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KNOWSLEY CARE CAMPUS WORKFORCE REDESIGN ENGAGEMENT METHODOLOGY Presented by: Julie Holland

KNOWSLEY CARE CAMPUS WORKFORCE REDESIGN ENGAGEMENT METHODOLOGY Presented by: Julie Holland Date: September 2011. Methodology. Organisation Development Services Population Centric Model for Workforce Planning (ODS 2008). Skills for Health - Competency Based Planning tools. (SfH 2011).

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KNOWSLEY CARE CAMPUS WORKFORCE REDESIGN ENGAGEMENT METHODOLOGY Presented by: Julie Holland

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  1. KNOWSLEY CARE CAMPUS WORKFORCE REDESIGN ENGAGEMENT METHODOLOGY Presented by: Julie Holland Date: September 2011

  2. Methodology • Organisation Development Services Population Centric Model for Workforce Planning (ODS 2008). • Skills for Health - Competency Based Planning tools. (SfH 2011) JH/MAY11

  3. ODS Model (ODS 2008) JH/MAY11

  4. Patient Proxy - Fred & Sonia elderly couple (80+) live in rented accommodation (private tenants) with access difficulties, and poor facilities/amenities and poor transport networks. have five children 3 very supportive 2 estranged. 1 estranged son is the landlord of their home and rent arrangements are difficult. Family dynamics are strained resulting in feuds’, and some complex financial issues. both socially isolated and lonely and have 5 pets to manage. benefit dependent. Sonia has diabetes, angina and epilepsy totally dependent on family for her care following a stroke, and is housebound. communication difficulties (speech) and depressed although mentally bright. Sonia is approaching the end of life and has chronic pain and pressure sores. She is a smoker and occasional drinker. Fred is Sonia’s main carer has rapidly declining health due to neglect. history of COPD, prostate cancer, hypertension and arthritis. struggles to care for Sonia and is often short tempered, stressed and verbally aggressive and is restricted by his wife’s immobility. Fred is an ex-smoker. 4 JH/MAY11

  5. BE PAIN FREE WOUND TO HEAL TO TALK & BE LISTENED TO MONEY WORRIES FEEL SAFE SONIA’S NEEDS WORRIED ABOUT DYING BE ABLE TO GO OUT HELP HERSELF 5 JH/MAY11

  6. HELP WITH SONIA TO BE PAIN FREE & ABLE TO BREATHE TO TALK & BE LISTENED TO MONEY WORRIES FEEL SAFE FRED’S NEEDS WORRIED ABOUT SONIA DYING BE ABLE TO GO OUT HELP WITH DOMESTIC WORK 6 JH/MAY11

  7. BE PAIN FREE HFM A2.4 HFM B1.1 HFM B14.2 HFM A2.5 HFM B3.1 HFM B15.1 HFM A2.8 HFM B4.3 HFM B15.6 HFM A2.9 WOUND TO HEAL HFM A2.4 HFM B1.1 HFM B4.3 HFM A2.5 HFM B3.1 HFM A2.8 HFM A2.9 HFM B14.2 TO TALK & BE LISTENED TO HFM 1.2 HFM C2.6 HFM 1.4 HFM 6.1 MONEY WORRIES HFM 1.5 HFM B16.4 HFM C2.4 HFM C2.6 FEEL SAFE HFM 3.5 HFM B16.4 HFM C2.4 HFM C2.6 SONIA’S NEEDS WORRIED ABOUT DYING HFM 1.5 HFM B18.1 HFM B3.1 HFM C2.6 HFM B14.2 BE ABLE TO GO OUT HFM 3.5 HFM A2.9 HFM 3.8 HFM B3.1 HFM 6.1 HFM B16.4 HFM C2.4 HELP HERSELF HFM 1.5 HFM B16.4 HFM C2.4 HFM B3.1 HFM C2.1 HFM F4.4 HFM B15.8 HFM C2.2 7 JH/MAY11

