CCAC Update

NSM LHIN/LTCH Summit
NSM CCAC Placement Improvements
May 2016
Objectives
• Update on work done since last
LHIN/LTCH Summit
• Highlights of Placement Improvements in
2015/16
• Waitlist information
• Initiatives planned for 2016/17
• LTC and Crisis Algorithms
LHIN/LTCH Summit Fall
2015
• Feedback from LTCH/LHIN Summit that
the behavioural assessments coming from
CCAC did not always provide a good
picture of the patient
• Recognition from LTC that caregivers
don’t always disclose behaviours because
of fear that they won’t get accepted
CCAC/LTC Task Group
Objectives:
• Improve the quality of information being
sent to LTC regarding patients with
behaviours
• Develop messaging for CCAC staff when
having the conversation regarding
behaviours to support full disclosure
from families regarding behaviours
CCAC/LTC Working
Group
•
•
•
•
•
•
•
•
•
•
Stephanie Walpole-Villa Care Centre
Debbie Emmerton-Villa Care Centre
Amanda Belanger-Creedan Valley Care Centre
Pam Weibe-Coleman Care Centre
Natalie Kidner-PRC
Maureen O-Connell-PRC
Zina Thompson-Wendat
Ann Gordon-CCAC
Cheryl Thurley-CCAC
Kathy Wolfer-CCAC
Changes to
the Tool
• Included guidelines
on form
• Changed language
to be less negative
and more person
centred
• Added cues to elicit
more information
• Added BSS
Resources
Revised
Behavioural
Assessment Tool
Education Sessions
• CCAC Care Coordinators involved in the
Placement
• Waypoint SW’s who complete the Tool
• LTCH’s-Regional LTCH meeting April 2016
PIECES Review
PRC’s provided a high
level overview of the
PIECES Framework to use when
completing the Behavioural Assessment
Tool
Messaging to
Caregivers
• Provided education to CCAC staff about how to
normalize the discussion with caregivers regarding
responsive behaviours
• LTCH must have accurate information to ensure the
safety of the patient and other residents
• LTCH’s are trained to provide an environment to
support people with responsive behaviours
• Behavioural Support Resources provide support to
LTCH’s meet these goals
• Goal is to support patients to live well in the
community and eventually transition successfully to
LTC
Placement Highlights
2015/16
Short Stay Respite
• Implemented the SSR e-Referral
• Developed SSR guidelines to guide
booking practice following a survey of
17 patients/caregivers
• Developed SSR Information Sheet for
completion by families regarding specific
care needs of patient
Smoking Assessment
• Revised to include e-cigarettes/marijuana
• Seeing an increase in LTC applicants who
are using marijuana and the challenges
that LTCH’s have in accommodating this
(prescribing physician, different forms of
marijuana, safety)
External Communication
Wizard
• Sharing of Placement Documentation
across CCAC’s using Health Partner
Gateway (HPG)
• Eliminate faxing-increase document
clarity, reduce privacy breaches
Standardized Naming of
Placement documents
• March 2016-all CCAC’s implemented
standardized names for common
placement forms
• Improved clarity in communication
provincially
Implementation of e-forms
for Placement documents
April 2016
All Placement documents were converted
from paper/manual to electronic
Crisis Priority
• Implemented the Provincial Crisis
Priority Tool which ranks patients within
the crisis category
• Implemented an Exception Process if a
patient has less than 3 choices as a
Crisis Priority
Updated Financial Counselling
Resources
• Received feedback from several LTCH’s
that patients were arriving and not
expecting to have to pay for LTC
• Collaborated with the Collingwood
Nursing Home to develop a more
comprehensive resource for Care
Coordinators to share with applicants
Wait List Information
•2219 patients waiting for LTC placement as of
March 31, 2016
•473 in Secondary Placement (314 in region and
159 out of region)
•70% basic accommodation
•30% preferred
Note: This does vary by areas within NSM region
20
Patients Served By Long Term Care Home Placement
Services
Clients Waiting for Long Term Care
There has been
an increase in
the number of
patients
waiting for LTC
through the
year.
*Count of Clients waiting taken on first day of the Month
Count of Initial Long Term Care Home Placements from NSM
Patients placed into
long-term care who
were in community or
hospital in the NSM
region.
LTCH Placement Services
21
Patients Served By Long Term Care Home Placement
Services
Number of Crisis Placements from Community
Generally, about 40% of
crisis placements from
community are to Barrie
and area LTC homes,
ranging from 32% of
placements (July 2015) to
53% (May 2015).
Long Term Care Home Rejections in NSM Region By Reason
In 2015-2016, there were
88 Tier 1 rejections due to
lack of physical , and 84
Tier 1 rejections due to
lack of nursing expertise.
LTCH Placement Services
22
Occupancy
• 99.1 % Occupancy in September 2015
(99.3% September, 2014)
• Provincial Average 99.2 %
• Basic-99.2% (99.5 in Sept 2014)
• SP-98.4% (97.9 in Sept 2014)
• Private-99.1% (99.4 in Sept 2014
23
Initiatives for 2016/17
1. Health Assessment
•
•
•
•
Outlier in the province related to the time from
“application to eligibility” for LTC
Delays in receiving completed Health Assessments
Targeting education to Primary Care and enotification to prompt completion
Suggest a Primary Care Metric-% completion of
Health Assessments within 2 weeks of request
Initiatives for 2016/17
2. Consent and Capacity
• Two years ago, launched enhanced
Consent/Capacity education using the
CACE tool
• Now building on this knowledge by
developing an E-learning module and Quiz
for Consent and Capacity for Care
Coordinators
Initiatives for
2016/17
3. Virtual Tours of LTCH’s
• Partnering with Georgian College to have
a student work on several projects
during the summer
• One project is to engage with interested
LTCH’s in developing virtual tours to post
on the nsmhealthline
Annmarie.kungl-baker@nsm.ccac-ont.ca
26
Long-term Care Algorithms
Provincial Assessment Solution
Project:
• CCAC’s moving to the new Inter-RAI
Assessment Tools
• Develop new evidence-informed tools to
support clinical decision making in care
planning
• Promote consistent processes and equitable
planning for LTC placement across CCAC’s
27
Long-term Care
Algorithms
2 Algorithms Developed:
1. Appropriateness for Care
• Classifies patients as “Appropriate” or “Not
Appropriate” for LTC Placement
• Replaces current Eligibility
2. Crisis
• measure of a patient risk of imminent crisis
placement
• Stratifies patients into 5 categories
28
29
30
31
32
33
Key Messages
• Technology and research is leading many of
the process improvements within the
Placement function provincially
• CCAC is committed to collaborating with
the Behavioural Support Task Group and
LTC to further develop strategies to support
patients with responsive behaviours
• Waitlists for LTC is growing
Questions?