REQUEST FOR PROPOSAL Alberta Home Care Survey 2015 · REQUEST FOR PROPOSAL . Alberta Home Care...

REQUEST FOR PROPOSAL

Alberta Home Care Survey 2015

1.0 INTRODUCTION

The Health Quality Council of Alberta (HQCA) is an independent organization legislated under the Health Quality Council of Alberta Act with a mandate to promote and improve health service quality and safety across Alberta. Through partnerships and collaboration, we are committed to achieving excellence in all dimensions of quality and safety across Alberta's health system.

1.1 Background

Over the past two years the HQCA has engaged in a rigorous process to develop and test survey instruments for clients receiving long term home care services, including both professional (nursing, therapy, etc.) and non-professional (home health aid’s supporting activities of daily living) services. This work has included an extensive literature review, identification and selection of existing survey instruments, substantive revision to meet the needs of Alberta stakeholders, several rounds of cognitive testing and revision, and a structured field test of 200 respondents from across Alberta. Two versions of the survey questionnaire have been developed and tested: A longer version for clients with no or very mild cognitive limitations; and a shorter version for those clients with more notable cognitive limitations, combined with a family proxy version of the full questionnaire.

The purpose of the survey is to provide actionable information that will assist care providers and administrators to improve home care services for clients and to obtain standardized and comparable data across the province. The survey is focused on those receiving long term and maintenance services; that is, it excludes those receiving short term (rehabilitative), palliative, respite, and pediatric home care.

1.2 Project

Conduct a 3-stage mail survey of clients and families receiving long term home care in Alberta. The survey protocol includes the provision of phone follow-up or phone support, and phone-based data capture for the minority who need this support. Provision for phone-based follow-up, support, and data capture may not be required depending on the findings of the pilot study, or may be added based on observed response rates during the first two stages. Cost adjustments for this must be included in the proposal. The sample will be stratified by zone (5), and by cognitive category (2) – with survey packages and versions specific to each of the 2 cognitive categories. The full version of the survey for cognitively able respondents includes 55 closed ended items, and 4 limited open ended items. The cognitively limited version includes 18 closed ended items for the client, and 51 items with 3 limited open ended items for the family care giver.

The projected number of clients included in the initial sample (to be included in the survey process) will be between 6,000 and 12,000, with approximately 65% of sample within Self-Administered and 35% within Cognitively Limited groups. Final numbers will be estimated based on the field test results.

The expected final raw (unadjusted) response rate (based on previous long term care surveys) is between 50% and 60%. More exact estimates for this specific survey and population will be available prior to the start of field from the pilot study.

2.0 SCOPE OF WORK

The objective of the project is to conduct a mail survey of long term home care clients according to the specified protocol and procedure document (Appendix A), capture of data from this survey, and generation of a data file according to specifications. Other aspects of the broader study such as related analysis and reporting are not part of this RFP.

2.1 Project deliverables:

2.1.1 The vendor will provide a fully labeled SPSS (version 21 or later) data file as specified in Appendix A. This data file must include all survey questions including open ends, any derived variables, and the study ID to connect to the administrative data file.

2.1.2 A preliminary data file must be provided to the HQCA within 1 week of completion of the post card stage (2). The final cleaned data file must be provided to HQCA within 2 weeks of closing the field.

2.1.3 A survey administrative data file of all sampled records (full sample frame) will be

provided for documentation of the survey process. Required variables and disposition codes for this data file are provided in Appendix C, and these include the study ID. This file must be provided to the HQCA within 1 week of closing the field.

2.1.4 An additional data file of open ended items must be provided for all records, and must include the study ID number and variable number for all open-ended items. Text comments must be captured verbatim.

2.1.5 Additional text comments written outside the text box, on the back of surveys, or

attached as letters, or similar must be returned to HQCA for further action. 2.1.6 A methodology report must be provided to the HQCA within 2 weeks of closing

the field. This report will document a) the final dispositions of all sampled records; by the 5 Alberta Health Services zones and 2 cognitive categories; b) any deviations from the protocol; and c) any issues that arose in the course of conducting the survey.

2.2 Time frames

We anticipate going into the field by March 10 with an projected completion date of May 8, 2015.

3.0 METHODOLOGY The survey methodology is fully documented in Appendix A. Given the unique nature of this population and the extent of validation and pilot testing results, only minor deviations from this protocol are expected. For the purpose of this document, the survey instruments and communication materials provided are considered to be part of the protocol. Such parameters as font size, use of white space, single column structure, and number of pages have all been considered carefully in light of the target population. Final formatted versions will be provided after the pilot. 4.0 FEE PROPOSAL

4.1 The fee proposal shall include the total fees and recoverable expenses, including a detailed breakdown of professional fees, staff hours for each component of the project, per unit material costs, postage, travel and other expenses for the following components:

4.1.1 Project deliverables listed in 2.1, Methodology as per 3.0 and Appendix A.

4.2 Also included should be an anticipated payment schedule with each fee item attached to

a specific deliverable.

4.3 The vendor shall provide the cost for the projected sample of between 6,000 and 12,000 clients. The proposal must address in detail how costs will be adjusted to reflect the actual number of clients included in the survey process. Costs should be provided for a range of sample sizes and presented in table format.

4.4 The vendor shall provide the cost for both telephone support of clients with questions and collection of a small proportion of responses via telephone interview if required.

4.5 The vendor shall provide the cost for a stage 4 phone follow up should this be used. This stage is optional as determined by the HQCA and may or may not be used.

5.0 PROPOSAL FORMAT

5.1 Vendor understanding of the HQCA and the requirements for the Alberta Home Care Survey Project.

5.2 Project approach and methodology including a detailed outline of the approach to be

used including processes, methods, workflow, tasks, data collection methodology and project timeline.

5.3 Vendor’s relevant experience to include previous related projects, deliverables, and timeframes 5.3.1 References – a list of three references of clients who can attest to the firm’s

ability to complete the required work.

