IMPLEMENTATION AND EVALUATION OF A CAPACITY BUILDING STRATEGY AT BAYCREST LONG-TERM CARE HOME Alison...

IMPLEMENTATION AND EVALUATION OF A CAPACITY

BUILDING STRATEGY AT BAYCREST LONG-TERM CARE HOME

Alison Corcoran, Advanced Practice Leader – NursingMaya Hohmann, Research Associate – Program Evaluation Unit

Angela Uy, Advanced Practice Leader - Nursing Baycrest Health Sciences

June 5, 2014

AgendaAgenda

• Background

• Capacity building at Baycrest

INTERACT® Clinical Skills Day

• Program evaluation

• Lessons learned

According to studies in Canada, what percentage of ED visits by LTC residents

are potentially preventable?

A. 10% – 15%B. 3% – 6%C. 25% – 55%D. 65% – 72%

0% 0%0%0%

Use your clickers!Use your clickers!

ED visits is a priority indicator for the Ministry of Health and Long Term Care

Quality Improvement Program (QIP)

A. TrueB. False

0%0%


Background: ED usageBackground: ED usage

• Seniors higher frequency of use- 60,509 ED visits over 12 months

• Potentially preventable transfers- 25% - 55%

•MOHLTC QIP 2014-2015- ED transfer rate a priority

indicator- Considerations for future:

preventable reasons for transfer

Why is action required?Why is action required?

• Elevated costs$260/ED visit$545/ACSC visit ($386/senior ED visit)

• Quality of lifeIatrogenic illnessLoss of functional abilityStress and anxiety

What can we do?What can we do?

Improve the identification, communication, and management of acute changes in condition in LTC.

1.INTERACT® tools2.Build capacity of staff3.Monitor and evaluate our outcomes

What is INTERACT®?A. Banking systemB. Online dating service for

nursesC. A quality improvement

program to minimize aggressive interactions

D. A quality improvement program to reduce ED transfers

A. B. C. D.

0% 0%0%0%


INTERACTINTERACT®®

Interventions to Reduce Acute Care Transfers (INTERACT®)

Quality improvement program to reduce ED Transfers from LTC• Advance Care Planning tools• Decision support tools• Communication tools (Stop and Watch, SBAR)• Quality improvement tools

Ouslander, J., et al. JAGS 2011

What are some common potentially preventable reasons for transfer to the ED?

A. PneumoniaB. UTIC. DehydrationD. Conjunctivitis E. Answers a, b, and c 0% 0% 0%0%0%


Building capacity at Clinical Skills DayBuilding capacity at Clinical Skills Day

Clinical Skills Day (CSD) – an annual, full day clinical education program for registered nursing staff.

•Interactive curriculum based on the INTERACT® program and Best Practices •Enhance capacity in assessing and managing most common reasons for potentially preventable transfers to acute

CSD:CSD: ImplementationImplementation

• Scope of INTERACT® components SBAR Introduction to Stop and Watch Introduction to Care Paths

• ResponseCard© Technology TurningPoint 5

• Case studies, physical assessment skills, discussion

CSD: LTC AttendanceCSD: LTC Attendance

Attended Did not attend

Evaluation: CSD session averagesEvaluation: CSD session averages

Evaluation: RN vs. RPNEvaluation: RN vs. RPN

Evaluation: Identify trouble spotsEvaluation: Identify trouble spots

CSD Session Question

% INCORRECT RESPONSES

PRE-TEST POST-TEST

2Info to include in SBAR “Situation”

Question not included

19.2%

3Signs/symptoms of

dehydration30.9% 26.4%

4 -- -- --

5Signs/symptoms of

pneumonia20.0% 21.4%

Art of the possibleArt of the possible

• Accessing INTERACT®

- http://www.interact2.net/• Evaluation

- Technology vs. paper

• Integrate education into existing offerings

• ED Transfers as an organizational priority

According to studies in Canada, what percentage of ED visits by LTC residents

are potentially preventable?

A. 10% – 15%B. 3% – 6%C. 25% – 55%D. 65% – 72%

0% 0%0%0%


ED visits is a priority indicator for the Ministry of Health and Long Term Care

Quality Improvement Program (QIP)

A. TrueB. False

0%0%


What is INTERACT®?A. Banking systemB. Online dating service for

nursesC. A quality improvement

program to minimize aggressive interactions

D. A quality improvement program to reduce ED transfers

A. B. C. D.

0% 0%0%0%


What are some common potentially preventable reasons for transfer to the ED?

A. PneumoniaB. UTIC. DehydrationD. Conjunctivitis E. Answers a, b, and c 0% 0% 0%0%0%


Contact informationContact information

Alison Anne Corcoran RN, BScN, MN

Advanced Practice Leader – Nurse Baycrest Phone: (416) 785-2500 Extension [email protected]

Maya Hohmann MA

Research AssociateBaycrestPhone: (416) 785-2500 Extension [email protected]

Angela Uy RN, MN, GNC(C)

Quality Partner BaycrestPhone: (416) 785-2500 Extension [email protected]

mailto:[email protected]



IMPLEMENTATION AND EVALUATION OF A CAPACITY BUILDING STRATEGY AT BAYCREST LONG-TERM CARE HOME Alison...

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