First Nations and Inuit Home and Community Care Standards Template Manual
Section 1: Leadership
First Nations and Inuit Home and Community Care Program
Standards Template Manual
Community Logo
Section: Leadership
Community Name
Standard: Community Needs Assessment
Standard Number: 1.1
Approval:
Date:
Standard
The health status and needs of the community(ies) served by the First Nations and Inuit Home and Community Care Program are regularly evaluated in order to plan appropriate services. This evaluation considers the Program in relation to broader population health issues.
Process Steps
Activities for assessing community need may include:
- Training staff in conducting community needs assessments and reporting findings
- Informing all concerned about the purpose of the needs assessment and its value
- Setting clear objectives of the needs assessment, and clearly defining the data to collect
- Setting timelines for conducting the needs assessment, summarizing findings, and analyzing results
- Designing an information management system for needs assessment data which is secure but easy to use and access by appropriate staff
- Establishing guiding principles for conducting needs assessment research in the community
- Documenting procedures that will be used in the needs assessment, including a description of information that will be given to people who choose to participate
- Identifying opportunities to coordinate the assessments with other research in the community
- Conducting informal interviews with randomly selected clients to identify service needs
- Conducting focus groups and meetings with randomly selected members of the community to identify service needs
- Conducting round table discussions at meetings with community leadership to identify changing community needs
- Conducting focus groups, meetings or informal interviews with other health care providers in the community to identify service needs
- Consulting with local school leaders for early detection of special needs of children
- Consulting with local housing leaders for early identification of trends that may result in changing health care needs
- Setting priorities of service needs, highlighting existing services and gaps in service availability
- Reviewing the literature and research about the determinants of health to ensure that the service focus is relevant to broader health issues
- Identifying high risk situations relevant to the community
- Tracking the trends in frequency of specific illness and disease in the community
- Tracking the trends of hospital admissions, denials, and early discharges
- Tracking trends in the demographics of the community
- Using data to make informed decisions when program planning
- Communicating findings from the needs assessment both internally within the Program, and externally
Evaluative Criteria
The success of community needs assessment initiatives may be evaluated by such criteria as:
- Conducting client satisfaction surveys
- Conducting satisfaction surveys with housing and school leaders
- Comparing the determinants of health and the community assessment activities to ensure balance
- Comparing local trends with those identified by Statistics Canada as being relevant to First Nations and Inuit Peoples
- Tracking demographic trends and health data of clients
- Completing a periodic inventory of services available in the community to identify gaps between availability and need Challenges to Consider
- Some people may not feel comfortable sharing their opinions in focus groups and other meetings, and even in individual interviews
- It can be challenging to gain trust needed for feedback
- Those most in need of services are often the ones who do not want to participate in research
- Other community health care providers may not be willing to coordinate assessment projects
- It may be difficult to raise awareness and ensure participation and understanding of the importance of a community needs assessment
Suggested Policy References
All of Part 1: The Organization
2.1 Services
2.2 Service Delivery Model
5.1 Quality Planning
All of Part 6: Operations
Some Suggested References
The First Nations and Inuit Home and Community Care Planning
Resource Kit: 1, 2, 5
Draft Liability Documents: May, introduction, section 2.2
CCHSA AIM Standards, 1999 -- Leadership and Partnerships
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives
First Nations and Inuit Regional Health Survey
DIAND population figures
Community Workload Increase System population figures
Review Process:
Dates:
First Nations and Inuit Home and Community Care Program
Standards Template Manual
Community Logo
Section: Leadership
Community Name
Standard: Development & Achievement of the Vision
Standard Number: 1.2
Approval:
Date:
Standard
The First Nations and Inuit Home and Community Care Program has
a formal process for developing its vision, involving the community
in this process, and achieving this vision in service delivery.
