ensuring quality care for our residents at every site
TRANSCRIPT
“Ensuring Quality
Care for our
Residents at
EVERY site – how
do health
authorities and
affiliates work
together to
ensure quality of care?”
Sandra Psiurski, RPC,
RPN, CCPCP
Interior Health
Authority
January 16, 2013
Quality of Relationships
Interior Health (IHA)
Private Partners (P3)
Division of Family Practice (DOFP)
“Shared Care: Partners in Care”
“Transitions in Care”
SOK Residential Care Program Prototype
How do we spread knowledge
across the spectrum?
ER
Acute
Community
Specialists
Residential
Who has the knowledge we
need to spread
Physicians
Physicians want to be engaged
Staff have the perception that physicians are
engaged in the decision making
Physicians have felt they had little influence at
the site level
THIS IS CHANGING WITH THE DOFP PARTNERSHIP
How to engage physicians in
initiatives
Clearly defined directives and processes
Gather input from the physicians/DOFP
Roll out initiatives in conjunction with DOFP
How to engage physicians at
the facility level
Communication needs to be clear and
comprehensive
Family/Resident RCA Nurses
Physicians
Projects & Pilots to improve
communication IDCC – Interdisciplinary Care Conference
Medication Reconciliation
MOST RAI Outcomes Care Plan
SBAR – Situation, Background, Assessment, Recommendations
Communication at Points of Transfer History Mental Health Records Acute stay summary
Facility Quality Review Process
Interior Health Authority Quality Review Process
All P3 and IHA facilities have an annual
quality review
Self Assessment
Review Process
Action Plan
Follow up reviews are conducted at 3 - 6
months
Multidisciplinary teams accompany quality
review coordinator – the team includes staff
from both P3 and IH facilities
Self Assessments & Pre-review
Facilities complete a self assessment document which is reviewed by the QRC
QRC also reviews information from the following areas:
PSLS
Licensing
PCQO
Contracting
Information is reviewed with the facility and discussions are held on-site with all departments
Tracers Tracers are in the process of development
Pressure Ulcer
Wound Care
Aggression/Behavior
Antipsychotic Use
Medication pass process and
documentation
… There are currently 24 tracers …
TRACER SAMPLE (DRAFT)
Private Partners (P3) Differences in organizational strategies and
philosophy
P3’s felt they had limited access to information
P3’s felt they had little influence over IH policy or practice
Engagement of the P3’s include
Meetings
Initiative education
Project participation – including leading the project
Committee participation
How do we engage P3 in
initiatives
Invite P3 as a partner in developing strategies
Quality Forum – IDCC
MHSU / Residential Care transition committee
Include information already developed at the P3 in IH projects
Provide specialized leads for the projects to help develop tools based on best practice
What has been working with
P3 engagement
Quality Reviews –
P3 managers and RCC’s are participants in
reviewing other facilities
P3 sites are provided opportunities to share
their struggles and achievements with other
facilities through the review process
Tools and reference materials are shared
among the P3 and IH facilities
P3 Engagement cont’ IH Clinical Practice Educators are available to
the P3 sites for support
South Okanagan Providers Meetings bring P3 and IH facilities together for open discussion about initiatives, struggles, regulations, and other issues relevant to providing quality care
RAI Outcome scores and benchmark reports allow P3 to compare their standing and collaborate with other facilities to improve indicators scores
SOK Outcome Scales - RAI
SOK Antipsychotic Indicator
Medication Reconciliation Medication reconciliation is part of the
review process
RAI outcomes and indicators are
reviewed for correlation, in/out of facility
Post Review Post review a report summary is provided
to the HSA, QRC supervisor for review
The report is reviewed with the facility
Facility develops an action plan based on recommendations
QRC provide support, suggestions, and connections with resources in relation to items on the facility action plan.
Follow up reviews are conducted to encourage ongoing engagement in quality improvement
Going Forward –
Engaging partners
Building Trust through open and honest
dialogue
Commitment to collaboration and
cooperation
Accountability to implement best
practice
Follow through and follow up
Winds may blow
Directions may change
but partnerships are the
foundations that will weather
the storms
- Sandra Psiurski, 2014
