Approach to Implementing the SMHPL in a Large Health Organization

1. Approach to Implementing the SMHPL in a Large Health Organization St. Joseph’s Health Care, London Site Liaison – Dr. Maggie Gibson Site Facilitator – Julia Horan jhoran@uwo.ca

2. Background • Located in London, ON • One of Ontario’s leading teaching hospitals • Advancing health care, education and research • Partner in London’s academic health sciences community • Publicly funded Catholic health care organization

3. Background • Owned by the St. Joseph’s Health Care Society of the Roman Catholic Diocese of London • Volunteer board of directors • 120 year legacy, advancing a ministry of compassionate, excellent service • Further information see http://www.sjhc.london.on.ca/

4. Strategy • Create one page handout to be presented to key contacts at SJHC • Included information re timeline of project, introduction to SMHPL, and 6 discussion questions • Email sent out to 5 contacts within SJHC selected by site liaison with attached handout • Set up meetings with contacts and give them a hard copy of the lens or link to online version prior to meeting

6. Discussion Questions • Have you ever heard of the SMHPL? • Are there any processes in place in terms of policy and programs where seniors’ perspectives and values are addressed? • Are there any processes in place that would benefit from the seniors’ mental health perspective? • Are you aware of any examples at SJHC where consideration of seniors' mental health issues specifically helped to shape the development of a policy? • What value might be added by a specific consideration of senior's mental health issues in policy development? • What thoughts/recommendations do you have on how a tool such as the SMHPL could be of use to St. Joseph's?

7. Approach to Implementing SMHPL • Interview-style meetings, approximately 45 minutes • Introduction of SMHPL, examples of use • Brief background of contacts’ roles • Discussion questions • Conclusion • Received feedback and obtained consent to be used in project • Create table of responses for comparison • Get references to other contacts

8. Contacts at SJHC • Deb Wiltshire – Veterans Care leader at Parkwood Hospital • Lisa Van Bussel – Psychiatrist at Regional Mental Health Care, London and St. Joseph’s Hospital, & member of Outreach team • Deb Miller – Director of Organizational Development and Learning Services at SJHC (phone interview) • Beth McCarthy – Director of Specialized Geriatric Services (SGS) at Parkwood Hospital • Lynda Martin – Mount Hope, LTC program (response pending)

9. Contacts at SJHC • Phyllis Brady – Patient Relations and Risk Management at LHSC and SJHC • Kendra Kasubeck – Risk Management and Patient Safety, Policy development at LHSC and SJHC, citywide policy, corporate development

10. Responses • Have you ever heard of the Seniors Mental Health Policy Lens?

11. Responses • Are there any processes in place in terms of policy and programs where seniors’ perspectives and values are addressed?

12. Responses

13. Responses

14. Responses • Are there any processes in place that would benefit from the seniors’ mental health perspective?

15. Responses

16. Responses • Are you aware of any examples at St. Joseph’s where consideration of seniors’ mental health issues specifically helped to shape the development of a policy?

17. Responses

18. Responses • What value might be added by a specific consideration of seniors’ mental issues in policy development?

19. Responses

20. Responses • What thoughts/recommendations do you have on how tool such as the Seniors’ Mental Health Policy Lens could be of use to St. Joseph’s?

21. Responses

22. Responses

23. What We Learned • Majority of responses included use of standardized policy template at SJHC, but not explicit • Process of going through SHMPL would be valuable to gain clarity, gain seniors’ perspectives, and consider things that were missed in policy/program development • Keep it short, simple, and in plain language • Be directed to individuals of different capacities • Valuable resource for people of all ages

24. Next Step • Create a one-page version of the SMHPL that is similar to the processes in place at SJHC, providing a shortened version for efficient use • Take questions directly from Part II: Assessing Policy/Program Content because Part I: Process Factors are already accounted for at SJHC • Follow-up email to contacts with the Seniors’ Mental Health Policy Lens Resource attached

26. Feedback • Online survey of questions to gain feedback based on the following questions: • Is the purpose of this resource clear? If not, can you explain what is needed? • Is the wording of each item clear? If not, which items need to be re-worked? • Is the follow up action listed at the bottom of the page clear? If not, can you comment on what is needed? • Where would you see this resource being housed in the organization? • Who would you see using this resource? • Do you have any suggestions as to how to increase visibility and use of this resource?

27. Survey Feedback • Clarity of purpose • Yes – I found the introductory overview very helpful. Clearly presented using the handout/booklet • Wording of each item • Yes – The framework is clear • Have the questions be positive or negative but not both (consistency) • Change wording of #3 – “Handicaps” to “Barriers

28. Survey Feedback • Clarity of follow-up action • Yes – It provides a great way to evaluate how "senior friendly" the policy is and an opportunity to understand how to improve (and validate) the draft • Location for potential use of resource • Policy formulation as it is drafted by the writer and then a "checklist" for use by a committee/workgroup as a last lens/feedback • Use of the resource • Anyone drafting a policy or participating a review of a policy

29. Survey Feedback • Suggestions to increase visibility • Get to senior leadership of organizations to incorporate into the development/approval process for policies • New Ontario Act and Regulations is clear that accessibility must be considered when policies are developed/revised and this reference could be added

30. Challenges • Because SJHC is a large organization directed to seniors’ needs, they have procedures in place and are committed to making facilities senior-friendly already • Standardized policy templates are city-wide – not a lot of flexibility • Not explicit use of templates – used as a general reminder • Availability of contacts for scheduling meetings

31. Follow-up Opportunities • Collecting and analyzing feedback from survey • Approach SHRTN AKE (Seniors Health Research Transfer Network, Alzheimers Knowledge Exchange) which is a web-based practice in Ontario as recommended • Approach provincial LHIN (Local Health Integration Networks) to review Aging at Home Policy • Develop plain language version of lens as a companion to the Patient and Family Handbook used at SJHC

32. Follow-up Opportunities • Approach Ontario Hospital Association (OHA) to get their feedback and approval of lens as province wide recommendation • Approach Communications department at SJHC to increase visibility of SMHPL Resource on website

33. Conclusion • In order to implement a policy template into a large organization, the best approach is to be used as a companion resource to what is already in place • Not a lot of flexibility in terms of what is used • Meeting with leaders in different areas helps represent the broad perspective at SJHC • Interview style was time efficient, to the point, and helped eliminate problems in scheduling meetings • Positive response to the content of the lens; perhaps different format such as the SMHPL Resource