First Nations and Inuit Home and Community Care Standards Template Manual
Introduction
Use of the Manuals
Development Process of the Template Manuals
The standards and policies templates, which appear in these First Nations
and Inuit Home and Community Care Program Standards and Policies
Template Manuals, have been developed with the assistance, input and
direction of the Working Group for Standards, Scope of Practice, Liability
and Training. This Working Group then provided its recommendation and
a copy of the draft standards and policies template manuals to the
National Steering Committee for their review and approval. A list of the
Working Group members appears at the end of this introduction.
In addition to the direction provided directly by the Working Group and
the Committee, input from First Nations and Inuit communities was sought
during the development of the manuals. This input provided feedback
from the perspective of those who will be using the manuals, and with the
fresh eyes of people who were not involved in the manuals'
development.
The manuals have been created as living documents. They should be
revisited and revised on an ongoing basis, and it is hoped that First
Nations and Inuit communities will share their own customized standards
and policies to enlarge the pool of information, examples and tools to
support the success of the First Nations and Inuit Home and Community
Care Program.
Intent of the Template Manuals
These First Nations and Inuit Home and Community Care Program
Standards and Policies Template Manuals provide examples and
templates on which local communities can build their own standards and
policies manuals. The manuals are intended to be used as tools to
support the development of customized standards and policies to
address the specific needs of each community and its First Nations and
Inuit Home and Community Care Program.
The manuals do not reflect mandatory practice. Instead they are building
blocks, or a starting point, that communities can use to help them in the
process of creating their own tools for their individual Programs and
community needs.
Graphic from Resource Kit
Suggested Use of the Manuals
It is suggested that the manuals be used during the development of your
community's First Nations and Inuit Home and Community Care Program
to help you more easily develop standards and policies to shape the
procedures and tools you will need for a successful Program. You may
choose to use these templates for a while before modifying them to more
effectively meet your own Program and community needs.
These templates and the customized standards, policies, procedures and
tools that you create will serve as guidelines for staff to ensure:
- Quality
- Client and family satisfaction
- Work satisfaction
- Fairness
- Sustainability and effectiveness of your Program
These tools will also support ongoing capacity building and help in the
regular evaluation and ongoing improvement of the Program.
It is suggested that the standards, policies and procedures that your
community uses should be reviewed every year. These template manuals
can be used as a resource during this process. They can provide useful
suggestions as to how your existing standards and policies might be
revised and improved to meet the changing needs in your community
and in your Program.
It is important to note that standards and policy development is an
ongoing activity that will make the actual delivery of Program services
much easier, more consistent and efficient, and with the assurance of
quality, fairness and client satisfaction.
As well, these standards and policies template manuals will be helpful if
you choose to participate in the accreditation process in the future.
Notes When Using the Manuals
To make the manuals easier to use, a number of features have been
included in their design:
- Cross references of policies to related standards
- Use of symbols to quickly and easily reference standards and
policies sections (the symbols used here are only examples and
communities are encouraged to create and/or select symbols that
reflect their community and its Program). Another way to provide
easy reference is to colour code each section of the manuals.
- A comprehensive glossary which appears at the back of each
manual to provide definitions of key words that are identified by
italics throughout the manual
- A listing of references which also appears at the back of each
manual to provide additional resources to help you in developing
your own standards, policies and procedures
- A flow chart that visually describes the contents of the two manuals
and how the materials, including suggested procedures, link
- References to sample tools that can be used as examples on which
to build customized tools to support policies and procedures
An Explanation of the Formats Used for the Standard and Policy
Templates
The various parts of the format used for the standard and policy templates
are explained on the following pages. You may want to read them
before reading the standards and policies templates so that you have a
better understanding of the flow of each format and the purpose of each
section within these formats.
Symbol for easy
reference to main
standards sections
(communities can
customize symbols)
An Explanation of the Format Used for the Standards Template
First Nations and Inuit
Home and Community Care Program
Standards Template Manual
Community
Logo
Section : Refers to major heading in the manual, for reference to
related standards
Community
Name
Standard: Provides specific standard name
Standard
Number: XXXX
Approval:
A signature (or signatures) here will
confirm that this standard has been
reviewed and approved, and is to
be used. These signatures reflect
the review process and include
community leadership.
Date:
This date helps you to be sure that this is
the most recent version of the standard
Standard
This text provides the key statement of the standard. The rest of the
information that you will find in the template builds and supports this
key statement.
