2018/19 Quality Improvement Plan

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1 2018/19 Quality Improvement Plan Headwaters Health Care Centre, 100 Rolling Hills Drive, Orangeville, Ontario, L9W 4X9 AIM Measure Change Quality dimension Issue Measure/Indicator Type Unit / Population Source / Period Organization Id Current performance Target Target justification Planned improvement initiatives (Change Ideas) Methods Process measures M = Mandatory (all cells must be completed) P = Priority (complete ONLY the comments cell if you are not working on this indicator) A= Additional (do not select from drop down menu if you are not working on this indicator) C = custom (add any other indicators you are working on) Effective Effective transitions Rate of psychiatric (mental health and addiction) discharges that are followed within 30 days by another mental health and addiction admission P Rate per 100 discharges / Discharged patients with mental health & addiction CIHI DAD,CIHI OHMRS,MOHTLC RPDB / January - December Maintain current performance whilst acknowledging constraints as our organization does not have mental health inpatient beds or a psychiatrist. 1)Evaluate Health Quality Ontario (HQO) Quality Standards for Major Depression in order to assess adherence and compliance with recommendations and quality statements. 2)Patient have a coordinated crisis care plan when they are assessed in Emergency Department. Utilize the "Getting Started" toolkit review quality Conduct a gap analsysis between current practice and statements for the organization and seek understanding review 12 Quality Statements of the problems encountered which can contribute to readmission of patients. Crisis worker within the Emergency Department assesses patients and ensures a coordinated crisis care plan is developed and all team members are aware of the plan of care including the patient/family. # of mental health & addictions patients who have a coordinated crisis care plan Target for process measure Completed reviews of 12 Quality Statements by Q2 for action planning 100% of mental health & addictions patients who are assessed in Emergency Department have a coordinated crisis care plan Comments 3)Continue to work and support the Sub-Region Collaborative for Mental Health initiatives Collaborate with colleagues and partners in order to develop, maintain and improve care for patients and families managing mental health and addictions. Attendance of bi-monthly sub-region collaborative meetings and participation in working groups. 5 out of 6 meetings attended 4)Continue to work with William Osler Health System to improve access to Ontario Telemedicine Network (OTN) and psychiatry services. Evaluation of patients who are eligible to access OTN psychiatry assessments and evaluation in order to reduce their length of stay within Emergency Department or within inpatient unit with the intention to provide care to prevent readmission. # of patients OTN psychiatry assessment within 2days of OTN assessment request 75% of patients eligible for OTN psychiatry service assessed within 48hrs Headwaters Health Care Centre does not have dedicated mental health inpatient beds and there is a MOU with William Osler Healthcare Centre to transfer patients who require inpatient mental health admissions. Risk-adjusted 30-day P all-cause readmission rate for patients with COPD (QBP cohort) Rate / COPD QBP Cohort CIHI DAD / January - December Improvement 1)Implement Enhanced targeted with a COPD Order Set 2% improvement Order Set reviewed through Professional Practice Approval of Enhanced COPD Order Set in Q1 Advisory Council and Medical Association Committee for approval. COPD order set implemented by Q2 Change idea not implemented on 17/18 plan carried over to 18/19 3year plan.

