Program Service Delivery

About This Handbook

Purpose

Handbook 5 describes the service delivery process for home and community care clients.

The Handbook is intended for Health and Social Service Team Members responsible for the delivery of home and community care services in First Nations and Inuit communities.

Using this Handbook

This Handbook is a guide. It provides suggestions and possible approaches to delivering the essential services of the First Nations and Inuit Home and Community Care Program from the time a client is referred, assessed and admitted to the program to the planning and delivery of care to discharge planning. The Handbook also discusses, in general terms, the essential services of program reporting, monitoring and data collection. Further elaboration and detail on the last topics will be covered in Handbook 6 - Evaluation.

Many of the suggestions and ideas documented in the Handbook come from individuals with hands on experience in delivering home and community care services in First Nations and Inuit communities. Select the suggestions in the Handbook that reflect the values of your community and that are the most appropriate for meeting your community's particular needs.

Other Supporting Material and Useful Reference Tools

Earlier in 2000, a joint First Nations/Inuit/Health Canada Working Group oversaw the development of Standards and Policies Template Manuals for the First Nations and Inuit Home and Community Care Program. The Manuals are intended to serve as a resource for communities to develop their home and community care programs and to support service delivery. The content of the two manuals is summarized in Appendix A. The Manuals are available on the First Nations and Inuit Health Branch Web Site and are available in CD-ROM and hard copy format through regional First Nations and Inuit Health Branch offices.

A Bulletin Board for the Home and Community Care Program has also been created and can be accessed through the First Nations and Inuit Health Branch Web Site. The Bulletin Board is intended to help facilitate in the sharing of program planning and development amongst programs, including feedback discussions regarding the barriers, challenges and successes experienced by the First Nations and Inuit Home and Community Care workers, leaders, regional and national representatives.

The Bulletin Board allows users to share information regarding their community based home care program and enables them to attach files to their messages so other users can download them, ask questions, and post tips and suggestions.

Introduction

Throughout the Handbook, reference is made to Vision, Philosophy and Mission Statements. These statements are the essence of what your Home and Community Care Program represents and generally guide decisions on home and community care service delivery. It is therefore recommended that the suggestions for service delivery outlined in this Handbook be applied within the context of your Program's Vision, Philosophy and Mission Statements.

For a successful program, it is important that the community leadership not only approve the Statements but truly understand and support them. They should also be communicated on a regular and ongoing basis to community members. If you have not developed Vision, Philosophy and Mission Statements for your program, please refer to Handbook 1 - Getting Started for examples.

Health care has changed dramatically in the past decade -- a trend that is likely to continue. Your Home and Community Care Program and service delivery process will need to remain flexible so that they are able to respond to these changes and to the changing needs of your community and its members.

The goal of Program Service Delivery is to allow clients to remain at home as long as possible. In order to achieve this, the necessary services to assist clients and families need to be provided in a safe, coordinated and efficient manner based on client need, while maximizing all resources.