CARF s Consultative Approach to Long-term Care Accreditation. May 15, 2018

Transcription

1 CARF s Consultative Approach to Long-term Care Accreditation May 15, 2018

2 Presenter Jill Allison, B.Sc., MBA Accreditation Advisor

3 Overview of Workshop About CARF CARF in Canada, MB Value, benefits, outcomes Field-driven standards Consultative accreditation process Resources and supports Questions

4 CARF International Group of Companies 4

5 About CARF CARF Commission on Accreditation of Rehabilitation Facilities Status Non-profit Independent Programs Health and human services 5

6 CARF Quick Facts Founded in 1966 First Canadian survey in ,500+ service providers with 56,000+ accredited programs/sites * More than 10 million persons served annually by CARFaccredited orgs * Accredited programs in 26 countries Incorporated in 2002 Offices in Edmonton & Toronto service providers with 4,400+ accredited programs/sites

7 Mission The mission of CARF is to promote the quality, value, and optimal outcomes of services through a consultative accreditation process and continuous improvement services that centre on enhancing the lives of persons served. 7

8 Moral Owners of CARF 8

9 CARF s Primary Business The CARF seal of accreditation signifies that a provider focuses on the needs of the persons served and demonstrates commitment to continuously improving service quality. 9

10 CARF Accredits Aging Services Behavioural Health Networks Child & Youth Services Employment & Community Services Medical Rehabilitation Vision Rehabilitation 10

11 Recognition of CARF in Canada British Columbia's Ministry of Children and Family Development (MCFD) and Community Living British Columbia (CLBC) have approved CARF accreditation for both contracted community living agencies and child, youth, and family services. Vancouver Coastal Health, Interior Health, and Fraser Health Authorities (BC) have confirmed that CARF is an accepted accreditation body for contracted residential care providers. Alberta Ministry of Health recognizes CARF as an accepted accrediting organization for seniors care (long-term care, supportive living, home care, palliative care), community mental health, and addictions services. Alberta organizations serving persons with developmental disabilities (PDD) may choose CARF as their accreditation body as a result of a decision by Disabilities, Inclusion and Accessibility Division of Community & Social Services. Ontario Ministry of Health and Long-Term Care recognizes CARF accreditation for long-term care homes and provides a funding premium to accredited homes. Ontario s Community Care Access Centres (CCACs) recognized CARF Canada as a choice for accreditation of certain contracted service providers. Ontario s Mississauga-Halton and Central West Local Health Integration Networks (LHINS) recognize CARF Canada accreditation for certain LHIN-funded agencies. Workers Compensation Board of Nova Scotia requires CARF accreditation for Tier 2 & Tier 3 service providers 11

12 In Manitoba Pilot evaluation underway CARF for Personal Care Homes CARF accepted as an accreditation option for Enhanced Home Care Services Health Care Aide and Home Support Worker Services RFP (WRHA) RHA legislation re: accreditation

13 CARF-accredited Programs/Sites in Canada April 5, 2018)

14 Why do organizations pursue CARF accreditation? Belief in the value of accreditation Establishes a quality framework Consultative accreditation process Distinguishes us in the community Relevance of standards CARF International. All rights reserved.

15 Benefits of CARF Accreditation Business improvement Service excellence Competitive differentiation Risk management Funding access Positive visibility Accountability Peer networking 98% of CARFs customers report accreditation helps improve their business* * CARF Brochure The Value of Accreditation

16 Why choose CARF? Long-standing provider of independent, third-party accreditation Relevancy of standards Well-suited to community-based (non-acute) orgs Non-prescriptive Collaborative CONSULTATIVE Free support from Resource Specialists Large, trained cadre of peer surveyors Self-paced 16

17

18 Ontario Pilot Project Introducing CARF Accreditation into the Long Term Care Sector in Ontario: Evaluation Report CONCLUSION: The overall results of our evaluation of the pilot project are positive. All four objectives of the pilot as outlined in the evaluation framework were substantially or completely met. M OHLTC Recognition (2008) ~270 (>40%) Reference: Introducing CARF Accreditation into the Long Term Care Sector in Ontario: Evaluation Report, Canadian Outcomes Research Institute, September