Process Steps
This section provides suggestions for activities to achieve the
standard. Not all of them may be appropriate for your program or
community; however, they should help you to identify what you
can be doing to achieve the standard.
Symbol for easy
reference to main
standards sections
(communities can
customize symbols)
Evaluative Criteria
It is important to evaluate the effectiveness of the activities to
determine if they are helping you to achieve the standard. This list
describes some suggestions to help you identify the activities that
you need.
Challenges to Consider
This section lists the challenges that you may face as you work to
achieve the standard. It is important to consider these challenges
so that you are prepared for the difficulties that may arise.
Suggested Policy References
This section lists policies that you can find in the policies template
manual to help you achieve the standard in practice. Clip art is
used to help find the related sections of the policies template
manual more easily.
Some Suggested References
In addition to the related policies, there are other materials that will
be useful in understanding and shaping this standard for your own
community's needs. These references are listed here and more
detailed information is provided at the end of each manual so that
you can find the documents you want to reference.
Review Process:
It is important to review standards
regularly to ensure that they are still
effective. As well as monitoring
how well they are being achieved,
it is important to be sure they are
updated as services and
communities' needs may be
changing. The review process
includes the participation of
community leadership.
Dates:
Recording the dates of the review
process will be a reminder to review
standards on an annual basis, or
more often if changes occur.
Symbol for easy
reference to main
policy sections
(communities can
customize symbols)
An Explanation of the Format Used for the Policies Template
First Nations and Inuit
Home and Community Care Program
Policies Template Manual
Community
Logo
Part:
Refers to major heading in the manual, for reference to
related policies
Community
Name
Policy: Provides specific policy name
Policy Number:
XXXX
Approval: A signature (or signatures) here will confirm
that this policy has been reviewed and
approved, and is to be used. These
signatures reflect the review process and
include community leadership.
Date: This date helps you to be sure that
this is the most recent version of the
policy
Policy
This text provides the key points of the policy. The rest of the
information that you will find in the template builds and supports
these key statements.
Policy Rationale
This section highlights the reason(s) for having the policy. It reflects
the related standard(s) and may, sometimes, be the actual
standard(s).
Policy Details
This section provides details about the most important part of the
policy to reinforce the message and helps to ensure the successful
application of the policy in day-to-day practices.
Symbol for easy
reference to main
policy sections
(communities can
customize symbols)
Process Guidelines
This section expands on the policy and provides information to be
considered in processes and in practice. If this information is used
as the base to build these processes, it is likely that the policy will be
achieved.
Performance Measurement Suggestions
This table offers suggested ways to determine how well the policy is
being achieved in day-to-day practice, related processes and
procedures. These measures provide a base on which to monitor
success and progress.
Related Standards
This section lists standards that will help to understand this policy,
and also uses the symbols to more easily guide you to the related
sections in the standards template manual.
Some Suggested References
In addition to the related standards, there are other materials that
will be useful in understanding and shaping this policy for your own
community's needs. These references are listed here and more
detailed information is provided at the end of each manual so that
you can find the documents you want to reference.
Review Process:
It is important to review policies
regularly to ensure that they are still
effective. As well as monitoring
how well they are being applied in
practice, it is important to be sure
they are updated as services and
communities' needs may be
changing. The review process
includes the participation of
community leadership.
Dates:
Recording the dates of the review
process will be a reminder to review
policies on an annual basis, or more
often if changes occur.
Symbol for easy
reference to main
policy sections
(communities can
customize symbols)
Each community is responsible for developing and putting in
place their own procedures. These procedures need to outline
the practical steps to be taken to carry out the process
guidelines for this policy.
Suggested Procedures
This section suggests procedures that should be used to practice
the policy described in day-to-day practice. As well, it lists
suggested tools that will help to effectively develop and use the
procedures that are recommended.
Standards and Policies
The Value of Standards and Policies
For Individuals and Families
Community members who are receiving services, or whose family
members are receiving services, are likely to feel more secure and
comfortable knowing that providers are guided in their work by standards
and policies designed to promote client rights, client satisfaction, fairness,
quality of care, appropriate training and work satisfaction.
Clients and families have the responsibility of understanding why
standards and policies are in place and how they can ensure appropriate
care, equitable access to services, and client rights.
