Page 1 of 27 Project Charter PROJECT INFORMATION Project Name Project Acronym or No. Planning for Grey Bruce Hospice Palliative Care Service Enhancement <assigned by LHIN> Target Project Completion Date [yyyy-mm-dd] Budget (per Project Resources section) Notice of Integration? Yes/no (per Integration section) September 2011 (initial funding recommendations Summer 2011) $50,000 No HSP Lead Organization (project funds flowed to) HSP Partner Organization(s) South West End-of-Life Care Network paymaster (SWCCAC) Grey Bruce End-of-Life Care Partnership, Grey Bruce Health Services, South Bruce Grey Health Centre, Grey Bruce Long-Term Care Committee, volunteer hospice agencies, Palliative Pain & Symptom Management Consultation Program, SWCCAC, CarePartners, VON, Owen Sound FHT, Grey Bruce Healthcare Chaplaincy Council, Hanover & District Hospital HSP Project Sponsor HSP Project Manager/Lead Steering Committee = Grey Bruce Health Network CEO Committee + representation from hospice, family health teams, long-term care homes and St Joseph’s Health Care London South West End-of Life-Care Network Director LHIN Project Sponsor LHIN Project Lead Kelly Gillis Debra Woods PROJECT DESCRIPTION Project Purpose: Explain the purpose of this project by describing, at a high-level, the background necessary to understand why the project was started, what will be done. What is this project aiming to achieve? What is its vision? What need or opportunity will it address? What problem will it solve? Hospice palliative care is a type of health care that provides physical, psychological, social, spiritual and practical support to people living with progressive, life-threatening illness and their loved ones. It is available to individuals and their families at any time during the course of the illness and during bereavement. Although hospice palliative care is a specialty, the reality is that there will never be enough specialists to provide direct care to all individuals and families in need. This reality is only going to become more evident in the next decade, as the number of people dying is projected to increase significantly at the same time that the number of paid caregivers is projected to decrease. Consultation services made up of hospice palliative care experts have been established in various jurisdictions to provide support to generalist providers of care who can, with adequate coaching and skill development, meet the needs of the majority of individuals and families through their journey. These expert consultants only become directly involved in care when complex situations arise that require an advanced level of skill to manage.
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Project Charter - Healthline · Page 1 of 27 Project Charter PROJECT INFORMATION Project Name Project Acronym or No. Planning for Grey Bruce Hospice Palliative Care Service Enhancement
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Project Charter
PROJECT INFORMATION
Project Name Project Acronym or No.
Planning for Grey Bruce Hospice Palliative Care Service Enhancement <assigned by LHIN>
Target Project Completion Date [yyyy-mm-dd]
Budget (per Project Resources section)
Notice of Integration? Yes/no (per Integration section)
September 2011 (initial funding recommendations Summer 2011)
$50,000 No
HSP Lead Organization (project funds flowed to) HSP Partner Organization(s)
South West End-of-Life Care Network paymaster (SWCCAC)
Grey Bruce End-of-Life Care Partnership, Grey Bruce Health Services, South Bruce Grey Health Centre, Grey Bruce Long-Term Care Committee, volunteer hospice agencies, Palliative Pain & Symptom Management Consultation Program, SWCCAC, CarePartners, VON, Owen Sound FHT, Grey Bruce Healthcare Chaplaincy Council, Hanover & District Hospital
HSP Project Sponsor HSP Project Manager/Lead
Steering Committee = Grey Bruce Health Network CEO Committee + representation from hospice, family health teams, long-term care homes and St Joseph’s Health Care London
South West End-of Life-Care Network Director
LHIN Project Sponsor LHIN Project Lead
Kelly Gillis Debra Woods
PROJECT DESCRIPTION
Project Purpose:
Explain the purpose of this project by describing, at a high-level, the background necessary to understand why the project was started, what will be done. What is this project aiming to achieve? What is its vision? What need or opportunity will it address? What problem will it solve?
