1. Client
Safety
–
An
Associa1on
Perspec1ve
Ontario
Home
Care
Associa0on
for
CPSI
Pa'ent
Safety
Week
October
2013

2. 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.

3. 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

4. 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.
2.
3.
4.
5.
Governance
&
Accountability
Service
Delivery
Finance
Quality
&
Excellence
Human
Resources
Ø Members
assess
their
performance
as:
§
§
§
§
§
Substan1al
Compliance
Par1al
Compliance
Minimal
Compliance
Non-­‐Compliant
Not
Applicable

5. Context
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

6. Safety
embedded
across
all
dimensions
Quality
Dimensions
Evidence
Governance
Engaged
in
client
safety
monitoring
and
ac1ons/
improvements
Service
Delivery
Culture
of
client
safety
Financial
Resources
dedicated
to
client
safety
S
A
F
E
T
Y
Quality
&
Excellence
Emergency
management
Human
Resources
Staffing
Ethical
Prac1ces

7. 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

8. 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
S
A
S
A
S
P
D
P
D
A
S
P
D
P
D

9. 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

10. 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

11. 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.

12. 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.

13. Thank
You
Sue
VanderBent,
CEO
sue.vanderbent@homecareontario.ca
www.homecareontario.ca
@HomeCareOntario