At the Table with Clients and Families for 90 Years

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3 At the Table with Clients and Families for 90 Years A Message from the President and Board Chair The kitchen table: it s where we gather to eat but it s also the study desk, the artist s workspace, the library, and the intimate spot where stories of the day are shared and connections are made. It s the centre of the home, it s family, it s friendship, and to us, it represents the very essence of a life lived as independently as possible. After 90 years of service, being at the table also symbolizes our resolve to fully realize our strategic pillar of being More Attuned to client, caregiver and partner voices. This was the year our Client and Family Voice initiative grew into its own, bringing over 40 VHA Home HealthCare (VHA) client and family partners into the fold to truly become co-designers in 22 different quality improvement initiatives. It was an insightful and meaningful experience to have clients and caregivers in meetings in person or virtually to glean their perspectives on a range of topics. From how we can better support children who have complex medical needs, to uncovering ways to add more value to personal support worker (PSW) visits for clients with dementia, it s clear that clients and their caregivers are bursting with ideas. When we opened up our Staff and Service Provider of the Year Award nominations to clients and families, we were blown away by the nearly 400 nominations received. Clients and families know spectacular care when they experience it and they were eager to share their touching stories. As the government rolled out, Patients First: A Roadmap to Strengthen Home and Community Care, we were heartened by the growing focus on home health care and by a commitment to expand investment in it over the next three years. We ve eagerly accepted the Ministry of Health and Long Term Care s (MOHLTC) invitation to come to the table, joining with government, other partners, clients and their families to help inform future policy and shape an exciting new direction for home and community care. Collaboration will undoubtedly be integral to this process and our strategic commitment to being More Connected underlines the need to roll up our sleeves and work together to ensure the 3

4 system is truly better for those who need support to remain at home. The selection of VHA by Central East s Community Care Access Centre (CCAC) to help deliver a new combined palliative care model in Durham and Scarborough is an exciting step in this direction. VHA is also breaking new ground in research. Our growing partnerships in this area which doubled in 2015 to 28 include research projects with Sick Kids Hospital, University Health Network (including Toronto Rehab), and Women s College Hospital exciting initiatives that bridge the worlds of hospital and community care and connect thought leaders in a meaningful, purposeful way. Completion of our three-year journey to become a Best Practice Spotlight Organization (BPSO) designate made 2015 extra special and reinforces our quest to uncover More Inspired Solutions that capitalize on our talent and technology. This Registered Nurses Association of Ontario (RNAO) sponsored program, ensures we re always serving up evidence-based care that is spectacular and continuously focused on quality improvement and safety. While this leg of the journey is over, our commitment is ongoing and we look forward to implementing new Best Practice Guidelines (BPGs) in our care in 2016 and beyond. Expansion of electronic charting into the community continued in 2015, allowing nurses and their clients immediate access to charts at the point of care, and the ability to track progress on items such as wound care. Feedback has been exceptionally positive and electronic charting in the community is the next critical step in our Electronic Medical Records Initiative (EMRI). The sophomore year of VHA Spark! an electronic tool that allows staff and service providers the ability to submit, vote and comment on quality improvement ideas put many new and exciting initiatives on the table. These included a safety calendar for clients and families, and the launch of two pilots to aid clients with cognitive impairment : One-Touch Connect a technology-driven initiative that provides individuals (who are often socially isolated) with a tablet 4

5 to easily video chat with family members and friends and MusicCare a partnership with the Alzheimer s Society to deliver pre-loaded ipods to clients to enjoy on their own and with their VHA PSW as a way of stimulating brain activity and linkages. The success of all we do would be impossible without the ongoing support of our partners, funders, donors and referral sources who back our beliefs of unearthing innovative answers to complex challenges and serving the most vulnerable in our communities. We are ever grateful for their contributions. Our spectacular service providers, staff and volunteers, including VHA s board of directors and our client and family partners, are an inspired, creative and skilled team that has tremendous heart. With all of you at the table sharing your knowledge, experience, insights and passion for home and community care VHA will continue to create possibilities for more independence now and for another amazing 90 years. Carol Annett President & CEO VHA Home HealthCare 5 Adwoa K. Buahene Board Chair VHA Home HealthCare

