Post on 01-Jan-2016
transcript
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
1
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
Qualityin the
Community
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
2
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Care in the Community --- Old Frontier
Early Days --- Care in the Home
Home Visits by Physicians
Public Health Nurses
Hospitals --- Hospital Insurance and Medicare
Long Term Care Institutions
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
3
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Things Changed Technology
New Drugs
Innovative Physicians
Societal Changes
Pressures on Hospitals
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
4
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• What Happened?
An Explosion of Home Care and Home Support
Programs
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
5
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Governments ---- Provincial
Each Province Developed Independently
Organizational Chaos ---- Social----Health
Cost Savings --- Cost Shifting
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
6
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Governments ----- Provincial
Unclear Policies ----- Non Policies
Public Health Nursing ---- Decline
Quality
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
7
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Care in the Community Now --- New Frontier
No Clear Rules
Rapid Change
Inconsistent Behaviours
Anything is Possible
Nothing Seems Possible
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
8
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Society --- What is Expected?
Services to be Available
Equality of Treatment
Balance the System
Quality Care and Services
A Program like Hospitals and Medicare
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
9
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Community --- What Has Been Occurring?
Rapid Expansion of Services --- Nursing and
Home Support
New Technologies
More Complex Cases
Sicker Patients
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
10
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Community (Cont’d)
Wage Disparities
Managed Competition
More Government Administrators
Continuous Public Debate
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
11
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Provider Organizations
Not for Profit and For Profit --- Community
Hospitals
Regional Authorities
Community Health Corporations
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
12
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Providers Informal (Unpaid)
Volunteers
Caregivers
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
13
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Who Provides Care in the Home
Nurses and Therapists
Unregulated Workers --- Home Support
Without Universally Approved Standards
Often Minimal Supervision
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
14
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Characteristics of Formal Providers
Mainly Women
Wage Disparities
Benefits Disparities
Training Gaps
Differentiated Working Conditions
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
15
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Characteristics of Informal Caregivers
Mainly Women
Family Members and Friends
Greater Incidence of Sickness
Little Training and Support
Lost Incomes
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
16
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• What about New Employees? Nurses Permanent Positions --- Temporary Positions
Full Benefits ------ No Benefits
Salary Equivalent to Hospital Nurses ------
Differential of 20%
Training as Required ----- No Training
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
17
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• What about New Employees?
Home Support Workers Temporary Position
Irregular Hours
No Benefits
Inadequate Training
Low Salary
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
18
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
19
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
What about QUALITYQUALITY in HOME HOME CARE CARE Today?
Should we be worried?
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
20
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• The Telegram Home care shortcoming (St. John's) Tue 15 Feb 2000 After 2 1/2 months in a St. John's hospital, 70-year-old Ralph Andrews is anxious to get back to his Shea Heights home. And his wife Gladys shares that feeling.
• The only thing, however, is Gladys has been told that in order for her husband to be released from the hospital, he will have to receive medications intravenously at home -- to be administered by her. Ralph had suffered some complications following heart bypass surgery that required extra treatment.
• ``I'm 70 years old and I find that whole thing (intravenous) complicated,'' Gladys said. ``They said Community Health can't come in and do it. The only other option would be for us to travel back and forth to the hospital every day. `
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
21
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Things That Impact On Quality
Leadership and Culture
Data
Skills and Training
Systems Development
Technologies
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
22
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Things That Impact On Quality (cont’d)
History and Tradition
Attitudes and Beliefs
Money
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
23
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Quality in Home Care --- Current Situation
Lots of Data Being Collected
No Agreement on Standards and Benchmarks
No Common Policy
Great Variations in Services
Uncertain Quality
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
24
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Current Approaches to Quality---CCHSA
Client Centred Accreditation Program
The AIM Project
Provincial Government Approaches
Contracting Agencies Approaches (CCAC)
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
25
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• What is the Main Factor in Determining the
Quality of Services in Home Care Today?
Professionalism and Training of the Nurses
and Therapists who provide and supervise the
care
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
26
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• What should we do about quality? National Standards
Improved information system
Investment in Training
Reduced Wage Disparity
Recognition of Need to Support Informal
Caregivers
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
27
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• National Principles and Standards Access to Home Care Based on Physical and
Social Needs
Support for Family and Friends who Provide
Care
Equity Between Home Care and Hospital Care
Flexible Options for Delivery Based on
Individuals Needs
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
28
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Improved Information and Communication
Common Data Definitions
Investment in Hardware and Software
Compatible Systems
National Standards
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
29
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Investment in Training and Education
Development of New Training Programs
National Standards
Recognition of New Roles and Relationships
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
30
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Support for Informal Caregivers
Training Counselling Respite Information Recognition
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
31
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
• Who should be involved?
Governments ---- Provincial and Federal
Providers ---- Community and Institutions
Consumers ---- Clients and Caregivers
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
32
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
Should we be worried about QualityQuality in
HomeHome CareCare today?
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
33
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
Should we be worried about QualityQuality in
HomeHome CareCare today?
You are “darn right” we should be worried!You are “darn right” we should be worried!
5 December 2000
CHCA 2000 CONFERENCEAmbrose M. Hearn, CHE
CEO, VON Canada
34
QUALITY AND COMMUNITYQUALITY AND COMMUNITYRESPONDING TO CHANGERESPONDING TO CHANGE
Thank You for your Attention
Good Luck