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Community Support Services Common Assessment Project (CMH CAP) OAILP May 5, 2010 Agenda • Who we are and what we’re doing – An Ontario-wide common assessment • The value of a good assessment – Leading to accessible and standard ways to care • What is a good assessment? – Generating good information for better planning • From thought to action – Implementing the common assessment tool • Working together – Applying knowledge to promote good health 2 Community Care Information Management (CCIM) Program Local Health Integration Networks (LHINs) CCAC CSS CMH&A LTCH interRAI CHA Ontario Common Assessment of Need Resident Assessment Instrument MDS 2.0 Common Intake Assessment Tool Assessment Projects Long Stay Assessment Software CHC SCCH Integrated Assessment Record Integrated Data Strategy Business Systems Management Information Systems Management Information Systems Management Information Systems Human Resources Information Systems Human Resources Information Systems Human Resources Information Systems Infrastructure & Operations Initiation stage CCAC = Community Care Access Centres LTCH = Long-Term Care Homes 3 Standards Pilot stage Management Information Systems Management Information Systems Security, Privacy & Risk Management Currently rolling out CSS = Community Support Services SCCH = Small & Complex Continuing Care Hospitals Management Information Systems Human Resources Information Systems Transition Completed and transitioned CMH&A = Community Mental Health and Addictions CHC = Community Health Centres CSS CAP implementation model 4 What we’re doing: The CSS CAP objective Every client who receives Community Support Services (CSS) will have an initial standard assessment and appropriate reassessments completed according to established guidelines. This approach will: • Enable appropriate care planning and service navigation • Ensure the right service at the right time – Indicating when a client requires a higher level of care • Facilitate data sharing and reduce repeated “story telling” • Provide high quality data for reporting at client, organizational, LHIN, and provincial level • Ensure a client receives an assessment regardless of services provided – Is appropriate to the level of care currently provided • Consider all populations within the sector • Identify potential areas for process redesign and streamlining 5 Current CSS sector profile • Over 900 CSS health service providers across Ontario which use an assessment instrument and many that do not – Includes 200+ EPC and 100+ Aboriginal, First Nation agencies • High demand for a common assessment in Ontario – No stranger to Ontario: 12-20% are currently implementing InterRAI CHA • Diverse array of service delivery models – Comprehensive models with a wide range of services including assessment and case management – Small volunteer organizations that deliver meals and provide transportation 6 Current Ontario CSS challenges • No common language or consistency of assessment approaches -- Ontario organizations have a choice of several assessment tools or develop their own with little or no guidelines • No formal collection of data across the Ontario CSS sector to identify and address gaps in services and resources • Lack of standardized quality data gathering for aggregate reporting, benchmarking and comparisons at the organizational, regional and Ontario Local Health Integration Network (LHIN) levels 7 The value of a good assessment 8 …to inform and promote better health! Using a good assessment… …and provides good information… …properly identifies clients needs… What is a good assessment? – Has buy-in from staff and sector – Effectively identifies needs – Service can be properly identified: Home, Supportive Housing, Retirement Home, Long-term Care – Allows for seamless delivery of services regardless of provider – Enables sector (CSS) and cross-sector (CCAC / CMH) communication – Provides good information for better planning 9 CSS Common Assessment vision Equipping Community Support Service providers with tools that can facilitate the collection and use of client information. Creating a sustainable approach to manage and measure improvement in client outcomes over time. Current Situation ORG 1 ORG 2 ORG 3 Focuses on Services Productivity and Efficiencies Track quality of services accessed by clients Vision Multi-Disciplinary Service Plan Focuses on Client’s Needs ORG 1 10 Track quantity of clients receiving services ORG 2 ORG 3 Report Functional Centre Productivity / Efficiency Report Outcomes / Effectiveness CSS CAP project scope Out of SCOPE Referral Less intensive services Screener Self administered or org administered Supportive Housing Adult Day Program Need for a comprehensive assessment Meals Delivery Transportation Drop-in Centre Data Management In SCOPE Reports Data Sharing Data Submission Service Planning Right Service for Right Client 11 More intensive services Outcomes From thought to action: Sector driven and developed • A collaborative effort through full sector representation – Endorsed by the CSS CAP Steering Committee and a working group which included front line staff, senior management, LHIN representatives, Ministry – Enthusiastic volunteer response to participate – Very