2 2)Develop and implement enhanced COPD Education for staff. Develop education and e-learning module in Learning Management System to standardize patient teaching. Education staff in the principles of teach-back methods as a method for enhancing patient education and support.utilize best practice literature and HQO Quality Standards for COPD. Learning module completed by Q3. % of staff completed e-learning module. % of staff completed education on the principles of teach back methods. 75% of staff completed e- learning module by Q4 As above 3)Identification and referral of patients at high risk for readmission to HealthLinks Program. In conjunction with discharge checklist and discharge promotion whiteboard, identify patients at high risk of readmission who would benefit from HealthLinks Program support. Develop method to identify # of patients not already registered with Health Links who are being discharged and track on a monthly basis in conjunction with home and community services. Monitor the # of newly identified patients to HealthLinks by 2% by end of Q3. As above 4)Development of discharge information package for COPD patients. Gather current information given to patients and review literature/advice available to assist patients with COPD with their discharge and transitions out of hospital. Review ARTIC PODS (patient orientated discharge summary) approach and HQO COPD Quality Standards Patient Information Guide. Discharge package developed, reviewed by Patient Discharge package Advisory and approved for implementation. Utilize PDSA implemented by Q3 with cycles for revision. feedback from 10 patients on content and helpfulness of information. Effective transitions Did you receive enough information from hospital staff about what to do if you were worried about your condition or treatment after you left the hospital? C % / All inpatients Inpatient Discharge Calls / April to June Maintain current performance 5)Explore opportunities to Partner to connect patients with remote monitoring optimally link patients with service for patients of Dufferin county to improve remote monitoring program support to patients with COPD. This would in from Paramedic Dufferin conjunction with other remote services such as Services. Telehomecare and emerging paramedic Dufferin 1)Development and implementation of Discharge Checklist for patients and clinical teams to ensure that early preparation for discharge is commenced on admission. Development of standard discharge checklist and procedures/proceses for use by clinical teams and patients. Gain feedback from patient advisors on design of patient discharge checklist. Review of services for scope and impact to improving readmission rates. monitor % of patient referred to remote monitoring programs. Approval of standard discharge checklist by internal governance committees and implementation through education Baselinie line measure review to be completed by Q2. Checklist to be piloted on 1 Change idea not acute inpatient unit by end implemented on 17/18 of quarter 3 by 2018/19. plan carried over to 18/19 in 3year plan. 2)Design discharge patient information package to provide helpful essential information to patients when being transferred from hospital to home. Gather current information given to patients and review literature/advice available to assist patients with their discharge and transitions out of hospital. Develop and implement HHCC Discharge information package with a view to developing others for top admission/readmission. Evaluate ARTIC PODS (Patient Orientation Discharge Summary) approach. Discharge package developed, reviewed by Patient Discharge package Advisory and approved for implementation. Utilize PDSA implemented by Q3 with cycles for revision. feedback from 10 patients on content and helpfulness of information. 3)Educate staff in the principles of teach-back methods as a strategy to enhance patient education and support post discharge. Develop and implement education sessions through Learning Academy with take away literature and develop e-learning module in Learning Management System. % of staff completing education. Monitor for improvement in patient feedback via inpatient survey results relating to discharge information. Achieve 75% of nursing Change idea not staff received education by implemented on 17/18 end of Q4. plan carried over to 18/19 in 3year plan. 4)Review and refresh of Patient Whiteboards communication tools on inpatient units. Redesign of patient whiteboards to enhance communication between patients, families and providers. Working group to design standard layout which includes patients' and families' feedback. Approved whiteboard redesign. Whiteboard refresh implemented on 3 acute units by Q2. Audit of completion rates for admitted patients on a bi-weekly basis. Education for providers on how to complete the whiteboard for 3 inpatient units. 80% completion of Patient whiteboards are whiteboards on 3 inpatient currently in use. units during Q3 & 4. Efficient Access to right level of care Total number of alternate level of care (ALC) days contributed by ALC patients within the P Rate per 100 inpatient days / All inpatients WTIS, CCO, BCS, MOHLTC / July - September Maintain current Review of coding indicated that mental health 1)Implementation of Blaylock Risk Assessment Screen Tool (BRASS) for early warning of increased length of stay and therefore Implementation of BRASS Tool for direct admissions from Emergency Department which will be integrated into admission assessment. % of direct admissions from Emergency Department to F Wing with BRASS Screening completed 75% of patients direct admission from Emergency Department with BRASS Screening completed. Evidence indicates that the use of BRASS Tool can contribute to improved care outcomes for patients.