Process Steps
Activities for vision development include:
- Involving the community leadership, clients, staff and the
community in development of the vision
- Clearly stating the values of the Program and developing a
mission statement to guide the vision
- Understanding services that are available in the community so
that the vision can be developed to complement these services
- Considering the broader determinants of health when
developing the vision
- Obtaining signed approval for the vision and mission statements
from the community leadership
- Communicating the vision to clients, staff and the community so
that it is well understood
- Engaging those involved in the development and management
of the First Nations and Inuit Home and Community Care
Program in community activities, in order to promote the
Program's vision
- Regularly communicating the mission, vision, activities and
decisions of the Program with clients, staff and the community
Evaluative Criteria
The First Nations and Inuit Home and Community Care Program
evaluates success in achieving the vision by:
- Conducting client satisfaction surveys which include measures of
the vision
- Conducting meetings and focus groups with clients to discuss
their views and experiences
- Conducting staff satisfaction surveys which include measures of
the vision
- Conducting an annual review with leaders to discuss their views
and experiences relating to the Program, and to further develop
the vision
- Annually reviewing the vision and revising it as needed
- Auditing internal activities and processes to ensure the fit with
the vision
- Annually evaluating the goals of the Program to ensure a fit with
the vision
Challenges to Consider
- Literacy challenges may limit opportunities to conduct surveys
that allow people to remain unidentified
- Some people may not feel comfortable sharing their opinions in
meetings and focus groups
- Vision statements may be considered by some to lack value
Suggested Policy References
- 1.1 Mission and Vision
- 1.2 Values and Beliefs
- 1.3 Goals and Objectives
- 4.8 Performance Management
- 4.11 Orientation
- 4.16 Compensation
- 5.2 Quality Planning
- 6.4 Annual Program Summary
Some Suggested References
The First Nations and Inuit Home and Community Care Planning
Resource Kit: 1, 2
Draft Liability Documents: May, section 17; June pg 27
CCHSA AIM Standards, 1999 -- Leadership and Partnerships
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives
First Nations and Inuit Regional Health Survey
DIAND population figures
Community Workload Increase System population figures
Review Process:
Dates:
First Nations and Inuit Home and Community Care Program
Standards Template Manual
Community Logo
Section: Leadership
Community Name
Standard: Capacity Building
Standard Number: 1.3
Approval:
Date:
Standard
The First Nations and Inuit Home and Community Care Program is committed to capacity building both with the Program and in the community. By building local capacities, the Program will establish and sustain quality services in the community.
Process Steps
Activities for capacity building may include:
- Designing and obtaining the community leadership's approval of an organizational structure with clear lines of accountability, responsibility and decision-making authority at every level
- Implementing conflict resolution and decision making processes
- Ensuring that the Program leadership is made up of individuals who are representative of the diversity in the community
- Documenting clearly defined roles and responsibilities at all levels of the Program and communicating this to staff, clients, families and local partners
- Developing mission, vision and value statements with input from clients, families and the community to ensure a good fit with local values
- Developing clear Program goals that fit with the local continuum of care
- Matching the mission, vision, values, and Program goals with community needs
- Communicating the mission, vision, values and goals, both with the Program and with the community, so that they are well understood
- Planning services and designing processes that are consistent with the Program's values and goals
- Using a clear process for developing and carrying out operational plans that fit with the Program's mission, vision, and goals
- Developing a culture of continuous quality improvement
- Working with the community to provide a continuum of services that address the known determinants of health
- Implementing a thorough orientation program for Program staff, Program leadership and community leaders
- Implementing a performance evaluation process for staff and Program leadership, and taking timely action to address performance concerns
- Allocating resources for capacity building at all levels of the Program organization, such as education, training, skill development
- Allocating resources for capacity building in the community through collaboration and consultation with other providers and other communities
- Developing a library of relevant resources and contacts for the Program
- Sharing knowledge and lessons learned in Program development, service delivery and management with other First Nations and Inuit communities
- Sharing resources such as consultants or workshop facilitation costs with other communities
- Supporting and encouraging staff who are interested in furthering their knowledge and skill development
- Following all relevant legislation as changes occur
- Collaborating with other First Nations and Inuit communities in research and information sharing
