OCAN Education

Training for OCAN Users

Day 1

2 2

Objectives

Upon completion of the 2 day OCAN training session, you will learn:

• OCAN is a consumer-centred, recovery based assessment

• How to complete an OCAN assessment• How to interpret and make use of information

from OCAN in a variety of ways• How to incorporate OCAN into the business

process of your HSP organization

3 3

Units of Instruction

• Instruction is standardized and consists of the following units:

• Unit 1: Overview• Unit 2: OCAN Tools• Unit 3: OCAN Outputs• Unit 4: Reassessment• Unit 5: Shared Assessment• Unit 6: Business Process

4 4

OCAN Training Agenda - Day 1• Welcome & Introductions• Objectives• Agenda• Icebreaker • Orientation to materials• Unit 1

• Overview Recovery

• Unit 2• OCAN Tool • Application of OCAN

• Introduce to consumer• Self-Assessment• Conversation• Staff assessment

• Wrap-up

5 5

OCAN Training Agenda - Day 2• Welcome & Introductions• Objectives• Unit 2

– Application of OCAN cont’d– Staff Assessment – Scoring Activity

• Unit 3– Outputs - Actions, Referrals, Reports

• Unit 4– Timelines and Reassessment

• Unit 5– Business Process

• Unit 6– Shared Assessment

• Next Steps• Evaluations

Icebreaker

Unit 1

Overview

8

OCAN Vision

9

What is OCAN?Ontario Common Assessment of Need (OCAN) is a standardized, consumer-led decision making tool that allows key information to be electronically gathered in a secure and efficient manner.

• Assists client-led decision-making at an individual level

• Identifies individual needs and helps match these to existing services and identifies service gaps

• Provides aggregate data to inform agency, regional and provincial level planning and decision making that is consistent with a recovery approach

• Further facilitates inter-agency communication through common data standards

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10

Phase 1 – Initiation (with stakeholder representation)

• Analysis of many assessments tools

• Selection of a core tool – Camberwell Assessment of Need

• Province-wide consultations to introduce the tool

• Formation of working groups

Phase 2 - Pilot

• Piloting of the automated OCAN in 16 community mental health service providers

• Early learnings gatherings

• NE LHIN Implementation pilot

Phase 3 - Implementation

• Provincial roll-out

• Integration with a changing CMH landscape

• Powerful reporting to drive enhanced consumer-centered service and system planning

2006

2008

Project Overview and Development

2010

2009

2011

2012

10

1111

VisionHealth service providers are attributed to a consumer

Track quantity of consumers receiving services

Reports on Functional Centre

Productivity / Efficiency

Current SituationConsumer is attributed to each health service provider

Reports on Consumer Outcomes /

Effectiveness of ServicesTrack quality of services

accessed by consumers (met needs)

OCAN Vision

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OCAN Benefits

Healthier Ontarians• Holistic consumer based approach• Health conditions flagged• Relevant information available for service planning• Improved delivery of service

Equitable Access• Every door leads to service• Standard approach to information gathering and sharing

Sustainability • Resource stresses and gaps identified• Improved sharing of financial and statistical information

1313

Relevant Research

• Consumer defined unmet needs• Focus on meeting needs• Better clinical relationship

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Philosophy of Needs Assessment

“If you only have a hammer, you tend to see every problem as a nail.” Abraham Maslow

Maslow’s Hierarchy of Needs

Peer Educator

Recovery and Assessment

1616

What is Recovery?

• A deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and roles. It is a way of living a satisfying, hopeful and contributing life even with limitations caused by the illness

Anthony WA (1993) Recovery from mental illness: the guiding vision of the mental health service system in the 1990s

Psychosocial Rehabilitation Journal, 16, 11-23

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Canada

• Goal 1: The hope of recovery is available to all

• A person-centred mental health system makes promoting recovery for people living with mental health problems and illnesses the focus of the organization and delivery of mental health services and supports.

• Through genuine partnership…all service providers share the hope and expectation that people they are working with can achieve a meaningful life in the community.

Mental Health Commission of Canada (2009) Toward recovery and well-being, Calgary, AB: MHCoC.

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The Foundation: Beliefs and Values of Recovery

Values EmpowermentConsumer perspective and input is central to information gathered in OCAN and the determination of priority areas to work on.

