viha - becoming a centre of excellence in seniors' care...for the vancouver island health...
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VIHA – Becoming a Centre of Excellence in Seniors’ Care
VIHA VIHA –– Becoming a Centre of Becoming a Centre of Excellence in SeniorsExcellence in Seniors’’ CareCare
Presentation to Active Aging Presentation to Active Aging SymposiumSymposiumTuesday, March 27, 2007Tuesday, March 27, 2007
Strategic PrioritiesStrategic PrioritiesS
TRA
TEG
IC P
RIO
RIT
IES
Improving Health of
Aboriginal & Rural & Remote
Populations
Delivering & Implementing a Comprehensive Primary Health Care Strategy
Building a Sustainable Network of Hospitals
Integrating Mental Health &
Addictions Services
Becoming a Centre of
Excellence for Seniors’ Care
SeniorsSeniors’’ care is a strategic priority care is a strategic priority for the Vancouver Island Health for the Vancouver Island Health AuthorityAuthority
Becoming a Centre of Excellence for Seniors’ Care:“…a leader in care and support that helps seniors and their families attain and maintain health and independence is a priority for VIHA”
- VIHA Strategic Plan
““Shock and AweShock and Awe”” DataData
Unfreeze complacencyMake a compelling case for action now!
(10,000) (5,000) 0 5,000 10,0009 0 +
MaleFemale
65+
75+
85+
65+
75+
85+
VIHA Population2006
PEOPLE31
18,4563%85+
64,1819%75+
125,30917%65+
VIHA Population2006
PEOPLE31
18,4563%85+
64,1819%75+
125,30917%65+
(10,000) (5,000) 0 5,000 10,0009 0+
MaleFemale
65+
75+
85+
65+
75+
85+
VIHA Population2010
PEOPLE31
21,6783%85+
67,7009%75+
137,83018%65+
VIHA Population2010
PEOPLE31
21,6783%85+
67,7009%75+
137,83018%65+
(10,000) (5,000) 0 5,000 10,0009 0+
MaleFemale
65+
75+
85+
65+
75+
85+
VIHA Population2020
PEOPLE31
24,5143%85+
82,60610%75+
192,41123%65+
VIHA Population2020
PEOPLE31
24,5143%85+
82,60610%75+
192,41123%65+
(10,000) (5,000) 0 5,000 10,0009 0+
MaleFemale
65+
75+
85+
65+
75+
85+
VIHA PopulationVIHA Population20302030
PEOPLE31
31,6343%85+
121,54213%75+
249,26127%65+
VIHA PopulationVIHA Population20302030
PEOPLE31
31,6343%85+
121,54213%75+
249,26127%65+
Population Change by Age Group Population Change by Age Group (2006(2006--2010) PEOPLE312010) PEOPLE31
POPULATION
85+5.5%
0.0%
11.0%
14.0%
-5%
0%
5%
10%
15%
20%
2006
2007
2008
2009
2010
VIHASouthCentralNorthPOPULATION
75+
5.5%9.2%
30.3%25.6%
0%
5%
10%
15%
20%
25%
30%
35%
40%
2006
2007
2008
2009
2010
VIHASouthCentralNorth
Population Change by Age Group Population Change by Age Group (2006(2006--2010) PEOPLE312010) PEOPLE31
POPULATION
85+
% of Population with Confirmed % of Population with Confirmed Chronic Conditions Chronic Conditions (2000/01)(2000/01)
36.0%
37.8%
38.6%
39.0%
40.3%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0%
BC
NORTH
SOUTH
VIHA
CENTRAL
Mortality Rates Mortality Rates –– All Causes All Causes (2000(2000--2004)2004)
0.97
1.00
1.01
1.06
1.07
0.9 0.9 1.0 1.0 1.0 1.0 1.0 1.1 1.1
SOUTH
BC
VIHA
CENTRAL
NORTH
Life Expectancy Life Expectancy 81.5
78.9
77.0
79.9
77.2
79.7
80.7
78.1
80.9
78.0
76
78
80
82
1987-1991 1992-1996 1997-2001 2002-2006
SouthCentralNorthVIHABC
0%
0%
3%
3%
7%
8%
8%
9%
9%
12%
12%
13%
15%
18%
0% 5% 10% 15% 20%
Vancouver Island North
Vancouver Island West
Gulf Islands
Lake Cowichan
Saanich
Cowichan
Courtenay
Ladysmith
Qualicum
Greater Victoria
Sooke
Nanaimo
Alberni
Campbell River
Due to Small Sample Size
%75+ in Low Income %75+ in Low Income andand Living AloneLiving Alone
Population and HealthPopulation and Health
COMPARED TO VIHA OVERALL2010 Growth in 85+ Population Chronic
Conditions Life Expectancy
SAME
HIGH
LOW
% Volume
South 9.2% +1,003 HIGH
Central 30.3% +1,763
+456
LOW
North 25.6% LOW
Inpatient Days per 1,000 by AgeInpatient Days per 1,000 by Age
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1 6 11 16 21 26 31 36 41 46 51 56 61 66 71 76 81 86
Age
Cum
ulat
ive
Perc
ent
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
Day
s pe
r 1,0
00 P
opul
atio
n
Days per 1,000 PopulationCumulative % of PopulationCumulative % of Days
VIHA DAD 2005/2006
