NSW Multipurpose Service Collaborative

Transcription

1 NSW Multipurpose Service Collaborative Principles of Care for Living Well in Multipurpose Services National Rural Health Conference CAIRNS 27 th April 2017 Rural Health Network Jenny Preece, Rural Health Network Manager

2 The Agency for Clinical Innovation What do ACI do? Service Redesign and Evaluation Implementation Support Specialist Advice on Healthcare Innovation Knowledge Sharing Initiatives including Guidelines & Models of Care Continuous Capability Building

3 64 Multipurpose Services

4 Background The gaps identified by the Australian Commission on Safety and Quality in Healthcare Consultancy between the National Safety and Quality Healthcare Standards (NSQHS) and the Aged Care Standards: Homelike Environment Role of the person in their own care (person-centred) Cognitive Impairment Hydration and Nutrition Leisure activities and Lifestyle

5 Diagnostic Findings

6 Key Issues to Address PERSON CENTRED CARE Care delivery / care planning OUTDOOR ENVIRONMENT Perceived Risk RECREATION AND LEISURE FOOD AND NUTRITION MULTIDISCIPLINARY SERVICES WORKFORCE - Aged Care Expertise / Culture

7 ENVIRONMENT OUTDOOR

8 Pre Packaged Foods Jams and Sauces

9 Which meal is home cooked?

10 Multidisciplinary Services The resident has access to individualised care Respect as an Individual The resident is respected as an individual with emphasis on rights, quality of life and wellbeing Positive Dining Experience The resident s meals are varied, nutritious and appetising Recreation & Leisure Activities The resident has access to activities that are meaningful and maintain links to the community Homelike Environment The resident lives in an environment which involves freedom and choice Informed & Involved The resident and carer receive timely and appropriate information Comprehensive Assessment & Care Planning The resident participates in Comprehensive Assessment and Care Planning Expertise in Aged Care MPS leadership enables staff to develop expertise in aged care and the delivery of resident-centred care

11 HOW DO WE MAKE THIS HAPPEN? Toolkit MPS Principles of Care Resource Guide Self-Assessment Tool Evaluation / Measurement Package Implementation - Clinical Innovation Program $$ - Collaborative EOI September 2016

12 Toolkit

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14 CIP Funding $$ Collaborative over 1 calendar year (Feb Nov 2017) Funding over 2 financial years 2016/ /18 Total $243,135 $170,375 $413, MPS - 1 Nurse Manager and 1 identified staff member (aged care champion) per MPS 1 Sponsor per LHD to first Learning Set MPS Advisory Team Backfill relief (1 aged care champion per MPS) Site visits start up meetings Write up successful strategies

15 A collaborative improvement process A collaborative is a process to spread and adapt existing knowledge to multiple settings to achieve a common aim. Sites leverage off each other s learning to achieve a greater collective level of improvement. Expression of Interest Process Learning Set One (3 days) Action Period One (3 months) Learning Set Two (1.5 days) Action Period Two (3 months) Learning Set Three (1.5 days) Action Period Three (3 months) 25 sites recruited Act Study Plan Do Community of Practice Web-based PDSA Sharing Monthly Reporting Weekly site support calls Act Study Plan Do Celebration of success event Write up & disseminate successful strategies AIM: To implement small scale changes to enhance lifestyle, independence and wellbeing for people who call MPS home, and their carers / families. To support staff capability in providing individualised care and a homelike environment for residents.

16 Developing the Measurement Package How will we know that we have changed things? How will we know that this is an improvement? Checklists Surveys Measuring Processes Measuring Outcomes (Quality of Life) Resident Carer/family Organisation Resident Staff Audits Measuring Compliance Staff Resident

17 Site Pre-Work (Nov 16 Jan 17) To prepare sites for the first Learning Set the team visited each LHD and met with the site champions: Pre-work tasks: Build the local team Collect baseline data (audits, checklists and surveys) Choose 2-3 principles to focus on Prepare Story Board Identify risks and challenges Build Relationships

18 Pre-work Tools Username: test_site_user Password: mpssite

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20 Summary of Checklist Responses Carer/Family Resident Multi Services Expertise Respect 100% 80% 60% 40% 20% 0% Informed & Involved Care Plan Expertise Multi Services 100% Respect 80% Informed & 60% Involved 40% 20% 0% Care Plan Dining Environment Dining Environment Recreation Recreation Organisation Multi Services Expertise 100% Respect 80% Informed & 60% Involved 40% 20% 0% Care Plan Dining Environment February 17 Recreation

21 Resident Comments I want to go home To be able to go outside No gates; would like to leave sometimes See more people I sit alone by myself a lot Meals are too repetitive Get rid of the plastic dishes Pain management

