First Nations and Inuit Home and Community Care Policies Template Manual

References

The following resources are referenced in the standards and policies and may be of value as you create and revise your own documents. The list is not exhaustive and serves as a starting point. It is also valuable to link with other Programs and communities to learn more about what they have developed.

• The First Nations and Inuit Home and Community Care Draft Liability Documents
• The First Nations and Inuit Home and Community Care Planning Resource Kit
• The First Nations and Inuit Home and Community Care Website
• Bill C54, Personal Information Protection and Electronic Documents Act
• Canada Labour Code
• Canadian Council on Health Services Accreditation (CCHSA) AIM Standards, 1999
• CCHSA Draft Quality Dimensions & Descriptors, 1998
• Canadian Health Records Association, Code of Practice and Principles and Guidelines for Access to and Release of Health Information
• Canadian Institute for Health Information
• Canadian Nurses Association, National Code of Ethics
• Colleges and Universities for ethics issues in data collection
• Community Workload Increase System population figures
• CQI Network Website
• DIAND Population Figures
• DIAND/FNIHB Home and Community Care Directives
• Environmental Health and Safety Act
• Fire and Safety Act
• First Nations and Inuit Regional Health Survey
• Hazardous Products Act of Canada
• Human Resources Development Canada, Labour Sector Study in Nursing, in progress; Labour Sector Study in Home Care, pending
• International Counsel of Nurses, International Code of Nursing Ethics
• National Association for Health Care Quality, www.cphq.org
• Occupational Health and Safety Act of Canada
• Professional Standards of Practice, including those of nursing and licensed practical nursing associations, home support associations, such as the Ontario Community Support Association, and other provincial and territorial associations
• Provincial/Territorial and Federal Legislation
• Registered Nurses Act, by jurisdiction
• Rozovsky, Lorne, Canadian Law of Consent to Treatment, 2^nd edition
• Statistics Canada
• WHMIS

Glossary

Accountability:

• The responsibility for a particular outcome, service or program. Tasks within a service or program can be delegated but the responsibility cannot.

Advanced Directives:

• Also referred to as living wills, a written set of instructions given by a competent client in the event that the individual will not be able to communicate care and treatment wishes due to illness, injury or impaired cognition. Advanced directives can include instructions about financial affairs, health care, legal issues, etc.

Advocacy:

• Specific actions that show support for a client's or group's concerns.

Allocation of Resources:

• See Resource Allocation

Anonymity:

• An unknown source of information.

Auditing:

• A systematic review of processes and documentation. Audits are most often done at year-end for financial data or conducted in an ongoing way as a quality improvement activity for client data.

Benchmarks:

• Comparing the evaluative results of organizational programs and services to other programs and services (often external to the organization) that are perceived to have achieved excellence. This comparison assumes common similarities between programs and client populations.

Benefit(s):

• Additional non-salary compensation such as paid vacation, paid sick days, pension plans, etc. Benefits also include group insurance, such as medical or dental coverage.

Best Practices:

• Processes that have been proven to be very successful in achieving desired outcomes.

Care Plan:

• A written document of the interventions required to achieve a particular goal. Care plans are developed based on client assessments and the identification of needs, and are regularly evaluated to measure their success or failure.

Capital:

• Expenditures are not associated with operating costs (such as salaries, supplies). Examples of capital expenditures include the purchase of computers or office furniture. Capital is usually associated with expenditures over a particular dollar limit, ie any expenditure over $500 or $1000 dollars.

Certification(s)

• A mandatory annual membership with a professional college or association that sets the standards of practice, such as the College of Nurses.
• An internal process of education for staff to ensure knowledge and competence in performing advanced skills. This process might include a learning package, self-test, lecture, demonstration and/or return demonstration, etc.

Client Assessments:

• A systematic process to evaluate the physical, emotional, social and spiritual needs of clients. The client assessment will help determine the amount and level of care required and the goals and outcomes of service.

Client Satisfaction Surveys:

• A process to gather information on the clientA process to gather information on the client' service, and whether the service has met expectations and needs. Client surveys can be done in writing or verbally, either while the client is receiving services, or after being discharged.

Clinical Outcome(s):

• The results achieved after a particular treatment or service has been provided to a client or group of clients.

Community Needs Assessment:

• A process that gathers information to identify the characteristics and potential needs of a particular population. This information will guide the development of new programs and services. Assessments are most often done through the analysis of demographic data and surveys.

Conflict of Interest:

• Examples of conflicts of interests include activities that interfere with performance or responsibilities, solicitation or acceptance of money or gifts from clients, and competing for services provided by the organization. These conflicts place an individual in a compromising position because personal and organizational interests are not aligned.

Contract Management:

• Processes to monitor the effectiveness and the ability to achieve the terms and conditions agreed to in a particular contract. This might be done through occurrence monitoring, quarterly or annual reports, or monthly variance analysis.

Compensation:

• The amount of salary and benefits paid to an employee.

Competencies:

• The skills and knowledge necessary to fulfil the requirements of a particular position within the organization. Competencies can be clinical, managerial or administrative.

Continuity of Care/Continuum of Care:

• A seamless transition of services to meet the needs of a client or group of clients. A seamless transition is achieved through internal and external service integration and coordination.

Criteria:

• Guidelines that facilitate making a decision. For example some of the criteria for admission to the program might be valid demonstrated need, the availability of physician's orders, and a safe home environment.

Demographics:

• Data used to describe a particular community or population, such as analysis based on language, age, disease trends, income levels, etc.

