Baycrest receives Leading Practice awards from Accreditation Canada
May 8, 2015
Baycrest has been awarded six Leading Practice designations by Accreditation Canada. To be recognized as a Leading Practice, the practice must be innovative and creative, client and family-centred, evaluated, able to demonstrate intended results, sustainable and adaptable.
The following is a summary of each Leading Practice.
Integrated Community Care Team
In response to the growing challenges in meeting the health care needs of frail, medically complex seniors, the difficulties in timely access to primary care, community care and specialty care, and the health care system’s priority to reduce unnecessary Emergency Department utilization by promoting the integration of geriatric care, a unique and innovative Integrated Community Care Team (ICCT) outreach model was developed, implemented and evaluated.
The Integrated Community Care Team supports home-bound frail older adults in their homes and consists of three arms including primary care, shared care, and consultation. The ICCT model fosters integration at the point of care by connecting patients and their primary care physicians to a dedicated, interprofessional team of primary and specialty care providers, community services including intensive case management, and specialty care resources.
Building Capacity in Interprofessional Integration of Care: Behaviour Support Outreach Teams.
Baycrest was identified by the Toronto Central LHIN as the lead organization for the Behavioural Supports for Seniors Program (BSSP). This program included implementation of a Transitional Behavioural Support Unit, an education consortium, and two outreach teams:
Long Term Care Behavioural Support Outreach Team (LTCBSOT): The primary role of the LTCBSOT is to provide support to 36 long term care homes in the TCLHIN. Support includes a Registered Nurse-Personal Support Worker dyad working with staff in LTCHs to build capacity through modelling different approaches for care of residents exhibiting responsive behaviours.
Community Behavioural Support Outreach Team (CBSOT): The CBSOT serves seniors living in the community. The team is embedded within the Toronto Central Community Care Access Centre and works closely with primary care and community support services. Working collaboratively with the client, their informal and formal caregiver(s) and circle of care, the team works to manage challenging behaviours in the home environment.
Development of an Advance Care Planning Policy and Toolkit
Baycrest implemented a robust process for determining and documenting resident and clients wishes for life sustaining treatment. These effective and efficient solutions included the development of an ACP brochure, booklet titled Your Wishes Matter, and the Plan for Life Sustaining Treatment form to ensure that, whenever possible, future care and treatment decisions are made that respect the values and wishes of the client.
The Antimicrobial Stewardship Program
In mid-2012, Baycrest implemented a centre-wide Antimicrobial Stewardship Program (ASP), adapting key principles from literature in acute care, to suit the needs, capability and capacity of a long-term care setting. The Baycrest ASP ensures the most appropriate use of antibiotics for Baycrest clients. Along with improving and maintaining resistance, the program aims to improve client care and safety by reducing unnecessary antibiotic exposure, and therefore risks of the antibiotics themselves (e.g. risk of allergic reaction, side effects and Clostridium difficile diarrhea).
Seniors Support Volunteer Program
The Seniors Support Program provides support to seniors and family caregivers residing in the community through friendly visiting, utilising technology including the telephone and electronic mail. In addition, a Skype service is also available. The friendly visiting service (Friendly Visits and ePals) is offered in over 10 languages (English, French, German, Hebrew, Hungarian, Italian, Portuguese, Russian, Spanish, Turkish, Yiddish) and is often the first connection to Baycrest for our clients and families. The Seniors Support Program is committed to ensuring that each client receives a contact every week. Delivered by a dedicated group of 27 volunteers, this free weekly program makes over 10,000 client contacts per year.
Keeping our clients safe through the development and implementation of enduring consent for the influenza immunization.
In chronic care and long-term care (LTC) facilities, patients and residents frequently go through multiple rounds of annual influenza immunization. As with any other medical intervention, immunization requires informed consent. In the past, this consent had to be re-obtained every year and had to always be in writing. Due to varying degrees of cognitive impairments in patients and residents at Baycrest, providing consent is often delegated to substitute decision makers (SDMs), who may not be readily available to sign a consent form. This is why immunization campaigns used to take months to complete, often leaving patients unimmunized and unprotected
To address the problem, Baycrest’s Infection Prevention and Control (IPAC) team led the development and implementation of enduring consent. Signed once (e.g. on admission), such consent maintains its validity for as long as the patient or resident remains in Baycrest care. In addition, a process was created for obtaining an enduring consent in a verbal format. This was important, as many SDMs unable to be physically present on-site could still be reached over the phone. Combined, these two improvements resolved the challenges associated with the annual consent. Following this implementation, there were significant improvements including a reduction in the time required to attain target immunization rates from 12 to 5 weeks, with >80% of all patients immunized within 3 weeks. Immunization rates were well above 80%, 93% and 90% in the Hospital, Long-Term Care facility and Assisted Living Facility, respectively.