Hospice palliative care is a type of health care that provides physical, psychological, social, spiritual and practical support to people living with progressive, life-threatening illness and their loved ones. It is available to individuals and their families at any time during the course of the illness and during bereavement. Although hospice palliative care is a specialty, the reality is that there will never be enough specialists to provide direct care to all individuals and families in need. This reality is only going to become more evident in the next decade, as the number of people dying is projected to increase significantly at the same time that the number of paid caregivers is projected to decrease. Consultation services made up of hospice palliative care experts have been established in various jurisdictions to provide support to generalist providers of care who can, with adequate coaching and skill development, meet the needs of the majority of individuals and families through their journey. These expert consultants only become directly involved in care when complex situations arise that require an advanced level of skill to manage.
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Health care providers in Grey Bruce have been hard at work developing a consultation model that would provide access to hospice palliative care expertise in a variety of care settings. It has faced the following challenges:
Stretching limited resources across a large, sparsely-populated geographic area
Recruiting and retaining qualified local / regional experts in an environment where health human resources are becoming increasingly scarce
Clarifying policy regarding how approximately $600,000 in available annual operating funding can be used
Aligning the model with current “givens” about how services are configured, particularly in the community
Deciding where the experts will be employed and to which agency or agencies the funding should be directed
Coming to a common understanding on the roles of internal vs. external consultants
Defining an accountability / governance structure The purpose of this project is to bring key partners together to work through these issues in order to develop a revised, implementable, sustainable model for providing access to hospice palliative care expertise in Grey Bruce with the aim of improving the quality and integration of care provided to individuals and their families. The project team will agree on a common set of parameters for defining good access to hospice palliative care expertise before re-examining the work already done on a local consultation team concept. The project team will also explore other initiatives which may present further opportunities to improve the integration of hospice palliative care services (e.g. implications of introduction of intensive case management model at CCAC or the development of a hospice palliative care education plan in the South West). The following principles will guide the interactions of the project team:
The project team needs to develop a shared vision and sense of common purpose – they will have to spend time together to do this
The consultant(s) leading the process will need to create a safe environment for the exchange of ideas
A fulsome, structured exchange of ideas will produce the best solution or set of solutions
There is a need to get a recommendation to the LHIN as quickly as possible. The trick is to do this in a way that fosters collaboration.
Transparency and frequent communication will be crucial to building trust
The consultant(s) on their own won’t be able to work out the solution(s) One of the key deliverables will be a detailed recommendation to the LHIN Board by Sep 2011 on how the approximately $600,000 in available annual operating funding should be used.
The following are a few important funding policy considerations:
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With residential hospice not part of the service delivery model, the parameters of the funding can be
changed but still must adhere to relevant legislation
The Long-Term Care Act, 1994 (LTCA), and updated Act 2007 apply to both delivery of residential hospice and other hospice palliative care services
Personal support services can be provided by or through CCACs, supportive housing agencies, and other approved agencies
Professional services (includes the services of a Nurse, Occupational Therapist, Physiotherapist, Speech Language Pathologist, Dietitian, or Social Worker) can only be provided by or through CCACs
Even though there is a growing desire to “get on with it” locally and start using the funding to provide services as quickly as possible, introducing any new service enhancements without fully addressing the challenges identified to date and clearly articulating how these changes will be implemented by all participating organizations greatly decreases the likelihood of success. Desired Outcomes Of the Project
a detailed recommendation to the LHIN Board on how the approximately $600,000 in available annual operating funding should be used
a clearly defined accountability / governance structure for hospice palliative care services as a whole, not just for the approximately $600,000 investment
clear expectations of governance and leadership structures that will achieve change and continuously improve the system of care for hospice palliative care services
an implementation strategy for any new or enhanced program(s) that incorporates sound management of change principles