3 specific reporting month/quarter using near-real time acute and post-acute ALC information and monthly bed census data ALC days contribute to ALC performance 2)Inpatient Care Team Education relating to ethical dilemmas, substitute decision making, Power of Attorney in order to support 3)Positive identification of ALC patients on discharge promotion whiteboard to improvement discharge planning and provide 4)Improve coding for ALC patients. Review of coding on a quarterly basis. Bi-annual training for inpatient teams. Development of # of inpatient care team staff attending training during training day, part of which is also covered in Professional 18/19 # of education sessions delivered Practice Orientation. Redesign of discharge promotion whiteboard to ensure high rate of completion at daily discharge promotion planning. Visual aid to "status at a glance" of patient requirements for discharge needs. Conduct audit of clinical coding for patients designated ALC to evaluate coding practices and improve clinical documentation for improved accurate coding. # of ALC patients identified on discharge promotion whiteboard on a daily basis as part of discharge promotion round. Discharge promotion boards redesigned by Q2. Audits to be completed in Q2 & Q3 to identify # of ALC patients coded correctly with Mental Health & Addictions diagnosis which contribute to ALC rate. 3 Education sessions completed with 20 attendees by end of Q3. 95% of patients who are ALC are positively identified on whiteboard by Q3. Audit to be completed in Q2 & Q3 Patient-centred Palliative care Percent of palliative P care patients discharged from hospital with the discharge status "Home with Support". % / Discharged patients CIHI DAD / April March Maintain 17/18 1)Early identification of patients who are palliative when attending in Emergency Department and on admission to inpatient unit. Review of Emergency Department visit assessment and inpatient admission assessment documentation to seek ways to improve early identification of palliative patients, thereby ensuring their needs for support at home is understood at discharge. Review of Emergency Department assessment Assessment documentation and inpatient admission documentation. documentation to be reviewed in Q2 for opportunities to improve early identification and aid in discharge planning supports for patients at home. 2)Socialize the HQO Quality DRAFT guidelines circulated and reviewed with clinical Standards for Care for teams and feedback gained for evaluation of guidelines Palliative End of Life patients and how this can be adopted and measured. (DRAFT)with the multidisciplinary team in order to embed the quality standards of care. Feedback received on guidelines and adoption of standards. Feedback received by Q2 of draft guidelines and action plan. 3)LEAP (Learning Essentials Approaches to Palliatve)Training to be accessed for interprofessional training relating to palliative care/end of life care practices and shared knowledge. 4)Implementation of enhanced Palliative Order Set which is based on best practice evidence of palliative care. Physicians and interprofessional team to be invited to attend LEAP training. Approval of palliative order set final approval through Medical Advisory Committee and implementation. Education for staff and audits for compliance. LEAP Training Session to be held during 18/19 1 session with 15 attendees Awareness and education for staff on revision of order set. Palliative order set use compliance in Q3. Implementation of order set by Q1. % of compliance on use of palliative care order set with patients Dx as palliative care Person experience "Would you recommend this emergency department to your friends and family?" P % / Survey respondents EDPEC / April - June (Q1 FY /18) Maintain current Target of 62.5% achieved, but would like to see consistency of results within the next 2 quarters before reviewing targets. 1)Continued implementation of ED Flow Project to improve patient experience and increase patient satisfaction to improve % of patients who respond "would definitely recommend this emergency department". Development of Fast Track and Sub Acute Treatment Areas and supportive processes with Plan-Do-Study-Act (PDSA) cycles to develop "streaming" and improve patient flow. Processing mapping and statistical analysis of various metrics to support project. Reduce # of patient Left without being seen Reduce Physician to Initial Assessment Time LWBS target is to reach <2 patients per day by Q3. PIA target is to reach <2hrs for 70% of patients

4 2)Improve waiting room Introduce new signage which includes "steps in care" to experience in ED and ensure guide patients through their ED visit. Introduce waiting patients are aware of any room "queue" system with the introduction of ticket delays and their steps in machine. care. Patient Feedback Survey which will be completed in Q1. 70% of patients report that signage and ticket machine has made an improvement in their experience. 3)From feedback themes in ED Patient Satisfaction Survey reduce common themes related to negative feedback to improve the patient experience to Yes Would definitely recommend. Utilize Experienced Based Design methods to review the patient journey utilizing a patient questionnaire as they go through their ED journey which can gather information on the various "touch points" and analyze patient feedback to greater understand concern areas from a patient perspective. # of EBD questionnaire completed in Q1 & Q2 50 EDB questionnaires completed by end of Q2 Experienced Based Design will give the care team for analysis and PDSA cycle the patient perspective of changes. their journey. Working with Patient Advisors to assist patients in completion of survey. 4)Development and Development of discharge advise/information booklet implementation of discharge for top 2 readmission diagnoses. Utilize best practice advice/information for guideline and information, seeking co-design with patients following treatment Patient Advisory. in ED ensuring that "steps in care" continue long after the patient is discharged and with the aim of reducing readmission. Development and implemenattion of 2 discharge advise packages. 2 discharge packages developed and implemented by Q4 Percentage of complaints acknowledged to the individual who made a complaint within three to five business days. A % / All patients Local data collection / Most recent 12 month period CB CB Currently collecting baseline data and establishing new processes. 