5.4 Engagement team to include a description of the personnel assigned, including resumes, availability, qualifications, responsibilities, and an estimate of hours by activity for each individual. Include the structure of the team for the project.

5.5 Detailed Fee proposal as noted above.

6.0 PROPOSAL EVALUATION AND RESPONSE RULES

6.1 All submissions shall be firm proposals and may not be withdrawn for a period of sixty (60) days following the last day to accept proposals. Proposals and documents submitted by the vendor will remain the property of the HQCA and will not be returned.

6.2 Acceptance/Rejection of Responses:

6.2.1 The HQCA reserves the right to cancel this RFP at any time and to reissue it for any reason without incurring liability and with no vendor having any claim against HQCA as a consequence.

6.2.2 The HQCA reserves the right to reject any or all proposals; the lowest fee proposal will not necessarily be awarded a contract.

6.2.3 All vendors submitting proposals will be advised of the contract award.

6.3 Evaluation The HQCA will establish a selection committee that will evaluate all proposals that are submitted by the deadline. Evaluation criteria will include: 6.3.1 Vendor experience and capability

6.3.1.1 Survey experience in the past three (3) years. 6.3.1.2 Best practice/current thinking. 6.3.1.3 Capacity to do the work.

6.3.2 Project Team 6.3.2.1 Overall experience of team members. 6.3.2.2 Experience specific to this type of project. 6.3.2.3 Ability to complete project on time and meet deliverables.

6.3.3 Methodology 6.3.3.1 Overall methodology, scope and tools. 6.3.3.2 Understanding of the project requirements.

6.3.4 Vendor privacy policies and procedures and ability to comply with the Alberta privacy legislation. (Health Information Act, and Freedom of Information and Protection of Privacy Act)

6.3.5 Fee Proposal 6.3.6 References

6.4 Any and all addenda to this proposal call will be issued in writing and sent to all firms having received documents from the HQCA prior to the closing deadline.

6.5 The selected vendor will be required to enter into a contract with the HQCA.

6.6 Closing of Proposal:

6.6.1 Firms may not submit new price proposals after the specified deadline. 6.6.2 Amendments to submitted proposals must be received in writing prior to the

deadline date. 6.6.3 All addenda issued during the time of the Request, and in closing, the addenda

will become part of the contract along with the response to the proposal.

6.7 Interviews Vendors may be required to attend an interview to discuss the responses to the Request for Proposal. The HQCA will notify the selected vendors for an interview if required.

6.8 Deadline for Submission Vendors are to deliver their responses no later than Feb 19, 2015 by 4:00 PM, Calgary time by email to: [email protected] Note: It is the responsibility of the vendor to confirm receipt of emailed materials.

6.8.1 All proposals received after this time will be rejected. Each proposal shall show

the full legal name and business address of the vendor, including its street address if it differs from the mailing address and shall be signed with the signature of the person/persons authorized to bind the vendor and shall be dated.

6.8.2 All costs/expenses will be the sole responsibility of the vendor submitting the

proposal. Each response must be duly signed and sealed and will be deemed irrevocable for 60 days after the deadline date. Fax copies will not be accepted.

6.9 All proposals must be clearly marked “Request for Proposal for Alberta Home Care

Survey 2015”. 6.10 Vendors must identify any terms and conditions of this Request with which they are

unable to comply. It will be assumed that the vendor accepts all terms and conditions unless otherwise noted and that all terms and conditions will form part of the contract.

7.0 CONFIDENTIALITY AND USE OF INFORMATION

7.1 All proposals received are confidential and shall be treated as such. All documents submitted to the HQCA are subject to the protection and disclosure provisions of the Alberta Freedom of Information and Protection of Privacy Act (FOIPPA) and the Health Information Act (HIA). While these Acts allow a person a right of access to records in the HQCA’s custody or control, it also prohibits the HQCA from disclosing personal or business information where disclosure would be harmful to business interests or would be an unreasonable invasion of personal privacy. Applicants are encouraged to identify what portions of their submissions are confidential and what harm could reasonably be expected from its disclosure.

7.2 The Acts named above can be obtained through the Alberta Queen’s Printer Bookstore

or website: http://www.qp.alberta.ca

7.3 The selected vendor is required to manage identifiable health information in compliance with the HIA and FOIPPA, as an agent under contract with the HQCA. Specific confidentiality and privacy requirements are included in the service contract. These requirements will apply to all sub-contractors, and all subcontractors engaged by the vendor must be identified clearly to the HQCA.

7.4 All disclosures of health information and survey data to a location other than the

principle location of the vendor must be disclosed to the HQCA in detail in the proposal and require HQCA approval prior to transfer of data.

mailto:[email protected]

http://www.qp.alberta.ca/

7.5 The records stipulated in this Agreement as being required to be maintained or submitted by the vendor may be subject to the protection and access provisions of FOIPPA and HIA. Should the HQCA receive a request for any of these records, it would be the vendor’s responsibility to provide the records, at their expense, to the HQCA within five (5) calendar days from official notification by the HQCA.

The purpose for collection of the personal information required to be provided in the Agreement is to enable the HQCA to ensure the accuracy and reliability of the proposal. Any questions about the collection of your personal information should be directed to Charlene McBrien-Morrison at (403) 297-8274, or email [email protected] 8.0 PROFESSIONAL LIABLITY INSURANCE

8.1 The Vendor shall, at its own expense and without limiting its liabilities herein, insure its operations under a contract of General Liability Insurance, in accordance with the Alberta Insurance Act, in an amount not less than $2,000,000.00 inclusive per occurrence, insuring against bodily injury, personal injury and property damage including loss of use thereof and shall provide evidence of such insurance to the HQCA upon request.

8.2 Throughout the term of this Agreement the Vendor shall maintain professional liability

insurance in an amount of not less than $2,000,000.00 and shall provide evidence of such insurance to the HQCA upon request.