a framework for evaluating new service enhancements recommended to the LHIN once they’re implemented
obtain available baseline data on current end-of-life care in Grey Bruce for planning and evaluation purposes
greater collaboration among partners in Grey Bruce to improve the integration and quality of hospice palliative care services
Of the Implemented System Enhancements
Improve access to hospice palliative care expertise across a number of settings, which may include long-term care, acute care, in-home care, and primary care
Earlier assessment and access to hospice palliative care resources / services
Better service to individuals with non-malignant progressive, life-threatening conditions
Access to advanced pain and symptom management
Access to additional resources such as spiritual care, bereavement support, and pharmacy consultation
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Complementary processes
Enhanced system navigation
Continuity of care across settings and programs
Roles and responsibilities for the partners are clearly defined
More instances of effective teamwork
Improved capacity to provide fundamental hospice palliative care at the primary level
Access to sufficient and sustainable secondary level expertise
Established links to tertiary expertise
Health Service Clients/Stakeholders (i.e., target populations)
General Description Equity
This proposal responds primarily to the needs of the following population(s):
Individuals with progressive, life-threatening conditions and their families
Aboriginal Francophone Rural/Remote Populations Inner-urban (e.g., homeless) Populations Religious, Ethno-Racial or Linguistic Minorities (please specify): Sex/Gender Sexual Orientation/LGBT Low Income/Under-employed Persons with Disabilities (e.g., physical, intellectual, sensory, learning, mental illness)
General Population Other, please specify:
Where Service/Initiative is Accessed
Please indicate where the service/initiative identified in this project can be accessed (check one):
Local Community: Services provided close to home; Delivery of high volume/low complexity services to broader population; Collaboration across local traditional and non-traditional providers; Emphasis on an individual’s self-health management
Multi-Community: Service delivery by geographic clustering of moderate volume/complexity services focused on target populations; Seamless referral relationships with local and LHIN providers
LHIN Community: Delivery of low volume/highly complex services to manage specialized populations; Support multi-community and local providers with accessibility to specialized services; May serve as a broader provincial resource
Please indicate the specific area(s) (e.g., town, city, county, etc.) from which the service will draw clients/stakeholders:
Grey Bruce
Health Service(s) Improvements for Clients/Stakeholders
Describe how clients and families will benefit from your idea (e.g., improved quality of care, faster access to care, easier movement through the system, etc.)
Improved quality of care, faster access to care, easier movement through the system
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More specifically:
Increased access to specialized hospice palliative care for clients in all settings (symptom management, disease progression, all domains of care)
Improved patient flow / coordination / integration across the continuum of care
Improved communication among health care professionals and with the client and family
Increased family / client participation in end-of-life care planning
Anticipate, plan for, or potentially avert crises in pain and symptom control
Make possible for clients to die with dignity in their location of choice
Project Scope
Describe specific items that will (“in-scope”) and will not (“out-of-scope”) be included as part of the work performed on this project. Consider specific features, functions, quality needs or other “must have” requirements and place them in the in-scope section. Spell out any exclusions (i.e., work that will not be performed) in the out-of-scope section.
In-Scope Out-of-Scope
Ensure common understanding of the current state and policy constraints, collect baseline data
Understand demand / need for hospice palliative care, not just based on current utilization data – who is not being served?
Learn more about other new initiatives being introduced in the community (eShift, intensive case management, Integrated Client Care Project, palliative care nurse practitioner); look for possible synergies
Better understand different levels of expertise - competencies, methods of access
Learn from successful initiatives in other rural areas
Look for opportunities to improve the system that won’t cost additional money on an ongoing basis
Decide how program funding should be invested
Propose a clearly defined accountability / governance structure
Develop an implementation strategy that incorporates sound management of change principles
Develop a framework for evaluating new service enhancements recommended to the LHIN
Implementing any proposed service enhancements
Pursuing a residential hospice option
Putting forward proposals that require ongoing funding beyond the approximately $600,000 that’s available
Integration
Is this an integration opportunity? Yes No
If yes, please check which type of integration opportunity:
Funding Integration (No Integration Decision required)
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HSP Proposed Integration (Integration Decision at LHIN’s discretion). If checked, please sign below.