6 Facts and Figures In 2015, VHA Home HealthCare s 2,271 staff and service providers delivered 2,531,463 units of service to 91,671 clients admitted to care, where and when they needed it. We provided 6,270 hours of parent relief and 101,726 hours of charitable community support services to clients in need. Our volunteers gave of their talents and enthusiasm to the tune of 6,116 hours of volunteer service. 496 Extreme Cleaning clients were able to stay safe in their homes and 26 tenants with severe mental illness received shelter and support at Adam s House a VHA transitional housing project for people at risk of homelessness. VHA staff and service providers had access to $200,000 from our Simple Comforts and Ideas to Innovation funds to provide clients with extra items they needed and to kickstart new projects to support more efficient and spectacular care. VHA also delivered 25,553 hours of staff training this year. 6

7 100% 75% REVENUE $111,441, % 2.2% 1.2% 1.1% 0.9% Community Care Access Centres Client Fees Other Municipal Funding United Way Toronto EXPENDITURES $108,426, % 6.6% Salaries, Benefits, and Purchased Services Building / Operations 6.6% 93.4% 50% 25% 0% 7

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9 Highlights In 2015, VHA celebrated 90 years of incredible service to Ontario communities. From our humble beginnings with just 14 housekeepers, our organization has grown to more than 2,200 staff and service providers. VHA services have expanded to encompass health care, personal support, and community support programs for individuals and families, where and when they need it. VHA was designated a Best Practice Spotlight Organization by the Registered Nurses Association of Ontario. The designation, profiled later in this report, recognizes and supports VHA s commitment to improved client care through evidence-based practice. VHA was selected by Central East CCAC as one of three organizations to deliver a new combined palliative care model in Durham and Scarborough. Integrating nursing and personal support services, the initiative is intended to increase collaboration and communication between health care providers and improve care and overall quality of life for palliative clients. 96% of clients surveyed said they would recommend VHA to family or friends who needed home health care. VHA continued to advance the Client Voice initiative to incorporate the insights, perspectives and ideas of clients and their families into all that VHA does. More than 40 client and family partners (CFPs) were recruited to support 22 quality improvement initiatives, standing committees, and our Client and Carer Advisory Council, and we continue to actively recruit and welcome the involvement of more CFPs in our work. VHA Voice, a quarterly newsletter co-designed by Client and Family Partners launched. VHA surpassed several international competitors to win the Best Event Video award from Ragan Communications PR Daily. The award honoured the emotional impact of our video series (created with FlashFrame Digital Media) that profiled VHA s Heart of Home Care Award winners and their amazing caregiving journeys. 9

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11 Sharing and Caring In collaboration with 14 partner agencies, we launched the Toronto Hoarding Support Services Network. VHA leads the network, which works collaboratively to effectively address problematic hoarding. It provides coordinated services to bridge existing support gaps, help clients to manage their clutter, and get them the emotional support they need to live safely. VHA s Champlain Rehab Solutions began providing Extreme Cleaning services in Ottawa to help people remain safe in their homes and avoid impending eviction due to unsanitary conditions. Launched the Mind and Body in Motion program as part of our caregiver support programs. It offers in-home recreational therapy to cognitively impaired clients. VHA s HeadStart Scholarship program awarded 20 exceptional children of VHA staff and service providers with $1,500 scholarships to support their studies at an accredited college, university or trade school. Scholarships were granted based on academic achievement, community involvement and financial need. Introduced a new Alzheimer s and Dementia Volunteer Support Program that gives caregivers a much-needed break by providing one-on-one support to a loved one who has mild to moderate cognitive impairments. Building on the success of our partnership with Holland Bloorview Kids Rehabilitation Hospital to provide an enhanced 12-week orientation program for new nurses to gain specialized practice in paediatric nursing, we added a two-week rotation at Emily s House a children s hospice facility and developed an adult nursing orientation program that includes a two-week rotation at Baycrest. MusicCare delivers personalized music to people with dementia and came out of a staff idea from VHA Spark! Alzheimer s Society of VHA MusicCare Toronto preloads clients preferred music selections on an ipod and VHA s PSWs help to set it up. Personalized music for people with dementia can trigger memories that unlock a sense of self, reduce need for medication by reducing stress and agitation, and improve quality of life. VHA is excited to be part of this initiative! 11

