Bette Jo Tunks RN Carol Ward MD
BCPGA ConferenceKamloops, BCApril 24, 2015
BJ Tunks & C Ward Tertiary Mental Health IHA
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
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
“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
BJ Tunks & C Ward Tertiary Mental Health IHA
P.I.E.C.E.S.™ 6th Ed.
A Model for Collaborative Care and Changing Practice
Common vision
Common language
Common approach
BJ Tunks & C Ward Tertiary Mental BJ Tunks & C Ward
Tertiary Mental Health IHABJ Tunks & C Ward
Tertiary Mental Health IHAHealth IHA
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
BJ Tunks & C Ward Tertiary Mental Health IHA
PhysicalIntellectualEmotionalCapabilitiesEnvironmentSocial
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
Individuals with complex physical, cognitive/mental health needs and behaviour changes.
BJ Tunks & C Ward Tertiary Mental Health IHA
BJ Tunks & C Ward Tertiary Mental Health IHA
BJ Tunks & C Ward Tertiary Mental Health IHA
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
BJ Tunks & C Ward Tertiary Mental Health IHA
BJ Tunks & C Ward Tertiary Mental Health IHA
Placement, Drugs and Therapy…
We Can Do Better
www.seniorsadvocatebc.ca
BJ Tunks & C Ward Tertiary Mental Health IHA
BJ Tunks & C Ward Tertiary Mental Health IHA
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
BJ Tunks & C Ward Tertiary Mental Health IHA
Drs. Donnelly/McElhaney – focus group/review of healthcare professionals/caregivers and their opinions for improving care
Acute Care ER
Person centered approach Triage
48/5 Screen for delirium
Consumer feedback Assess behaviours’ origins & follow standard approaches to management
Least restraint Caregivers
Assess and manage behaviours
Educate
BJ Tunks & C Ward Tertiary Mental Health IHA
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
E Drance & C Ward 2015
TranslatingKnowledge
Shared SolutionFinding
TeamCollaboration
ActingTogether
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
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
BJ Tunks & C Ward Tertiary Mental Health IHA
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
BJ Tunks & C Ward Tertiary Mental Health IHA
4 PrioritiesIncreasing 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
BJ Tunks & C Ward Tertiary Mental Health IHA
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
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
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 WardTertiary Mental Health IHA
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
Leadership Lessons from Dancing Guy
BJ Tunks & C Ward Tertiary Mental Health IHA
BJ Tunks & C WardTertiary Mental Health IHA
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