Comments:
I acknowledge that this submission is a formal notice of a proposed integration to the LHIN.
Signature:
Name:
Date:
ALIGNMENT
Strategic Alignment: Describe linkages to South West LHIN directions, provincial priorities and/or organizational strategies.
Blueprint/IHSP Alignment
The project aligns to the following South West LHIN Blueprint Approaches & IHSP Directions:
Primary Alignment (check one)
Population-based Integrated Health Services
Seniors & Adults with Complex Needs
Chronic Disease Prevention and Management
Mental Health and Addictions
Centrally Coordinated Resource Capacity
Emergency Services
Critical Care
Medicine
Surgery
Secondary Alignment (check one)
Comments:
Key Enablers
The project aligns to the following Key Enabler (check one):
Information & Clinical Technology
System Navigation
Human Resource Strategies
Implementation & Accountability
Provincial Priorities
This project aligns to the following Provincial Priorities (e.g., ALC/ER, Diabetes, Family Health, Wait times):
ALC/ER
Impacts on Organization(s)
System Impacts
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Identify the impacts this project is expected to have on the health care system in the South West LHIN:
Of the Project (i.e. Planning Efforts) Ensure effective use of funding to enhance hospice palliative care services in Grey Bruce
All partners invested in a common plan
Proposed plan is sustainable in the long-run
Accountabilities and evaluation plan are clear
Improved trust between organizations
Of the Implemented System Enhancements
Reduced ER visits for symptom control in the last 6 months of life
Reduced bed days in hospital for patients in need of hospice palliative care
Improved capacity for managing patients with complex problems
Integrated client care provided in collaboration with CCAC
Seamless transitions between all sectors
Organizational Objectives and Strategies
Identify the organizational objectives and strategies this project aligns to (e.g., improved performance measurement, cultural shifts, improvement processes/methodologies):
Process improvement
Better system navigation and clinical coordination
Improved capacity to provide fundamental hospice palliative care across settings
Access to secondary level expertise
Broadened understanding of hospice palliative care (as not just end-of-life care) and all that implies
Process Change Impacts
Identify the process change impacts this project will have on your organization or on other organizations (e.g., increased efficiency, improved performance reporting):
More clarity around work flow
Transitions between care settings handled well on a consistent basis
Role of full care team clarified
Related Projects & Initiatives
Are there dependencies with other initiatives or projects (at the organizational, LHIN or Provincial level)?
Yes No
If “yes”, please describe below.
Project/ Initiative Interdependency & Impact
List the project or initiative. State the dependency and indicate how the dependency impacts your project.
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eShift need to understand opportunities it creates, the number of people it’s likely to serve, how it will be supported, how it might link with proposed service enhancements
Intensive case management need to understand opportunities it creates, the expanded role of case managers, and how they’ll potentially link with secondary experts
Integrated Client Care Project (ICCP) learn from process mapping and other work that’s been done on this provincial project, understand opportunities it might create
possibility of funding from Ontario College of Family Physicians for areas of the ICCP
Palliative care nurse practitioner understand role, level of hospice palliative care expertise
Share The Care™ understand how this approach can be of benefit to “informal” caregivers and may interface with enhanced services
Automation of transfer from GBHS cancer unit to CCAC
need to understand opportunities it creates
Plan of Treatment for CPR process potential area for improvement that won’t require ongoing funding
developed in Grey Bruce, additional tools soon available to integrate process into practice
electronic documentation being developed at GBHS
Education offered through Geriatric Education Cooperative in Grey Bruce
Possible links related to capacity building
Education project (Network strategic plan) it will be developing a hospice palliative care education plan for the South West – will have implications for the efforts to build capacity in Grey Bruce
Transitions project (Network strategic plan) it will be looking at improving care hand-offs in another geographic area of the South West – an opportunity for collaboration
University of Toronto research project with SWCCAC studying experiences of clients and families
will provide important information to inform / evaluate changes
Are there opportunities to spread to Local Community, Multi-Community, LHIN Community (as described above)?
