Behavioural Supports Ontario (BSO) Presentation to the Hamilton Niagara Haldimand Brant (HNHB) Local Health Integration Network (LHIN) Board of Directors October 25, 2011 1
BSO Project Overall Goal: • To enhance services for older adults with complex behaviours wherever they live through the development and implementation of new models of care that focus on: • quality of care • quality of life 2
BSO Project – Population and Collaboration Population: • Older people with cognitive impairments due to mental health problems, addictions, dementia, or other neurological conditions often exhibit responsive or challenging behaviours such as aggression, wandering, physical resistance and agitation. Collaboration Between: • Ontario‟s LHINs • Alzheimer Society of Ontario • Health Quality Ontario (HQO) • Ministry of Health and Long-Term Care (ministry) 3
Background and Context Phase 1 (January - October 2010) • Developed a Framework for Care that emphasizes: • system coordination and management • integrated service delivery • a better experience for patients and their caregivers. • The framework serves as a foundational reference document for the development of new care practices. Phase 2 • Began May 2011, with a competitive BSO “Expression of Interest” (EOI) process in which all 14 LHINs participated. • The ministry and external experts identified four Early Adopter LHINs that: • have demonstrated readiness to implement the BSO Framework first • will develop and implement new care pathways and clinical tools • will spread these lessons province-wide. 4
Framework Principles • Overarching principle: Person and Caregiver-directed Care : • Everyone is treated with respect and accepted “as one is”. • Person and caregiver/family/social supports are the driving partners in care decisions. • Respect and trust characterize the relationships between staff and clients and among health care providers across systems. • Supporting Principles: • Behaviour is communication. • Diversity. • Collaborative care. • Safety. • System coordination and integration. • Accountability and sustainability. 5
Behavioural Support Systems (BSS) Framework 6 Source: BSO Kick off Presentation August 2011
The BSS Framework Three Components • Facilitate Continuous Improvement • Supporte orted d transiti tions ons for persons ns System stem Coordinat rdination on & & • Standard dard service protocol ols & r referral al system tem Manage agement ment • Shared ed system em governa nanc nce Integr egrat ated ed service ce delivery: very: • Shared ed care/ collabor aborati ation on intersect ersectoral oral & & • Cross secto tor, r, system em support rt teams interdi erdisci scipl plina nary Know owledgeab edgeable e care team • Education ation and training ng & & • Supportiv ortive e learning ng capac acity y building ng • Innov ovati tion, on, best practi tice 7 Source: BSO Presentation www.akeresourcecentre.org/BSOResources
8 Source: BSO Presentation www.akeresourcecentre.org/BSOResources
BSO Phase 2 Implementation • The ministry has confirmed $40 million in funding to all Ontario LHINs to: • implement the BSO Framework • develop new care pathways and clinical tools • share these lessons province-wide. • 4 Early Adopter LHINs received one-time funding to implement the framework and share lessons learned with remaining 10 LHINs. 9
New BSO Funding for Increased Staffing Resources • BSO resources have been proportionately allocated across all 14 LHINs to support: • 200 nurse FTEs in long-term care homes (LTCHs) • 300 PSW FTEs in LTCHs • additional healthcare personnel that could be deployed to mobile teams, in service clusters, and/or community services. • Funding for the new behavioural staffing resources will be made available in November 2011 for the four Early Adopter LHINs, and in February 2012 for remaining 10 LHINs. 10
4 Early Adopter LHINs • 4 Early Adopter LHINs • Central East (CE) (LHIN 9) • Hamilton Niagara Haldimand Brant (HNHB) (LHIN 4) • North Simcoe Muskoka (NSM) (LHIN 12) • South East (SE) (LHIN 10) • Expectations: • implement BSO Framework • enhance coordination among existing local behavioural services • identify and translate best practice from one sector to the next • provide coaching/mentoring and knowledge transfer to the designated LHINs to assist in rapid cycle improvements • evaluate outcomes for province side implementations and dissemination. 11
Project Reporting and Accountability 12 Source: BSO Kick off Presentation August 2011
BSO Implementation in HNHB LHIN “ I am who I am so help me continue to be me” HNHB LHIN Community Stakeholder Client Value Statement 13
HNHB LHIN BSO Oversight Committee • Membership – representation from: • HNHB LTCH Council • HNHB LHIN LTCHs • T.R. Adams Regional Centre Dementia Care • St. Joseph‟s Healthcare Hamilton (SJHH), Hamilton Geriatric Psychiatry Program • HNHB Regional Geriatric Program – Central • St. Peters Hospital, Hamilton Health Sciences Corporation (HHSC) • Alzheimers Society – Niagara • Dementia Alliance • HNHB Community Care Access Centre (CCAC) • Community Addiction Mental Health Services of Haldimand Norfolk • Consumer 14
HNHB LHIN BSO Governance Structure 15
BSO Early Adopter LHINs Time Line & HNHB Key Accomplishments To Date • HNHB LHIN identified as Early Adopter • HNHB LHIN BSO Oversight Committee established • HNHB LHIN LTCHs engaged through LHIN LTCH Council • HNHB & NSM LHIN hosted Value Stream Mapping Session attended by 25 HNHB LHIN health service providers (HSP) front line staff • HNHB LHIN hosted five focus groups across the LHIN attended by over 75 HSP front line staff • Oct 14, 2011 HNHB LHIN submitted Action Plan • Confirmed HSPs to receive „other health care personnel funding. • October, 2011 -- Early Adopter LHIN begin buddy system 16
HNHB LHIN BSO Approved Funding • $3,878,900 annual base funding: • $1,450,900 for 19 Registered Nurses and/or Registered Practical Nurses in LTCHs • $1,160,000 for 29 personal support workers in LTCHs • $1,268,000 for additional healthcare personnel (can be allocated to any LHIN funded health service provider). • Note this funding will be prorated in 2011-12. • Early Adopter LHINs: • $900,000 one-time to support the service redesign component of the BSO project. 17
Defining Success • Improve patient, family and public experience with services along the continuum of care. • Reduce the need for LTCH residents to be transferred to an emergency room for behaviour issues. • Reduce avoidable emergency room visits for individuals living in the community with behaviour issues. • Improved/increased support for caregivers of individuals with behaviour issues living in the community. • Reduce length of stay for individuals with a history of responsive behaviours waiting in hospital for transfer to a LTCH. • Build health system capacity for the care of individuals (and caregivers) with behaviour issues. 18
Questions? 19
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