- Communicating with clients, families and the community about Program services, and local improvements in home and community care service delivery
- Conducting regular community needs assessments to ensure the value and fit of services, mission and goals of the Program
- Engaging clients, families and the community in key Program decision making
- Engaging in local fundraising for the Program, as appropriate
- Maintaining buildings and the physical environment to ensure the safety and well-being of staff, clients, families and the community
- Collaborating with the community to protect its natural resources and improve the working environment
- Working with local programs, organizations and other resources to promote health and well-being in our communities
- Implementing staff recruitment and retention initiatives into the human resources plan
- Recognizing that the most valuable resource is Program staff and their development, support and skill building is vital to the success of the Program and to the community's ongoing development
- Encouraging staff to improve their skills and knowledge by developing their sense of pride and desire and through incentives
Evaluative Criteria
The First Nations and Inuit Home and Community Care Programevaluates its success in capacity building by:
- Regularly reviewing the mission, vision and value statements and revised them as needed
- Annually reviewing the Program goals, and evaluating if they have been achieved
- Using information from a variety of sources, including risk management reports, financial reports, client satisfaction surveys and comments, and clinical outcome reports, to determine if there is a need to modify strategy
- Modifying Program goals as needed, in light of changing community needs and the known determinants of health
- Regularly reviewing the scope of roles and responsibilities of staff to ensure a good fit with Program goals
- Reviewing orientation processes and modifying them as needed
- Reviewing policies to ensure a good fit with legislation and the Program's values
- Talking to staff to find out if they are satisfied with the opportunities for learning and growth
- Talking to clients, families and the community (including other providers) to find out if they are aware of the Program's services, are confident with the services, and are satisfied with the Program's responsiveness to community needs
- Keeping an inventory of publications, useful contacts, educational opportunities and other resources
- Measuring the successfulness of staff education and Program leadership education initiatives
- Keeping up-to-date with and understanding changing legislation
- Tracking fundraising successes
- Tracking the success of recruitment and retention initiatives
- Tracking staff education, skills and development
Challenges to Consider
- Capacity building takes careful planning, time and resources
- It can be difficult to recruit and retain staff in rural and remote areas, especially those with special skills who are in high demand
- Funding support for capacity building initiatives can be challenging
Suggested Policy References
- 1.1 Mission and Vision
- 1.2 Values and Beliefs
- 1.3 Goals and Objectives
- 1.4 Organizational Structure
- 4.1 Equal Opportunity
- 4.5 Recruitment
- 4.6 Hiring
- 4.7 Performance Management
- 4.11 Orientation
- 4.13 Employee Relations
- 5.3 Quality Improvement
- 6.1 Program Management
- 6.4 Annual Program Summary
Some Suggested References
The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 1, 2
Draft Liability Documents: May, sections 1.3.4, 2.3, 2.4; June, pgs 30- 31
Review Process:
Dates:
First Nations and Inuit Home and Community Care Program
Standards Template Manual
Community Logo
Section: Leadership
Community Name
Standard: Resource Management
Standard Number: 1.4
Approval:
Date:
Standard
The First Nations and Inuit Home and Community Care Program manages financial, human and physical resources efficiently to serve the community in the most dependable, effective way.
Process Steps
Activities for effective resource management may include:
- Implementing a sound and secure documentation process for budgets
- Using information from a variety of sources (e.g. community needs assessment, finance, human resources, quality, clinical outcomes) to make resource allocation and budgeting decisions
- Using community input and community needs assessment information to project future service needs and resources
- Identifying resource gaps that may limit ability to meet future needs
- Ensuring resource allocation fits with planning priorities and the Program mission, vision and goals
- Assessing costs before making changes to the services offered
- Engaging the Program leadership and management in an annual budget review and planning process for capital and operations
- Using staff input when reviewing budgets
- Engaging staff at all levels of the organization in ongoing variance analysis, and modifying spending to meet budgetary targets
- Understanding the impact of investment choices on the community, and making responsible investment decisions in the best interests the community
- Regularly monitoring results of investments made by Program leadership and management and ensuring good stewardship with Program funds and any surpluses
- Fundraising, when appropriate
- Following relevant legislation as changes occur
- Working with community leadership to plan and coordinate resource allocation in the community
- Partnering with other programs and other communities, whenever possible and appropriate, to share costs