Yes No
If “yes”, please describe below.
Process improvements identified in Grey Bruce may be relevant to other parts of the South West
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PROJECT PERFORMANCE
Project Goals, Objectives & Performance Measures
Provide the details of what this project aims to accomplish by listing its specific goals and objectives. State the goals in terms of high-level outcomes to be achieved. Identify specific objectives for each goal listed. Objectives are clear statements of specific activities/tasks that must be performed to achieve the goals. Identify both project product/service and people/organization change objectives. Performance measurement indicators and targets are used to determine if objectives and expected results have been successfully achieved.
Goals Objectives Performance Measurements
Indicators Targets
List all goals to be achieved by the project. Ensure alignment with project purpose.
For each goal, list specific objectives that will signify achievement of goal when finished.
For each objective, list the performance measurement indicator and target that will be used to evaluate success of results achieved.
Provide a detailed recommendation to the LHIN Board by Fall 2011 on how the approximately $600,000 in available annual operating funding should be used
Propose a clearly defined accountability / governance structure
Decide where the experts will be employed and to which agency or agencies the funding should be directed
Structure service enhancements so that they improve the integration of services
Develop an implementation strategy for any new or enhanced program(s) that incorporates sound management of change principles
Develop a framework for evaluating new service enhancements once they’re implemented; gather baseline data
accountability / governance structure finalized and agreed to
deployment of experts and funding flow agreed to
finalized process map of service delivery for end of life care services
completed implementation strategy
baseline data compiled
N/A
Identify opportunities to improve system that won’t cost additional money on an ongoing basis
Describe potential improvement projects and resources needed to support them
If circumstances permit, develop a project proposal that makes use of any funding that likely won’t be used in 2011/12
Potential improvement projects described
Project proposal for unused 1-time funding developed (as appropriate)
N/A
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Goals Objectives Performance Measurements
Indicators Targets
on a 1-time basis
Project Timelines & Deliverables
Indicate when the project will take place. Provide a preliminary estimate for the duration of the project by documenting the target completion dates for high-level project milestones. Milestones are significant project events that usually signify completion of project phases or major deliverables.
Milestones Deliverables Dates
Description.
Give clear definition of the milestone and/or deliverable, clarifying how you will know when it has been successfully achieved.
Absolute date where possible or time from start of project. (assuming confirmation of project funding provided by LHIN April 15)
Start up Clarification of roles of resource people provided by partner organizations
Development of requests for quotations (RFQs) from consultants
Issuing of RFQ
Selection of successful consultants by panel made up of members of the project team
Preparatory work can be done before funding is confirmed from the LHIN (April 1-15)
Project team develops terms of RFQ and method for evaluating candidates (with the Network Director coordinating the process)
Project team also identifies potential consultants
Issuing of RFQs would take place immediately once funding is confirmed from the LHIN (by April 18)
Proposals evaluated by a panel made up of members of the project team (week of May 9)
RFQ process takes 1 month to complete (aim is to have consultant(s) in place by mid-May)
Defining and confirming expectations Development of detailed project work plan
Review of literature on HPC consultation services complete (consultation etiquette, important considerations in planning, etc.), some of which would already have been done for outreach team proposal
Different levels of expertise (competencies, methods of access) defined
Challenges of providing access to secondary expertise in a rural
Mid-May through early June
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Milestones Deliverables Dates
area defined
Common set of parameters for defining good access to hospice palliative care expertise agreed upon
Developing a common understanding of key issues
Additional baseline data collected as necessary
Shared understanding by the project team of Related Projects and Initiatives achieved
Review of outreach team proposal and other relevant initiatives complete
Mapping of some key current processes complete
Agreement on a few key indicators for which data are available now (to be used for a high-level evaluation before a more detailed program evaluation is conducted)
June (including proposed 2-day workshop in late June)
Agreeing on recommendations Agree on a clearly defined accountability / governance structure
Decide where the experts will be employed and to which agency or agencies the funding should be directed
Describe potential improvement projects and resources needed to support them
June (including proposed 2-day workshop in late June)
Preparation of submission to the LHIN Board
Preparation of a formal submission (part 1) to the LHIN Board defining accountability structure, employment relationships, funding flow
Develop an implementation strategy for any new or enhanced program(s) that incorporates sound management of change principles
Develop a framework for evaluating new service enhancements once they’re implemented
Sign off by project partners
After workshop in late June
Submission to the LHIN Board Submission to the LHIN Board defining accountability structure, employment relationships,
Early summer
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Milestones Deliverables Dates
funding flow, implementation plan and evaluation plan
PROJECT TEAM MEMBERS
Project Team
Identify who is needed on the core project team to complete project deliverables and achieve goals and objectives. What skills, knowledge and experiences are required? Consider the need for special expertise to deal with people and organization change challenges. This section may include any new Human Resource(s) required to support the project.