19 2013 Study Impact of voluntary accreditation on short-stay rehabilitative measures in U.S. nursing homes. Finding: CARF-accredited nursing homes demonstrate better quality with regard to the short-stay quality measures. Conclusion: Approaches beyond traditional regulation and governmental inspections are necessary to improve the quality of care in nursing homes. Reference: Wagner, L. M., McDonald, S. M. and Castle, N. G. (2013), Impact of Voluntary Accreditation on Short-Stay Rehabilitative Measures in U.S. Nursing Homes. Rehabil Nurs, 38: doi: /rnj.94

20 Aging Services Programs Adult Day Services Case Management Specialty Programs: Dementia Care Stroke PC Long-Term Care Community (Personal Care Homes) Networks. Independent Senior Living (Retirement) Home & Community Services Assisted Living (Supportive Housing) (Home Care) 20

21 Development of Standards Active support of: Providers Consumers Purchasers of service Field-driven International consensus standards Process emphasizes performance improvement in business and service delivery

22 CARF Standards Field-driven Non-prescriptive Achievable Community-based Universal Practical Relevant Current

23 Survey Experience Feedback Report, % 94.1% 93.6% 96.2% % Standards Relevant Survey Beneficial All CARF (N=1922) (N=1933) (N=102) Aging Services 23

24 AS Manual Sections Introduction Accreditation Policies and Procedures Changes Program Descriptions and Applicable Standards Sections 1-4 Appendix A: Required Written Documentation Appendix B: Operational Time Lines Glossary Index

25 Manual Updates Annual updates Changes Tab

26 Aging Services Standards Manual: Organization Section 1 ASPIRE to Excellence : Business Practice Standards Practices common to all providers Section 2 Care Process for Person Served Entry, transition, exit and processes for services Section 3 Program- Specific Standards Unique to service type and/or setting Section 4 Specialty Program Standards Optional specialized services Process & Outcome Focus 26

27

28 Section 1: Business Practice Standards ASSESS THE ENVIRONMENT Leadership Governance (Optional) SET STRATEGY Strategic Integrated Planning PERSONS SERVED & OTHER STAKEHOLDERS OBTAIN INPUT Input from Person Served and Other Stakeholders IMPLEMENT THE PLAN Legal Requirements Financial Planning and Management Risk Management Health and Safety Human Resources (in 2018, Workforce Development and Management) Technology Rights of Persons Served Accessibility REVIEW RESULTS Information Measurement and Management EFFECT CHANGE Performance Improvement 28

29 Sample Standard Input (Section 1.D.) Standard 1.D.1. The organization demonstrates that it obtains input: a. On an ongoing basis. b. From: (1)Persons served. (2)Personnel. (3)Other stakeholders. c. Using a variety of mechanisms. Intent Statement Examples Input is requested and collected to help determine the expectations and preferences of the organization s stakeholders and to better understand how the organization is performing from the perspective of its stakeholders. The input obtained relates to the persons served and the organization s service delivery and business practices. The organization identifies the relevant stakeholders, in addition to the persons served and personnel, from whom it solicits input. There are a variety of mechanisms to solicit and collect information. They range from the informal to the formal. * Source: 2017 CARF Aging Services Standards Manual CARF International. All rights reserved.

30 Your organization s input mechanisms Person Served Personnel Other Stakeholders

31 Input Mechanisms Examples Performance improvement activities Written or telephone surveys Suggestion boxes Councils or committees composed of persons served Formal & Informal Complaint or incident summaries Input forums (e.g. advisory groups or consumer forums) Program/ service development Strategic planning 31 * Source: 2017 CARF Aging Services Standards Manual, 1.D.1. Examples CARF International. All rights reserved.