1)Revision of Patient & Family Feedback Management Policy to enhance policy, process and education for teams relating to patient feedback and compliant process. 2)Revision of Safety Quality Information System (SQIS) in order to ensure reporting categories are aligned with HQO framework. Policy for feedback from key stakeholders with approval of policy. Policy will enforce regulation 188/15 Excellent Care for All Act Implement changes. Create categories for complaint themes/sub-themes and actions taken in SQIS. Develop query reports in order to extract data as required and report monthly to various internal committees for learning of trends and to build action plans for improvement. Policy approved and available on HHCC intranet % of complaints within each complaint category/subcategory % of complaints with closing actions Policy approved by Q1 Establish baseline data 3)Revision of Safety Quality Develop data fields in SQIS to capture date/times at Information System (SQIS) in each stage of the complaint in order to calculate order to accurately calculate acknowledgement time of complaint and how long the time to acknowledge complaint took to resolve (closure). complaints as per HQO standards of 3 to 5 business days. % of complaints acknowledged within 3 to 5 days. Establish baseline data 4)Provide education and learning on new process and categories for Leaders managing complaints through the Safety Quality Information System (SQIS). Education session, handout and e-learning module to provide detail on complaint categories/subcategories, actions taken and acknowledgement time requirements. Provide support to Leaders through 1:1 support when registering a complaint in SQIS via the Quality Team. # Education Session # Leaders received education handout # Leaders completed Learning Management System E-Learning Module 2 Education Sessions by Q2 100% of Leaders received education handout by Q2 100% of Leaders completed E-Learning Module by Q3

5 "Would you recommend this hospital to your friend and family?" (inpatient care) C % / All inpatients Inpatient Discharge Calls / April to June Achievable stretch target of 88% with a 3-5% improvement target set. Last 2 quarters have remained between 80-85%. 1)Redesign and implementation of patient Whiteboards to improve communication with patients, families and care team. 2)Refresh of inpatient unit daily team performance huddles to communicate inpatient discharge survey feedback and improve awareness and effectively communication of themes that impact "would you recommend". Redesign of patient whiteboards to enhance communication between patients, families and providers. Working group to design standard layout which includes patients and families feedback and communicating expected date of discharge. Physician engagment will be provided through hospitalist attending daily rounds on inpatient unit. Approved whiteboard redesign. Whiteboard refresh 80% completion of implemented on 3 acute units by Q2. Audit of whiteboards on 3 inpatient completion rates for admitted patients on a bi-weekly units during Q3 & 4 Daily basis. Education on how to complete the whiteboard for rounds attendance by 3 inpatient units. Hospitalst attening daily round on hospitalist on Medicine Medicine Unit. Unit. Provide data to team in relation to monthly inpatient # of Team Performance huddle whiteboards with survey feedback, with focus on top consistent themes of monthly inpatient survey results posted 1 small change communication, lack of care and professionalism. Also plan completed monthly to improve WYR metric provide recognitions and positive feedback to balance negative response to drive the teams for increased Display inpatient until feedback charts so teams can see each other's performance (healthy competition). Monthly audit of Team Performance huddle boards commencing Q2. 100% of Team Performance Huddle whiteboards displaying monthly inpatient survey results by Q4 30 "1 small change plans" completed by end of Q3 Development of "1 small change plan" which utilizes PDSA methodology for teams to generate ideas for improvement and discuss at Team Performance Huddles with the support of the Charge Nurses/Managers/Directo rs. 3)Establish Patient Develop Patient Engagement Strategy and seek Engagement Strategy and feedback from patient advisors and stakeholders. improve methods for Recruit additional Patient Advisors. patient engagement which will support improvement of patient engagement. Recruit 6 patient advisors Recruit 6 patient advisors by Q2. 4)Address common themes Nursing teams invited to take CNO (College of Nurses of arising from monthly Ontario) Learning Modules and take learning/reminders inpatient survey relating to from professional standards and apply in order to professionalism and reduce negative feedback relating to professionalism. communication. Completion of College of Nursing Learning Modules relating to nurse-client relationships and professional relationships. # of nursing staff completed CNO Learning Modules 75% of nursing staff completed CNO Learning Modules by Q3 5)Adopt "bedside shift report - Transfer of Accountability" with 1:1 nursing on inpatient units. Phased approach to transfer of accountability (TOA) at bedside. Pilot on 1 inpatient unit in March and transfer learning to other inpatient unit during the year. # of inpatient units with TOA implemented Feedback from patients with regard to perceptions of communication at bedside. 2 inpatient units with TOA fully implemented at bedside by Q3 Completion of patient feedback surveys during Q3 (10 patients) Safe Safe care/medication Medication P Rate per total Hospital collected Maintain current safety reconciliation at discharge: Total number of discharged patients for whom a Best Possible Medication Discharge number of discharged patients / Discharged patients data / October December (Q3) Increase from 17/18 target of 80%. 1)Roll out BPMH (Best Possible Medication History)into Day Surgery and Obstetrics Implement BPMH in Day Surgery and Obstetrics. Work with Chief of Surgical Services and Leadership team to ensure medications are being reconciled by the nursing teams. Review pharmacy technician coverage requirements. Review of practices and processes with teams Commence collection of BPMH and medication reconciliation in Day Surgery and Obstetric Unit Review of practices/processes by Q2 Collection of BPMH and med reconciliation in Day Surgery and Obstetric Unit by Q3.

