1. Developing & Implementing Evidence-Informed Policy Framework for Person-Centered Care in Substance Use Services
Ashley Ward, Valerie Sadler, Heidi Klett, Corrie McIlveen
Mission Services of Hamilton
May 30, 2016

2. Organizational Context
Mission Services of Hamilton (1956-present), a faith-based social service agency.
Three campuses: Men’s campus, women’s campus, community services.
Initiating person-centered framework across substance use programs (outpatient, supportive housing, Drug Treatment Court).

3. Workshop Objectives
Understand the components of person-centered policy and its implementation.
Understand how the policy was enacted within service delivery in two substance use services.
Identify particular implementation issues experienced by social service agencies.
Begin to consider a similar process for person-centered policy for their organization.

4. Part I: About Policy and A person-Centered Approach

5. “Policies and procedures link vision to operations”
- Tom Bartridge

6. Why Policies are Important
Communicates values and expectations for how things are done at your organization.
Ensures accountability in the organizational context of expediency.
Facilitates the documentation and implementations of best practices appropriate to service delivery.
Facilitates decisions that align with quality improvement: consistent, predictable, and uniform.

7. Our Foundation: Quality Care (Health Quality Ontario, 2016)
Excellent Care for All Act (ECFAA) (2010)
“A high quality health care system is accessible, appropriate, effective, efficient, equitable, integrated, patient centered, population health focused, and safe.”
Institute of Medicine (IOM)
“Safe, effective, patient-centered, timely, efficient, and equitable.”

8. Person-Centered Pathways (Canadian Centre for Substance Abuse, 2008)

9. What is a person-centred approach?
An overarching philosophy and approach that all client services are derived based on client needs and preferences.

10. Elements of Person-Centered Care (McCormAck et al., 2015)
Holistic care
Working within the person’s lived context, perceptions, values, etc.
Shared decision-making
Continuous engagement
A sympathetic response

11. Policy and Procedures Development
Organize a committee and delegate one person to take the lead.
Create a work plan with realistic timelines.
Develop and draft policy content with a review schedule.
Write out procedures with quality indicators of person-centered care.
Implement the policy.
Check out for further guidance

12. Who Benefits from Your Policy? (Springtide Resources Inc., 2008)

13. Practice Examples: CCSA Behaviour Indicators(2014)
Client-Centered Change
“Enhance, facilitate, support, empower, and otherwise increase client motivation for positive change.”
Client Service Orientation
“Provide service excellence to clients (which can include individuals, groups, communities and organizations). Includes making a commitment to serve clients and focusing one’s efforts on discovering and meeting client needs.”

14. Making Policy Accessible (Springtide Resources Inc., 2008)
Is the policy available in different formats?
Is the policy written in language that is easy for all to understand? Could it be translated to other languages?
Does the policy state who it affects?
Does the policy state who is responsible for implementing it?

15. Example: Person-CentereD Policy

16. Example: Attending to Language
We will teach and educate our clients.
We will holistically care for our clients.
Treat others in the manner we wish to be treated.
We will provide the support and resources to meet the wishes and goals of the person.
We will work in partnership to meet the goals of the person in their lived context.
We will honour the person’s cultural beliefs and values in all aspects of care.

17. Part II: Putting Policy into Practice

18. Fostering a Person-centered Culture (McCormAck et al., 2015)
Competence
Interpersonal skills
Commitment to working towards a person-centered standard
Clarity of beliefs and values
Knowing self

19. RNAO Clinical Best Practice Guidelines in PCC (2015)
Practice, education, and policy recommendations.
Practice recommendations include:
Assessment
Planning
Implementation
Evaluation

20. Outcomes of Measurement (McCormack et al., 2015)
Satisfaction with care
Involvement with care (i.e., engagement)
Feelings of well-being
A healing environment

21. Measuring Care Experience
Client experience
How clients perceive and experience their care, requiring providers to understand and use this information to shape policies, practices, rules and responsibilities, etc.
Client engagement
The way in which providers collect information about client needs and preferences to ensure they are delivering client- centred care.

22. The Engagement Continuum

23. Quality Targets: Making PCC Happen
Assess current PCC practices to identify gaps in service delivery.
Align goals with best practice and/or competency standards.
Design SMART person-centered goals aligned with policy indicators.
Build a plan for training and education.
Build in points of supervisory and/or team oversight.

24. Example: Policy Indicator Monitoring Sheet

25. Practice Examples: Person-Centered Care in Two substance use services

26. Suntrac Wellness & Addiction Treatment Centre
Outpatient substance use support services
Assessment
Holistic intake practices that facilitates client-identified needs and priorities for care
Establish collaborative partnership approach to care
Planning
Goal-focused case management support, Mental Health Collaboration Plans, safety plans, etc.
Work together to address any barriers to service delivery

27. Suntrac Wellness & Addiction Treatment Centre
Implementation
Continuous collaborative goal setting and achievement
Negotiable service changes and return to service
Evaluation
Client engagement through satisfaction surveys, annual focus groups
Development of a client advisory group

28. Lessons Learned
Assigning “champions” of the practice can facilitate change.
Having regular communication about what expectations are and what is flexible empowers staff.
Capacity building takes time; education and training on an ongoing basis is necessary to evolve practice.
Plan-Do-Check-Act.

29. Addiction Recovery Housing Program
Long-term housing and abstinence recovery support
Assessment
Flexibility in program eligibility criteria where possible
Advisory Committee review and advocacy
Planning
Collaborative and tiered goal planning for long-term support
Build internal and external partnerships

30. Addiction Recovery Housing Program
Implementation
Ongoing tailored in-house client support
Extended care and maintenance support available
Evaluation
Client engagement through satisfaction surveys, annual focus groups
Collaborative program development with clients where possible

31. Lessons Learned
Positively frame rights and responsibilities of all roles.
Make engagement accessible.
Plan out all activities and anticipate barriers for sustainable, long-term change.
Emphasize community partnerships to address service gaps.

32. Questions?