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13 Learning and Innovating VHA began a phased, province-wide rollout of a customized Electronic Medical Record Initiative (EMRI) among nursing providers this year. Soon all of VHA s nursing clients and providers will benefit from the efficiency and flexibility of having electronic medical information available during client visits. The EMRI will eventually include VHA s rehab services, as we move toward paperless record keeping. Several grants were awarded to VHA in 2015 to initiate or enhance a variety of activities, including: New volunteer and Extreme Cleaning programs in Durham Various poverty reduction/homelessness prevention initiatives Renovations at Adams House, VHA s transitional housing complex that provides people living with mental health issues a safe and clean alternative to life on the streets, in psychiatric facilities or in temporary shelters. We worked extensively with clients and family members this year to determine VHA s priority focus areas. Together we examined literature, our own data, best practices and client and family perspectives to identify staff training programs, potential projects, and initiatives to improve the client experience, including the Music Care program profiled on page 11 and a Play Date program for children with complex medical needs. VHA became the only home care organization to receive the government s SIM-one grant to provide a computer simulation education program for PSWs (in collaboration with other institutional partners and Women s College hospital as principal investigators). The program will support PSWs to identify common signs, risks and strategies for addressing dementia, delirium and depression in their clients. We finalized training for staff and service providers on using a self-management approach in practice. The module, based on the RNAO Best Practice Guidelines, teaches skills for service providers to assist clients to self-manage their chronic disease. With diabetes being a common chronic disease with many of our clients, a Diabetic Resource Guide has also been developed for our nurses. VHA Spark!, our online idea-sharing platform to improve client care, workplace processes and work/life quality, continued to generate innovative ideas. VHA implemented 27 initiatives based on ideas submitted by staff and service providers on this platform. 13

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15 Reaching Out We more than doubled our number of partnerships to 28 in 2015 as we began 10 new collaborative initiatives. VHA initiated 17 new research projects, practice models and service projects, including partnership studies with AGEWELL and the University of Waterloo into the use of technology to support caregivers and research with the Toronto Rehabilitation Institute and the University of Waterloo into sensor technology and caregiver safety. Choosing from more than 60 staff nominations, VHA identified 17 deserving staff and clients to present with a Spectacular Spirit Surprise during the holiday season. VHA captured the surprises on video as we presented each spectacular recipient with a gift suggested by their nominee. The resulting heartwarming videos were popular viewing for VHA staff and social media followers. award winners at our annual appreciation events held across the province. The Ontario Association of Community Care Access Centres awarded Best Booth to VHA s Clients and Families are the Centre of our Universe interactive selfie booth at its annual conference, as voted by attendees. We also raised awareness of VHA programs and events through a dozen media hits, including CBC s Metro Morning, City TV and The Globe and Mail. With our continued focus on innovation and quality improvement, VHA staff and service providers produced or gave 51 external presentations, publications and displays. Acting on a suggestion from a caregiver workgroup, VHA rolled out VHA Voice. This quarterly newsletter was created with input from clients and family members. It provides insight into VHA service providers and initiatives as well as health and safety tips. More than 10,000 copies are produced with each issue. VHA received nearly 400 nominations from clients, client family members and colleagues for our Client Choice Awards, which recognize VHA staff and service provider excellence. We shared the inspiring profiles of 2015 s eight winners at bit.ly/clientchoicewinners and recognized OACCAC booth

16 Milestones in VHA s 90-Year History lllllllllllllllllllllllllll 1920s 1925 With a team of 14 workers, Barbara Blackstock-Cody founds Visiting Homemakers Association to care for children with ill or absent mothers. 1950s 1951 VHA extends homemaker services to sick children of working single mothers Three-year pilot begins providing home care to seniors. The pilot is extended into the 1960s. lllllllllllllllllllllllllllll MM s 1935 The Visiting Homemakers Association (V.H.A.) incorporates V.H.A. provides parental relief for polio sufferers. 1960s 1969 V.H.A. moves to 170 Merton St. donated by the W. Garfield Weston Foundation in memory of Mrs. Garfield Weston, a V.H.A. client. 16