22 Carer/Family Comments Be allowed to go outside more to access the garden The MPS services are improving but it still is a 'hospital'. Mum is treated as an individual but some staff keep a hospital routine. ACTIVITIES!!!! Residents are bored and feel neglected Mum complains that the food is over cooked and cold

23 Staff Comments A comprehensive care plan for the residents - Looking at social and emotional needs and daily activities to keep them entertained. Make resident s area less like a hospital Somewhere the families could sit outside with shelter maybe a gazebo on the lawn Would love to have more staff who understand dementia

24 Expression of Interest Process Learning Set One (3 days) Action Period One (3 months) Learning Set Two (1.5 days) Action Period Two (3 months) Learning Set Three (1.5 days) Action Period Three (3 months) Learning Set One Coaching - to create person-centred care, enhance lifestyle, independence and wellbeing for people who call MPS home, and presentation of successful case studies Project Management / PDSA cycles Self assessment to determining priority areas & Planning Learning Set Two 50 / 50: coaching / sharing Learning Set Three All sharing Write up & spread successful strategies

25 Expression of Interest Process Learning Set One (3 days) Action Period One (3 months) Learning Set Two (1.5 days) Action Period Two (3 months) Learning Set Three (1.5 days) Action Period Three (3 months) Action Periods Each MPS undertakes multiple Plan Do Study Act (PDSA) cycles to create continuous small improvements. PDSA cycles are identified at the learning sets and from the Principles for living well in an MPS. Every PDSA cycle is shared online so that other sites can learn from successes/failures. It is as important to report what didn t work as to report what did work. Monthly reporting to track progress Write up & spread successful strategies

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27 PDSA Portal

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29 PDSAs as at 20/4/2017: Respect for Rights as an individual 9 Informed and Involved 25 Comprehensive Assessment and Care Planning 16 Homelike Environment 29 Recreation and Leisure Activities 65 Positive Dining Experience 45 Multidisciplinary Services 5 Expertise in Aged Care 10 Total 205

30 Logo/Name of MPS here Living Well in MPS Collaborative BI-MONTHLY REPORT XXX 2017 Site Lead: Site Sponsor: AIM: This should remain the same throughout your collaborative program. Please replace this text with your aim. FOCUS AREAS 1. Creating an enjoyable dining experience 2. Improving the availability of Multidisciplinary Services to residents 3. Access to meaningful and enjoyable recreational activities PDSAs completed Introduction of condiments to dining room tables implement stage Bringing the Dentist in into the home- implement stage Volunteers Morning Tea Spread 100% 50% 0% Breakthroughs: What worked well? Engagement has been very positive from all groups staff, residents, volunteers, family & Carers. Resident Headline Indicators Place hold for resident headline indicators Barriers We have recently had 3 residents pass away who was part of the data collection. Currently we have 2 empty beds and 1 new resident who at the time of data collection had only been with us for 2 weeks. 100% 50% 0% Next Steps Introduction of short education sessions for staff during handover periods to increase knowledge and skills. Having Advanced Care Plans and End of Life Plans completed Staff Headline Indicators Place hold for staff headline indicators Poor Neutral Good How do you find working with the collaborative model? It has been very enjoyable and encouraging to be working with other sites across NSW who share the common focus and to see the work being achieved. Poor Neutral Good Approved by Project Sponsor: Signed (or electronic): Date:..

31 Urbenville

32 Boys Outing

33 Some Examples Activities Balloon Tennis, Outings, Wedding Dress show, High Tea, Veggie Gardens, Singing, Memory Books, Pamper Days, School children Food Crockery, Salt and pepper shakers, table cloths, tray V dining room, menus, BBQ, Aromas (toast, coffee) Expertise in Aged Care Dementia education, Top 5 Care Planning Family Case Conferencing, Advance Care Plans, NFR (AND)

34 More Examples Rights as an individual - social profiles, one on one with residents, resident s stories, personalised doors Homelike Environment bringing crockery from home, Outdoor furniture, Renaming wing, Pot plants, dining room redesign, Pets Informed and Involved Memorial table, volunteer and community networks, Resident s meetings, Auxiliary meetings, MPS Newsletters MDT Services podiatry, dental van, telehealth dietetics

35 Expression of Interest Process Learning Set One (3 days) Action Period One (3 months) Learning Set Two (1.5 days) Action Period Two (3 months) Learning Set Three (1.5 days) Action Period Three (3 months) Write up and dissemination of successful strategies At the conclusion of the Collaborative, there will be a body of knowledge about what changes worked to achieve the goal and what did not work. Write up & spread successful strategies This is written into a report so that other MPS wishing to make the change in the future will have fast access to proven strategies to achieve the goal.

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