The Caregiver-Friendly Hospital and Community Hub Cultivating Change: The Caregiver-Friendly Hospital and Community Hub November 19th, 2018 Caregiver Training Prototyping Co-Design

Proposed Agenda 8:50 a.m. 9:00 a.m. 9:05 a.m. 9:35 a.m. 9:55 a.m. Breakfast 9:00 a.m. Introductions | Goals for the day | Review Agenda (5min) 9:05 a.m. Shared understanding of ideal features for our project (30min) 9:35 a.m. Examples of what others are doing (20min) 9:55 a.m. 8 Lean Wastes, Hierarchy of Effectiveness, Adult Learning Principles and Health Literacy (25min) 10:20 a.m. Session 1: Design possible solutions (100min) 12:00 p.m. Lunch 2

Proposed Agenda 12:45 p.m. Report back (15min) 1:00 p.m. Barrier and mitigation strategy (20min) 1:20 p.m. Developing our work plan (70 min) 2:30 p.m. Report Back: What are our deliverables (20min) 2:50 p.m. Reflection & Next Steps (10min) 3:00 p.m. Adjournment 3

What is the scope of our project? Project Name Objective Caregiver Training Proactively prepare caregivers to effectively support patients with their health care needs. Comprehension checking: Is the caregiver confident that they understand their role throughout the rehab journey? Provide caregivers with comprehensive transition instructions. 4

Caregiver ID/Circle of Care All Stroke Projects Project Name Objectives Caregiver ID/Circle of Care Circle of Care: Improve how caregivers identify who are the health care providers in the patients’ circle of care. Caregiver ID: Improve how providers identify who is in the patients’ support system. Communication: Improve communications between caregivers and healthcare providers. Knowing What To Expect Provide clear and realistic expectations of what caregivers and patients can expect during their rehab journey. Caregiver Training Proactively prepare caregivers to effectively support patients with their health care needs. Caregiver Support Improve supports available to caregivers by creating (1) a support group for caregivers and (2) caregiver peer-peer support. 5

Current State Review Process mapping exercise Patient-Oriented Discharge Summary (PODS) My Guide for Stroke Recovery Binder Stroke Education Series (6 modules) 6

Examples of what others are doing 7

Toronto General Dialysis Training Provides patients and families the education and training they need to perform dialysis at home, on their own. The Innovation Room offers a home-like environment, where staff is close by for help. https://www.uhn.ca/MCC/PatientsFamilies/Clinics_Tests/Home_Peritoneal_Dialysis 8

Toronto Rehab Stroke Education https://www.uhn.ca/TorontoRehab/PatientsFamilies/Clinics_Tests/Outpatient_Stroke_Services Intuitive, easy to use website Resources are plainly listed at the bottom and clickable 9

St. Elizabeth Health Care (Elizz) https://elizz.com/caregiver-resources/caregiving-tips/caregiver-back-health-and-safety Collaboratively written with regulated health care professionals and communications team Short tidbits about specific care needs and tips 10

St. Elizabeth Health Care (Elizz) https://elizz.com/caregiver-resources/caregiving-tips/assisting-someone-with-daily-living-needs Collaboratively written with regulated health care professionals and communications team Short tidbits about specific care needs and tips 11

Toronto Western Stroke Education Classes Class is offered from 9:00 a.m. until 12:30 p.m. A printable booklet is available online Classes are offered as a 3 ½ hour block as opposed to multiple short sessions 12

Sunnybrook and St. John’s Classes are offered only on outpatient Hosts 2 group sessions where the My Guide to Stroke Recovery Binder is reviewed in-depth (1 hour each) Current outpatients Series focuses on home with stroke “Home With Stroke” is offered to patients and caregivers and is provided in a group education format Two sessions, one hour each Review the My Guide to Stroke Recovery binder 13

Current state of online education for stroke survivors and family caregivers 14

Electronic Caregiver Training Systems: Trualta 15

Lean Wastes, Hierarchy of Effectiveness, Adult Education, & Health Literacy 16

https://www.youtube.com/watch?v=bVCe9vs68Pk T – Transport I – Inventory Excess M – Motion W – Waiting O – Overproduction O – Overprocessing (using unnecessary higher grade materials) D – Defect (Rework Waste) S – Skills Waste (Underutilized creativity) 17

Hierarchy of Effectiveness 18

Adult Education Principles “Adults are characterized by maturity, self-confidence, autonomy, solid decision-making, and are generally more practical, purposeful, self-directed, experienced, and less open-minded and receptive to change.”   Adult Learners desire: Relevance Autonomy/control of the Learning Experience Acknowledgement of prior experiences Feedback and reward 19

https://www.youtube.com/watch?v=_8w9kdcRgsI 20 1. Look for clues. - Does the patient/caregiver miss appointments? - Do they write down information/instructions? - Do they take their medications correctly? - Do they complete forms properly? - Do they ask for more information if they don’t understand? 2. Use audio-visual aids. 3. Use demonstration. 4. Highlight or circle any take home points. 5. Use plain language and convey the most important concepts first. - Speak slowly. - Avoid jargon/acronyms. 6. Teach back. 7. Encourage patient/caregiver partnerships. 8. Encourage a support network. 20

Session: Let the prototyping BEGIN! 21

LUNCH 22

Report Back Session 2: Construct Prototype and prepare to present to the group. 23

Barriers and Mitigation Strategy 24

Developing our work plan 25

Report Back 26

Group Reflection 27

Next Steps 28

Thank you! 29