Redesign of VCH Allied Health Professional Leadership - Health

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					Redesign of VCH Allied Health
  Professional Leadership
          Staff Forums
         Aug 8 - 12, 2011

                     Susan Wannamaker
                     Jo Clark
                     Judith Bowen
• Role of Professional Practice Leadership
• Driving Forces for Redesign
• Why a Regional Structure for Allied Leadership
    – Vision
•   Overview of Current State
•   Characteristics of Redesign
•   Project Leadership, Proposed Timelines
•   Next Steps
             Role of
Professional Practice Leadership
               Clinical innovation, patient safety and
               • Ensure all clinicians are licensed
                 and qualified
               • Ensure compliance with legislation and
                 regulatory body standards, limits and
               • Support ongoing clinical competency
               • Support advanced practice competency
               • Support implementation of evolving
                 evidence based practice
               • Development and implementation of
                 practice guidelines, protocols and alerts
               • Ensure safe roll out and use of
                 changing clinical equipment and supplies
               • Input to staffing models, workforce
                  forecasting and planning
        Driving Forces for Redesign
• The current allied health practice leadership structure is patched
  together from resourced (acute care facilities) to unresourced areas
  (community and rural health)
• No regional structure for allied health leadership
• Allied health professional leadership structure has not been
  reviewed or restructured since the development of the health
  authority in 2002
• The historical leadership structure has been driven by dated
  language in the collective agreement
• It functions on consultation and consensus, with ‘committees’ that do
  not have full jurisdiction for all practitioners across the health
• Patients, clients and residents do not receive consistent and
  equitable services across the health authority
 Why a Regional Structure for Allied
        Health Leadership
A Regional Allied Health Structure will provide:
• Equitable access to the highest level of quality and care across VCH
• Accountability, consistent standards of care
• Alignment of local, regional, provincial and academic strategies and
   plans and human resource planning
• Education capacity as well as academic and leadership
• Innovation and people focus
• Smoothing of practice resources across primary, home and
   community, acute, rehabilitation and residential care settings across
   urban to rural and remote
• Cost efficiency
        Vision for Allied Leadership
• Regional allied health leadership framework will provide for access
  to equitable care, standardized, safe, evidence-based interventions,
  innovation and quality
• Construction of an overall model of service that is based on a VCH-
  wide framework of leadership for all the allied health professions
• Achieve HSPBA Association engagement
             Allied Health Professions
                (Excluding Lab, Pharmacy and DI)

•   Occupational Therapy (284 Fte)   • Speech-Language
•   Physiotherapy (249 Fte)              Pathology (62 Fte)
                                     •   Recreation Therapy (26 Fte)
•   Social Work (172 Fte)
                                     •   Psychology (18 Fte)
•   Respiratory Therapy (123 Fte)    •   Audiology (15 Fte)
•   Dietetics (89 Fte)               •   Spiritual Care (6 Fte)
                                     •   Music Therapy (5 Fte)

    All clinical and practice leadership positions
                are included in contract
CURRENT STATE - Allied Health Practice Support
    Variation Across the Health Authority
       Characteristics of Redesign
 •   Early union engagement
 •   Transparent with frequent communication
 •   Data and discussion inform decision-making
 •   Includes standard ways of working together
 •   Is an inclusive process that engages all levels of the organization and
 • People focused: a) Patient – safety, quality and equity in consistent,
   standardized and evidence based allied health services; b) Staff –
   practice support, competency development and education
 • Redistribution of practice support positions to provide representation and
   clinical guidance across the continuum of care (home and community
   care, acute, rehabilitation, residential, rural)
 • Promotes active participation and contribution in design
 • Cost effective
                                         Process Steps

 to include
  the union

                         • Surveys – incumbents & cost center managers
                         • Focus Groups - clinician reps
         Working Group                                     Working Group                   Working Group
         Session 1                                         Session 2                       Session 3

