Applied Health Services Research Workshop March 4, 2014 Advancing Continuing Care A Blueprint to Support System Change Provincial Priority Applied Health Services Research Workshop March 4, 2014

Foundation / Facilitators Strategic Framework Manitoba Health’s Vision – “Healthy Manitobans through an Appropriate Balance of Prevention and Care” Areas for Action Navigation of Health System, Effective Transitions, Restorative Care, Culture of Caring Provincial Policy, Organizational Capacity, Partnerships, Communication / Education MB Health Vision Areas for Action Goal of Strategy -Ensure the sustainability of the health care system through efficiencies and effective service delivery in order to maximize the health and quality of life of Manitoba’s aging population Embedded Themes Foundation / Facilitators

Areas for Action Helping individuals stay at home by investing in community supports and focusing on wellness, capacity building and restoration when delivering home care services Improving access to Home Care services Strengthening and promoting co-operation among health care partners to keep people at home Strengthening and expanding options for community-based housing as alternatives to personal care homes Ensuring there are enough Long Term Care beds to meet the needs of Manitobans Developing new, innovative ways of delivering services to improve health outcomes for residents of personal care homes Committing to dedicated health technology to help improve quality and co-ordination of care and in making informed decisions and policy

Blueprint Priority Initiatives & Research Opportunities ; Area for Action Strategic Issue / Goal Opportunities #1 Helping individuals stay at home by investing in community supports and focusing on wellness, capacity building and restoration when delivering home care services Capacity for and Utilization of Evidence-Informed Decision-Making and Processes Reduction in clients transitioning to long term care Home care model revised (capacity, wellness, accessibility and rehabilitation services) to support individuals remaining at home, to provide support to caregivers and to promote system sustainability Enhance evaluation of dementia programs by including; structures (available resources), process (care that is delivered) and outcomes (excellence in care – quality of care/life) Develop an evaluation plan for the renewed Alzheimer Framework Develop evaluation plan related to benefits of increasing capacity and resources to provide palliative care services Develop evaluation framework for revised home care model that enhanced case management role for HC Case Coordinators, increased support for care givers and initiation of a more restorative approach in provision of services Evaluate outcomes and or benefits of different rehabilitation/restorative HC initiatives i.e. rural vs. urban, costs etc. Develop evaluation plan for enhanced delivery of in-home and outside the home respite services

Blueprint Priority Initiatives & Research Opportunities Area for Action Strategic Issue Gaps/Opportunities #3 Strengthening and promoting co-operation among health care partners to keep people at home Capacity for and Utilization of Evidence-Informed Decision-Making and Processes Improved health outcomes, including chronic disease management Improved coordination and communication in the health care system Develop evaluation framework related to improved communication/ partnerships between primary care providers and home care providers Evaluate new models that will facilitate partnerships with HC and Family Physicians / Primary Care Providers e.g. Hospital Home Teams

Blueprint Priority Initiatives & Research Opportunities Area for Action Strategic Issue Gaps/Opportunities # 4Strengthening and expanding options for community-based housing as alternatives to personal care homes Capacity for and Utilization of Evidence-Informed Decision-Making and Processes Demonstrated need for additional community supports as evidenced by reduced wait times for service, reduced number of Alternate Level of Care (ALC) stays/ beds days in hospital and reduced number of individuals waiting to receive the most appropriate service in the most appropriate setting Provide analysis and evaluation of Supportive housing model based formal review of model including eligibility criteria, exit criteria and staffing Model and evaluation should encompass and allow for regional differences. Develop an evaluation related to development of specialized environments and programming for unique populations

Blueprint Priority Initiatives & Research Opportunities Area for Action Strategic Issue Gaps/Opportunities # 6 Developing new, innovative ways of delivering services to improve health outcomes for residents of personal care homes Capacity for and Utilization of Evidence-Informed Decision-Making and Processes Improved quality of life for residents of personal care homes Demonstrated need for additional community supports as evidenced by reduced wait times for service, reduced number of Alternate Level of Care (ALC) stays/ beds days in hospital and reduced number of individuals waiting to receive the most appropriate service in the most appropriate setting Evaluate outcomes of investing in Special Support teams Evaluate outcomes of enhancing and investing in geriatric mental health or psychology resources in LTC Promote knowledge transfer related to leading practices on respect and dignity. Additional opportunities in light of TREC project.

Blueprint Priority Initiatives & Research Opportunities Area for Action Strategic Issue Gaps/Opportunities # 7 Committing to dedicated health technology to help improve quality and co-ordination of care and in making informed decisions and policy Demonstrated quality of decisions, policy development and accountability Utilization data PCH and or HC electronic Information System for planning , submission to CIHI, jurisdictional comparisons Develop an evaluation framework for implementation of a provincial clinical information system for HC and LTC (standardized assessment and care planning tools, clinical capacity, standardized data set to support provincial reporting, program planning, future resource allocation and quality monitoring)