report, record, respond. adult guardianship legislation representation agreement act health care...
TRANSCRIPT
Adult Guardianship Legislation
• Representation Agreement Act
• Health Care (Consent) and Care Facility (Admission) Act
• Adult Guardianship Act– Part 3 (2000)– Part 2
• Public Guardian and Trustee Act
CHANGES
NEW
NEW
Getting your Acts together
• Mental Health Act• Patients Property Act• Power of Attorney• Licensing• Criminal Code• Hospital Act• Marriage Act• Community Care and
Assisted Living Act• FOIAPP Act
Adult Guardianship Act (Part 3)
• Abused, neglected & self-neglected and unable to seek support and assistance due to:– Physical restraint– A physical handicap that limits their ability to
seek help– An illness, disease, injury or other condition
that affects their ability to make decisions about the abuse and neglect
Designated Agencies
• 5 Regional Health Authorities and PHC
• Community Living BC (Ministry of Children and Family Development)
Vancouver Coastal Health• Provides all levels of acute, primary and
public health, mental health & addiction services
• Richmond, Vancouver, Coastal Communities including Whistler, Sunshine Coast, Powell River, Bella Bella and Bella Coola
• Approximately 27,000 staff• Over 500 sites, 15 hospitals
• Every employee has a responsibility to act in situations of abuse, neglect and self-neglect of vulnerable adults
• Health Authorities did not receive any additional resources to implement their new “Adult Protection” role – it was added to existing duties of health staff
What the D.A. Must Do• Receive reports of abuse & neglect
• Conduct investigations to determine needs
• Involve the adult as much as possible
• Report criminal offences
• Keep the name of the person making the report confidential
• Use the tools in the legislation (possible court orders etc.)
AGL (Part 3) Tools
• Mandate• Power to investigate (Section 48)
• Right of DA to information and duty to ensure confidentiality (Sec. 62)
• Access order (Sec.49)
• Warrant to enter for purpose of interview (Sec. 49)
• Interim restraining order – 30 days (Sec.51)
• Emergency provisions (Sec. 59)
• Support and assistance order – 6 months (Sec. 56)
VCH Designated Responders• Acute Care
– Social Workers– Clinical Practice Coordinators/Leaders– Patient Service Coordinators
• Mental Health Teams
• Long Term Care Case Managers
• Licensing Officers
• Managers of Assisted Living
Who Else is Involved?
• Substitute Decision Maker (Committee, Guardian, Trustee, TSDM, Representative, PoA)
• Physician/Health Care Team
• Another Designated Agency
• Police (Elder Abuse Unit)
• Public Guardian & Trustee
Process for Designated Responder
• Document at each step
• Interview the adult
• Assess the urgency of the situation
• Coordinate the collection of collateral
• Coordinate the assessment of abuse, neglect or self-neglect
Process for D.R. (cont’d)
• Coordinate the assessment of ability to seek/refuse support and assistance
• Determine if the adult has a Representative, Committee, or Power of Attorney
• Coordinate the development of a care plan to provide support and assistance
Process for D.R. (cont’d)• Advise the most responsible physician of
the situation and actions taken
• Make reports as necessary to the PGT
• Report crimes to police
• Keep the identity of the person who made the report confidential
• Use the tools in the legislation as a last resort if the S & A is refused
Data & Communication Challenges
• Documentation
who? where? what?• Retrieval• Confidentiality• Security/Privacy• Communication • Tracking• Quantifying• Evaluation
Patient Safety Learning System• Province wide “safety event” reporting
system
• Captures, stores, summarizes events and promotes timely investigations of:– Patient Incidents– Employee Incidents– Claims, Complaints– Safety Hazards etc
Meanwhile…
PSLS Re:Act - SLS• $20,000 grant from BC Solicitor General
• Leverage the existing PSLS to meet requirements for statutory obligations of AGA
• Stakeholder agreement throughout BC
• Developed a specific Adult Abuse and Neglect Report Form & Follow-Up Form
• Pilot in 5 sites within VCH
Abuse and Neglect Event Reporting Process
20
Reviews Feedback
Supports Investigation
Reports Abuse/Neglect Event
SLS-Abuse and Neglect via
VCHA Intranet
Reports Abuse/Neglect Event
SLS-Abuse and Neglect via
Re:act Resource
Reviews SLS-A&N Event
Reporter•Designated Responder•Frontline Staff
Handler•Designated Responder Coordinators•Practice Leader
Participant• Manager•Re:act Resource•Other Designated Responder Coordinator
Final Approve
Event
Collects Additional Info as Required
Added as Participant on
Event by Handler
Reviews SLS Event
Provide Feedbac
k
SLS-Abuse and Neglect Form Benefits
• Easy to use, intuitive interface– 8 mins: typical time for an
end-user to log an incident– Focus on simplicity and key
data capture
• Auto-notification of abuse and neglect reports to relevant groups:
– Designated Responder
Coordinator
• Supports investigation & analysis of safety events
• Feedback on progress of the event
Pilot Results
• 5 Sites in VCH (2 Community Health Centers, 1 Mental Health Team, 1 Acute Hospital, 1 Re:Act)
• 58 Reports & Investigations over 3 months
• Feedback from users through bi-weekly teleconferences lead to revisions to forms
• New Pilot Phase beginning October 2009
Contact info
• Anne Beer, Project Manager, VCH, 604-875-4111 Ext 69504
• Amanda Brown, Director, Re:Act, 604.984.5957
• BC Patient Safety Learning System http://www.bcpsqc.ca/initiatives-we-support/learning-system.htm