OCAN Education

Training for OCAN Users

Day 2

Objectives

Learn how to:• Complete staff assessment• Interpret and make use of information from

OCAN in a number of ways• Introduce Shared Assessment model in your

health service provider (HSP) organization• Introduce assessment, re-assessment

guidelines• Introduce OCAN into business process

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OCAN Training Agenda - Day 2• Welcome & Introductions• Objectives• Unit 2

– Application of OCAN cont’d– Staff Assessment – Scoring Activity

• Unit 3– Outputs-Actions, Referrals, Reports

• Unit 4– Timelines and Reassessment

• Unit 5– Business Process

• Unit 6– Shared Assessment

• Next Steps• Evaluations

Unit 2 Continued

Staff Assessment

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OCAN Part II: Staff AssessmentScore NeedScore Need

Score HelpScore Help

• In each of the 24 domains the staff is determining scores for need and help and recording these

• For every met or unmet need, the help score must be completed

• If there is no identified need, a help rating is not required, but the extra questions in the domain should be completed

• Action and comments fields should be completed as robustly as possible when indicated

• Information gathered is important to inform the ongoing work with the consumer and is reflected in reports

OCAN Part II: Staff AssessmentKey Points

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Many reasons can cause an increase in consumer-identified unmet needs from assessment to reassessment including:

• consumer’s perceived decline in these areas• consumer’s journey of recovery allows them to

identify different or new unmet needs as their horizons expand

OCAN Part II: Staff AssessmentKey Points cont’d

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Need in Relation to Help• No Problem / No Need

– Help is not provided

• No/Moderate Problem due to help given / Met need– Help is provided

• Serious Problem / Unmet need– Help is or is not provided

OCAN Part II: Staff AssessmentKey Points cont’d

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Pop Quiz!

1. What does OCAN stand for?

2. What are the 4 steps of OCAN?

3. Who can help complete the Self-Assessment?

4. What if a Consumer does not wish to complete a Self-Assessment?

5. If informal or formal help is scored as 3, what does that mean?

6. If a score of 1 is given for need, what could that mean?

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Practice Module includes:• Self assessment• Dialogue• OCAN Part 2-staff

assessment with collateral information

Practice: Scoring OCAN

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1. How can you use a recovery focus to talk about variances (differences) between the consumer self-assessment and the worker assessment?

2. How do you dialogue about successes when the consumer has indicated that there is “No Need”?

3. How can you use a recovery focus to talk about unmet needs that both you and the consumer identify?

Practice: Scoring OCAN Debrief

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LUNCH

Unit 3

Outputs

• At the end of the assessment, actions will be summarized in a table that looks like the following:

Priority Domain Action

1 Accommodation Submit application for supported housing

Summary of Actions

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• At the end of the assessment referrals and status of the referral can be documented in this chart

• This working tool is helpful to track referrals on an ongoing basis

• An outcome of the Summary of Referrals is the identification of gaps in service

Optimal Referral

Specify Actual Referral

Specify Reason for Difference

Status of Referral

Drop down of functional centres

Name Program Drop Down of functional centres

Name Program See Data Elements

See Data Elements

Summary of Referrals

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1. Individual Need Rating Over Time

2. Needs Over Time

3. Summary of Actions and Comments

4. Staff Workload

Individual Assessment Reports

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Unit 4

Timelines and Reassessment

What is reassessment?• a structured, documented review using OCAN• an opportunity for consumers and providers to regularly

review needs, identify accomplishments and inform next steps

• consists of the consumers self assessment, the staff assessment and information from other sources e.g. providers and family members

 

 

Reassessment

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Sustaining the “Heartbeat”

Assessment 1May 1 2008

Reassessment 1at 6 monthsNovember 1 2008

Reassessment 2at 12 months

May 1 2009

Reassessment 3at 18 monthsNovember 1 2009

Other Assessment 1Significant Change

Other Assessment 2Client Request

Regardless of any “Other” assessment completed between the “heartbeats”, the assessments continue every 6 months .

Start DateAssessment

1May 1

End DateAssessment

1May 30

Start DateAssessment

2November 1

End DateAssessment

2November

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30 Days Max 30 Days Max

6 M O N T H S

Initiating the “Heartbeat”

Once the start date is chosen, the end date is 30 days from the start date. The next assessment happens 6 months from the start date of the previous assessment.

Assessment on a ‘Heartbeat’

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BREAK

Assessment on a ‘Heartbeat’

Resetting the “Heartbeat”

Assessment 1Core Ax or

Core + Self AxMay 1 2008

Reassessment 1at 6 monthsNovember 1 2008

Other Assessment 1November 15, 2008

Referral to Housing or agency that completes a

Full OCANHeartbeat is Reset

Reassessment 1May 15, 2009

6 month heartbeat continues to

accommodate Full OCAN schedule

The heartbeat is reset when service begins with a Health Service Provider that completes a Full OCAN – also known as the fullest dataset.

Reassessment 2November 15, 20096 month heartbeat

continues to accommodate Full OCAN schedule

6 M O N T H S 6 M O N T H S6 M O N T H S15 DAY GAP

Types of Assessment

• Assessment types are chosen in OCAN and include:– Initial OCAN– Reassessment – (Prior to) Discharge– Significant Change– Review– Re-key– Other

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Initial OCAN

• An “Initial OCAN” is only completed by the OCAN Lead when the person participating is new to the Community Mental Health system or is re-entering the Community Mental Health system more than 90 days after a previous discharge.

