a4 - community practice
TRANSCRIPT
Preparing for the Future ‘Towards 2026’:
A new Community Service model at
Mary Potter Hospice
Teresa Read, Enhanced Community Services Project ManagerTanya Loveard, Allied Health Lead
Objectives of this session
• To share planning and developmentof a new community service model
• To reflect on the role of leadership
• To outline the key processes critical to the project
• To share achievements and challenges
“A Model of Care....broadly defines the way health services are delivered.
It outlines best practice care and services for a person or population group or patient cohort as they progress through the stages of a condition, injury or event. It aims to ensure people get the right care, at the right time, by the right team and in the right place”
(Agency for Clinical Innovation, NSW 2013)
National Issues
• Palliative care managed clinical network (HWNZ)
• Central palliative care network
• 3DHB
Regional issues
• Specialist service specifications for palliative care (Ministry of Health 2014)
• Resource and Capability Framework (Ministry of Health 2012)
• End of life care Working Party (Palliative Care Council 2014)
• Population profiles and projected palliative care needs by DHB (Palliative Care Council 2014)
Referrals to Mary Potter Hospice
Caseloads
Falling through the cracks
• Navigating across providers
• Repeating your story
• Referral delays
• Information
• Fragmentation in care• Who do I go to?
• What do I do at the weekend?
• How do services communicate and update each other?
Death data
and...understand changing family and...understand changing family structuresstructures
Multi-Multi-generational families and the growing role of grandparentsgenerational families and the growing role of grandparents
Strategic Plan 2011-2015
Education
&
Training
Enhanced Community
Services
Fit for purpose
Facilities
Strategic Drivers
Grow our service leadership and reputation as a Centre of
Excellence
Grow People, Partnerships and Community Capability
Grow our Operational Sustainability and Capacity
Enhanced Community Service Model
• Enhance ‘Hospice in the Home’ service and increase afterhours access
• Build improved community partnership model
Mary Potter Hospice Needs Assessment
• Time and motion study
• Workshops with teams
• Conversations
• Literature review
• Visits
• Process mapping Patient journey
• Learning from complaints
2012
Process Mapping patient journey
•improved standardisation•teams accept referrals•triage patients•needs assessment tools•coordination and flexibility of services•electronic patient management system
2012
Time and motion study201
2
0
1000
2000
3000
4000
5000
6000
Minutes
Category
PCC 's - Time Spent in Each CategoryTime and Motion Study
Wel PCC 1
Wel PCC 2
Por PCC 1
Por PCC 2
Por PCC 3
Kap PCC 1
Enhanced Community ServicesBusiness Case 2013 (2014)• Increased community resource
PCC
• Nurse Practitioner candidate role
• Project management roles (12 months)• Enhanced Community Service Project
Manager (0.3 FTE)
• Day Hospice and Allied Health Lead (0.3FTE)
2013
Leadership of project
• Project Sponsor
• Project Lead
• Project Team
• Reference Group
• Team Leaders Forum
• Leadership Programme
• Secondments for staff
• Nurse Practitioner
• PDRP
• Allied Health Leadership Model
2013
Allied Health
Leadership Model
Maori Service
Plan
Strengthening Medical structure
Consumer Engagemen
t
Practice Sharing
ServiceModel
Caseload Managemen
t
Day Hospice Pacific Service
Plan
Strengthen partnerships• Shared practice roles
• Shared records/Palcare
• Day Hospice pilot
• Triage and needs assessment roles
• Carers programme
• Community Volunteer pilot
• Ambulance plans
• Patient flow meetings with external partners
• Managed Clinical Network proposal
• Healing grief bereavement support group for Maori
2013
Fact finding mission201
3
•Summarised intent of project and proposed changes
Tool to consult and engage with stakeholders
Service Update Report
2014
Enhanced Community Service Model
Workstream development:
1. Community Service design
2. Day Hospice Model
3. Community Volunteer Plan
4. Community Engagement
5. Workforce capability
2014
What would success look like?201
4
Literature review findings and Fact finding
Key themes across all:
• Support rehabilitative, educational and psychosocial approach
• Day Hospice expansion
• Multidisciplinary
• Patient and family experience
• Service integration
• Community hubs – ‘Hospice in the neighbourhood’
2014
Consumer engagement• Current Consumer Engagement study
aims to explore patient and carer experience of inpatient services in particular relation to care of people living with dementia.
• This framework will be used further to validate our proposed future model of care and pilot a process of seeking on-going consumer feedback.
2014
Challenges
• Pace of change
• Time
• Communication
• Workforce adapting to change
• Internal/external relationships
• Information & communication technology
2014
AchievementsRobust leadership and teamwork to bring staff with us
• Staff satisfaction survey 2014 –
• 12% increase in 2012 satisfaction score to 73%
• 100% satisfaction in ‘change management’ – Clinical Services Team
• Workforce professional achievements
• External EQUIP accreditation results: 19 EA and 1 OA awards
• CCDHB Leadership award and a Quality award
• Leadership in progression of Managed Clinical Network
Service Options report
Strategic Plan Implementation Timeline
SummaryWe have :
• shared the planning and development of an enhanced community service model
• reflected on the role of good leadership
• outlined the key processes critical to the project
• Shared the achievements and challenges to date
Preparing for the future to ensure
people:get the right care, at the right time, by the right team
and in the right place
References
• Agency for Clinical Innovation, New South Wales (2013) Framework for the State wide Model for Palliative and End of Life Care Service Provision. Agency for Clinical Innovation 2013.
• Abel J, Walter T, Carey L, Rosenberg J, Noonan K, Horsfall D, Leonard R, Rumbold B, Morris D (2012) Circles of care: should community development redefine the practice of palliative care? BMJ Supportive Palliative Care
• Angelo J, Egan R, Reid K (2013) Essential knowledge for family caregivers: a qualitative study. International Journal of Palliative Nursing; Aug 2013, Vol. 19 Issue 8, p383
• Davidson P, Hickman EH, Phillips J, Graham B (2006) Beyond the Rhetoric:What Do We Mean By a "Model of Care". Australian Journal of Advanced Nursing, 2006. 23(3): p. 47-55.
• Health Foundation (2013). Improving patient flow: how two trusts focused on flow to improve the quality of care and use available capacity effectively. London: Health Foundation.
• Help the Hospices Commission in to the Future of Hospice Care (2013) Working towards a hospice workforce that is fit for the future. Oct 2013
References
• Help the Hospices Commission (2012) Future needs and preferences for hospice care: challenges and opportunities for hospices: A working paper of the Commission into the future of Hospice Care.
• McIlfatrick S et al (2013) Public awareness and attitudes toward palliative care in Northern Ireland. BMC Palliat Care. 2013; 12: 34.
• Paget A, Wood C (2013) Ways and Means: ‘Peoples final journey must be one of their choosing’. Demos
• Statistics New Zealand (2010) Mortality and demographic data
• The Kings Fund (2014) Community Services: How they can transform care. The Kings Fund 2014.
• Tan H, O’Connor M, Wearne H and Howard T (2011) The evaluation of a triage tool for a community palliative care service provider. Journal of Palliative Care 28:3.
