Transcript SWOGAN Team Exchange

Canadian Coalition for
Seniors’ Mental Health
The Southwestern Ontario
Geriatric Assessment Network
Catherine Glover
Dr. Lisa VanBussel
September 24-25, 2007
Declaration
We are unaware of any apparent
conflict(s) of interest that may have a
direct bearing on the subject matter of
this presentation.
SWOGAN
Network of specialized teams of
clinicians located in the ten
counties of Southwestern Ontario
that provide specialized services to
the frail seniors and their
caregivers.
SWOGAN
Figure 1: Map of Southwestern Ontario
Table 1: Population 65 years of Age and Older in Southwestern Ontario
Population 65+,
Area
2001
Bruce
11,100
Chatham-Kent
16,210
Elgin
11,195
Essex
47,980
Grey
16,035
Huron
10,365
Lambton
20,085
Middlesex
52,570
Oxford
14,910
Perth
10,745
% 65+,
2001
17.4
15.1
13.7
12.8
18.0
17.4
15.8
13.0
15.0
14.6
% 65+,
2006
18.0
15.3
13.8
12.5
18.4
17.7
16.3
13.2
15.0
14.3
% 65+,
2010
20.0
16.0
14.7
12.9
20.0
18.5
17.8
14.1
15.8
14.5
Note: 2001 information from 2001 Census data, Statistics Canada; 2006,
2010 and 2016 population projections from the Ministry of Finance
% 65+,
2016
24.4
18.4
14.4
14.4
23.3
21.3
21.2
16.2
18.0
15.8
Vision
To lead and sustain a network of
care in the Southwestern Ontario
region that builds local capacity to
care for older adults with multiple,
complex needs.
Programs and Service
Delivery
• Consultation
• Education
• Research
• Evaluation
Implementation
• Integration of programs and services:
local and specialized; Geriatric Mental
Health and Geriatric Medicine
• Leadership
• Infrastructure creation
• Partnership
• Implementation of education initiatives
• Network-wide evaluation framework.
Service Delivery Model
• Vision of the Network
• Why a “Service Delivery Model”
• Current function
• Future opportunities
• Breakthrough success
Reference: Making It Happen MOHLTC 1999
Partnership
Local
Collaborative Care
Community
Family Doctor with
Expertise in Eldercare
Alzheimer Society
Local Geriatric Nurse
Home Care
Family Doctor
Long Term Care
Local Hospital
Specialized
Geriatric Psychiatry
Geriatric Medicine
Service Delivery Model
Service Delivery Model
• Development and implementation of
network-wide service delivery model.
• This model is expected to support
timely and consistent access to
expertise in Geriatric and
Psychogeriatric care throughout the
Southwest.
SWOGAN Evaluation Framework
Development of a Network Balanced
Scorecard
Consensus approach




Framework
Quadrant themes
Indicator selection
Data collection procedures
Feedback
 Local team meetings
 Leadership forum discussions
Education
• Build Capacity
• Links with Academic Community
and Resources
• Links with LHIN’s
• Links with provincial and national
bodies
Innovation and Learning
Indicators
• Number of educational opportunities
delivered and received.
• SWOGAN Spring Team Exchange.
• Research and Evaluation Inventory.
Challenges
• Categories.
Process
• Submitted annually.
Utilization and Quality
Indicators
• # referrals, # consultations, # initial
assessments, # follow-ups, wait times
Challenges
• Definitions
• Setting targets
Process
•
•
•
•
Collected throughout year
Data quality checks
Submitted quarterly
Summaries available within 1 month
Client Satisfaction
Indicators
• Tool development.
Challenges
• Some pre-existing tools / expectations.
• Additional work.
• Satisfaction of other stakeholders also
important.
Process
• Clients seen in 1st & 3rd quarter sent
questionnaire in 2nd or 4th quarter.
Infrastructure
• Network Strategic Plan
• Communication Mechanisms
• Structures and processes for
clinical collaboration.
• Provincial linkages
Staff: Indicators
Percent of Time Allocated to Each Activity: SWOGAN
50
40
30
20
10
0
Direct Patient Care
Indirect Patient
Care
Travel Time
Educ Delivered & Team Developmnt/
Received
Admin
Linkages and
Marketing
Vacation/Sick Time
2002-03
20.0
30.0
5.0
10.0
2003-04
19.1
31.5
7.1
17.9
9.0
5.0
20.0
9.3
7.1
7.9
2004-05
22.5
28.4
8.4
12.8
8.6
3.5
15.8
2005-06
19.2
30.0
7.2
14.6
10.1
4.6
13.8
Data Collection
Challenges
•  Staff burden.
• Complexity of data entry.
Process
• Four 1-week snapshots.
• Face-to-face meetings with local teams
about data collection processes.
• Ongoing support.
2002-2006 New and Follow up Assessments
1800
1673
1400
1501
1200
new and follow up together
# of Patients seen
1600
1000
800
600
400
200
1572
1486
1244
1146 1119
2003-2004
2004-2005
2005-2006
0
New Assessment
2002-2003
Follow up Assessment
Strategic Planning
• SWOGAN continues to grow and the
commitment of Network partners to
develop an evidence-based model of
care is further reflection of its
commitment to evidence-based
practice, evaluation, and the full
engagement of Network partners in
planning.
Getting back to Vision
• Increase in quality of care provided to
frail seniors in a large geographic area
• Locally available with access to
specialized services when necessary
• Influence on Public policy
• Influence on Education of Health
providers
• Collaborative care within communities
combined influencing methods of care
delivery across the Region
Getting There
• Never doubt that a small group of
thoughtful, committed citizens can
change the world. Indeed it’s the
only thing that ever has”
Margaret Mead
Breakthrough Success
• Work of the task team
• Discussion and Consensus process
today
• Delivering on the strategic goals
• Abstracts and publications
• Service to clients: Blueprint
• Local access –Regional access
Contacts
• Bonnie Kotnik, Director, Geriatric
Psychiatry Program
• Maureen Vickers, Director,
Specialized Geriatric Services
• Dr. Lisa Van Bussel, MD Physician
Leader, Regional Psychogeriatric
Program