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P.I.E.C.E.S.™ & BC Dementia Action Plan: Putting It Altogether

Learn about the P.I.E.C.E.S.™ learning and development program and the BC Dementia Action Plan. Understand the goals for enhancing care in persons with dementia in the province.

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P.I.E.C.E.S.™ & BC Dementia Action Plan: Putting It Altogether

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  1. P.I.E.C.E.S.™ & BC Dementia Action Plan: Putting It Altogether • Bette Jo Tunks RN • Carol Ward MD BCPGA Conference Kamloops, BC April 24, 2015 BJ Tunks & C Ward Tertiary Mental Health IHA

  2. Faculty/Presenter Disclosure • 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 BJ Tunks & C Ward Tertiary Mental Health IHA

  3. Objectives 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 BJ Tunks & C Ward Tertiary Mental Health IHA

  4. P.I.E.C.E.S.™ “Only after we understand the behaviour can we meaningfully manage the problem” (P.I.E.C.E.S.™ Consultation Team 02-10-03) BJ Tunks & C Ward Tertiary Mental Health IHA

  5. Questions for audience BJ Tunks & C Ward Tertiary Mental Health IHA

  6. Putting the P.I.E.C.E.S.™ ...together A Model for Collaborative Care and Changing Practice P.I.E.C.E.S.™ 6th Ed.

  7. What is P.I.E.C.E.S.™? Common vision Common language Common approach BJ Tunks & C Ward Tertiary Mental BJ Tunks & C Ward Tertiary Mental Health IHA BJ Tunks & C Ward Tertiary Mental Health IHA Health IHA

  8. P.I.E.C.E.S.™ 3 Question Template • 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

  9. What are the possible causes?P.I.E.C.E.S.™ Physical Intellectual Emotional Capabilities Environment Social BJ Tunks & C Ward Tertiary Mental Health IHA

  10. P.I.E.C.E.S.™: Who are the Targeted Learners and Participants? • Regulated Health Care Professionals (RN, RPN, NP, OT, PT, SW) • Health Care programs and organizations (internal and external BJ Tunks & C Ward Tertiary Mental Health IHA

  11. P.I.E.C.E.S.™: Who are the Populations it can be used with? Individuals with complex physical, cognitive/mental health needs and behaviour changes. BJ Tunks & C Ward Tertiary Mental Health IHA

  12. BJ Tunks & C Ward Tertiary Mental Health IHA

  13. Inter-RAI & P.I.E.C.E.S.™ BJ Tunks & C Ward Tertiary Mental Health IHA

  14. P.I.E.C.E.S.™ By The Numbers • 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 BJ Tunks & C Ward Tertiary Mental Health IHA

  15. Evaluation BJ Tunks & C Ward Tertiary Mental Health IHA

  16. Workplace Health & Safety BJ Tunks & C Ward Tertiary Mental Health IHA

  17. Office of the Seniors AdvocateReport #3 2015 Placement, Drugs and Therapy… We Can Do Better www.seniorsadvocatebc.ca BJ Tunks & C Ward Tertiary Mental Health IHA

  18. 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 Vancouver Sun Headline (April 10, 2015 ,Erin Ellis) BJ Tunks & C Ward Tertiary Mental Health IHA

  19. Drs. Donnelly/McElhaney – focus group/review of healthcare professionals/caregivers and their opinions for improving care Improving B.C.’s Care for Persons with Dementia (Acute Care/ER) BJ Tunks & C Ward Tertiary Mental Health IHA

  20. Where to start the discussion on capacity building and sustainability for regulated health professionals? BJ Tunks & C Ward Tertiary Mental Health IHA

  21. What works? Capacity Building & Sustainability for Regulated Health Professionals • 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

  22. The 4 Pillars of P.I.E.C.E.S Shared Solution Finding Team Collaboration Translating Knowledge Acting Together E Drance & C Ward 2015

  23. What’s happening in BC with respect to Behavioural and Psychological Symptoms of Dementia (BPSD)? • 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 BJ Tunks & C Ward Tertiary Mental Health IHA

  24. BC’s Dementia Action Plan Refresh 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 BJ Tunks & C Ward Tertiary Mental Health IHA

  25. 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 BC’s Dementia Action Plan Refresh 2015 BJ Tunks & C Ward Tertiary Mental Health IHA

  26. 4 Priorities Increasing 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 Provincial Dementia Action Plan for BCLiving Well with Dementia2015/16-2017/18 BJ Tunks & C Ward Tertiary Mental Health IHA

  27. 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 Sustainability BJ Tunks & C Ward Tertiary Mental Health IHA

  28. Examples of Other Educational Initiatives • 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] BJ Tunks & C Ward Tertiary Mental Health IHA

  29. Supports • 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 Ward Tertiary Mental Health IHA

  30. Outstanding Issues Regarding Sustainability • Commitment by MOH and Health Authorities • Funding- P.I.E.C.E.S.™ licences terminate March 2016 unless renewed • Fostering collaboration • Evaluation outcomes BJ Tunks & C Ward Tertiary Mental Health IHA

  31. How to start a movement Leadership Lessons from Dancing Guy BJ Tunks & C Ward Tertiary Mental Health IHA

  32. BJ Tunks & C Ward Tertiary Mental Health IHA

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