I am a unique individual who wants to live fully with meaning and dignity throughout my life journey

Transcription

1 \ ADDENDUM TO SW LHIN BEHAVIOURAL SUPPORTS ONTARIO ACTION PLAN NOVEMBER 8 TH, 2012 I am a unique individual who wants to live fully with meaning and dignity throughout my life journey

2 Purpose The purpose of this report is to amend the original South West LHIN Behavioural Supports Ontario (BSO) Action Plan previously approved by the BSO, Central Reporting Office January 10th, The highlights of this addendum were presented to the Provincial Resource Team (PRT) Committee on Friday, November 2 nd, Operational challenges were discussed and proposed modifications to the original action plan endorsed. Adjustments to the original action plan will be outlined in the sections below. Summary of Approved BSO South West LHIN Action Plan The LHIN-wide coordination for the BSO and Behavioural Supports Systems (BSS) project (funded through year 2 Aging at Home) will be provided by St. Joseph s Health Care London (SJHC). These Behavioural Supports initiatives, in collaboration with existing geriatric and geriatric mental health programs and services [Community Care Access Centre (CCAC) Geriatric Resource Teams (GRT) and Nurse Practitioners, Alzheimer Societies, Adult Day Programs (ADP), Regional Geriatric Program (RGP) and Regional Psychogeriatric Programs (RPP)] will form a virtual team to enhance services across the LHIN. A collaborative care approach will be utilized to improve access to care and transitions of care for older adults with responsive behaviours across the care continuum. A hub and spoke model has been developed to ensure BSO Long-Term Care (LTC) Home (PSWs,RNs, RPNs) funded positions work in an integrated manner with the Behavioural Supports Mobile Teams, CCAC geriatric resource teams and nurse practioners, Alzheimer Societies, Overnight ADPs, and all other existing programs/services including specialized tertiary supports (RGP, RPP, Geriatric Psychiatry). Additional Health Care Personnel dollars were allocated to hire the following LHIN wide supports: Geriatric Psychiatrist (.8fte), Psychologist (1 fte), Enhanced Psychogeriatric Resource Consultant (EPRC, 1 fte), Alzheimer Society Enhancement of the First Link Program ( 3.0 fte social workers) Overnight Respite ADPs (2.8 fte) Quality Improvement Facilitator (1 fte)

3 Proposed Adjustments to the Behavioural Supports Ontario Model An innovative BSO secondment model was developed for implementation across the LHIN based on extensive consultation with LTC Homes. LTC Homes were asked to second RNs, RPNs and PSWs to become members of the Behavioural Supports Mobile Teams working out of Schedule 1 Hospitals. Collaborative working groups were formed with LTC Home membership to develop an expression of interest application form, expression of interest (EOI) process, question /answer form (with responses to legal, union, risk, human resources issues), and a Memorandum of Agreement (MOU). The EOI packages were sent out to all 78 LTC Homes on August 27 th, 2012 with a September 19 th, 2012 deadline for submission. Despite careful planning and thorough engagement with the sector, too few EOI applications were received and the proposed model could not move forward. A total of 10 EOI applications were received with strong support in Grey Bruce and Huron Perth counties. A shortfall of applications in other counties (London, Middlesex, Oxford, Elgin) prevented the model from moving forward. One of the major barriers identified was the ongoing recruitment and retention of frontline staff. Despite the fact that the majority of LTC Homes supported the secondment model in principle, they were reluctant to loan out their staff for a one- or two-year period. The second barrier identified was that the BSO approach to staffing did not fit with the Behavioural Supports model already in place across the South West LHIN funded through Aging at Home. To mitigate the risk, the local BSS Steering Committee proposed three new models for consideration and discussion. After consultation and engagement with LTC Homes and community partners a new model embedded model was endorsed. The new strategy, similar to the Waterloo Wellington LHIN model, supported the allocation of BSO health human resources to each of the 78 LTC Homes across the South West LHIN. LTC Homes receiving BSO funds will create specialized behavioural support PSWs, RPNs or RNs. Behavioural support positions must work in an integrated manner with existing Behavioural Supports Mobile Teams that operate out of Schedule 1 hospitals.

4 Emerging Model and Implementation New Model endorsed by Steering Committee, SJHC, LHIN, LTC Home Network Council Emerging Model - Distribute BSO funds to each of the 79 LTCH s across the South West LHIN (similar to WW LHIN model) to enhance supports for the effective management of residents with responsive behaviours Funds must be used to create specialized behavioural support positions (PSWs/RPNs/RNs), Behavioural support positions must work in an integrated manner with the Schedule 1 Behavioural Supports Mobile Teams, other specialist supports, and LHIN wide project team Enablers to be Aligned and Strengthened The following enablers were identified and to be aligned with the emerging BSO model: Key contact, leadership and expert roles within each home for other supportive resources (EPRC, Behavioural Supports Mobile Teams, quality facilitator, tertiary team) to directly link to create virtual team Best Practices incorporation of standardized role descriptions, qualifications, recruitment and interview questions, training/education, Quality Improvement (QI) template (Residents First), funding allocation based on number of beds Accountability LHIN Service Accountability Agreement (SAA), MOU with SJHC, quarterly reporting of quality and performance indicators Opportunities to share learnings from each other, Ontario Telemedicine Network (OTN) enhancements

5 BSO Implementation Timeline Nov 16 Funding package to LHIN for review Nov. 27 LHIN funding letters out to LTCHs Nov/12 to Feb/13 education sessions for BSO LTCH staff. Nov. 9 Feedback from CRO Nov. 26 LHIN Board Meeting review package Dec/12 Teleconference with LTCHs Question and Answer Dec/12 to Jan/13 LTCHs hire BSO staff (completed by end of Jan/13)

6 Jan 7 to Jan 18/13 LTCH Work plan Development Days Feb/13 - TCON/OTN with LTCHs (each county) Work Plan Check in March/13 to May/13 individual meetings with LTCHs to review work plans and support progress Feb/13 Collaboration Day Clinical Collaboration Day with LTCHs BSO funded staff Feb 28/13 MOAs Signed by all LTCHs June/13 Collaboration Day Celebrating Successes