bette jo tunks rn carol ward md bcpga conference kamloops, bc april 24, 2015 bj tunks & c ward...

Bette Jo Tunks RN Carol Ward MD

BCPGA ConferenceKamloops, BCApril 24, 2015

BJ Tunks & C Ward Tertiary Mental Health IHA

Faculty: Bette Jo Tunks and Carol Ward

Relationships with commercial interests:◦ Grants/Research Support: Nil◦ Speakers Bureau/Honoraria: Nil◦ Consulting Fees: Nil◦ Other: Nil

This program has received no in-kind support from outside organizations


The learner will be able to:◦ Describe the purpose of the P.I.E.C.E.S.™

learning and development program and its role-out in BC

◦ List some of the key outcomes of this educational initiative

◦ Reference the BC Dementia Plan Update to better understand the goals for enhancing care in persons with dementia in the province


“Only after we understand the behaviour can we

meaningfully manage the problem”

(P.I.E.C.E.S.™ Consultation Team 02-10-03)


P.I.E.C.E.S.™ 6th Ed.

A Model for Collaborative Care and Changing Practice

Common vision

Common language

Common approach

BJ Tunks & C Ward Tertiary Mental BJ Tunks & C Ward

Tertiary Mental Health IHABJ Tunks & C Ward

Tertiary Mental Health IHAHealth IHA

What has changed? Think atypical

What are the RISKS & possible causes? Think P.I.E.C.E.S.™

What is the Action?BJ Tunks & C Ward

Tertiary Mental Health IHA


PhysicalIntellectualEmotionalCapabilitiesEnvironmentSocial

Regulated Health Care Professionals (RN, RPN, NP, OT, PT, SW)

Health Care programs and organizations (internal and external


Individuals with complex physical, cognitive/mental health needs and behaviour changes.


Kamloops Integrated P.I.E.C.E.S. Initiative and P.I.E.C.E.S. ™ Leadership & Performance Improvement program

IHA Residential Care

Provincial Residential Care

Tertiary Older Adult P.I.E.C.E.S. Initiative


Placement, Drugs and Therapy…

We Can Do Better

www.seniorsadvocatebc.ca



More than one-third of B.C. seniors in long-term care prescribed antipsychotic

drugs: advocate

Medication often used for dementia patients although it was created for

psychiatric illnesses


Drs. Donnelly/McElhaney – focus group/review of healthcare professionals/caregivers and their opinions for improving care

Acute Care ER

Person centered approach Triage

48/5 Screen for delirium

Consumer feedback Assess behaviours’ origins & follow standard approaches to management

Least restraint Caregivers

Assess and manage behaviours

Educate

Staff education, training & coaching

Develop practical evidence-based resources

Use of quality indicators & evaluation

(Collett et al. 2009, Moyle et al. 2010, Gibson et al. 2010)

C Ward Tertiary Mental Health IHA

E Drance & C Ward 2015

TranslatingKnowledge

Shared SolutionFinding

TeamCollaboration

ActingTogether

P.I.E.C.E.S.™ (2012-current)◦ Kamloops Integrated P.I.E.C.E.S.TM

Initiative◦ BC Residential Care◦ BC Tertiary Older Adult Mental Health

BC BPSD Guidelines 2013 BC BPSD Algorithm 2014

Dementia Action Plan Update 2015


Expands on 2012 plan

Attempts to provide a comprehensive approach for the person with dementia from diagnosis to end of life

Organised four areas of care*

◦ Staying healthy◦ Getting better◦ Living with illness and disability◦ Coping with end of life *BC Patient Safety & Quality Council



Implementation of actions will be phased in over 2015-2018

In next year focus on wandering and increasing public awareness

Begin planning on increasing training of health care professionals across all appropriate sectors


4 PrioritiesIncreasing public awareness and early recognition

Supporting individuals to live independently and safely

Improving the quality of care in residential care facilities and improving palliative and end-of-life care

Increasing system support and adoption of best practice in dementia care


MOH acknowledges the good uptake of P.I.E.C.E.S.™ and the use of the BC BPSD guidelines and algorithm (www.bcbpsd.ca) in the province to date

MOH collaboration on evaluation of current P.I.E.C.E.S.™ initiatives:◦ Educator surveys◦ Post-evaluation 24 Hour Program◦ Inter-RAI

Gentle Persuasive Approach (GPA)◦ Interior Health Authority◦ Vancouver Coastal Health◦ Providence Health Care

iLearn modules Integrating Care Approaches for Complex Behaviours

4 hr workshop for Physicians Dementia-related Responsive Behaviours: Putting It Altogether using

P.I.E.C.E.S.™ TM and the BC BPSD Algorithm (pilot, April 25, 2015)

Other CLeAR report 2015 Dementia: Understanding risks and preventing violence [Worksafe BC]


BC Patient Safety & Quality Council◦ Call for Less Antipsychotic Use in Residential Care

(CLeAR)◦ Clck web-site

UBC Tertiary Older Adult P.I.E.C.E.S.™ Initiative◦ Project Lead: Dr. Mary Lou Harrigan◦ P.I.E.C.E.S.™ Newsletter

BJ Tunks & C WardTertiary Mental Health IHA

Commitment by MOH and Health Authorities

Funding- P.I.E.C.E.S.™ licences terminate March 2016 unless renewed

Fostering collaboration

Evaluation outcomes


Leadership Lessons from Dancing Guy


BJ Tunks & C WardTertiary Mental Health IHA

bette jo tunks rn carol ward md bcpga conference kamloops, bc april 24, 2015 bj tunks & c ward...

Documents

cognitivemental health

collaborative care

longterm care

swhealth care programs

dementia patients

grantsresearch support

inkind support

antipsychotic drugs