66% of all Hospital Days Attributed 57+
33% of all Hospital Days Attributed 78+
50% of all Hospital Days Attributed
70+
BC Per Capita Health Expenditures BC Per Capita Health Expenditures by Age Group (2003)by Age Group (2003)Source: CIHISource: CIHI
$6,623
$868 $1,396 $1,808$1,667 $2,103$3,179
$5,745
$11,651
$22,074
$1,000
$6,000
$11,000
$16,000
$21,000
> 1 10-14 20-24 30-34 40-44 50-54 60-64 70-74 80-84 90+
Changing Profile of Seniors in CanadaChanging Profile of Seniors in Canada
Almost 23% of seniors had internet access in 2004 compared to 3% in 1997.High levels of community involvementImmigrant and Aboriginal seniors: Aging evident in both groups (immigrants represent 40% of 65+ in BC)
Changing Profile of Seniors in CanadaChanging Profile of Seniors in CanadaRising rates of obesity among seniors- senior men more physically active while senior women are not
Retiring younger (65 in 1976 and 61 in 2004)Only 6% of seniors report a sense of “mastery” (ability to change important events) compared to 25% in the 25 to 54 age group- more seniors are less stressed (60% vs. 30%)
ENVIRONMENTALSCAN
ENVIRONMENTALSCAN
Strategic Planning ProcessStrategic Planning ProcessVALUES &
PRINCIPLESVALUES &
PRINCIPLESDATA /
INFORMATIONDATA /
INFORMATION
VISION / PURPOSE
Shock and Awe Data!
Understand Needs
Inventory Current Services
Best Practices
Borrow from the Best
Avoid Reinventing
Collaborate
We are here…
Establish Values and
Principles to Guide the
Planning Process
Actions To DateActions To DateCore Strategy Working Group establishedReview of previous work and plans within VIHAView strategy from a determinants of health perspective – include other stakeholdersTwo Forums held in March ’07:
Objective: engage VIHA leaders in the health of seniors – a shared responsibilityEmbrace a vision of excellence in seniors’ health Focus on the Geriatric Giants - transfer knowledge to action
Integrate Services Based on the Individual Patient’s Experience
• Include patients in planning
• Consult with individuals and families regarding service
• Support caregivers• Work with community
partners
Key Input From LeadersKey Input From Leaders’’ ForumsForums
Integrate Current Initiatives
Falls, Dementia, Elder Friendly Care, End of Life
• Many existing initiatives• Integrate and leverage• Build structures around
what is already working
Build Capacity Education • Health Service Providers / Professionals
• Families / Caregivers• General Public
Partner Community Stakeholders
• Can’t act alone• Seniors’ Health is broader
than Health Care• Acknowledge, value and
build on existing work eg. volunteers, faith groups
Key Input From LeadersKey Input From Leaders’’ ForumsForums
Focus on Geriatric Giants
Falls, Dementia & Elder Friendly Care
• Benefit from research and best practice
• Leverage Provincial work and initiatives
Improve Urgent Care Access
Reduce Emergency Department Visits
• Expand response service capacity
(e.g. ambulance, assisted living and residential care)
Reduce Acute Care Admissions
• Outpatient clinics & community services
• Develop integrated service models
• Test innovative services
Explore other Service Models
Key Input From LeadersKey Input From Leaders’’ ForumsForums
Strategic Planning ProcessStrategic Planning Process
STRATEGIES / GOALS
STRATEGIES / GOALS
ENVIRONMENTALSCAN
ENVIRONMENTALSCAN
VALUES &PRINCIPLESVALUES &
PRINCIPLESDATA /
HISTORYDATA /
HISTORY
VISION / PURPOSE
GAP ANALYSISGAP ANALYSIS
What do we need to succeed?What do we need to succeed?
Sharing between Health AuthoritiesIdentification and updates of best practicesPartnerships with local communities and other health service providers
We do not have the time or resources to do this alone!!
Ultimately, we must change Culture
Strategy alone is not enough…
““Never doubt that a small, Never doubt that a small, group of thoughtful, committed group of thoughtful, committed citizens can change the world. citizens can change the world. Indeed, it is the only thing that Indeed, it is the only thing that
ever has.ever has.””
Margaret Mead