Team Member and/or Title/Profession, Organization
Role on the Project Required Involvement
Estimated Duration Level of Effort
Provide names and/or titles/professions of core project team members.
Describe the role & responsibility of each core project team member.
Indicate target dates or number of weeks/months.
Indicate full-time or days per week/month.
The project team will work with the consultant(s) to prepare for a 2-day planning session in June and do necessary follow up. The initial team meeting will include all members, but after team member roles are further defined, a core group will do most of the work with the consultant(s). It’s suggested that those organizations that have more than one representative on the project team designate one person to serve on the core group.
Susie Furlong, Grey Bruce Health Services
Make quality improvement expertise available as needed
Provide and analyze acute care data
Participate in designing a solution that will improve access to secondary hospice palliative care expertise in acute care
Commit to a plan for improving primary level hospice palliative care in acute care
Mid-May through July
2-3 days per month
Sue McCutcheon, Grey Bruce Health Services
Organizational sponsor
Clear barriers, use influence to support the aims of the project
Connect regularly with organization rep on project team
April through July ½ day / month
Rhonda Ridgeway, South Bruce Grey Health Centre
Participate in designing a solution that will improve access to secondary hospice palliative care
Mid-May through July
2-3 days per month
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expertise in acute care
Commit to a plan for improving primary level hospice palliative care in acute care
Dianne Waram, South Bruce Grey Health Centre
Organizational sponsor
Clear barriers, use influence to support the aims of the project
Connect regularly with organization rep on project team
April through July ½ day / month
Mary Lynne Kennedy-McGregor, long-term care
Participate in designing a solution that will improve access to secondary hospice palliative care expertise in long-term care
Liaise with other long-term care homes in Grey Bruce
Help to develop a plan for improving primary level hospice palliative care in acute care
Mid-May through July
2-3 days per month
Rep for volunteer hospices (to be confirmed)
Ensure that volunteer hospice is represented as an important part of the hospice palliative care team
Mid-May through July
2-3 days per month
Lisa Malbrecht, St Joseph’s Health Care London (responsible for Palliative Pain & Symptom Management Consultation Program)
Organizational sponsor
Clear barriers, use influence to support the aims of the project
Connect regularly with organization rep on project team
April through July ½ day / month
Liz Laird, Palliative Pain & Symptom Management Consultation Program
Act as a subject matter expert (secondary level hospice palliative care expert)
Mid-May through July
2-3 days per month
Donna Ladouceur, SWCCAC
Provide and analyze community care data
Participate in designing a solution that will improve access to secondary hospice palliative care expertise in community care
Commit to a plan for improving primary level hospice palliative care in
Mid-May through July
2-3 days per month
Gord Milak, SWCCAC Mid-May through July
2-3 days per month
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community care
Shannon Yeo, CarePartners
Participate in designing a solution that will improve access to secondary hospice palliative care expertise in community care
Commit to a plan for improving primary level hospice palliative care in community care
Mid-May through July
2-3 days per month
Christine Vallis-Page, VON Participate in designing a solution that will improve access to secondary hospice palliative care expertise in community care
Commit to a plan for improving primary level hospice palliative care in community care
Mid-May through July
2-3 days per month
Project manager (consultant)
Develop and deliver on work plan
Coordinate communication
Organize and lead project team meetings
Mid-May through July
1.0 FTE
Paul Cavanagh, South West End-of-Life Care Network
Project lead
Develop project charter in consultation with key partners
Negotiate with project partners for in-kind resource contributions
Coordinate any Request for Quotations for consultants
Report to LHIN
April through July 2-3 days per month
A larger group of providers of hospice palliative care services will be invited to attend an intensive planning event in June (or part of it). Included in this group would be Dr. Hilli Huff, Esther Millar (Hanover & District Hospital), and a representative from the Grey Bruce Healthcare Chaplaincy Council, among others. Many other people who were invited to the workshop in Owen Sound on Feb 4 will also be invited.
