Module 4: OCAN Training

1. Module 4:OCAN Training

2. Objectives • How to accurately rate “need” and “help” in the Full OCAN • “Outputs” - Information to support your work with consumers: • Summary of Actions • Summary of Referrals • OCAN Software Generated Reports • OCAN Aggregate Reports • Final Tips and Experiences from HSP organizations Increase understanding about:

3. Reviewing Homework: Completing The Staff Assessment Mock Client: Mike OCAN Lead: Lorraine Materials: Full OCAN User Activities • Assessment conversation scriptpgs. 24-28 • Mike’s partially completed OCAN • Completed self assessment pgs. 31-34 • Partially completed staff assessment pgs. 36-51 * The mock scenario is for training purposes and doesn’t give you the kind of detail you would likely get in a real situation. With the information there, select the ratings that fits best

4. Reviewing Mike’s Mock Assessment

5. Module 4 Training Materials Reports Resources: • Software Generated Report Examples • Software Generated Report Specifications Quality Improvement Resources: • OCAN Quality Toolkit • Strategies to Support OCAN Quality and Use

6. Reassessment

7. Reassessment • A “Reassessment” OCAN is completed every 6 months by the OCAN Lead – This is referred to as the Reassessment Cycle • Taking a step back from the day to day work and doing a periodic review with clients (sharing feedback) improves outcomes* *Carina K et al (2009) Effect of feedback of treatment outcome in specialist mental healthcare: meta-analysis, British Journal of Psychiatry, 195, 15–22.

8. Reassessment Many reasons can cause an increase in consumer identified unmet needs from assessment to reassessment including: • consumer’s perceived decline in some areas • consumer’s journey of recovery allows them to identify different or new unmet needs (sign of progress)

9. Approaches to OCAN Reassessment Presented By: Sondra Urquhart sondra.urquhart@shipshey.ca 2017 Supportive Housing In Peel

10. Process of Reassessment with a Client • Refer to information in the previous OCAN to guide the reassessment conversation • The components primarily reviewed are the: • Summary of Actions – discuss accomplishments and next steps • The consumer self assessment – Refer to last self assessment and ask “What needs have changed” Supportive Housing In Peel ׀Approaches to OCAN

11. OutputsMaking OCAN Useful • Summary of Actions • Summary of Referrals • Reports

12. OCAN is completed - Now What? Making OCAN information useful • Information in the OCAN can assist in: • prioritizing actions • determining referrals • informing client driven service plans • highlighting accomplishments • supporting intentional, action oriented work to help clients achieve their goals

13. Summary of Actions • At the end of the assessment, all actions documented will be automatically listed in a chart • Review Summary of Actions with your client • Have your client determine the priority • Priorities need to be entered manually • Use the Summary of Actions in your work: • Informs your client’s service/goal plan • Refer to the domain and action you’re focusing on each client meeting Client Driven Care 1

14. Summary of Referrals • At the end of the assessment, referrals and the current status of the referral can be documented in this chart • An outcome of the Summary of Referrals is the identification of gaps in service

15. OCAN Reports

16. HSP Standardized Reports HSP Reports: 1. Software generated: • 4 reports generated within the HSP’s own software • CCIM developed the software specifications for 4 reports • Reports are built into HSP’s source system 2. IAR generated: • 6 IAR standardized reports generated from aggregate OCAN data uploaded to the Integrated Assessment Record (IAR) *HSP reports can be used to inform direct service delivery, strategic planning decisions and quality improvement strategies * Transition to OCAN 3.0: There will be a delay in reports as CCIM does the report development work

17. Software Generated Report: Needs Over Time • Report about an individual client to be used as a tool for review • Shows changes in needs over time to review with client and staff team • Time frame and domains are selected to generate a tailored report • Identifies progress: converting unmet need to met need or no need • Shows domains that remain an unmet need • Identifies new unmet needs to focus on

18. Experience Using ReportsAlpha Court Community Mental Health and Addiction Services Nicole Latour nlatour@alphacourt.ca 18

19. Client scenario • Client started attending post secondary institution. Over a few months of being in school, she started to express feelings of inadequacy • Client had difficulty identifying her strengths and accomplishments • Worker would verbally tell the client her strengths and the gains she had made; however, the impact was greater with a review of the OCAN (tangible, measureable)

20. Software Generated Reports Walk through of Reports Reference Materials 1. Software Generated Report Examples 2. Software Generated Reports Specifications: e.g. Staff Workload Reports: “Additional functionalities that are not part of the core requirement of this report/view can be added to the view to improve the user experience”

21. OCAN IAR Standardized Report • What do the reports contain? • De-identified aggregate data - no personal health information • The most recent OCAN of every consumer that has been active in your HSP within the previous 12 months (with the exception of Report #6 – refer to slide 20) • This provides a recent picture of your HSP’s client population • The report does NOT contain all of the OCANs submitted to IAR because it only includes one OCAN per client • Reports #1-3: represents total client population of the HSP • Reports #4-6: broken down by functional centre

22. Questions OCAN Reports can Help Answer • What are the most prevalent areas of need for the client population we serve? • What service activities should we focus on? • Is the service we provide contributing to positive outcomes for consumers? • Are we using a client-centred approach? • Is the information going into OCAN accurate? • How many clients are living in hostels and shelters?

