1. Introduction to the sfCare Framework and Getting Started Toolkit
July 19, 2018

2. Objective of this slide deck
To provide reference slides that can be used or adapted to introduce various stakeholders to the sfCare Framework and the sfCare Getting Started Toolkit

3. The Evolution of Ontario’s SFH Strategy into sfCare
Five
Domains
An evidence-informed framework applied organization-wide to help hospitals achieve better outcomes for frail seniors
Ontario
Pan-LHIN SFH Strategy
The Senior Friendly Care (sfCare)Framework builds on the success of the Senior Friendly Hospital (SFH) Framework. The SFH Framework was used as the foundation for the pan LHIN SFH Strategy
A highlight of the strategy is SFH ACTION - a knowledge-to-practice collaborative for quality improvement which comprises over 400 participants from 87 hospitals across all 14 LHINs.
The final element of Ontario’s SFH Strategy involves the creation of the sfCare Framework, which broadens the focus from hospital to cross-sectoral. 3

4. Creating the sfCare Framework
The sfCare Framework was developed by the RGP of Toronto in collaboration with provincial stakeholders, including older adults, caregivers, and care providers. It provides a foundation for achieving the best possible outcomes for older adults across the healthcare continuum; not just in hospitals.
The development of the sfCare Framework included a literature review, qualitative analysis and theming, an expert Delphi panel, and stakeholder engagement.
The Framework was launched in Oct 2017.

5. Click here for a print-ready-version
The sfCare Framework’s is comprised of 7guiding principles, 5 domains and 31 defining statements which collectively describe what senior friendly care looks like. The 5 domains in the sfCare Framework and the SFH Framework are the same – the development process for the sfCare Framework confirmed that these 5 domains remain relevant across the healthcare continuum.
Click here for a print-ready-version

6. Senior friendly care is an organizational priority
At least one leader in the organization is responsible for senior friendly care
There is organizational commitment to recruit and develop human resources with the knowledge, skills, and attitude needed to care for older adults
The values and principles of senior friendly care are evident in all relevant organizational policies and procedures
The organization has a senior friendly policy that values and promotes older adults’ health, dignity and participation in care
The organization demonstrates commitment to all domains of the Senior Friendly Care Framework - organizational support, processes of care, emotional and behavioural environment, ethics in clinical care and research, and the physical environment
The organization collaborates with system partners to meet the needs of older adults
The organization implements standards and monitors indicators relevant to the care of older adults
The Organizational Support domain addresses the elements that are required to create a solid foundation for senior friendly work, such as: a leadership structure, staff development, policies, strategic priorities, system collaboration, and standards and indicators. 6

7. Care is guided by Evidence-informed practice
Assessment is holistic and identifies opportunities to optimize the physical, psychological, functional, and social abilities of older adults
Care addresses the physical, psychological, functional, and social needs of older adults
Care is guided by Evidence-informed practice
An interprofessional model of care is preferred especially when older adults are frail
Care is integrated and provides continuity especially during transitions
Goals of care may include recovery from illness, maintenance of functional ability and preservation of the highest quality of life as defined by the individual
Older adults are partners with the care team
Care is flexible and aligned with an individual's preferences
Communications and clinical and administrative processes are adapted to meet the needs of older adults
Older adults are provided information in a way that makes it easy to understand so that they can make informed decisions
The Processes of Care domain underlines the importance of providing holistic care by providers who collaborate with each other and with older adults and their caregivers to deliver care that is aligned with the older adults goals and preferences. 7

8. Care is compassionate and sensitive to the needs of older adults
The care provided is free of ageism and respectful of the unique needs of older adults
Care providers are able to identify and address issues of elder abuse and older adults' safety
The care of older adults is planned and delivered in alignment with their personal goals
Care providers demonstrate competency providing care to an older population with diversity in all its many forms
Care providers respect each individuals' breadth of lived experience, relationships, unique values, preferences and capabilities
Care is provided in a way that enables the older adult to feel confident in their care providers
Care is compassionate and sensitive to the needs of older adults
Family and other caregivers are valued and supported as care partners
Social connections are recognized as an important contributor to the health and wellbeing of older adults
The Emotional and Behavioural Environment domain focuses on care that is provided in a way that is respectful, compassionate, sensitive, and free of ageism. 8

