them other resources within the community that may be more appropriate for addressing their current needs. Kali, Project Lead 36

37 E-QIP Project Profile: Salvation Army Centre of Hope London Michael Annett, The Salvation Army Centre of Hope Withdrawal Management Manager Andrew Span, E-QIP Data Coach Quality Improvement, Technology and Special Projects Wayside House of Hamilton 37

38 Salvation Army Centre of Hope Problem: The Salvation Army Centre of Hope has been collecting withdrawal symptom severity data for its clients for a number of years. Currently the organization does not have a data interface or technology to support decision-making and QI with respect to managing withdrawal symptoms. Equitable Safe Individual Effective Aim: The purpose of this project is to develop an Excelbased interface that will track withdrawal symptom severity data, provide a user friendly interface for statistical analysis and evidence to inform decision making going forward. The project aims to have this deliverable completed by March 31st, 2017 Timely Efficient Personcentred 38

39 Salvation Army Centre of Hope 39

40 Salvation Army Centre of Hope 40

41 Salvation Army Centre of Hope 41

42 Resources

43 Resources and Access Peer Support Advanced IDEAS Introduction to IDEAS Leadership Training Supporting QI Webinars E-QIP Collaborative Community of Practice Institute for Health Improvement (IHI) Open School QI & Data Coaching (30 agencies) Resources Access Training & Education Coaching Agency Coaching Project Coaching

44 Questions & Discussion Are there opportunities or initiatives that you think E-QIP should be aware of? What would supports helpful to further expand QI efforts?

45 Learn More about E-QIP #EqipON

46 Michael Dunn, MSc Director of Quality Improvement CMHA Ontario (Toll-free in Ontario) Sandra Cunning, PhD, CE Director of Quality Improvement Addictions and Mental Health Ontario #EqipON