8.3 The Vendor shall maintain automobile liability insurance on all vehicles owned,

operated or licensed in the name of the Contractor in an amount not less than $2,000,000.00 and the Contractor shall provide evidence of such insurance to the HQCA upon request.

9.0 CLARIFICATIONS

9.1 Clarifications regarding this RFP can be requested by email to: [email protected].

Please include “Home Care RFP” in the title line.



PROJECT TIMELINES (2015 dates) Feb 6 RFP Mailed to prospective Vendors Feb 19 RFP response must be received by email at the HQCA offices by 4:00

pm. Feb 23 Successful vendor will be selected and notified. Mar 4 Sample data and contact info provided to Vendor Mar 12 Expected date for first mail out Mar 20 Stage 2 post card mailing complete, submit preliminary data file to HQCA Mar 31 Final Mailing Complete April 13 Phone follow-up initiated (CONDITIONAL) April 24 Survey protocol complete, all data captured. May 1 Methodology Report and Dispositions Submitted to HQCA May 8 Submit final data file to HQCA

Appendix A Survey Process and Protocol (Home Care)

2.1 Survey tools The initial survey instruments and mailing materials are provided in Appendix B. Note: the third stage letter is not provided, but will be similar to the stage 1 letter. The HQCA may make minor modifications to the tools and supporting materials based on a final pilot test that is currently in field, but these will not add notably to length or number of items. The survey forms and materials provided have been designed and formatted according to the requirements of the population being surveyed. This includes use of 14 point font, inclusion of generous “white space”, and avoidance of column formatting. This requires a longer survey form, but one which is better suited to completion by members of this population. As such, substantive changes to formatting are not allowed, and any changes must be approved by the HQCA.

2.2 Respondent Eligibility Home care clients receiving Long Term or Maintenance Services are eligible to complete the survey. Long Term and Maintenance clients are those home care clients who have received home Care for at least 3 months; for sampling purposes a two month criterion will be used given that 3 service-months will have elapsed by the time the survey is received. Additional Criteria

• Clients are 18 years of age or older • Clients have had an RAI Home care assessment completed in the past year. • Clients who are living in their own homes, or Supportive Living (SL) 1and SL2

(private lodge or retirement homes), and are receiving publicly funded home care services.

Exclusions • Clients who are SL3, SL4, SL4D residents, or Long Term Care Residents. • Pediatric Clients (Under 18 years of age) • Short term, Rehabilitation, or Palliative clients • Deceased (after the point of sample generation) • Clients with a Cognitive Performance Scale (CPS) score of 4 or higher indicating

significant cognitive limitations

2.3 Two processes and associated sets of materials are used, with sample divided by

cognitive ability according to the respondents’ most recent CPS Score, which will have been completed within the last year. Clients with a CPS score of 0 (no limitations) or 1 (mild limitations) will be provided with a full version of the survey and related materials designed for self-administration. Family care givers may physically assist clients to complete the self-administered survey but are discouraged from influencing the responses. Clients with a CPS score of 2 or 3 and with a family caregiver available, will be provided with a shortened and simplified client survey questionnaire to be completed with the assistance of a family member; and a survey questionnaire parallel to the first process described above but completed by the family member (proxy) on behalf of the client.

2.4 Sample A sample will be generated from a database of all Long Term and Maintenance Home care Clients. The sample will be stratified by Alberta Health Services zone (of which there are five), and by (binary) cognitive classification, and potentially by level and type of service. The projected number of clients included in the initial sample (to be included in the survey process) will be between 6,000 and 12,000, with approximately 65% of sample within Self-Administered and 35% within cognitively limited groups. Final numbers will be determined based on the field test results.

Note: Final sample size will be determined according to the amount of data available by the start date of the full survey, and will be increased or decreased to reflect response rates obtained in the pilot. A cost adjustment table must be provided by the vendor to specify exact costs should sample size be increased or decreased.

2.5 Survey Protocol This is a mail mode survey protocol using 3 mail stages (modified Dillman protocol), with an option of fourth stage phone contact, with assistance and completion for those who require assistance to complete. We expect a response rate of at least 50% (raw response rate1), and will provide a more precise estimate accurate estimate upon completion of the pilot. Note: Using the same protocol with Long Term Care Families, HQCA has achieved an 80% response rate for mail protocol alone, and 82% with phone follow-up included. Despite this we expect slightly lower response rates owing to a more physically frail set of respondents.

Required components (calendar days) Day 1 1st mailing of questionnaire and cover letter (Step 1) Day 12 Reminder post card (Step 2) Day 20 2nd mailing of questionnaire and new cover letter (Step 3) Day 32 Phone follow up, with option to complete over the phone

Note: The fourth stage phone contact may be dropped from the protocol based on the findings of the pilot study.

2.5.1 Each sampled respondent must have a unique Study ID, to be tracked throughout the entire process which links all survey data with all required administrative data.

2.5.2 Where home addresses are the same (i.e. clients are both receiving services – minor modifications to the cover letters will be required)

2.5.3 All mail material will be provided in draft by the HQCA, and the HQCA must approve final versions of all material prior to use.

2.5.4 The survey forms provided in Appendix B may be used, or a form may be designed by the vendor as long as layout is the same or nearly the same as Appendix B. Final versions must be approved by the HQCA.

2.5.5 Each survey form must include the Study ID to be tracked to the specific respondent for administrative purposes. Survey forms sent in the first and second mailings must be distinguished from each other.

2.5.6 Cover letters for survey mailings (both stages if needed) must be addressed to the client, or client and family member and include the date of printing.

2.5.7 Full survey package (mailing 1 and 3) must use a full size white envelope, and will be printed as per the design provided by the HQCA (Appendix B)

1 Raw response rate = Completed Surveys / Completed Surveys + all other sample

2.5.8 The post card reminder will be addressed similarly to the first mailing, and will be post card size on card stock.

2.5.9 Survey return envelope must be prepaid or use Business Reply Mail (preferred) with pre-address to vendor such that there is no cost to the respondent for mailing, and mail charges apply if the survey is returned.