32 Section 2.A.: Care Process Standards Program/Service Structure Scope of services Entry/exit criteria Communication Written agreement/orientation Screenings/assessments Person-centred plans Family/support system involvement Medications training, procedures, Physical plant Wellness promotion Dining services Records Continuous learning Serving persons with dementia Skin integrity and wound care 32

33 Sample Standard Care Process (Section 2) Standard 2.A.2.The organization provides the resources needed to support the overall scope of each program/service. Intent Statement The ability to provide the program/services defined in the scope statement is evidenced by adequate materials, equipment, supplies, space, finances, training, and human resources. Examples Resources may include, but are not limited to, personnel; finance; leadership; space, materials, and equipment; continuing education for personnel; and education for the persons served, their families/support systems, and the community. No Required Written Documentation * Source: 2017 CARF Aging Services Standards Manual 2017 CARF International. All rights reserved.

34 Section 2.B.: Care Process Standards Congregate Residential Program Service delivery planning (e.g. dining, hskg, etc.) Arrangement for wide range of health-related services Physician input End-of life choices Relationship with pharmacist Outside service contracting Polices (pets, guests, smoking, etc) Transportation Individual units (personal choices, emergency call system) Safety and security 34

35 Sample Standard Section 2.B. Standard 2.B.3. Dependent on the needs of the persons served, the program provides, arranges for, or assists with arrangements for the following services: a. Health-related services: (1) Nutrition. (2) Medical care. (3) Health promotion. (4) Home health. (5) Dental care. (6) Nursing services. (7) Mental health. b. Rehabilitation services: (1) Physical therapy. (2) Occupational therapy. (3) Speech therapy. (4) Creative arts therapy. (5) Therapeutic recreation. (6) Assistive technology. c. Social services: (1) Counseling for the persons served. (2) Counseling for members of their families/support systems. (3) Support services. (4) Education on community resources. d. Housekeeping services. e. Laundry services. f. Security services. g. Transportation services. * Source: 2017 CARF Aging Services Standards Manual No Required Written Documentation CARF International. All rights reserved.

36 2017 CARF International. All rights reserved.

37 Sample Standard Section 3.C. Person-Centred Long-Term Care Community Standard 3.C.15. Policies and written procedures address nursing services, including assessment, implementation, and planning, as well as critical decision making regarding: a. Education related to identified needs of persons served. b. Post medical/surgical care issues. c. Medications. d. Pain. e. Rehabilitation issues. f. Skin integrity. g. Need for specialty consultation. Intent Statement Examples 15.b. Services could include incision care, Foley catheter care, deep vein thrombosis prevention, and respiratory care. * Source: 2017 CARF Aging Services Standards Manual Required Written Documentation CARF International. All rights reserved.

38 Sample Standard Section 3.D. Home and Community Services Standard 3.D.7. Service delivery is scheduled at an agreed-upon time that supports the person-centred plan. Intent Statement Examples No Required Written Documentation * Source: 2017 CARF Aging Services Standards Manual CARF International. All rights reserved.

39 CARF maintains contact with the organization Contact CARF Canada staff CARF International Resource Specialist assigned Conduct a self-evaluation Submit the Annual Conformance to Quality Report Submit a Quality Improvement Plan Steps to Accreditation Submit the Survey Application CARF invoices for the survey fees CARF renders the accreditation decision The survey team conducts on-site survey CARF selects the survey team 2017 CARF International. All rights reserved.

40 Resource Specialist Important contact! Consultation Customer Connect Interpretation of standards Process guides Continuous support Complimentary 40

41 About CARF Surveyors Selection matching expertise with organizations Training/experience Conflict of interest process Consultation ~1,400 41

42 The Survey Presurvey Poster Pre-survey contact Survey Orientation conference Interviews, observation, documentation Exit conference 42

43 Step 6: Peer Review Survey Observation Tours Services Interviews Persons served Staff Other stakeholders Documentation Records Policies Procedures Plans 43

44 Possible Accreditation Outcomes* Three Year One Year Provisional Non-Accreditation *Excludes CARF-CCAC programs. 44

45 Resources & Supports CARF Canada Staff Resource Specialist Publications Networking Training Events and Webinars 45

46 Questions? Jill Allison Accreditation Advisor ext