Values and Elicits HopeThe OCAN tool includes open ended questions where consumers share and later discuss hopes and dreams.

Values Self DeterminationOCAN focuses heavily on consumer-voiced needs, through the assessment of 24 concrete life domains.

Works Toward the Elimination of Prejudice and DiscriminationThe OCAN approach views a consumer as a whole person and an active participant in the assessment process, not as a diagnosis (“patient”)

Values Meaningful ChoiceConsumers engage with their workers to focus on their perspective inpreparation for action and service planning.

Source: Based on recovery principles from the Self Help Alliance

19

BREAK

Unit 2

OCAN Tools

2121

Three Types of OCAN

• Full OCAN: This OCAN assessment contains the most elements of information in order to paint the most accurate picture of the consumer as possible

2222

Three Types of OCAN

• Core + Self OCAN: This subset contains both Consumer Information Summary elements, CDS elements, the Consumer Self-Assessment and the Service Use Record

2323

Three Types of OCAN

• Core OCAN: This subset of the assessment primarily consists of the Consumer Information Summary which includes CDS elements and the Service Use Record

2424

Consumer Information Summary

• Reason for OCAN• Consumer Self-Assessment Completion (except

core)• Consumer Information

2525

Service Use Record

Present situation• The Current Service Use will be used to capture

all internal programs that are supporting one consumer

Vision• The Service Use Record will provide information

about all of the community mental health services, internal and external, that are supporting one consumer

26

ConnexOntario

• Provides information to vendor to pre-populate the Service Use Record

• HSP organizations are responsible for keeping this information up to date:– Data and Information Services at ConnexOntario:

Phone: (519) 439-0174 or 1-866-531-2600 Email: data_info_services_mhsio@connexontario.ca

27

Application of Full OCAN

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Assessment completion period

• The assessment start and completion date should be within 30 days of each other

• Start date of assessment in the system is whichever is started first: consumer Self-Assessment or Staff Assessment

2929

OCAN Process

Introduce OCAN - introduce the assessment to the consumer Introduction

OCAN Part I

Conversation

OCAN Part II

Introduce

OCAN Part I

Conversation

OCAN Part II

OCAN Part I - enable the consumer to complete the self-assessment

Begin your conversation around the consumer’s needs

OCAN Part II - complete the staff assessment with all the necessary information.

30

LUNCH

3131

Introduction to Consumer

Benefits for Consumers• Provides opportunity for consumers to

participate in assessment process and to voice their goals, hopes and dreams in a comprehensive assessment

• Links consumers to the most appropriate services based on their needs

• Ensures that individual risk has been assessed in a timely manner

• Reduces duplication of assessments

Introduction

OCAN Part I

Conversation

OCAN Part II

IntroduceIntroduction

OCAN Part I

Conversation

OCAN Part II

Introduce

3232

Introduction to Consumer

• Review purpose of OCAN with focus on recovery

• Offer support • Discuss confidentiality and consent• Inform how assessment information will be used

by health care worker, health service provider and system

• NB: Inform client when and where his comments will be used now and in the future

Introduction

OCAN Part I

Conversation

OCAN Part II

IntroduceIntroduction

OCAN Part I

Conversation

OCAN Part II

Introduce

33

Consumer Self-assessment

Rating need

34

Consumer Self-assessmentAdditional Questions

Please write a few sentences to answer the

following questions:

• What are your hopes for the future?

• What do you think you need in order to get there?

• How do you view your mental health?

• Is spirituality an important part of your life?

• Is culture (heritage) an important part of your life?

Introduction

OCAN Part I

Conversation

OCAN Part II

OCAN Part I

35

Consumer Orientation

As a group, brainstorm…

What are the factors to consider when

preparing to orient a Consumer to OCAN?

35

36

Consumer Orientation

Factors you may have considered:

Language Used Literacy Level

Mental Status Cognitive Status

Privacy Issues Available Supports

Length of Explanation Their starting point

Many others…

36

37

Introduction

Divide into groups:

• Come up with a script that you can use when introducing each other to the OCAN Assessment, considering these factors

• Debrief using questions provided and flip chart

Introduction

OCAN Part I

Conversation

OCAN Part II

OCAN Part I

37

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Let’s Practice!

• Individually:

– Complete OCAN Self Assessment

• In a group:

– Discuss debrief questions

– Record on flip chart paper

– Discuss with large group

OCAN Part I Consumer Self-Assessment Practice!