         Review vision and purpose, changes in             Review staff information,       Review alternatives for
         practice environments, patient priority           Identify themes and areas for   regional model and identify a
         interventions, equity and access to service       improvement                     preferred model to submit to
         Information, Identify themes and areas for                                        the Executive Leadership
         improvement                                                                       Committee
 Allied Health Redesign Leadership
         and Project Teams
       Executive Leadership Team
 CNO and Executive lead for Professional Practice,     Leadership and infrastructure support to
  VP HR, Regional Allied Health Practice Director,     overall initiative. Final decisions related to
Director - Employee Relations, Director, Recruitment   regional allied health model.
      & Compensation/Classification Services

                                                       Working with Project Manager, plan and
 Project Team - Steering Committee                     lead data collection, facilitate Project and
 Project Manager, Regional Allied Health Practice      Working Group sessions, analyze data,
 Director, Director - Employee Relations, Director,    provide leadership during Working Group
    Recruitment & Compensation/Classification          sessions, coach and mentor, summarize
      Services, HR Advisor, Compensation &             recommendations, draft model to go to
 Classification Lead, Finance, Business Support        Executive Leadership Team, develop
                  Lead – HR Data                       implementation and communication plan

               Working Group                           Identify themes and areas of improvement
Project Team, Operations Directors and Managers,       based on data, make recommendations to
           Practice Leader Reps, Union                 inform future model, review draft model and
                                                       provide input, champion change
        Proposed Timeline – Phase 1 & 2
PHASE 1 – Set Up
June 2011
Achieve HSPBA Association engagement and agreement to participate
Formulate Project Team
Hire project manager
Formulate Working Group
Confirm data collection sources and strategies
                                                          Sept 2011
       PHASE 2- Occupational Therapy and Physiotherapy
     Working Group Session 1 – review vision, patient information, ideal practice journey & identify themes and areas for
                              July – Sept 2011
     Working Group data collection
     Project Team - Session 2 - review information from surveys and focus groups & identify themes and areas for
     Project Team - summarize recommendations and draft potential models
     Union and management meet to review draft models
                                                       October 2011
          Working Group Session3 - Review draft models and provide recommendatyios
          Project Team - draft model to go to Executive Leadership Team
          Executive Leadership Team – Confirms final decision regarding model
          Union and management meet to review final model
          Working Group – Final model communicated, implementation and communication discussed
                                                          Nov 2011
               Project Team - develops implementation and communication plan
               Project Team – determines implementation with the union
               Communication plan rolls out
                                                                        Dec 2011 – Jan 2012
                                                       Implementation and Communication
           Timeline – Phase 3 & 4

PHASE 3- Respiratory Therapy and Social Work
Timeline to Be Determined
Data collection, analysis, leadership model development
within existing framework, communication and implementation

            PHASE 4- All Remaining Allied Professions
            Timeline to Be Determined
            Data collection, analysis, leadership model development
            within existing framework, communication and
                  Benefit of Redesign
• Patient, staff, practice and operations-centered approach to provide:
    – equity in nature/position and quality of allied health services across VCH
    – equity in access to practice support and education for all allied health
• Establishment of lean, consistent practice leadership structure
  through collaboration and engagement of HAS, BCGEU and CUPE
  with practice and clinical operations
• Redistribution of practice support positions to support all sectors and
  jurisdictions (acute, community, residential, rural)
• Reinvestment in front line clinical services addressing known gaps
  in access to care through redesign
• Retainment of our staff as valued members of VCH team; FTEs will
  not be reduced; plan to:
    – reassign to regional responsibilities
    – maintain clinical positions intact with decrease to appropriate grade
              Next Steps

• Allied Health Staff Forums (August)
• Surveys - Grade 3 – 6 PT and OT and
  managers of those cost centers (Aug-
• Focus Groups – Clinician Reps (Aug-
• Working Group sessions – stakeholder
  input (Sept – Oct)

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