2.5.10 Mail returned as invalid address

• Where a phone number is available, phone calls will be placed for all returned mail to determine current address. Where the phone number is also invalid, a final disposition will be coded accordingly. Other procedures for identification of correct mailing address may be considered (i.e. reverse lookup).

2.5.11 Provision of a no charge phone number to respond to basic questions from

potential respondents (simple clarification about meaning of items, instructions or procedures.

• Procedure to triage and refer more complex questions to the designated HQCA contact if required.

2.6 Record level tracking and documentation of survey process and dispositions

2.6.1 The survey process must be documented with the variables provided in Appendix C (as a minimum).

2.6.2 Events such as return of survey materials, and current disposition of respondent must be kept up to date such that the date of return is documented accurately, and such that responders are not mailed redundant material. Record dispositions must be up to date prior to each mailing or stage of the process.

2.7 Data Capture (scanning or data entry)

2.7.1 For capture of mail survey data, either double entry for manual data entry, or

scanned data capture with OCR of closed ended responses and verification step for ambiguous responses; is acceptable. Preference is that scanned forms be used. In both cases open ended responses should be typed (No OCR).

2.7.2 Variable names should reflect question number and where possible should be based on and identical with the full self-administered client survey.

2.7.3 Some variables unique to the specific survey forms (simple client, and proxy

family forms) will have different unique variable names; but across survey forms, same items must have the same variable name and data format.

2.7.4 Variable names and response choice coding must be approved by the HQCA

prior to start of field. Ideally a mock or blank data file would be generated for review.

2.7.5 Data resulting from different survey forms, or by phone must be identified

according to a “source” variable which specifies how the survey data was collected (i.e. SELF-paper, SELF-phone, SHORT-paper, SHORT-phone, PROXY-paper, PROXY-phone)

2.7.6 If undertaken (optional stage), survey data collected over the phone must be

combined with data captured on the equivalent paper form, with variable names and response codes being identical.

2.8 Data Files

2.8.1 A full record level data file representing the full survey administration process (Appendix C) must be provided to the HQCA within 1 week of closing the field. This may be provided as an Access database, DBF, Excel, or SPSS. All field names and codes must be labeled or annotated.

2.8.2 The survey data files must be provided as an SPSS data file, with full labels for all variables and values.

2.8.3 Open ended responses must be provided verbatim, in a file format which does not truncate the length of the response. The unique Study ID must be provided for all open ended responses. File format to be negotiated.

2.8.4 A preliminary data file must be provided to the HQCA following completion of the post card stage.

2.8.5 A final data file must be provided according to the HQCA secure data transfer requirements, within 2 weeks of closing the field.

Appendix B Letters & Survey Forms

Stage 1 Letter Family (Note: The stage 3 letter will be slightly modified from this) February 6, 2015

Dear Click and type Recipient Name

Your feedback about home care services is valuable

We invite you and your family to take part in a survey about the quality of care and services you receive from Home Care. The information that you, and others, provide will be used to improve Home Care services. The survey is being conducted by the Health Quality Council of Alberta (HQCA) in collaboration with Alberta Health Services and Alberta Health. The HQCA is an independent agency with a mandate to improve the quality and safety of healthcare in Alberta.

There are two questionnaires enclosed. One is for the family member most involved in your care, and the other is for you to complete. Each questionnaire should take no more than 10 to 15 minutes. If you have difficulty, it’s OK to have your family member help you. Please use the postage-paid envelope to return the questionnaires. Your participation is entirely voluntary. Your answers are strictly confidential and you will not be identified as an individual in the reports. Your services will not be affected if you don’t fill out the questionnaire, however your feedback is very important and we sincerely hope you will participate. We want to give you every opportunity to participate. If we don’t receive anything from you within seven days, we will send you a reminder notice. If you have any questions or need our assistance in completing this survey you are welcome to call Pam, weekdays, at 403-703-8039 (Calgary) or 1-844-703-8039 (toll-free) or Gisele, weekends, at 403-968-1574 (Calgary) or 1-844-968-1574 (toll-free). Results will be available in late 2015 on the Health Quality Council of Alberta’s website www.hqca.ca or you can request a copy by calling us at 403-297-8162. Thank you in advance for your participation! Sincerely,

Charlene McBrien-Morrison, Executive Director

More about the HQCA: The HQCA is an independent agency with a mandate under the Health Quality Council of Alberta Act to promote and improve patient safety and health service quality in Alberta. For further information please refer to our website - www.hqca.ca or phone 403-297-8162. Postcard Family

ID # ___

Alberta Home Care Survey

For Family Caregivers

January 23, 2015

Note: This Caregiver survey is administered along with a short form for clients These two surveys are used for clients with some cognitive limitations (CPS 2 or 3)

Instructions • This survey asks questions about your family member’s Home Care

services from or arranged for by Alberta Health Services (not services that your family member may be paying to receive from a private agency).

• Your answers are strictly confidential and it will not be possible to

identify you or your family member in reports on the results.

• There are no right or wrong answers – just your views, but you are free to skip any questions that you don’t want to answer.

• For each question, please mark your choice with a blue or black pen

by filling in the circle ⃝ • If you have questions or need assistance in completing this survey

you are welcome to call:

Pam, weekdays, at 403-703-8039 (Calgary) or 1-844-703-8039 (toll-free)

Gisele, weekends, at 403-968-1574 (Calgary) or 1-844-968-1574 (toll-free)

• Your feedback is very important for planning and improving Home

Care services. Thank-you!

