Client Safety – An Associa1on Perspec1ve
Ontario Home Care Associa0on for
CPSI Pa'ent Safety Week October 2013
Ontario Home Care Associa1on Ø Membership organiza1on of those engaged in and/or suppor1ve of home-‐based health care.
Ø Mandate to promote growth & development of the sector through advocacy, knowledge transfer, and member service.
Ø In Ontario, service provider organiza1ons deliver approximately 54 million hours of publicly and privately purchased home care.
Aim
Ø Clients will receive support to live safely in their homes and will not be harmed by the care they receive.
Principle of the OHCA Standards for Home Health
Care Service Provider Organiza1ons
Context Ø OHCA members undertake a self-‐assessment of their performance
to OHCA standards as part of their membership renewal. Ø Standards are grouped into five dimensions:
1. Governance & Accountability 2. Service Delivery 3. Finance 4. Quality & Excellence 5. Human Resources
Ø Members assess their performance as: § Substan1al Compliance § Par1al Compliance § Minimal Compliance § Non-‐Compliant § Not Applicable
Ø Performance by members to OHCA standards is presented to the community using a Balanced Scorecard. (Kaplan and Norton)
Ø Organiza1onal perspec1ves: – Customer – sa1sfac1on & client-‐centredness – Internal Business – efficiency & effec1veness – Financial – value & risk – Learning and Growth – staff training & cultural a^tudes related to individual and organiza1onal self-‐improvement
Context
Engaged in client safety monitoring
and ac1ons/ improvements
Culture of client safety
Resources dedicated to client safety
Emergency management
Staffing Ethical Prac1ces
Governance
Service Delivery Financial
Quality &
Excellence
Human Resources
Quality Dimensions
Evidence
Safety embedded across all dimensions
S A F E T Y
Issue Ø Determining provider accountability for client safety when the staff are not in the home and cannot control the environment.
Ø Reflected in self assessments of performance to OHCA standards. – Comments explaining the self assessed score – Concern expressed by members & brought to the Board for discussion
Interven1on Ø The Plan-‐Do-‐Study-‐Act (PDSA) cycle allows the tes1ng of
ideas before implemen1ng a full scale change. Ø From the Associa1on context the improvement cycles
are longer. Ø Board, members and staff engage in the cycle.
A P S D
A P S D
A P S D
A P S D
Interven1on Ø Ac1ons:
• 2004 – Partnership with Accredita1on Canada • 2005 -‐ Par1cipa1on on Cri1cal Indicator Data Collec1on Expert Panel for
MOHLTC funded research – Adverse Events in Home Care • 2007 -‐ Support Peel Senior Link Medica1on Management ini1a1ve • 2008 – Discussion with Board by N Sears, Principal Inves1gator, Adverse
Events in Home Care • 2009 – Establishment of Pa1ent Safety page within OHCA members only
resources • 2010 – 2012 Knowledge Exchange Broker, Safety at Home: A Pan-‐Canadian
Home Care Study, funded by CPSI, CIHR, CHSRF • Ongoing since 2008:
§ Research Month – educa1onal sessions for members and their staffs § Educa1onal webinars such as Infec1on, Preven1on & Control; Mee3ng & Exceeding the Excellent Care for All Act Expecta1ons; Crea1ng Befer Value in Home Care; Understanding RAI-‐HC assessments
§ Board agenda
Measurement Ø Measurement is cri1cal to bringing new knowledge into
prac1ce. Ø Improvement in OHCA’s goal of ensuring client safety when in
receipt of home care service was achieved through qualita1ve measures: – Reports from members on annual their self-‐assessments that their
organiza1on has established a Client Safety Plan which aligns to strategy & quality
– Feedback from members that client safety metrics are measured and descrip1on of metrics used
– Provider discussion at Board mee1ngs Ø Quan1ta1ve measures include:
– # of visits to OHCA member only client safety web page – # of par1cipants on OHCA webinars related to client safety
Contribu1on
Ø There is an important role for associa1ons to champion safety in home care.
Ø Based on the OHCA quality journey, the Associa1on recognizes the need for safety as a dis1nct standard and scorecard perspec1ve.
Ø A dedicated policy paper on client safety in home care in Ontario will be developed.
Lessons Learned
Ø While safety issues permeate all aspects of service delivery, client safety needs to be iden1fied as a strategic priority.
Ø Associa1ons can enable collabora1ve work to help educate and enable sustainable prac1ces regarding client safety; risk management; managing, mi1ga1ng or preven1ng harm.
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