Long Term Care Comparing Residents First and ECFAA QIP
Welcome and Introductions Presentation Team Lynn Dionne Manager, QIP and Capacity Building HQO Terri Donovan QIP and Capacity Building Specialist HQO Julie Latreille QIP and Capacity Building Specialist HQO 1
How to Participate Today
Agenda 1.Overview of ECFA and QIP 2.Residents First and ECFA QIP comparison 3.How to Complete your QIP 4.QIP components a) Narrative b) Workplan 5.Developing your QIP: moving from Residents First to QIP 6.QIP Indicators 7.HQO Supports 3
Learning Objectives By the end of this session, participants will be able to: Understand the role of Quality Improvement Plans as a tool for driving organizational quality Compare Residents First QI plans and ECFA QIP Understand how to develop a QIP using the foundations from Residents First Develop targets & change ideas that will result in improving performance Understand how to use process measures to monitor improvement on specific change ideas 4
POLL #1 How familiar are you with the QIPs that were part of Residents First Program? 1. Very familiar I was responsible for developing & submitting Residents First plan(s) Familiar with Topic Specific Familiar with excel QIP 2. Somewhat familiar I know about it; heard about it at meetings 3. Not familiar I have not been involved in the development of a Residents First QI Plan 5
POLL #2 How familiar are you with the QIPs developed for ECFAA? 1. Very familiar I have reviewed the guidance materials and templates on the MOH website 2. Somewhat familiar I have heard of the new QIPs and understand some of the expectations 3. Not familiar I very recently heard about this 6
Value of Quality Improvement Plan? Quality Improvement Plans (QIPs) are formal, documented set of commitments made on behalf of a health care organization to its patients/clients/ residents, staff and the local community at large; therefore QIP must be aligned with system and provincial priorities while being responsive to local improvement opportunities. Ministry of Health and Long Term Care. Quality Improvement Plan. Guidance Document for Ontario s Health Care Organizations. Accessed on December 24, 2013 at http://www.health.gov.on.ca/en/pro/programs/ecfa/legislation/qualityimprove/qip_guide.pdf 7
ECFAA, QIPs and HQO ECFA Act states the following: Quality Improvement Plans 8. (1) In every fiscal year, every health care organization shall develop a quality improvement plan for the next fiscal year and make the quality improvement plan available to the public. 2010, c. 14, s. 8 (1). Copy to Council (5) Every health care organization shall provide a copy of its annual quality improvement plan to the Ontario Health Quality Council in a format established by the Council that permits province-wide comparison of and reporting on a minimum set of quality indicators. 2010, c. 14, s. 8 (5). 8
Indicators: Symbiotic relationships Across Sectors Core cross cutting metrics: Hospital Each organization s QIP will include core transformational priorities where improved performance is co-dependent on collaboration with other sectors. LTC CCAC Primary care From MOH presentation, Oct 1, 2013, Nurse Lead Practitioner Clinics 9 9
Phases of Implementation Year Phases Sector One Two Three Four and beyond Implementation, launch, provide guidance, establish priorities, identity baseline Standardization, standardize measurement of indicators with system priorities Establish benchmarks/targets and accountability for change Continue to establish benchmarks/targets and accountability for change CCAC & LTC Primary Care Hospital 10
Comparison: RF and QIP RF QIPs 3 types: Topic specific Organizational (annual planning) Implementation Plan ECFAA QIP Organizational (1 per licensed home) Priority indicators focus on key dimensions of quality Cross cutting metrics for all sectors Understand current state, set priorities, set targets, document plan to improve 11
Dimensions of Quality for LTC QIPs Quality Dimension Patient-Centred Safe Accessible Effective Efficient Equitable Integrated Indicator Resident Experience Falls, Pressure Ulcers, Restraints Incontinence ED visits for ambulatory care sensitive conditions ACSC Appropriately Resourced Population Health Focused 12
GETTING STARTED 13
How to Complete Your QIP 1. Download the QIP resources from the MOHLTC website: http://health.gov.on.ca/en/pro/programs/ecfa/legislation/quality_improve.aspx 2. Identify priorities (6 priority indicators on workplan) 3. Identify indicators 4. Use what data you have to confirm or identify baseline 5. Use the guidance document 6. If possible, involve all those who are involved in managing, providing, and overseeing care in your organization in the development, finalization and implementation of the QIP, including your board, residents/families, clinicians and other staff 14