Your Family Member’s Case Manager By Case Manager we mean the person who is in charge of your family member’s services, that is, the person who checks what she or he needs, arranges for care, and makes sure things are going well. 1. When the last Case Manager started, they introduced themselves to my family member and explained their role in his/her care. (please fill in the circle beside your answer)

⃝ Yes ⃝ No ⃝ I don’t know who my family member’s Case Manager is ⃝ I don’t know

2. In the last year, we were able to reach the Case Manager when we needed her/him.

⃝ Yes ⃝ Partly ⃝ No ⃝ I don’t know who my family member’s Case Manager is ⃝ I don’t remember

3. In the last year, the Case Manager helped us get all of the Home

Care services that my family member needed.

⃝ Yes ⃝ Partly ⃝ No ⃝ I don’t know who my family member’s Case Manager is ⃝ I don’t remember

4. In the last year, the Case Manager helped us get changes to my

family member’s Home Care services.

⃝ Yes ⃝ Partly ⃝ No ⃝ She/he didn’t need changes ⃝ I don’t know who my family member’s Case Manager is ⃝ I don’t remember

5. In the last year, approximately how many different Case Managers has your family member had?

⃝ Just one ⃝ 2 or 3 ⃝ More than 3 ⃝ I don’t remember

Planning Your Family Member’s Home Care Services

The Care Plan By Care Plan we mean the written document prepared by the Case Manager, that has the details about your family member’s needs and services. 6. In the last year, my family member was involved in making his/her Care Plan.

⃝ Yes, a lot ⃝ Yes, a little ⃝ No, not at all ⃝ No, I don’t think he/she should be involved ⃝ I don’t know

7. In the last year, I was involved making my family member’s Care Plan.

⃝ Yes, a lot ⃝ Yes, a little ⃝ No, staff didn’t include me ⃝ No, I was unable to be involved ⃝ I don’t know

8. In the last year, my family member’s Care Plan included…

⃝ Most of the things he/she needs ⃝ Some of the things he/she needs ⃝ Almost none of the things he/she needs ⃝ I have not seen his/her Care Plan ⃝ I don’t know

9. In the last year, Home Care provided…

⃝ Most of the things in my family member’s Care Plan ⃝ Some of the things in my family member’s Care Plan ⃝ Almost none of the things in my family member’s Care Plan ⃝ I don’t know

Care Meetings 10. In the last year, my family member was part of a meeting with her/his Case Manager about his/her care

⃝ Yes ⃝ No, he/she wasn’t part of a meeting ⃝ No, there was no meeting ⃝ I don’t know if there was a meeting

11. In the last year, my family member’s family doctor seemed to know about important details of his/her Home Care services

⃝ Yes, most of the time ⃝ Yes, some of the time ⃝ No ⃝ I don’t know ⃝ He/she doesn’t have a family doctor

12. Who would your family member talk to if she/he wanted to change his/her Home Care Services?

⃝ His/her Case Manager ⃝ Other Home Care Staff ⃝ Family or friends ⃝ My family doctor ⃝ I don’t know

12a. In the last year, did the Case Manager ask you about your needs as a family caregiver?

⃝ Yes ⃝ No ⃝ I don’t remember

Home Care Professional Services

By professional services we mean treatments like care for your family member’s wounds, or physiotherapy, provided by professional staff like nurses, physical therapists and occupational therapists. If your family member did NOT get at least 3 visits for professional services, fill in this circle ⃝ and skip to Question 31. 13. In the last year, professional Home Care services met my family member’s needs for managing pain.

⃝ Yes ⃝ Partly ⃝ No ⃝ Not applicable ⃝ Don’t know

14. In the last year, professional Home Care services met my family member’s needs for help with medical procedures or therapy (like wound care or physiotherapy).


15. In the last year, professional Home Care services met my family member’s needs for setting up his/her home so he/she could move around safely.


16. In the last year, professional Home Care services met my family member’s needs for setting up the home so she/he could do things independently.


The next few questions are about your family member’s medications: 17. In the last year, professional Home Care staff talked with my family member about the purpose of his/her medications.


18. In the last year, professional Home Care staff reviewed all of my family member’s medications.


19. In the last year, professional Home Care staff talked with my family member about the side effects of his/her medications.


20. In the last year, professional Home Care staff talked with my family member about when to take his/her medications.


21. In the last year, professional Home Care staff met my family member’s needs for help with IV medication or tube nutrition.


The next few questions are about how your Home Care professional staff treated your family member. 22. In the last year, Home Care professional staff explained things in a way that was easy for him/her to understand.

⃝ Yes ⃝ Partly ⃝ No ⃝ Don’t know

23. In the last year, Home Care professional staff knew what kind of care she/he needed and how to provide it.


24. In the last year, Home Care professional staff treated him/her with courtesy and respect.


25. In the last year, Home Care professional staff treated her/him as gently as possible when providing care.


26. In the last year, Home Care professional staff gave him/her choices about how care was provided.


27. In the last year, Home Care professional staff listened carefully to my family member’s wishes and needs.


28. In the last year, Home Care professional staff made him/her feel safe and that his/her belongings were safe.


29. Do you have any concerns about your family member’s Home Care professional services?

⃝ No ⃝ Yes: (If you wish to, please describe your concern(s) in the box below):

30. OVERALL, how would you rate your family member’s Home Care Professional Services? (please think about all professional staff together)

⃝ Poor ⃝ Fair ⃝ Good ⃝ Very Good ⃝ Excellent

Personal Care Services By Personal Care services we mean things like help with dressing, eating, bathing and going to the bathroom. These services are provided by Personal Care staff (also called Health Care Aides). These services do not include help from family or friends. If your family member did NOT get at least 3 visits for personal services, fill in this circle ⃝ and skip to Question 48. 31. In the last year, how do you feel about the number of different Personal Care staff your family member has had?

⃝ I’m very happy with the number she/he has had ⃝ I’m OK with the number he/she has had

⃝ I’m not happy at all with the number he/she has had ⃝ Don’t know

32. In the last year, Personal Care staff met my family member’s needs for help with showering or bathing.


33. In the last year, Personal Care staff met my family member’s needs for help with getting dressed.


34. In the last year, Personal Care staff met my family member’s needs for help with using the bathroom.


35. In the last year, Personal Care staff met my family member’s needs for help with eating.


36. In the last year, Personal Care staff met my family member’s needs for help with taking medications.


The next few questions are about how Personal Care staff treated your family member. 37. In the last year, Personal Care staff let my family member know when they could not come.