Evaluative Criteria
The First Nations and Inuit Home and Community Care Program evaluates the success of resource management initiatives by:
- Measuring the costs and benefits of services
- Obtaining client and community feedback on their satisfaction with the types of services offered by the Program and the way resources are allocated
- Ongoing discussions with other programs in the community, including those outside the health care sector, to find out if the Program is seen as being responsive to community needs
- Tracking surpluses and losses and identifying trends to improve Challenges to Consider
- Decisions to set priorities of resource allocation are difficult when resources are limited
- Fundraising may not be appropriate
Suggested Policy References
- 1.5 Mission and Vision
- 1.6 Values and Beliefs
- 1.7 Goals and Objectives
- 4.5 Recruitment
- 4.6 Hiring
- 4.12 Orientation
- 4.13 Training and Development
- 5.2 Quality Monitoring
- 5.4 Risk Management
- 6.1 Program Management
- 6.5 Financial Management
Some Suggested References
The First Nations and Inuit Home and Community Care Planning Resource Kit: Program Criteria, 3A, 4
Draft Liability Documents: May, section 2.6
CCHSA AIM Standards, 1999 -- Human Resources, Environment
CCHSA Draft Quality Dimensions & Descriptors, 1998
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives
Review Process:
Dates:
First Nations and Inuit Home and Community Care Program
Standards Template Manual
Community Logo
Section: Leadership
Community Name
Standard: Contract Management
Standard Number: 1.5
Approval:
Date:
Standard
The First Nations and Inuit Home and Community Care Program engages in ethical and legally sound management of contracts. Process Steps
Activities for ethical and legally sound contract management may include:
- Using contracts whenever purchasing services for the Program or selling the Program's services, research or knowledge
- Implementing processes for establishing a service contract which include a thorough review of the partner(s), the contract, and the potential risks
- Including in all contracts the following: signatures, statements of liability, responsibilities, and an evaluation plan
- Addressing potential risks before signing contracts, and including the evaluation of risk issues in contracts
- Ensuring that those who contract with the Program operate in a way that has the best interests of our community in mind
- Ensuring that those who contract with the Program understand and value the Program's mission, vision and values
- Ensuring that contracts do not involve conflict of interest between organizations or individuals
- Negotiating all contract agreements with the community's best interests in mind
- Updating contracts when changes occur or as needed
- Having a clear process to monitor contracts in an ongoing way
- Implementing a process for addressing service-related contract disputes or failure to meet contract obligations
- Working with service contract partners to evaluate services and implement quality improvement initiatives
- Implementing a process for evaluating research proposals that includes consideration of the research design, ethics, benefits, risks, and qualifications of the researchers
- Ensuring that research contracts respect client rights, including privacy and confidentiality
- Establishing clear guidelines for student placements and research initiatives
- Clearly defining access to information by students and researchers, and the consequences for not complying to these guidelines
- Implementing a process for staff, clients and the community to express concerns about research and education contracts
- Working with education partners to ensure that adequate resources and supervision have been provided to students
Evaluative Criteria
The First Nations and Inuit Home and Community Care Program evaluates contract management initiatives by:
- Regularly reviewing contracts to ensure that they continue to reflect the service arrangement
- Monitoring the services provided or purchased to ensure that they continue to meet contract obligations
- Regularly reviewing research initiatives to ensure that contract obligations are being met
- Meeting regularly with those involved in education initiatives to ensure contract obligations are being met
- Meeting with contract partners regularly to find out if they are satisfied with contract management processes and service, research or education progress
Challenges to Consider
- The number of contracts that can be effectively managed may be limited by availability of staff to do this function
- Clients may be hesitant to participate in research and education initiatives and their rights must be respected
- Expert legal advice, which may be needed when negotiating contracts, can be costly and difficult to obtain in rural and remote areas
Suggested Policy References
- 2.2 Service Delivery Model
- 4.15 Conflict of Interest
- 5.3 Quality Monitoring
- 5.4 Risk Management
- 6.5 Financial Management
- 7.5 Liability Protection
Some Suggested References
The First Nations and Inuit Home and Community Care Planning Resource Kit: 1, 3A, 4
Draft Liability Documents: May, sections 4.9, 4.10, 4.12, 4.13, 4.14; June, pgs 30-33
CCHSA AIM Standards, 1999 -- Leadership and Partnerships
CCHSA Draft Quality Dimensions & Descriptors, 1998
Provincial/Territorial and Federal Legislation
DIAND/FNIHB Home and Community Care Directives
Review Process:
Dates:
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