For Communities
Communities as a whole are likely to benefit from standards and policies
that help to ensure the sustainability and effectiveness of the First Nations
and Inuit Home and Community Care Program. The standards and
policies encourage ongoing program evaluation, quality improvement,
cost effectiveness and client satisfaction. Therefore, they help to ensure
the success, sustainability and necessary capacity building to support the
First Nations and Inuit Home and Community Care Program in the future.
In addition, this experience in program development, implementation
and evaluation provides an excellent base of experience and wisdom as
the community continues to develop programs in health and other
services in the future.
Community leadership, the political body of the community, has the
responsibility of receiving, understanding, and approving the standards
and policies for the delivery of the Program. Community leadership
provides overall direction in this way, rather than becoming involved in
the day-to-day operations of the Program.
Standards and policies provide the community leadership with the tools
necessary to respond to requests and complaints from community
members. They provide the basis for decision-making and conflict
resolution.
For Program Staff
Standards, policies, procedures and tools provide clear direction and
enable Program staff to conduct their tasks and activities with
confidence, effectiveness and efficiency. In addition to improving quality
and client satisfaction, staff will likely experience greater work satisfaction.
The environment in which they work will reflect values of respect, ongoing
learning and staff development.
Program management has the responsibility of implementing the
approved policies and ensuring adherence at all times, and of
monitoring, reviewing and updating them on a regular basis. Program
staff are responsible for knowing the policies and adhering to them in their
daily activities. Both Program management and staff participate in the
review and revision of policies.
Graphic from Resource Kit
Standards, Policies and Procedures: Definitions
The following definitions from the 1999 Canadian Council on Health
Services Accreditation AIM (Achieving Improved Measurement)
Standards help to clarify and explain the differences and relationship of
standards, policies and procedures.
The Goal:
A Standard is defined as the "desired and achievable level of
performance against which actual performance can be compared".
The "What":
A Policy is "a written statement that clearly indicates the position and
values of the organization on a given subject". A policy identifies what
needs to be done to achieve the standard.
The "How":
A Procedure is a "written set of instructions that describe the approved
and recommended steps for a particular act or sequence of acts". A
procedure outlines how the policy will be carried out in day-to-day
practice.
Standards, policies and procedures must all link together to ensure
success of any program. Procedures are based on policies that enable
standards to be achieved. Procedures are the most practical, in that they
reflect the day-to-day practice that reflects the policies of the Program.
The policies template manual suggests procedures and tools that should
be developed at the practical level. The following chart identifies the
connection of standards, policies and procedures:
Background
The First Nations and Inuit Home and Community Care Program
The Federal Government is committed to improving the health and well
being of First Nations and Inuit and in February 1999 funding of the First
Nations and Inuit Home and Community Care Program was approved.
Autonomy and control of health programs and resources by local First
Nations and Inuit communities are inherent components of the planning
of this Program. The intent of the Program is to ensure that First Nations
and Inuit are provided with quality care in their own homes and
communities.
A Joint Health Canada/DIAND/First Nations/Inuit Working Group was
formed to develop a framework for the First Nations and Inuit Home and
Community Care Program. The Program is based on accepted home
care principles and is flexible and adaptable to cultural values and to the
individual needs of First Nations and Inuit communities. The need for an
increased focus on community-based home care programs and services
to support and maximize independence of First Nations and Inuit in their
own communities is an essential component of the framework.
The First Nations and Inuit Home and Community Care Program is
committed to building capacity within the communities served through
assessment and evaluation of the needs of its people and the community
as a whole. Where possible a comprehensive continuum of services will
be available in First Nations and Inuit communities.
The First Nations and Inuit Home and Community Care Program will
collaborate and partner with other providers to deliver care to clients and
families in their home setting. Where services exist, duplication of services
will not occur.
Graphic from
Resource Kit
Individuals and families will participate in care delivery, individual rights
will be respected, traditions and culture will be respected, and the client
will have the choice to accept or refuse services.
The Accountability Framework for the First Nations and Inuit Home and
Community Care Program is to be used in the development of the
standards, policy and procedure manuals for the program.
A Planning Resource Kit has been provided to each First Nations and Inuit
community to support the planning development of the First Nations and
Inuit Home and Community Care Program at the local level. To further
assist communities in the development, implementation and ongoing
evaluation of their Programs, Home and Community Care Program
Standards and Policies Template Manuals have been created.