Introduction

OCAN Part I

Conversation

OCAN Part II

OCAN Part I

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Engages the person with lived experience and the person with assessment knowledge in a conversation focused on the consumer’s strengths, weaknesses and

goals for recovery.

Assessment ConversationIntroduction

OCAN Part I

Conversation

OCAN Part II

Conversation

4040

The Assessment Conversation

Tips for successful assessment

conversations: • Create a mental map• Be familiar with navigation & taking notes• Variances• Create safe, private supportive space• Unfold naturally• Summarize key points

Introduction

OCAN Part I

Conversation

OCAN Part II

Conversation

41

Assessment Comparison Self Staff

• Need rating 24 domains• Help rating 24 domains• Comments• Additional questions• Consumer information

summary• Actions and referrals• Current Service Use • Additional Data Elements

42

BREAK

43

OCAN Part II: Staff AssessmentScore NeedScore Need

Score HelpScore Help

4444

Scoring Need/Staff Assessment

0 = No need

1 = Met need

2 = Unmet need

9 = Not known

OCAN Part II: Staff Assessment

4545

Scoring informal and formal help• based on frequency and intensity of help

0 = No help

1 = Low help

2 = Moderate help

3 = High help

9 = Not known

OCAN Part II: Staff Assessment

4646

Scoring Help, Question 2, 3a/bOCAN Part II: Staff Assessment

4747

Comments:• Include all pertinent, “need to know” information• Ensure that the information is thorough,

objective, concrete and descriptive• Comments should follow your guidelines for

electronic documentation• Comments are written for viewing by other

service providers involved in supporting consumers

• Comments may capture historical information and collateral information

OCAN Part II: Staff Assessment

4848

Actions:

• Actions are only recorded in the Staff Assessment

• Actions can be identified by the consumer or staff on either assessment or during the conversation

The Actions field allows you to capture information about:• mutually agreed

actions in each domain• who is responsible for

completing the action• timelines for

completing and reviewing agreed actions

OCAN Part II: Staff Assessment

4949

Hopes and Dreams:• The staff summarizes or elaborates on

the hopes and dreams that the consumer expresses in their self assessment or during the therapeutic conversation

OCAN Part II: Staff Assessment

50

Summary of Referrals• At the end of the assessment referrals and status

of the referral can be documented in this chart

Optimal Referral

Specify Actual Referral

Specify Reason for Difference

Status of Referral

Drop down of functional centres

Name Program Drop Down of functional centres

Name Program See Data Elements

See Data Elements

OCAN Part II: Staff Assessment

Examples of Domain Scoring of NEED

52

Scoring Need

Person is “couch surfing” and has been asked to move tomorrow

Buys food and cooks nutritious meals at his apartment

Irregular housekeeping has attracted vermin in otherwise clean building

Client showers at YMCA and does laundry at peer support drop-in centre

Client is afraid to leave their apartment & spends most of day smoking and watching television

Type 2 Diabetes, client overweight, doesn’t follow diet or med. regime

Chronic symptoms, moderately well controlled by meds dispensed daily by family

Person has a good understanding of their illness and its treatment based on learning acquired after several years of living with illness

2

0

2

1

2

2

1

0

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Client effectively calls telephone distress centre several times per week

Scheduled supervision for daily in home risk assessment & monitoring

Receives 1-1 supportive therapy to identify triggers and coping strategies

Caught driving while impaired after taking meds and too much alcohol

Unconfirmed reports of client observed smoking crack cocaine

Meets with court diversion since caught stealing re “pro-line” gambling habit

Person frequently expresses intense feelings of being lonely and isolated

Happy with life-long “best friend” who serves as her confidante

Client and partner receiving counseling re: connection between,

communication intimacy and sexuality in relationships; both acknowledge

progress occurring

Scoring Need1

1

1

2

9

1

2

0

1

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Scoring Need

ACT providing child care instruction, arranging for respite care & coordinating

enrichment opportunities for children,

Person receives support for respite time

Extent of cognitive deficits unknown; awaiting psychometric testing

Phone company will not provide service due to past debts

Cognitive impairments cause him/her to get lost when using public transit

Person under Public Guardian and Trustee services provided

Person’s citizenship status in question; not eligible for many forms of aid

1

1

9

2

2

1

2