23. Report #1: Aggregated Assessment Response What percentage of consumers have a family doctor? 53% *HSP can set a target and measure progress e.g. increase percentage to 65% by 2016 What is the most common presenting issue reported among my organization’s client population? specific symptom of serious mental illness? = 43%

24. Report #1: Aggregated Assessment Response What is the most common medical condition reported among my organization’s client population? Arthritis = 17% What services are we offering or linking with to help address this identified physical health issue?

25. Report #2B – Need Analysis-Most Recent Staff Assessment of Unmet Need Focus Service Planning on Identified Unmet Needs • Developed groups partnering with the Chronic Disease Programto address both domains • Examples: Community Kitchen and Walking Group with health teaching as a component. • We do not use #2A: • difficulty with getting self assessments completed • Two of the highest areas of unmet need • daytime activities and physical health e.g. diabetes, complications from smoking

26. Report #3: Need Agreement • Is the overall level of agreement in the moderate to high range? Yes • Are there domains with low alignment that should be explored? No

27. Report #4: Need Analysis – Met & Unmet Needs • What are the domains in this functional centre where the consumers we serve have identified the most need? (combined unmet and met need) • psychological distress, daytime activities and physical health • What are the implications for programming and training? • psychiatrist provided training for staff on symptoms related to specific mental illnesses as well as best practices to address symptoms

28. Report #6: Change in Unmet Need Over Time • What does report #6 contain? • The number of consumer OCAN sets • OCAN set: two assessments of the same individual at different stages along their assessment cycle • The two assessments are the “most recent” OCAN and the “previous” OCAN six months earlier • This report includes OCANs that have been submitted over the past 17 months

29. Report #6 Change in Unmet Need • Accommodation • 100% progress - conversion from unmet need to met need and no need • Looking After The Home • Highlights that there has been conversion from unmet to met need - 67% • CM service has helped clients address this need • Daytime Activities • Highlights that the conversion from unmet need to met need is low -14% • Identifies an area to monitor and explore service planning activities • HSP can set a target and measure progress. e.g. increase percentage to 40% by 2016 *Note: numbers in this example are low

30. Tips and Experiences of HSP Organizations

31. Let’s Debunk the Myths* • OCAN is for data collection only and has no clinical value • OCAN takes clinicians away from direct service • No one ever looks at the OCAN – it goes into a black hole OCAN If this is how you feel, something has to change *Jennifer Berger, Canadian Institute for Health Information

32. There’s a better way *Dr. Val Ulstad, Adaptive Leadership

33. You have the Power to Change! Take a step back, reflect and adjust your approach to using OCAN that is more recovery focused

34. Tips for using OCAN • The main purpose of OCAN is to enhance conversations • Have the conversation and document the important pieces of information using the “template” of OCAN • “Unknowns” are OK • Use an approach that: • Is guided by the client • Fits your style of practice • Respects the diversity of people’s needs and is culturally responsive • Aligns with the context of the service

35. OCAN: Continuous Quality Improvement

36. Strategies to use OCAN in the work • Determine ways to use OCAN so it becomes a tool that supports your practice • Here are some examples of what other HSPs have done

37. Strategies • Use OCAN to structure and guide team meetings • Action items generated from OCANs are provided as part of the client case transfer to appropriate service • Use OCAN information to develop actions and regularly review progress to maximize clinical utility of the tool • Utilize software generated OCAN Reports to enable you to review changes in need over time with clients and support decisions that have a positive impact

38. Sharing Client and Clinician Perspectives using OCAN Compare self and staff assessments • A guide for the person with lived experience and the clinician to share their ideas • Use variances as an opportunity to discuss recovery goals Client highlights their priority recovery goal • e.g. To live independently Clinician links this with other goals that the client may not have identified • e.g. To develop skills in order to successfully live independently: cooking, cleaning, budgeting CMHA Toronto 38

39. Tips for staying on track with OCAN • Ensure clinical value of OCAN by using the information – recovery focused • Clinical decisions based on information – using data • Reminders – Alerts/schedules so staff know when OCANs are due • Monitoring - audits • Train new staff • Provide refresher training & mentoring • Use in quality improvement CMHA Toronto 39

40. Key Tips for Success • Approach to using OCAN that supports the direct service work • Emphasis on client perspective captured in OCAN • Reminders – Alerts/schedules so staff know when OCANs are due • Monitoring - audits • Train new staff • Ongoing Refresher Training for staff: e.g. have team work together to complete an OCAN on a client known to whole team. • Train once and hope for the best doesn’t work • Use OCAN in quality improvement • Getting Buy In at every level of the organization • OCAN mentors to do “on the job” training and support • OCAN committee or agenda item on an existing committees

41. Service Provider VideoMelody Wootton

42. Questions?