Strategic change
- 2. My Focus Holistic Wellness: balance mind, body, spirit and community connections. Organizational Success: fostering healthy connections, recognition, and building upon strengths for a supportive culture. Recognizing Resources: building capacity, exceed goals, go beyond perceived boundaries
- 3. My Role 1. Evaluate Organization: programs, resources, policies, needs/gaps, culture 2. Evaluate the Environment: SWOT, systems, politics, social, cultural, economical 1. Determine Critical Issues/Risks: safety, population, organization, environment, quality, insurance 1. Create Plans for Strategic Change: long term/short term vision, mandate, metrics, change management
- 4. Past Accomplishments Wait time reduction Technological design to Step Care Model Integrating Mental Health with Primary Care Collaborative Vision with First Nations Revision of Program Policies and Mandate Securing Community Funding to Build Capacity Maximizing Human Resources to Build Capacity Quality Assurance Projects Regional Child Abuse Policy Development/Implementation Curriculum Implementation Evaluation Implemented new Mental Health Act Regional Suicide Prevention Protocol Implementation & Revisions Progressive Employee Reviews Commissioning Assisted Living Facilities Developed Proposal for a Transition Unit Cost Savings to Redevelop Systems and Care Models
- 5. Quality Improvement Prospective and Retrospective Maximize Resources Identify & Eliminate Risk Contingency Planning Policy Legal Implications Clinical Implications Reduce Waste Reallocate Resources Live Well
- 6. Context-Input-Process- Product Model: used to evaluate program/curriculum Concerns Based Adoption Model: perception based model regarding implementation is a process and not event. Ties to change management and measurable outcomes. Innovations Profile Model: aims to reduce social gaps or obstacles for new ideas/new teachings to be accepted. Logic Models: Operations identify all resources to build capacity, reduce redundancy, economize, re-structure.
- 7. Metrics to Benchmarks Descriptive Stats: mean, median, mode, variability Standard Scores: distributions, t-scores Sampling Distributions and Interval Estimation Significant Differences: T-tests, two-sample tests, chi square, ANOVA Correlations, Regressions, ANOVA’s Probability Themes from client/family/stakeholders verbal feedback are used to further understand the ‘client’ and systems to identify areas for improvement in programs, processes, policy, staffing, and organizational values. Qualitative measures can be used to design curriculum to educate staff, influence policy, advocacy.
- 8. How they happen . . . LEAN Project Management Collaboration & Team Work Staff, Client & Stakeholder engagement Breakthrough ideas Dashboards – objectives, timelines, accountability Process mapping Visual boards, Metrics, Benchmarks Change Management Vision/Goal Staff, Client & Stakeholders: everyone is part of the solution and process Resistance to change can be an adverse obstacle – prevent by on-boarding all (process) Clear expectations, roles, professionalism The goal is close to the heart
- 9. Integration Model: Mental Health & Primary Health Care Goals 1. Improve access to improve quality of care 2. Prevent and reduce risk 3. Build capacity Objectives Develop interdisciplinary teams Define roles, clinical supervision, team meetings Cross training Electronic reporting system Medication monitoring program Screening mental health and substance use (treatment of mild cases, 1-3 sessions) Maximizing human resources in rural areas Example 1
- 10. Integration Model Metrics • Services Accessed • Through which program? • Frequency of screening tools used • Wait time • Duration of service • Re-entry to system: same or different health concern (coded) • Hospital utilization • Suicide: successful and near misses • Client Satisfaction (quantitative/qualitative) • Client reported outcomes • Discharge planning satisfaction, fails, successes • Impacts within the organization • Employee productivity Progress Year 1: Sites to have implemented integrated teams outlining roles, coverage, standardized screening, addressed policy issues, have clinical support and reporting structures in place. Data Collection Electronic reporting, audits, client feedback, QI, staff and stakeholder feedback. Operation leads, stakeholders, client groups engaged in developing feedback tools.
- 11. Integration Model Reduction in harm 20% the new model detected more higher risk cases which we attribute to cross training, availability of staff. Improved discharge planning 94% up from 57% by working with staff to develop client/family centered plans, and connecting community supports with clients in hospital prior to DC. Hospitalization rates for moderate clients down 20% Client satisfaction 90% reports of reduced stigma Long term we will see greater reduction in severity of illness and substance use. Year 1: Example Outcomes • Wait times met at 100% • Reduction of moderate cases 50%, benchmark set 100% • Redirection of mild cases 80% Clients accessing services met wait times in all portfolios (child/youth, adult, rehab). Benchmarks are set at 1 day turn around for severe, 24-72 hrs moderate, five days mild. This has been attributed to primary health screening, providing 1-3 sessions for mild Highlights & Benchmarks
- 12. Why hire a consultant? Consultants facilitate engagement and opportunities to approach a problem from a different lens Consultants can teach organizations how to get the results they want Methods utilized can help engage employees disengaged from the process or engaging in toxic group think from an outsider perspective taking some pressures off of management. Holistic approaches are person centered which impact a persons overall sense of engagement and productivity. Supporting a ‘person’ builds a healthy sustainable organizational culture, the foundation for success.
Editor's Notes
- Thank you for joining me as I introduce myself and past work in the area of Mental Health and Substance Use.
- My role: Help organizations understand their resources and how to optimize them to produce desired outcomes. Assist in evaluating, designing and implementing organizational and program changes. Assist in change management.
- Working with operations and stakeholders to ensure initiatives are based in research and client/family/community focused. Working to ensure operations have sufficient resources. I consider cultural and environmental factors along with clinical implications, legalities, policies, funding and impacts on community and broader systems. I develop reporting systems to gather reportable data for analysis to measure and monitor our progress and design evaluation frameworks.
- These tools transform into QI, PM, Six Sigma techniques which I use to engage stakeholders to get the job done.
- Within evaluation frameworks metrics are identified to produce data specifically for a region, or province and stakeholders identified benchmarks. We use the results to see if we have met our benchmarks/goals. Benchmarks are based on set goals, projections, proportions, probability, relationships, research, systems, and resources taking into consideration a margin of error. Moving on to our Accomplishments, I will focus on the transformations in our models of care.
- Application of LEAN management, project management, and change management we are able to make key changes to our programming. Key areas include: 1. Integrating primary care with mental health substance use Step Care Collaborative new vision with First Nations. Intersectorial committees
- Integration of resources between primary health care and mental health improve quality of care by preventing escalation of illness when identified early, improve access to services and reduce stigma, and allows health care professionals to develop a common language to relay the same message on wellness to clients/families/caregivers. From an organizational perspective, models of this nature are economical by recognizing an illness early, thus reducing cost of hospital treatments and accessing community resources that can assist in provision of care; travel time/over time can be reduced in rural/remote locations (if telehealth is not available); staff are fully utilized; and in some cases employee satisfaction and retention are positively impacted.
- Clients accessing services met wait times in all portfolios (child/youth, adult, rehab). Benchmarks are set at 1 day turn around for severe, 24-72 hrs moderate, five days mild. This has been attributed to primary health screening, providing 1-3 sessions for mild cases and linking clients to community or on-line resources. Reduction in harm to self: the new model detected more higher risk cases which we attribute to cross training, availability of staff. Client discharge planning was measuring in the 50’s and has improved by working with staff to develop client/family centered plans, and connecting clients in hospital with community supports in person prior to DC.