17 1974 Parental Relief Program financed by United Community Fund V.H.A. accredited by the National (U.S.) Council for Homemaker-Home Health Aide Service Inc VHA adds nursing in private homes, hospitals and long-term care facilities, and health services to complement home and community support services. 1970s 1990s 2010s 2011 VHA adopts Creating More Independence tagline and moves head office to 30 Soudan Avenue Introduces the Client and Family Voice, including Client and Carer Advisory Council, and advises other home care organizations on creating similar programs VHA becomes a Best Practice Spotlight Organization (BPSO) designate of the Registered Nurses Association of Ontario s 1980 V.H.A. s Executive Director becomes first President of Canadian Council on Homemaker Services V.H.A. has provided 355,000 hours of homemaking service. 2000s 2000 V.H.A. accredited by Canadian Council on Health Services Accreditation and also starts extreme cleaning program V.H.A. officially changes its name to VHA Home HealthCare COTA Health s Rehabilitation Services join VHA, forming VHA Rehab Solutions. ::::::::::::::::::::::::::::::::::::::::::::: 17

18 Taking our Seat as a Best Practice Spotlight Organization On April 15, 2015 VHA was named a Best Practice Spotlight Organization (BPSO) by the Registered Nurses Association of Ontario (RNAO). This designation recognizes VHA s focus on continually improving client care through evidence-based practice, and is the culmination of a three-year candidacy process with the RNAO. But our leadership journey to use best practice knowledge to enhance outcomes and the client experience goes on. We re looking forward to 2016 and beyond as we continue implementing more Best Practice Guidelines that align with our strategic focus. During our candidacy, VHA implemented and evaluated five Best Practice Guidelines (BPGs) to advance excellence in client care outcomes. Our BPGs focused on: Assessment and management of pain Client and family centred care Assessment and management of stage I - IV pressure ulcers Prevention of falls and fall Injuries in the older adult End-of-life care during the last days and hours. This is one more milestone in our quest for continuous quality improvement. 18

19 Vision: Accessible, quality care for all who need it Mission: Creating possibilities for more independence Core Beliefs: Our care must be: Board of Directors Adwoa K. Buahene, Board Chair John Macfarlane Past Board Chair Adrianne Largo Cory Ross Jeff Litwin Catherine Wiley Joseph Mayer Diane Savage* Cheryl McGrath James Robertson* Client-driven, because what matters most to clients and families is what counts Spectacular and continuously focused on quality improvement and safety Zeeva Millman Paul Moroney Tomi Nieminen* Ann Weir** Integrated and collaborative to unearth innovative answers to complex challenges *Term ended May 2015 **Resigned July 2015 Inclusive and committed to serving the most vulnerable in our communities Inspired and creative, delivered by a skilled team that has tremendous heart As a charitable not-for-profit organization led by a volunteer Board of Directors, VHA is committed to: Valuing and supporting our staff and care providers Fiscal responsibility Ethical practices in all our operations Driving positive change in community support and home health care Thank you to all our community partners, funders, volunteers and donors. With your support, we re creating possibilities for more independence every day. 19

20 Head Office 30 Soudan Avenue, Suite 600 Toronto, Ontario M4S 1V6 tel: toll-free: fax: VHA Home HealthCare has no corporate or other affiliation with VHA Health & Home Support, also known as VHA Ottawa. VHA Health & Home Support can be reached through their website at Branch Offices Toronto 700 Lawrence Avenue West, Suite 360 Toronto, Ontario M6A 3B4 tel: fax: Chatham 111 Heritage Road Suite 103 Chatham, Ontario, N7M 5W7 tel: toll-free: fax: London 633 Colborne Street Suite 150 London, Ontario N6B 2V3 tel: fax: Ottawa Champlain Rehab Solutions 2625 Queensview Drive Suite 101 Ottawa, ON, K2B 8K2 tel: fax: Registered Charitable Number RR