positively received by the sector • Promote best practices to ensure quality assessment and reporting • Ensure the instrument will be used to generate information valuable to HSPs, the sector and LHINs 12 Selecting the common assessment: Approach • Engaged a Fairness Advisor to: – Oversee the conduct of the process for consistency with process design and adherence to fairness – Review documentation and materials that establish, manage and facilitate all stages of the process – Submit a final report to Project team and presented the results of the process to Steering Committee 13 Process used to determine instrument selection Activities Define benefits and criteria Define list of instruments to be evaluated Approve benefits, criteria and instruments to be evaluated Advocates presentation on instruments (March 3rd) Evaluation assessment instruments Teleconference to discuss individual evaluations Finalize recommendation to Steering Committee Review recommendation from Working Group Recommend assessment instrument for CSS Common Assessment to MOHLTC 14 Working Group Steering Working Group Recommendation made to CSS CAP Steering Committee The InterRAI Community Health Assessment (CHA) was chosen as the common assessment instrument for the Community Support Services sector 15 What is the InterRAI CHA? InterRAI Community Health Assessment (CHA) can assess the well elderly individual and identify persons meriting further assessment to prevent or stabilize early functional or health decline. • • • • • Assists clients in accessing most appropriate available services Reduces duplication of assessments Informs service plans Further develops the practice of assessment and care planning Standardized, aggregate data can inform decision-making and planning • Further facilitates inter-agency communication through a common language based on recognized data standards 16 Test for best practice Are all clients appropriate for a comprehensive assessment? • What is the value to the client? • What requirements are needed for resourcing and capacity? • What subset of HSPs is required to administer the comprehensive assessment? Opportunities for screener • What is the purpose of the screener? • What is the minimum set of data required? • What does the screener need to inform? 17 Test for best practices Referral Processes • How does the client access the right service in the right place at the right time? • How is client information shared between sectors? CCAC? CMH? • How is assessment information shared to reduce duplication and assessment burden? 18 Assessment Skills Workshop pilot Assessment Skills Workshop • Best practices focus of a generic assessment interview to understand: – How to conduct an effective assessment – How to effectively engage clients in an interview process – Methods to introduce clients to an assessment – Ways to involve clients in conversations that yield required information Expected outcomes: • Validate core assessment skills workshop is appropriate for sector • Identify participants and programs appropriate for this workshop and any changes/enhancements needed Expected outcomes of the workshop from participants 19 • Learn new skills in facilitating conversations • Learn from peers regarding tools in use and associated best practices • Networking opportunities Comments from the workshop “I want to bring this material back to staff at my organization. I think this would help our assessment skills and customer services.” “I learned valuable tips / strategies for conducting an effective assessment.” “I enjoyed learning from other's experiences” “A great opportunity to recognize things I'm doing well and areas that I could improve on” Comments were based on the evaluation results from two workshops run in Toronto on March 26th and Hamilton on April 8th 20 Working in partnership Information Management Alliance CSS CAP Steering Committee LHIN Implementation Steering Comm Working and Reference Groups Consent Management Aboriginal Data Mgmt Mobility Shared Ax Reports Best Practices -DQ Education Screener Cross Sector LHIN 1 LHIN 2 etc. Common Assessment PROJECT TEAM Implementation 21 Project Management Business Process Communications Education Working together to align with sector, LHIN and provincial initiatives ALC • Use outcomes of assessment to help inform right service in right place • Support quality of life and sustains clients in their home Screener modules • Assist, MH LHIN; CNAP, TC LHIN; Easy Access to Care, WW LHIN; etc. • Ensure the common assessment aligns to interRAI CHA Aboriginal Priorities • Work closely with the Aboriginal community to align common assessment with their processes • Link health service providers to assessment best practice Aging at Home Strategies • Improve access to care through standard assessment, care planning, referral and outcomes 22 Timeline 2009 2010 Sep Jan Feb Mar 2010 2011 2012 2013 Sep May Oct April Transition Environmental Scan First Steering Committee Meeting Assessment Tool Approved by Steering Committee Assessment Tool Evaluation and Selection 23 Full Implementation Pilot to confirm full implementation approach Sustainability Strategy Transition Plan Contact information CSS CAP Support Centre Phone: 1.866.909.5600 e-mail: [email protected] Thank you! 24