6 Medication Discharge Plan was created as a proportion the total number of patients discharged. 2)Expand nursing training for BPMH and Medication reconciliation. Improve knowledge and standard of collection of BPMH within the nursing teams on inpatient units. Education sessions and materials devised by the Pharmacy Team and Professional Practice to support nursing teams with collecting BPMH. Clinical Nurse Educators to support education and training. % of nurses on inpatient units trained % of BPMH completed by nursing staff on inpatient units. 75% of nurses on inpatient units trained to complete BPMH for transfers from D Wing to E Wing by end of Q3 70% of BPMH completed by nursing staff for transfers from D Wing to E Wing by end of Q3. 3)Refresh education materials relating to roles and responsibilities in medication reconciliation in order to support expansion of nursing taking BPMH on inpatient units and support of wider interprofessional team members. Review of existing materials for educatin of BPMH and medication reconciliation. Drawn on current best practices and literature available and search for other approaches to improvement in HQO site. Review and revision of supporting materials Completed by Q2 to support education and learning in Q3. 4)Patient and public awareness campaign to increase awareness of "knowing your medications". Utilize various best practice marketing materials to launch poster/handout campaigns quarterly in partnership with patient advisors. Develop small working group to review campaign requirements. Poster campaign and handouts each quarter Campaigns completed and review of impact on inpatient and ED patient surveys relating to medication Workplace Violence Number of M workplace violence A incidents reported N by hospital workers D (as by defined by A OHSA) within a 12 T month period. O R Y Count / Worker Local data collection / January - December CB CB Collecting baseline data whilst establishing new processes and educational roll out for incident reporting and data collection. 1)Develop Sub Committee steering group which reports to Joint Health and Safety Committee 2)Conduct a workplace violence risk assessment survey to assess the current risks of workplace violence to inform revisions to workplace violence prevention policy and programming. Develop Terms of Reference and establish membership of group in order to set out work plan and provide accountability for reducing Workplace Violence Incidents. The assessment will focus on the general physical environment, risk factors, as well as assessments of specific risks. Sub-committee will evaluate risk assessment outcome for further planning. Monthly meetings and attendance of membership Minimum of 8 meetings this calendar year with 60% membership attendance at each meeting. Completion of risk assessment Risk assessment completed by Q1 3)Introduce new workplace violence indicators to Headwaters' corporate dashboard to engage stakeholders in the monitoring of metrics related to workplace violence Presentation and discussion within various committees and Quality Committee of the Board to gain approval of addition of indicator to corporate dashboard and provide support and assurance to the leadership team of actions being taken. Inclusion of Workplace Violence Indicator to Corporate Performance Dashboard once reporting strategies finalized. Inclusion of workplace violence indicator to Corporate Performance Dashboard by Q2

7 4)Revise employee Safety Quality Information System (SQIS) to enhance information gathering related to workplace violence events so that themes can be readily identified and addressed. The revision will involve training for leaders within the organization to facilitate their understanding of their role and responsibilities in investigating and following up on workplace violence events and reporting mechanisms. Revision of SQIS reporting themes # incidents within reporting monthly % of incidents within reporting themes Establish baseline data 5)Complete and validate a workplace violence prevention training needs analysis that will inform our educational needs and requirements. Assessment of training matrix to identify workplace violence prevention training needs. We will commit to developing a sustainable training program for Management of Aggressive Behaviours (MOAB) and Gentle Persuasive Approach (GPA). Completion of training needs analysis # of staff trained in MOAB and GPA Completion of training needs analysis by end of Q2 30 nursing staff completed either MOAB and/or GPA by end of Q4

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