Report, Record, Respond

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

SLS-Abuse and Neglect Access and Homepage

Click here to access SLS Abuse and

Neglect report form

What Do You Want To Report?

Provide a few more details

Is it an Adult Guardianship Case?

Details of the Vulnerable Adult

Details of the Suspected Abuser

Confidential Details of Reporter

Details about the SLS Reporter

Choose the Follow Up Person

Follow Up (Investigation)

Ability to see who is involved

Record Investigation Details

Risk Assessment

Include others & send emails

Close the file when A&N issues are resolved

Dashboard & Accountability

Overdue Items!

Still Investigating

Closed & Approved

Audit TrailExampl

e

Show DIF1 value

s

Data Reports

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