Program Roles and Responsibilities
Communities
Communities will:
- Plan and deliver home and community care services
- Monitor and maintain the quality of services
- Ensure training requirements are met
- Maintain performance accountability to community members
and the Federal Government
- Maintain liability and malpractice insurance, delegation of
responsibility
- Collaborate with the Federal Government on the development
and maintenance of appropriate First Nations and Inuit home
and community care standards of care and practice
Federal Government
- Provide funding resources and ensure appropriate financial
arrangements with First Nations and Inuit to facilitate the
implementation and maintenance of the First Nations and Inuit
Home and Community Care Program
- Ensure that appropriate authorities have been secured for the
implementation of services
- Provide various technical, professional and capacity building
supports which are developed in collaboration with and
mutually agreed to by First Nations and Inuit
- Work in partnership with First Nations and Inuit on the
development and maintenance of appropriate First Nations and
Inuit home and community care standards of care and practice
Graphic from Resource Kit
Future Activities
Tips for Customizing Standards and Policies to Meet the Needs
of Your Community
It is suggested that you review and consider the standards and policies
templates as you develop your Program. The templates can then be
tailored for the specific needs of your community and the services your
Program will be providing.
Specific factors to think about when developing Program standards and
policies include:
- your community's infrastructure
- related programs, services and resources
- linkages with other communities
In customizing standards and policies, the following tips are
recommended:
- The process for development, review, revision and approval of
standards and policies needs to be clearly documented and
understood by everyone. The process may involve a standards and
policies committee, a home and community care advisory
committee, a health management team, or some combination so
that representation of all appropriate input is included. Community
leadership needs to be included in the process and this can occur
in a number of ways, ie as part of the team, or with a designate or
designates who can make recommendations to the leadership for
their consideration and approval.
- Include all members of the Program team in the development of
standards and policies, and their ongoing review and revision.
- Evaluate each standard and policy template as it applies to your
community and to your Program and services.
- Build flexibility into the manuals that you create so that standards
and policies can easily be moved, added and revised. For
example, the standards and policies can be kept in three-ring
binders so pages can be easily changed. Instead of page
numbering the entire document, use reference numbers for policies
and standards. You may also want to page number each of these
standards and policies, for example, policy 5.4 could be page
numbered as 5.4 page 1, 5.4 page 2, etc.
- Use symbols or colour code sections of the manuals to make
referencing easier. The symbols used in the templates are only
offered as an example, and communities are urged to select their
own symbols that better reflect each specific community and its
Program. Local artists could be invited to create the symbols, or
they may be selected from existing artwork and graphics.
- Procedures and supporting tools should be developed to reflect
practical ways of implementing and achieving the policies and
standards that you have identified.
- All standards, policies, procedures and tools should be reviewed on
an annual basis and revised, as necessary.
Preparing for Accreditation
As communities establish their individual First Nations and Inuit Home and
Community Care Programs, they may choose to participate in the
accreditation process. Accreditation will provide a measure of the
quality of the Program, and help the community to identify current
strengths and areas that may require additional effort to improve the
Program and its management.
The standards and policies template manuals have been designed to
reflect the practices that should be implemented to achieve
accreditation. It is important to consider the goal of accreditation at the
time you create your Program standards and policies. Otherwise, it may
be necessary to rework the standards and policies in the future so that
they reflect the requirements to achieve accreditation.
Members of the Working Group for Standards, Scope of
Practice, Liability and Training
Todd Armstrong Pauktuutit Ottawa, ON
Rhonda Blood Canadian Council on Health Services Accreditation Ottawa, ON
Janet Brewster Inuit Tapisariat of Canada Ottawa, ON
Elsa Cheeseman Baker Lake Hospice Baker Lake, NV
Linda Deer Kahnawake, QC
Alma Favel-King Assembly of First Nations Ottawa, ON
Deborah Greyeyes Bonnyville, AB
Mabel Horton Manitoba Keewatinowii Okimakanak Thompson, MB
Michele Landry Union of Nova Scotia Indians Sydney, NS
Donna Loft Chiefs of Ontario Marysville, ON
Francis Macklin Health Canada Winnipeg, MB
Maria MacNaughton Health Canada Ottawa, ON
Tracy Scott Anishinaabe Mino-Ayaawin Winnipeg, MB
Edna Stevens Health Canada Winnipeg, MB
Carol Trudeau North Shore Tribal Council Massey, ON
Helen Verhovsek Health Canada Ottawa, ON
Heather Young Health Canada Edmonton, AB
|