38. In the last year, Personal Care staff knew what kind of care my family member needed and how to provide it.


39. In the last year, Personal Care staff treated him/her with kindness even during difficult or embarrassing tasks.


40. In the last year, Personal Care staff listened carefully to her/his wishes and needs.


41. In the last year, Personal Care staff encouraged my family member to do things for him/herself if he/she could.


42. In the last year, Personal Care staff kept us informed about when they would arrive.


43. In the last year, Personal Care staff explained things in a way that was easy for her/him to understand.


44. In the last year, Personal Care staff treated my family member as gently as possible when providing care.


45. In the last year, Personal Care staff made my family member feel safe and that his/her belongings were safe.


46. Do you have any concerns about your family member’s Personal Care services?


47. OVERALL, how would you rate your Personal Care Services?

(please think about all Personal Care staff together)


Other Service Needs

The next questions are about any other services that your family member may have needed that are NOT provided by Alberta Health Services Home Care (such as yardwork or grocery delivery). These may be paid services or services provided by family, friends or volunteers for free. 48. In the last year, was there any service of any kind that you felt your family member needed but didn’t get?

⃝ No ⃝ Yes: (if you wish please describe in the box below)

49. In the last year, did your family member’s Case Manager help him/her to get these other types of services in your community?

⃝ He/she did not need other services ⃝ No, he/she needed services but the Case Manager didn’t help ⃝ The Case Manager tried to help but he/she still didn’t get other services ⃝ Yes, he/she was helped by the Case Manager to get other services

Your Overall Rating of Home Care Services

50. OVERALL, how would you rate the quality of your family member’s Home Care services (including both Professional and Personal Services)?


51. OVERALL, how would you rate the quality of your family member’s Home Care services (including Professional and Personal services), where 0 is the worst and 10 is the best.

⃝ 0 ⃝ 1 ⃝ 2 ⃝ 3 ⃝ 4 ⃝ 5 ⃝ 6 ⃝ 7 ⃝ 8 ⃝ 9 ⃝ 10

Your Health & Wellbeing The next questions are about how your family member is doing in general. 52. In general, would you say your family member’s overall health is…..


53. In general, would you say your family member’s overall mental or emotional health is…


Please feel free to write any other comments you have about your family member’s Home Care Services or this survey on the back of this page, and then return your completed survey in the postage-paid envelope. Results will be available on the HQCA website in Fall 2015 or you can call 403-297-8162 then to request a copy by mail. Thank you very much for your feedback. It will be used to make Home Care services better!

ID # ___


For Clients

Note: This short form survey for clients is administered with the caregiver survey. This is for clients who have some cognitive limitations (CPS 2 or 3)

Note to Family Caregivers:

• If your family member is unable to read and respond to this questionnaire on their own, you can help by reading the items to them; and recording their responses.

• If your family member receives BOTH professional and personal care services, please guide them to complete all items.

• If they receive professional services ONLY, then please guide them to complete sections A and C only.

• If they receive personal care services ONLY, then please guide them to complete sections B and C only.

• It may also be helpful for you to tell them the name(s) of the staff person(s) that the questions refer to as you go through sections A and/or B.

• If you are certain that they are not understanding the items and making appropriate responses, please fill in this circle ⃝ and return the ques the prepaid envelope.

A. Home Care Professional Staff

The first 7 questions are about your home care professional staff – like your nurse or therapist. Please fill in the circle ⃝ beside your answer.

1. My home care professional staff explains things in a way that is easy to understand.

⃝ Yes ⃝ Partly ⃝ No

2. My home care professional staff knows what kind of care I need and how to provide it.


3. My home care professional staff treats me with courtesy and respect.


4. My home care professional staff treats me as gently as possible when providing care.


5. My home care professional staff listens carefully to my wishes and needs.


6. My home care professional staff makes me feel safe and that my belongings are safe.


7. I rate my Home Care Professional Staff as:


B. Home Care Personal Staff

The next questions are about your home care personal staff, the person or people who helps you with things like dressing, eating and bathing.

8. My home care personal staff lets me know when they can’t come.


9. My home care personal staff knows what kind of care I need and how to provide it.


10. My home care personal staff treats me with kindness, even during difficult or embarrassing tasks.


11. My home care personal staff listens carefully to my wishes and needs.


12. My home care personal staff encourages me to do things for myself if I can.


13. My home care personal staff explains things in a way that is easy to understand.


14. My home care personal staff treats me as gently as possible when providing care.


15. My home care personal staff makes me feel safe and that my belongings are safe.


16. I rate my Home Care Personal Staff as: (please circle one) ⃝ Poor ⃝ Fair ⃝ Good ⃝ Very Good ⃝ Excellent

C. Health Status The last 2 questions are about how you are doing in general. 17. In general, would you say your overall health is…..


18. In general, would you say your overall mental or emotional health is….


Thank you very much for your feedback. It will be used to make Home Care services better!