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Reassessment

• OCAN is completed every 6 months. • This is referred to as the “heartbeat” • The “Reassessment” is chosen for clients who

have completed a prior OCAN or they are existing clients for whom this will be their first OCAN

• Completed by the OCAN lead

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(Prior to) Discharge• Discharge for the purposes of OCAN is planned discharge from the

mental health system. This assessment type is completed by the OCAN Lead. For details, please refer to the guidelines below:

• (Prior to) discharge – REQUIRED

• Client is leaving the Community Mental Health System (planned discharge)

• (Prior to) discharge – NOT REQUIRED

• Client “drops out” of Community Mental Health Services (unplanned)

• Transfer of a client from one Community Mental Health program / HSP organization to another*

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Significant Change

• A Significant Change OCAN does not change the “heartbeat”

• It is completed by the OCAN Lead• OCAN can also be completed when there is a

significant change in the person’s life that may require closer assessment to ensure that the most current needs are identified

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Review

• A Review OCAN does not change the “heartbeat”

• When information from one HSP organization’s assessment is updated or changed as part of a review process before entering it into another HSP organization’s automated solution, the staff will choose “Review” as the reason for assessment

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Re-key

• A Re-key OCAN may or may not be completed by the OCAN Lead and it does not change the “heartbeat”

• Re-key OCAN is conducted when an HSP organization receives an OCAN from another HSP organization and does not update any of the fields when they enter it into their own system

• HSP organizations may choose to re-key when a paper copy is not needed

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Other

• An “Other” OCAN is completed by the OCAN Lead but it does not change the ‘heartbeat’

• One examples of an other reason for assessment could be ‘consumer request’

• For any “Other” reason for assessment, the staff person records the reason

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Unit 6

Shared Assessment

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Vision

VisionOne assessment and one submission of CDS per consumer

Current SituationMultiple assessments for same consumer

Single Framework (CDS – OCAN)

Assessment Part I: Consumer Self

Assessment

Assessment Part II: Staff Assessment

Consumer Information Summary

Service Use

Single Framework (CDS – OCAN)

Assessment Part I: Consumer Self

Assessment

Assessment Part II: Staff Assessment

Consumer Information Summary

Service Use

Goals of Shared Assessment

• A single OCAN submitted across the mental health system for any one consumer

• Collective contribution by all providers working with the client into one OCAN

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Benefits of Shared Assessment

• Collaborative approach focuses on needs of the consumer

• Integration and co-ordination of services provides better consumer support and clear roles for staff

• All health service providers are given credit for the support they are providing to same consumer

• Access to reports by all orgs involved in services to same consumer

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Business Process

6 Months 6 Months

Input* Input Input Input Input

6 Months

Input Input Input

OCAN LeadContributing CMHProviders

New OCAN Lead*Input for Assessments to the OCAN Lead can be communicated anytime between Assessments

Self Ax CM Ax

Self Ax CM Ax

Self Ax CM Exit

HousingClub

HouseHousing

Club House

Peer Support

HousingClub

HousePeer

Support

Self Ax Housing

Ax

Housing

Self Ax Housing

Ax

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Roles

Consumer:

– consents to share OCAN

- involved in choosing who completes OCAN

OCAN Lead:

–completes and submits one OCAN in agency with input from other staff (contributing providers) involved in providing services to consumer

Contributing Provider:

- Participates in assessment process

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OCAN Lead

Activity:

Determine OCAN Lead in your agency• Discuss and develop some guidelines for

choosing who would be OCAN lead when two of your programs are involved with the same consumer.

• What would be their responsibilities in completing an OCAN?

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Three Types of Reporting Structures

Organizations that have

consumers who see multiple

providers

Results in multiple

instances of OCAN and CDS

Results in multiple

instances of CDS (highest

aggregate level)

No OCANNon-HICs

OCAN and No SharingOCAN and

SharingOCAN and

Sharing

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OCAN and Sharing

Unit 5

Business Process

What is an HSP organization Business Process?

• A series of connected steps / actions / tasks to achieve an outcome

• It is what you do in your agency from the time a consumer enters your agency up to planning services for him\her

• Business Process Mapping is a diagram showing how work flows through your agency

Business Process

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ORIENTATIONTO HSP ORG

ACCEPTANCETO

SERVICE

SERVICE PLANNING

INTAKE

• Where does OCAN fit?

• What can it replace?

Business Process

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Business Process

Think about how your agency will use OCAN in your current business process.

Questions:?

Will OCAN replace part of current assessment?

Will OCAN replace current assessment?

Will OCAN be added to current assessment?

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Available Resources & SupportsResources• Your Change Team• Kick-off binder• OCAN 2-day training user binder• Co-ordinator training binder• Quick reference guides• Consumer support materials

Supports• Portal(s)• Project Support Centre (CMH CAP)• OCAN Knowledge café • IT services

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• Supported training• Sign-up sheets• Evaluations

Next Steps

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Thank You!