22 nd PANDDA Conference Owning our Practice: “Learn from yesterday, live for today, hope for tomorrow” 3 rd & 4 th November 2011, Parramatta NSW : A Transdisciplinary Support : A Transdisciplinary Support : A Transdisciplinary Support : A Transdisciplinary Support Planning Tool Planning Tool www.i-can.org.au Samuel R.C. Arnold Ralph Forbes
I-CAN v4.3 CAN v4.3 www.i-can.org.au I CAN DO IT! I CAN DO IT! Samuel Arnold Vivienne Riches Vivienne Riches Trevor Parmenter Roger Stancliffe Gwynnyth Llewellyn Jeff Chan Gabrielle Hindmarsh
How happy are you? How happy are you? � ���������� � ����� In comparison to the happy times in your life, how happy � � �������������� �������������� were you in the past two weeks? were you in the past two weeks? � ���������������� � ������� Proxy � ������������ Respondent
How healthy do you feel? How healthy do you feel? � ������������ � ������� In comparison to the times in you life when you felt healthiest, how healthy have you felt in the how healthy have you felt in the � � ���������������� ���������������� past two weeks? � ������������� � ���� � ���������
In Today’s Presentation In Today’s Presentation • A Brief Introduction to I-CAN • Examples of I-CAN as used by DD Nurses and other Allied Health – Outcome measurement – Outcome measurement – Assessment of ‘Support Needs’ in mental health needs context – Resident ‘Compatibility’ • Continually Improving I-CAN – Findings from trialing ‘Version 5’ of I-CAN – Reliability data and outcome sensitivity – Predicting costs
What is the I What is the I-CAN? CAN? The Instrument for the Classification and Assessment of Support Needs (I-CAN) “a support needs assessment designed to assess and “a support needs assessment designed to assess and guide support delivery for people with a disability including mental illness. It provides a support services and family friendly holistic assessment, conceptually based upon the internationally recognized WHO ICF framework.”
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I-CAN v4.3 CAN v4.3 �&�!��'���'������������������������ !������%�#��"��!�������"!������(������ Domains Domains �������������������������� ������������������� ������������������������������������ ������� ��������������� ���!�������� "��#$����������������%�#� "��#$����������������%�#� '��������)��������������� '�&����� �������!���#� ������ *�������������*��������������+������������ %�#��%����%������� ���������"!������"������� ���!������"�������� �����%�#� '�������
Individual Support Needs Report Individual Support Needs Report
An I can statement An I can statement • Instead of writing ‘Bob can’t make breakfast’ (an I can’t statement) • Simply try ‘Bob can make his breakfast with prompts to remember each step in with prompts to remember each step in sequence’ I-can’t: (name) cant (do this) I-can: (name) with (type of) support can (do this)
Let’s turn those I can’t Let’s turn those I can’t statements upside down! statements upside down! • ‘John can’t tie shoelaces’ • ‘Judy can’t catch the bus unless she has been on it before’ been on it before’ • ‘Robert can’t dress himself’
"You're not disabled by the disabilities you "You're not disabled by the disabilities you have, you are able by the abilities you have." have, you are able by the abilities you have." Oscar Pistorius aka ‘Blade Runner’ ‘The Fastest man on no legs’ Courtesy of wikipedia
I-CAN Online Functions CAN Online Functions
Track Track Changes Changes Compare Compare Needs Needs
Outcome Measurement • Relative newness of ‘Support Needs’ as an indicator • Study currently underway to determine ‘Sensitivity’ ‘Sensitivity’ • Increase versus Reduction of ‘Support Needs’ • Increase versus Reduction of ‘Support Needs’ • Usefulness of the assessment for : � Showing change � Illustrating ’effectiveness’ � Prioritisation � Funder perspectives � Resource allocation
Quantitative Output from I-CAN Assessment
*Thanks to Marie Cameron of HISA and Royal Rehab, and to Jennifer Hennessy, Royal Rehab, for their crucial support
I-CAN v4.3 CAN v4.3 • Broader conceptualization of support • Web based assessment • e-Health, telemedicine, telepsychology • Comprehensive supports planning & profiling tool • Intake or discharge assessment • Additional online functions include: • Additional online functions include: • Upload a photo! • Compare scores & track changes over time • Custom Summary Report • National Minimum Data Set (NMDS) export • Excel export (import into SPSS) • Cost Estimation Tool • Resource Allocation • Outcome Measurement / Service Quality
Concurrent / Multiple Ratings • Usually you will only complete one rating and will not have to give it a name. • Some examples - name each rating in as few words as possible – ‘Normally’ vs. ‘During an Episode’ – ‘At the institution’ vs. ‘In a community home’ – ‘At the institution’ vs. ‘In a community home’ – ‘At hospital’ vs. ‘Returning home’ – ‘Now’ vs. ‘in 24 months’ – ‘Home’ vs. ‘Work’ ��3 – ‘Support Needed’ vs. ‘Support Received’ – ‘Informal’ vs. ‘Formal’ vs. ‘Funded’ – ‘Staff rating’ vs. ‘Family rating’
The I The I-CAN in different contexts CAN in different contexts Focus on Mental Health • 26 assessments completed on site • Involvement of three agencies • Age 34 - 79 years • For some this was the first documentation of this information which had ever occurred for them • Assessments conducted by two facilitators in partnership • Significant input from people who had known each person for a number of years
The I The I-CAN in different contexts CAN in different contexts Resident Compatibility • Three phase assessment process for determining future accommodation options • Analysis of the I-CAN data • ‘Health Care Plan’ information • Resident friendships and relationships • Interactions observed between residents • Social inclusion and participation in recreation and leisure activities and social groups • Incompatible relationships • Barriers/obstacles to the development of friendships and relationships
Trial of I Trial of I-CAN ‘Version 5’ CAN ‘Version 5’ Design Change User Perspective Flexibility • Yes – Definitely increased flexibility • Worried that you might be missing out something important Single text box in each domain • Brief outline at the top of the box might be helpful • Nurse might want more boxes – a • Nurse might want more boxes – a Social Worker might want just one!! Specific boxes for goals in each domain • ‘Can Do’ design Examples of support activities and • Used these a lot scoring All demographic information optional • Need this on first time completion
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