  8. HELP WITH SONIA HFM 3.8 HFM 6.1 HFM B17 HFM B2.2 HFM C2.6 HFM F4.1 HFM B4.3 HFM C2.4 TO BE PAIN FREE & ABLE TO BREATHE HFM A2.4 HFM B1.1 HFM B14.2 HFM A2.5 HFM B3.1 HFM B15.1 HFM A2.8 HFM B4.3 HFM B15.6 HFM A2.9 HFM B15.8 TO TALK & BE LISTENED TO HFM 1.2 HFM C2.6 HFM 1.4 HFM 6.1 MONEY WORRIES HFM 1.5 HFM B16.4 HFM C2.4 HFM C2.6 FEEL SAFE HFM 3.5 HFM B16.4 HFM C2.4 HFM C2.6 FRED’S NEEDS WORRIED ABOUT SONIA DYING HFM 1.5 HFM B18.1 HFM B3.1 HFM C2.6 HFM B4.3 HFM B14.2 HFM B18.3 BE ABLE TO GO OUT HFM 3.5 HFM A2.9 HFM 3.8 HFM B3.1 HFM 6.1 HFM B14.2 HELP WITH DOMESTIC WORK HFM 3.8 HFM B16.4 HFM C2.6 HFM 6.1 HFM B17 HFM C2.4 HFM A2.4 8 JH/MAY11

  9. Fred & Sonia’s Needs Competences JH/MAY11

  10. Knowsley Care Campus Data Collection & Analysis; diagnostics Entry: Critical Episode Risk Stratification New patient Joint Multi Disciplinary Meeting Single Point of Access Referrer Eligible for Active Case Management Allocate to Key worker Step Down From Active Case Management Active Case Management Pathway for Critical Episode Clinical Triage STEP2. STEP 3. STEP 4. STEP 5. STEP 1. Signpost to Other Services; other pathways Patient STEP9. STEP8. Discharged Deceased STEP 6. STEP7. • CORE WORKFORCE: • Assistant Practitioner • Community Matron • Community Staff Nurse • District Nurse • Health & Social Care Worker • Re-ablement Worker • Social Worker • Step Down • Transfer to other care pathways • Self Caring • No longer risk stratified (return to general practice for routine management Intermediate GP Care Patient Centred Care Care Co-Ordination Key Worker; Active Monitoring Effective Utilisation of Integrated Resources Promotion of Self Care/ Management Family Third Sector P Carers Direct Care Specialist Practitioners/Nurses Reablement JH/MAY11 10

  11. Fred & Sonia’s Care Campus Pathway STEP 1. Fred phones the single point of access requesting an urgent response to Sonia ‘s deteriorating health. STEP 3. Practitioner reviews Sonia’s existing electronic health records in the community. STEP 2. Urgent referral process set in motion - practitioner contact within 4 hours. STEP 8. Step down from active Case Management. Sonia & Fred remainon the District Nurse caseload to address Sonia’s pressure area needs. Urgent response- practitioner visits within 4 hours to assess and address Sonia’s urgent needs. STEP 7. Active Case Management. Assessment of Sonia & Fred’s needs, intervention, advice, information and review of health & wellbeing. STEP 4. Practitioner presents Sonia & Fred’s current health status and needs to MDT meeting – Case Management agreed . STEP 6. Key worker allocated 11 JH/MAY11

  12. Fred & Sonia’s Care Campus Competences

  13. Step Up/ Step DownTrigger points for patients to access appropriate service and support based on risk factors KNOWSLEY CARE CAMPUS WORKFORCE COMPETENCES Very High level workforce competences: 4 Skills for Health HFM B4.2 HFM B4.3 HFM B14.1 HFM B15.1 RISK STRATIFICATION = V. HIGH High level workforce competences: 17 HFM A2.2 HFM B16.4 HFM A2.3 HFM B17 HFM A2.4 HFM B18.1 HFM B14.2 HFM B18.3 HFM B15.6 HFM C2.5 HFM B15.8 C A R E C A M P U S RISK STRATIFICATION = HIGH Core workforce competences:100 HFM 1.2 HFM 4.6 HFM A2.4 HFM B3 HFM 1.4 HFM 4.7 HFM A2.5 HFM B14 HFM 1.5 HFM 5.1 HFM A2.6 HFM B16 HFM 2.1 HFM 5.2 HFM A2.8 HFM C2 HFM 2.2 HFM 6.1 HFM A2.9 HFM D2 HFM 3.5 HFM A2.1 HFM B1 HFM F4 HFM 3.8 HFM A2.3 HFM B2 CORE WORKFORCE: Assistant practitioner. Community Matron. Community Staff Nurse. District Nurse. Health & Social Care Worker. Re-ablement Worker. Social Worker. 13 JH/MAY11

  14. References ODS (2008). Organisation Development Services Population Centric Model for Workforce Planning. ODS Skills for Health (2011). Competency Based Planning Tools. SfH

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