Improvements at the Veterans Centre
In March of this year, Veterans Affairs Canada released results of an audit conducted on the veterans' residences at Sunnybrook. While the review noted the care of Canada's war veterans at the hospital is excellent, there were a number of opportunities the review identified to improve issues such as the reporting of complaints and ongoing communication training of staff. Sunnybrook took the recommendations of the review seriously, and for the past seven months, teams across the Veterans Centre have been working to implement the results of the review.
Below are areas identified for improvement and a progress update on what we've accomplished so far.
Improve the communication of survey results and other monitoring activities by making the links between the results and quality initiatives undertaken, to improve engagement of residents, families and other stakeholders.
- Every unit is holding regular community meetings where residents and families have the opportunity to be informed of our quality monitoring and provide input into any resulting quality improvement initiatives.
- In November 2013 the Veterans Centre is participating in the next Accreditation Canada cycle, as well as the NRC (National Research Corporation) Resident & Family Satisfaction Surveys. The results of these will be shared on the Veterans Centre website, as well as through on-unit postings and newsletters.
Enhance the quality assurance process to ensure that up-to-date goals and care plans are individualized to each resident.
- An audit process has been implemented to ensure goals and care plans are in place, current, and signed off accordingly.
Share care planning and care protocols with residents and families to promote a more collaborative approach.
- Residents and families are able to review care plans, evidence-based protocols and best practices upon request. This information is also shared at scheduled and ad hoc family meetings.
- A new Resident & Family Resource Centre is now open with evening and weekend hours to provide families and residents with a comfortable and welcoming location to obtain general health information on a wide variety of topics, including dementia/Alzheimer's disease, end of life, Parkinson's disease and other health care topics.
- Quarterly education forums are being held, and all families receive invitations to attend. The October session featured Advance Care Planning, and the next scheduled session is on Dementia Care.
Review the effectiveness of the Partners in Veterans Care training program as a means of improving communication between staff and families.
- Our Partners in Veterans Care program has been revised and the new iteration implemented in the spring of 2013. Unit-based focus groups inform the individual sessions so that they are tailored to address the specific communication issues identified on each unit.
- Each 2-day Partners in Care session is evaluated quantitatively and qualitatively.
- The Partners in Veterans Care communication strategies have also been embedded into a new "Early Recognition & Response to Concerns" strategy being rolled out to all staff and referenced on the intranet for 24-hour access to staff. This strategy includes a "tip card" for staff and links to educational resource for staff to refresh their training in the Partners in Veterans Care, and the corporate iCare sessions focusing on customer service and communication.
Promote a more collaborative approach through family conferences and inclusion in decision making.
- The process for scheduling and documenting family conferences has been standardized and is being audited. Additionally, the template for recording family meetings in our computerized clinical documentation system has been revised to include the date that a meeting was offered and when it was declined, if that should happen.
Work on follow-up mechanisms, including mediation when necessary, for those complaints when resolution is less than satisfactory in terms of outcomes.
- The majority of concerns continue to be managed successfully at the point of service, and if Patient Care Manager involvement is required, concerns are now documented and tracked by the Manager through the pre-existing on-line documentation system.
- Families continue to be able to bring concerns forward through the Office of the Resident & Family Experience (formerly Patient Relations) and these concerns are also documented and tracked through the same on-line system.
- New brochures on the concerns process are available on the patient care units as well as the new Resident & Family Resource Centre. The current policy and procedure for the management of concerns includes an escalation strategy that goes from the point of service to the Patient Care Manager to the Office of the Resident & Family Experience to the Operations Director to the EVP and then to mediation if appropriate.
Report regularly on complaints management to Sunnybrook's Veterans' Advisory Committee of the Board.
- Reports of concerns from residents and families are presented quarterly through the Veterans Advisory Committee of the Sunnybrook Board of Directors as well as the Program Council, which is a multi-disciplinary group of senior leaders across the program.