Stage 1 Letter Client (NOTE: for clients with minimal or no cognitive limitations – CPS 0 or 1) Stage 3 letter will be slightly modified from this stage 1 letter February 6, 2015

Dear Click and type Recipient Name

Your feedback about home care services is valuable

We invite you to take part in a survey about the quality of care and services you receive from Home Care. The information that you, and others, provide will be used to improve Home Care services. The survey is being conducted by the Health Quality Council of Alberta (HQCA) in collaboration with Alberta Health Services and Alberta Health. The HQCA is an independent agency with a mandate to improve the quality and safety of healthcare in Alberta. The enclosed questionnaire takes about 10 to 20 minutes to fill out. Please use the postage-paid envelope to return your questionnaire. Your participation is entirely voluntary. Your answers are strictly confidential and you will not be identified as an individual in the reports. Your services will not be affected if you don’t fill out the questionnaire, however your feedback is very important and we sincerely hope you will participate. We want to give you every opportunity to participate. If we don’t receive anything from you within seven days, we will send you a reminder notice. If you find it difficult to complete the questionnaire on your own, please feel free to get help from family or a friend. If you have any questions or need our assistance in completing this survey you are welcome to call Pam, weekdays, at 403-703-8039 (Calgary) or 1-844-703-8039 (toll-free) or Gisele, weekends, at 403-968-1574 (Calgary) or 1-844-968-1574 (toll-free). Results will be available in late 2015 on the Health Quality Council of Alberta’s website www.hqca.ca or you can request a copy by calling us at 403-297-8162. Thank you in advance for your participation! Sincerely,

Charlene McBrien-Morrison, Executive Director More about the HQCA: The HQCA is an independent agency with a mandate under the Health Quality Council of Alberta Act to promote and improve patient safety and health service quality in Alberta. For further information please refer to our website - www.hqca.ca or phone 403-297-8162.

http://www.hqca.ca/

Postcard:

ID # ___


January 23, 2015

NOTE: This long form survey is for clients with minimal or no cognitive limitation (CPS 0 or 1)

Instructions • This survey asks questions about the Home Care services your

receive from Alberta Health Services (not any private services that you may be paying for).

• There are no right or wrong answers – just your views, but you are

free to skip any questions that you don’t want to answer.

• It’s fine to seek help from family, but for a few questions it is very important that the answer reflect YOUR own personal opinion. These are noted inside.

• For each question, please mark your choice with a blue or black pen

by filling in the circle ⃝

• If you have any questions or need assistance in completing this survey you are welcome to call:

Pam, weekdays, at 403-703-8039 (Calgary) or 1-844-703-8039

(toll-free) Gisele, weekends, at 403-968-1574 (Calgary) or 1-844-968-1574

(toll-free)

• Your feedback is very important for planning and improving Home Care services. Thank-you!

Your Case Manager By Case Manager we mean the person who is in charge of your services, that is – the person who checks what you need, arranges for care, and makes sure things are going well. 1. When my last Case Manager started, they introduced themselves and explained their role in my care. (please fill in the circle beside your answer)

⃝ Yes ⃝ No ⃝ I don’t know who my Case Manager is ⃝ I don’t remember

2. In the last year, I was able to reach my Case Manager when I needed her/him.

⃝ Yes ⃝ Partly ⃝ No ⃝ I don’t know who my Case Manager is ⃝ I don’t remember

6. In the last year, my Case Manager helped me get all of the Home

Care services that I needed.

⃝ Yes ⃝ Partly ⃝ No ⃝ I don’t know who my Case Manager is ⃝ I don’t remember

7. In the last year, my Case Manager helped me get changes to my

Home Care services.

⃝ Yes ⃝ Partly ⃝ No ⃝ I didn’t need changes ⃝ I don’t know who my Case Manager is ⃝ I don’t remember

8. In the last year, approximately how many different Case Managers

have you had? ⃝ Just one ⃝ 2 or 3 ⃝ More than 3 ⃝ I don’t remember

Planning Your Home Care Services Your Care Plan By Care Plan we mean the written document prepared by your Case Manager, that has the details about your needs and services. By Family we mean your spouse, siblings, children or any other person you consider to be family. 6. In the last year, I was involved in making my Care Plan.

⃝ Yes, a lot ⃝ Yes, a little ⃝ No, not at all ⃝ No, I don’t think I should be involved ⃝ I don’t remember

7. In the last year, my family was involved making my Care Plan. ⃝ Yes, a lot ⃝ Yes, a little ⃝ No, staff didn’t include them ⃝ No, I didn’t want family involved ⃝ No, my family was unable to be involved ⃝ I have no family available ⃝ I don’t know

8. In the last year, my Care Plan included…

⃝ Most of the things I needed ⃝ Some of the things I needed ⃝ Almost none of the things I needed ⃝ I have not seen my Care Plan ⃝ I don’t know

9. In the last year, Home Care provided…

⃝ Most of the things in my Care Plan ⃝ Some of the things in my Care Plan ⃝ Almost none of the things in my Care Plan ⃝ I don’t remember

Care Meetings 10. In the last year, I was part of a meeting with my Case Manager about my care.

⃝ Yes ⃝ No, I wasn’t part of a meeting ⃝ No, there was no meeting ⃝ I don’t know if there was a meeting

11. In the last year, my family doctor seemed to know about important details of my Home Care services.

⃝ Yes, most of the time ⃝ Yes, some of the time ⃝ No ⃝ I don’t know ⃝ I don’t have a family doctor

12. If I wanted to change my Home Care Services, I would talk to…

⃝ My Case Manager ⃝ Other Home Care Staff ⃝ Family or friends ⃝ My family doctor ⃝ I don’t know

Home Care Professional Services

By professional services we mean treatments like care for your wounds, or physiotherapy, provided by professional staff like nurses, physical therapists and occupational therapists. If you did NOT get at least 3 visits for professional services, fill in this circle ⃝ and skip to Question 31. 13. In the last year, professional Home Care services met my needs for managing my pain.


14. In the last year, professional Home Care services met my needs for help with medical procedures or therapy (like wound care or physiotherapy).


15. In the last year, professional Home Care services met my needs for setting up my home so I could move around safely.


16. In the last year, professional Home Care services met my needs for setting up my home so I could do things independently.


The next few questions are about your medications: 17. In the last year, professional Home Care staff talked with me about the purpose of my medications.