Project Oversight (for planning phase)
Identify who is responsible for decision-making and oversight of scope, changes, etc.
A project steering committee will act as an executive sponsorship group and will give final approval for any recommendations submitted to the LHIN. The existing Grey Bruce Health Network CEO Structure (made up of CEOs from the 3 Grey Bruce hospital corporations, the health unit, and the CCAC) will function as the core
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Steering Committee, with a representative (to be confirmed) from each of hospice, family health teams / primary care, long-term care homes and St Joseph’s Health Care London (responsible for the Palliative Pain & Symptom Management Consultation Program) joining in when the Grey Bruce hospice palliative care project is on the agenda.
Project Partners
Is this project carried out in partnership with other groups/organizations? Indicate who else, in addition to those listed as project team members above, has committed to contributing to this project. Partners are individuals, groups or organizations who work together towards joint interests to achieve common goals. Identify shared, mutually beneficial objectives below and the contributions of each partner.
Partners Common Interests & Priorities Roles & Responsibilities
List names, groups or organizations. State shared objectives and identify priorities for each partner listed.
What commitments have been made?
Members of the Grey Bruce End-of-Life Care Partnership
Interested in improving hospice palliative care in Grey Bruce
Have been involved in planning for several years
The project team will connect in with them at key points in the project
Assist with project communication (carry key messages to their organizations and other contacts)
Provide advice to the project team
Grey Bruce Healthcare Chaplaincy Council
Interested in improving access to spiritual care specialists
Have been involved in planning for several years
Provide advice with respect to the spiritual care component of any consultation model
Assist with project communication
Project Stakeholders
Stakeholders are individuals or organizations that have a vested interest in the initiative. They are either affected by, or can have an affect on, the project. Anyone whose interests may be positively or negatively impacted by the project or anyone that may exert influence over the project or its results is considered a project stakeholder. All stakeholders must be identified and managed appropriately.
List names, groups or organizations. Why are they stakeholders? How are they involved?
How will the project manage expectations and meet their needs and requirements?
Members of the Grey Bruce Integrated Health Coalition
Interest in making sure funding is effectively spent in Grey Bruce
Benefits to member organizations and their clientele
Regular updates at Coalition meetings. Emphasis on what this means to Coalition members and their clients, how service enhancements address system issues.
South West LHIN Interest in improved hospice palliative care
Impact on ER, ALC
Regular progress reports. Seek policy clarification as necessary. Engage in project meetings from time to time as required. Develop clear evaluation strategy.
Acute care sector Helping to relieve ER, ALC pressures (Owen Sound)
Understand their pressure points. Ask them to collect baseline data and
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Defining the role of community hospitals in hospice palliative care
Helping acute hospitals to develop their primary level skills in providing hospice palliative care and accessing secondary level expertise
participate in development of evaluation strategy. Ask project team members representing the sector to communicate with their colleagues about the project.