9. Autonomy, choice and dignity of older adults are protected in care processes and research
Care is delivered in a way that protects the rights of older adults especially those who are vulnerable
An older adult will not be denied access to care or the opportunity to participate in research based solely on their age
The structures, spaces, equipment, and furnishings provide an environment that minimizes the vulnerabilities of older adults and promotes safety, comfort, functional independence, and well-being
The Ethics in Clinical Care and Research domain addresses equity and rights.
The Physical Environment domain promotes the need for physical spaces that are conducive to the needs of older adults. 9

10. The sfCare Getting Started Toolkit
Click here for the most recent version of this Toolkit
The goal of the sfCare Framework launch in Oct 2017 was to start conversations about what senior friendly care will look like as a collaborative effort across the healthcare system. These conversations have guided the development of the “SfCare Getting Started Toolkit”, which launched in June 2018
The toolkit answers the most frequently asked questions:
The sfCare Framework is an excellent blueprint, but how do we implement it?
How do we know how senior friendly our organization is, and what can we do to improve?
How do we compare to other organizations?
The sfCare Getting Started Toolkit helps bring the foundational vision of the Framework to life by providing practical resources for assessing where an organization is on the sfCare journey and for implementing real change.
Organizations may be in the early stages of implementing change to deliver more senior friendly care, or may be quite far down the road and looking for ways to sustain their efforts. The Getting Started Toolkit is designed to help organizations get started, no matter where they are starting from.

11. The sfCare Getting Started Toolkit
Recommendations and questions to identify strengths and opportunities.
Curated tips and tools to inform action plans.
5 minute must-see videos for staff and executives.
Self-Assessment Tool
Implementation Resources
Intro to sfCare training
The sfCare Getting Started Toolkit is like the “how to guide” for the sfCare Framework. The Toolkit includes:
An online self-assessment tool with recommendations and questions to identify strengths and opportunities
Implementation resources, which are a selection of curated tips and tools for each recommendation
And training modules for executive leaders and staff

12. sfCare Self-Assessment Tool
Recommendations and questions to identify strengths and opportunities.
Self-Assessment Tool
An online tool with questions based on 10 recommendations which were derived from the Framework’s 31 statements.
Customized report card
Aggregate reports for sectors - Ontario and LHIN
The Self-Assessment Tool turns the 31 statements in the sfCare Framework into 10 actionable recommendations, and provides a way for healthcare organizations in all sectors to identify achievements and opportunities in their provision of senior friendly care.
It is recommended that 2 people complete the assessment together: a leader in the organization who has been designated as responsible for senior friendly care, and a clinician who provides care to older adults.
The online tool is in it’s beta version until Sept 30, 2018, when it maybe refined based on user feedback.
Once you have entered your results in the online tool it will be reviewed by the RGP of Toronto, and a customized report card will be sent to you. Your results will not be shared with others, except in an anonymized aggregate form (that is, a report on results by sector).

13. sfCare Implementation Resources
Curated tips and tools to inform action plans.
Implementation Resources
Practical tips and tools for each recommendation in the self-assessment
Use the resources to inform your action plans
There are many resources available to support senior friendly care initiatives. The sfCare Implementation Resources are a curated selection of tips and practical tools which can be used to create an action plan.
After completing the sfCare Self-Assessment, organizations are encouraged to identify their priorities and create an action plan. Some organizations will prefer mapping out a multi-year plan to accomplish all recommendations, while others may start by creating a plan to implement a quick win. There is no right or wrong way to create an action plan. Every step taken towards becoming a more senior friendly organization is an excellent step.

14. A great foundation for staff and executives with information, such as:
sfCare Training
5 minute must-see videos for staff and executives.
Intro to sfCare training
A great foundation for staff and executives with information, such as:
what senior friendly care is
why it’s important
the needs of older adults
what they can do to make a difference
The sfCare Getting Started Toolkit comes with 2 training videos, each 5 minutes in length: 1 for staff and 1 for executives.
If your organization does not have training curriculum or educational material for staff and leaders on the basics of Senior Friendly Care these 5 minute videos (1 for staff and 1 for executives) are “plug and play”
If your organization has training curriculum, you may want to refresh your content by using some or all of the material from the ppt versions.