18. In the last year, professional Home Care staff reviewed all of my medications.


19. In the last year, professional Home Care staff talked with me about the side effects of my medications.


20. In the last year, professional Home Care staff talked with me about when to take my medications.


21. In the last year, professional Home Care staff met my needs for help with IV medication or tube nutrition.


The next few questions (22 to 30) are about how your Home Care professional staff treated you. Please provide ONLY YOUR OWN OPINION for these questions. 22. In the last year, my Home Care professional staff explained things in a way that was easy to understand.


23. In the last year, my Home Care professional staff knew what kind of care I needed and how to provide it.


24. In the last year, my Home Care professional staff treated me with courtesy and respect.


25. In the last year, my Home Care professional staff treated me as gently as possible when providing care.


26. In the last year, my Home Care professional staff gave me choices about how care was provided.


27. In the last year, my Home Care professional staff listened carefully to my wishes and needs.


28. In the last year, my Home Care professional staff made me feel safe and that my belongings were safe.


29. Do you have any concerns about your Home Care professional services?


30. OVERALL, how would you rate your Home Care Professional Services?

(please think about all professional staff together)


Personal Care Services By Personal Care services we mean things like help with dressing, eating, bathing and going to the bathroom. These services are provided by Personal Care staff (also called Health Care Aides). These services do not include help from family or friends. If you did NOT get at least 3 visits for personal services, fill in this circle ⃝ and skip to Question 48. 31. In the last year, how do you feel about the number of different Personal Care staff you have had?

⃝ I’m very happy with the number I’ve had ⃝ I’m OK with the number I’ve had

⃝ I’m not happy at all with the number I’ve had ⃝ Don’t know

32. In the last year, Personal Care staff met my needs for help with showering or bathing.


33. In the last year, Personal Care staff met my needs for help with getting dressed.


34. In the last year, Personal Care staff met my needs for help with using the bathroom.


35. In the last year, Personal Care staff met my needs for help with eating.


36. In the last year, Personal Care staff met my needs for help with taking medications.


The next few questions (37-47) are about how your Personal Care staff treated you. Please provide ONLY YOUR OWN OPINION for these questions. 37. In the last year, Personal Care staff let me know when they could not come.


38. In the last year, Personal Care staff knew what kind of care I needed and how to provide it.


39. In the last year, Personal Care staff treated me with kindness even during difficult or embarrassing tasks.


40. In the last year, Personal Care staff listened carefully to my wishes and needs.


41. In the last year, Personal Care staff encouraged me to do things for myself if I could.


42. In the last year, Personal Care staff kept me informed about when they would arrive.


43. In the last year, Personal Care staff explained things in a way that was easy to understand.


44. In the last year, Personal Care staff treated me as gently as possible when providing care.


45. In the last year, Personal Care staff made me feel safe and that my belongings were safe.


46. Do you have any concerns about your Personal Care services?


47. OVERALL, how would you rate your Personal Care Services? (please think about all Personal Care staff together)


Other Service Needs

The next questions are about any other services that you may have needed that are NOT provided by Alberta Health Services Home Care (such as yardwork or grocery delivery). These may be services you have to pay for or services provided by family, friends or volunteers for free. 48. In the last year, was there any service of any kind that you felt you needed but didn’t get?

⃝ No ⃝ Yes: (if you wish please describe in the box below)

49. In the last year, did your Case Manager help you get these other types of services in your community?

⃝ I did not need other services ⃝ I needed services but my Case Manager didn’t help me ⃝ My Case Manager tried to help me but I still didn’t get other services ⃝ Yes, I was helped by my Case Manager to get other services

Your Overall Rating of Home Care Services 50. OVERALL, how would you rate the quality of your Home Care services (including both Professional and Personal Services)?


51. OVERALL, how would you rate the quality of your Home Care services (including both Professional and Personal services), where 0 is the worst and 10 is the best?

⃝ 0 ⃝ 1 ⃝ 2 ⃝ 3 ⃝ 4 ⃝ 5 ⃝ 6 ⃝ 7 ⃝ 8 ⃝ 9 ⃝ 10

Your Health & Wellbeing The next questions are about how you are doing in general. 52. In general, would you say your overall health is…..


53. In general, would you say your overall mental or emotional health is….


54. Did someone help you complete this survey?

⃝ No ⃝ Yes, my spouse ⃝ Yes, another family member ⃝ Yes, someone else (please specify) ____________________

55. If Yes, how did that person help you? (please mark all that apply) ⃝ Read the questions to me ⃝ Wrote down the answers I gave ⃝ Answered the questions for me ⃝ Talked with me about what my answer should be ⃝ Translated the questions into my language ⃝ Helped in another way (please describe how they helped in the box below)

Please feel free to write any other comments you have about your Home Care Services or this survey on the back of this page, and then return your completed survey in the postage-paid envelope. Results will be available on the HQCA website in Fall 2015 or you can call 403-297-8162 then to request a copy by mail. Thank you very much for your feedback. It will be used to make Home Care services better!

APPENDIX C: Required Variables Record by Record Documentation of Process

Variable Description Study_ID Unique client identifier consistent between all surveys and data Adv_dt Date of Advance Letter Mail1_dt Date of first survey A mailing Disp1 Disposition at postcard mail date Card_dt Date of postcard mailing Disp2 Disposition at second survey B mailing Mail2_dt Date of second survey mailing Phone1 Date of phone attempt (initiated by Vendor) Phone_C Date of phone contact initiated by respondent Disp_F Final disposition recv_dtA Date survey A received by vendor (Use A if A is received and complete) recv_dtB Date survey B received by vendor Int_phone Date of completion over the phone Comment Open comment on record

Disp_code Description INVADR invalid address (mail returned) INVPHON invalid phone number (upon step 4 phone attempt) LANG language or communication barrier REF refused COMP_M completed by mail COMP_P completed by phone with assistance of interviewer PROT_C protocol complete OTH other disposition (must annotate) OTH_TXT open text for other disposition

REQUEST FOR PROPOSAL Alberta Home Care Survey 2015 · REQUEST FOR PROPOSAL . Alberta Home Care...

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