QIP Process Step Use organization level data Review priority indicators Identify which priorities to address Complete the narrative Complete the workplan Sign off & Submit Monitor performance Process Identify current performance and/or baseline for priority indicators Determine which are relevant to your organization Create a plan to address system level priorities Provide information on each of the areas identified in the narrative section of the guidance materials Use the Excel template to complete your organizations workplan By Board Chair, Quality Committee or Quality Lead, Executive Director/ Admin. Email to QIP@hqontario.ca by April 1, 2014. Throughout the year monitor performance on the indicators on the QIP 15
Components of the First QIP 1.Narrative 2.QIP Workplan 3.Progress Report N/A this year. To be submitted to Health Quality Ontario by April 1 st, 2014 via email: QIP@hqontario.ca 16
Narrative Template 17
Narrative Content Overview This portion of the QIP enables you to: Profile your organization and provide context for your QIP Share your organization s improvement goals and objectives for the coming year Share engagement activities and communicate commitment to the organization s QIP It is recommended that this section be no more than 2-3 pages in length, and written in a manner that can be easily understood by all audiences. 18
6 Areas of Focus in Narrative 1. Overview 2. Integration & Continuity of Care 3. Challenges, Risks & Mitigation Strategies 4. Information Management 5. Engagement of clinicians & Leadership 6. Accountability Management Sign off: Administrator/ED, Quality Chair. 19
QIP Workplan AIM Quality dimension Objective MEASURE Measure/ Indicator Current performance Target for 2013/14 Target justification CHANGE Planned improvement initiatives (Change Ideas) Methods and process measures Goal for change ideas (2013/14) Comments 20
QIP Workplan - Overview Main portion of your QIP Describes improvement targets and initiatives Priority indicators (6 for LTC) Designed to align with the model for improvement 21
Residents First Topic Specific Plan 22
Residents First - AIM Statement Measure/Indicator Current Performance Target for 2014/15 23
Workplan: AIM and Measure 12 6 Reduce defect by 50% 24
Workplan: Setting Targets Indicate the targeted outcome expected to be achieved by the end of the fiscal year. Key considerations when setting targets: Represent what the organization aspires to, first and foremost. Are meaningful and (residents, staff, system) in an area of priority Set in a direction that demonstrates improvement; careful not to set targets below baseline. 25
Provincial Results in LTC Provincial Averages Benchmarks 26
Workplan: Change Ideas Change ideas are actionable steps for change, targeted at improving specific processes. They often originate from evidenced-based best practices, brainstorming, and creative thinking by frontline staff, providers and patients. 27
Components of a QIP Workplan Change 28
QIP Indicators 29
Priority Indicators Reflect organizational, sector-specific priorities, and transformational priorities where improved performance is codependent on collaboration with other sectors Organizations are expected to review the (6) priority indicators for their sector and determine which are relevant for their organization. If your organization elects not to include a priority indicator in the QIP (for example, because performance already meets or exceeds the benchmark/ theoretical best), then this should be documented in the comments section of the QIP Workplan. Source: Quality Improvement Plan (QIP) Guidance Document for Ontario's Health Care Organizations [PDF] 30
Priority Indicators for LTC 1. Falls 2. Pressure ulcers 3. Restraint use 4. Incontinence 5. Resident Experience 6. ED visits for ACSC Source: Quality Improvement Plan (QIP) Guidance Document for Ontario's Health Care Organizations [PDF] ) 31
Additional Indicators Also measure important areas for quality improvement Organizations can include these Additional indicators or any other indicator in their QIP as relevant to their quality improvement goals Source: Source: Quality Improvement Plan (QIP) Guidance Document for Ontario's Health Care Organizations [PDF] ) 32
HQO Supports Residents First information on HQO website http://www.hqontario.ca/quality-improvement/long-term-care RF Posters & RF Change Packages LTC Quality Improvement Guide Quality Improvement Plans in Long-Term Care: Lessons Learned http://www.hqontario.ca/portals/0/documents/qi/qi-ltcimprovement-guide-en.pdf http://www.hqontario.ca/portals/0/documents/qi/rf-qip-lessonslearned-en.pdf Quality Compass on HQO website QIP inbox: QIP@hqontario.ca 33
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