VP Quarterly Report on Strategies Q3 – 2015/16 VP: Michael Redenbach – Integrated Health Services Seniors Multi-year Plan Vision: Healthy people, families and communities.

Portfolio Overview Seniors services cross the continuum of care and are addressed by many programs and portfolios. All Service Lines have a role in Seniors care, most notably: -Primary Health Care -Facility-based Continuing Care -Mental Health and Addictions -Medicine -Surgery -Clinical Support -Ambulatory Care

Multi-year Strategic Plans VP is Leading on: Seniors Multi-year Plan will focus on: –Community-based services – Home First/Quick Response, Seniors Home Visiting, Home Care opportunity analysis, standard work –Long-term care – Purposeful Hourly Interactions (Rounding), Gentle Persuasive Approach, Enhanced Dining –Acute care – Seniors Friendly Hospital approach –Proposal for multiple facility replacements

Inpatient Medicine Initiatives ‘More 2 Eat’ Study – aimed at early identification of, and response to, malnutrition Gentle Persuasive Approach – as in long- term care, all staff will be trained by certified coaches. Work with Geriatrician (when hired)

Seniors Multi-year Plan Provincial Outcome & Improvement Targets By March 31, 2020, seniors who require community support can remain at home as long as possible, enabling them to safely progress into other care options as needs change –By March 31, 2017, the number of clients with a Method of Assigning Priority Levels (MAPLe) score of three to five living in the community supported by home care will increase by 2%

Seniors Multi-year Plan Outcome Measure

Status of Strategy Implementation Successes Successes/What is working Dementia Assessment Unit Three Kaizens events completed –Design of unit –Unit Staffing –Resource Team development Purposeful Hourly Interactions All LTC facilities have completed initial training – continuing to work on 100% implementation and audit metrics Resident Centred Care The LTC held a two day visioning session November 23-24, The group started the development of a vision statement and identified key objectives and accountabilities Enhanced Dining Initiative “All Hands On Deck” embed standard work associated with Relaxed Breakfast/Enhanced Dining Experience started at Echo Lodge. Currently replicating standard work in Balcarres Integrated Care Centre

Status of Strategy Implementation Successes PHC Response team –integrated the Home First RN’s and the Senior’s House Calls program (NP’s and Community Paramedics) to create a 7 day a week quick access to home based community primary health care. Frail elderly clients living at home are the target population of this team. The goal is to help prevent ER visits and acute revisit/readmission.

Status of Strategy Implementation – Challenges & Risks Challenges/Gaps/Risks Many initiatives devoted to improving service and quality of care – creating workload pressures on managers and staff. Need to prioritize initiatives; focus and finish. Severe physical infrastructure needs in several long-term care facilities Quality of care and safety remain key priorities and to implement the required structure, standards and processes to audit will require vision and planning. Work devoted to Special Care Home Guidelines will be critical – but will also be time-consuming and complex. Management capacity- many LTC sites fall into the 15% who have the highest staff:resident:manager ratio, often with 100+ residents/families and 150+ staff, with no non-clinical supervisory or administrative support. With the Ombudsman review, the requirements for oversight will increase

Next Steps Regional policies and procedures to operationalize the standards of care in the Program Guidelines for Special-Care Homes. IV therapy Protocol for Quick Response Unit Enhanced Dining Initiative Geriatric Program Specialized Dementia units/behaviour Unit –Unit construction is underway, with completion date of prior to March 31, – Project is on target and on budget Senior Hoshin