Determinants of Health:

• Demographic, genetic, and other environmental factors that influence the well being of people in their community. Examples of such factors include income levels, size and characteristics of the community, education, access to services, and family history.

Discrimination:

• The unfair or inequitable treatment of one individual or group of individuals. The basis for some discriminatory practices could include age, race, or religion.

Diversity:

• Characteristics that are unique to individuals or populations, such as language, culture and religion.

Ethics:

• Guides behaviour that is morally acceptable. Used as standards of conduct for most professional organizations.

Evaluation:

• Processes used to determine the degree of success or failure of a program, service or procedure. The criteria/tools used in the evaluation are usually developed prior to initiating the program, service or procedure.

Exit Interviews:

• A face-to-face meeting between the manager and the employee at the time the employment relationship ends. This meeting is to identify reasons for leaving the organization, thus providing some information regarding strengths and areas for improvement for the organization as perceived by the terminating employee.

Focus Groups:

• Meetings conducted with select groups of people (such as clients, family caregivers, staff, community members). These meetings use a framework for guiding discussion to obtain input from the various participants regarding certain issues.

Goals:

• Statements that identify the ambitions of the organization, program, service, or individual and guide activities to achieve those ambitions. An organizational goal might be "To enhance community health care through the development of new home and community services".

Health Status:

• A measurement of the state of well being of a client, community or population that includes physical, emotional, social and spiritual needs.

Holistic:

• A philosophy of care that encompasses the physical, emotional, social and spiritual needs of clients in addition to the symptoms of a disease.

Impaired Mental Capacity:

• A predetermined condition that inhibits a person's ability to make informed decisions. Conditions that cause impaired mental capacity might be age, Alzheimer's disease, or mental illness.

Incidents:

• An occurrence or action that is considered out of the ordinary and may have a negative impact on the client, staff, community or organization. Incidents should always be measured in terms of the degree of risk.

Indicator(s):

• A measurement that can be used to determine the degree of success or failure in achieving desired outcomes. Indicators can be applied to all areas of the organization such as clinical (ie, is the wound smaller in size? ); financial (ie, travel time, km per visit, productivity); and human resources (ie, staff turnover rate ).

Informed Client Consent:

• Giving voluntary permission for a treatment or service after all details and risks of the treatment or service and the consequences of declining or refusing the treatment or service have been explained. To obtain informed consent it is assumed that the client is competent to understand the information. If the client is not competent then a substitute decision maker must be used to gain consent.

Job Descriptions:

• Detailed, written outlines of specific functions, responsibilities and reporting lines in an organization. All management, clinical and support staff require job descriptions to guide behaviour and measure performance.

Living Will:

• Also known as advanced directives, a written set of instructions given by a competent client in the event that the person becomes unable to communicate wishes due to illness, injury or impaired cognition. An example of the content of a living will might include orders not to resuscitate or use mechanical devices to prolong life.

Mission/Mission Statement:

• A written statement that identifies the customers, stakeholders and goals of the organization and guides the policy development.

Orientation:

• A process that familiarizes staff with the mission, vision, values, programs, services, policies and procedures of the organization. Orientation may include a period of time for preceptorship (the shadowing of the new employee with an experienced employee).

Performance Review/Performance Evaluation:

• A written description of the knowledge, skills and professional behaviours of the staff that includes strengths, weaknesses, and a plan for improvement. Performance reviews are most often completed annually and at the end of the probationary period.

Quality:

• The degree to which the expectations and needs of clients, staff, funders, communities, and the organization are met.

Quality Improvement:

• An organizational philosophy that guides the analysis of information to identify trends and make changes in processes/procedures. These changes enhance programs and services to meet client/community needs, reduce organizational risk, improve efficiencies and improve the work environment.

Recruitment:

• The process used to attract, inform and select qualified individuals to meet the human resource needs of the organization. Recruitment strategies include local advertising, job fairs, and referrals for existing staff and others.

Reference(s):

• A written or verbal verification of the employment and/or performance of a current or previous employee. Permission from the employee must be obtained prior to the release of any information.

Referral and Intake:

• The process of client identification and eligibility for a particular program or service.

Resource Allocation:

• The identification of the human resource needs and staff utilization. This is often stated as full time equivalents (FTEs) and includes full time and part time staff.

Retention:

• The ability of an organization to keep staff from pursuing employment elsewhere. Some retention strategies include professional development opportunities, promotions within the organization, and increased compensation related to skill level.

Risk:

• The measurement of the potential harm that may come to clients, the community, staff or the organization. Risk is most often measured as low, medium, or high.

Stewardship:

• To act on behalf of others, in this case the community, to ensure that resources, both financial and human, are used effectively and efficiently

Self-care:

• The ability of a client to safely do the tasks associated with activities of daily living and health maintenance. Such activities might be cooking, cleaning, shopping, attending appointments, as well as managing some of their own health care, such as monitoring their condition, managing their own medications, etc.

Substitute Decision Maker:

• A person identified by the client to make decisions in the event that the client lacks the ability to do this for him/herself. This process is usually confirmed in writing.

Termination:

• A process where by the employment relationship is ended due to dismissal with cause, retirement, reduction of workforce or resignation. All terminations should be done in writing.

Value/Value Statement:

• A written statement of the beliefs of an organization that guide the development of programs and services.

Variance Analysis:

• An examination of the reasons for not meeting a particular target or outcome. The results of the examination guide improvement activities.

Vision/Vision Statement:

• A written statement that provides direction for the organization and guides the development of the strategic goals.