Cancer centre in Owen Sound Majority of end-of-life care clients in the community now have a cancer diagnosis
Understand their pressure points. Explore opportunities to improve transitions between cancer centre and other settings.
Long-term care home sector Recognition that the vast majority of long-term care residents require a hospice palliative care approach
Helping them to define their role in hospice palliative care
Helping them to develop their primary level skills in providing hospice palliative care and accessing secondary level expertise
Understand their pressure points. Ask them to collect baseline data and participate in development of evaluation strategy. Ask project team member(s) representing the sector to communicate with their colleagues about the project.
Primary care sector See patients throughout their illness trajectory
Have a key role in making sure referrals are made early
Primary care support essential for expected death in the home
Understand their challenges. Seek their input at key stages. Look for opportunities to promote early identification of patients in need of hospice palliative care. Clarify how consultation services would support them.
Volunteer hospices An underutilized resource on the hospice palliative care team
Bereavement component
Seek to better understand their potential contributions to the team.
Community care sector (esp. service providers not represented on project team)
PSWs may have most frequent contact with clients and families
Therapists often don’t feel part of the team
Seek to better understand their potential contributions to the team.
PROJECT RESOURCES: NOTE: If there is more than one HSP requesting funding, please fill out a “Project Resources” table for each HSP in Appendix A and the LHIN will roll up into the final in this section. If only one HSP is requesting funding, fill out the section below.
Human Resources
Provide an overview of the new Human Resources (HR) required to support the initiative beginning with the project start up as well as ongoing project support. As well, consider volunteer resources to be leveraged to support the information and provide information on these resources.
Position Title and Designation Required (if applicable) (e.g., PSW, Case Manager)
Project Start-up (Number of FTEs)
Ongoing Project Support (Number of FTEs)
<insert Project Acronym or No.> Project Charter
Target Project Completion Date: Sep 2011
South West Local Health Integration Network Page 17 of 27
Volunteer Services Project Start-up
(Number of Volunteers) Ongoing Project Support (Number of Volunteers)
Services to be provided:
OHRS/MIS Functional Centre Description and/or Code
Individuals to be Served Service Units/Volumes
FUNDING DETAILS
One-Time Funding Budget Comments
Consultation/Training $50,000 (estimated 63 days x $750/day + meeting expenses)
The following skills will be needed for this project. Where they cannot be provided by project partners as in-kind contributions, they will be sought from a consultant or consultants (through a competitive process):
Project management expertise
Quality improvement and program development expertise
Business plan development expertise
Management of change, communication expertise
Program evaluation expertise
Information/Technology $
Staff $
Other (Specify in Comments) $
Other (Specify in Comments) $
Total Funding Required $
Money from Other Funding Sources $
Total Net One-Time Funding Required from LHIN
$
Ongoing Base Funding Year 1 Budget
Year 2 Budget (if applicable)
Year 3 Budget (if applicable)
Comments
Salaries & Wages $
<insert Project Acronym or No.> Project Charter
Target Project Completion Date: Sep 2011
South West Local Health Integration Network Page 18 of 27
Benefits $
Supplies & Sundry Expenses $
Other (Specify in Comments) $
Other (Specify in Comments) $
Total Funding Required $
Money from Other Funding Sources $
Total Net Ongoing Base Funding Required from LHIN
$
Total Funding Required from LHIN $0
In-Kind Contributions
Are there any in-kind contributions? (e.g. office space/furniture, technology)
Yes No
If yes, describe:
<insert Project Acronym or No.> Project Charter
Target Project Completion Date: Sep 2011
South West Local Health Integration Network Page 19 of 27
PROJECT COMMUNICATIONS
Project Team Communications
Identify information needs of steering committee, project sponsor, project manager, team members, working groups, partners, stakeholders and others. List strategies for ensuring that right information is provided to right audience in most suitable and timely manner. Be sure to identify format and frequency of communication between the project manager and project sponsor regarding project status, performance, risks, issues, etc.
Audience Information Needs Format & Timing Responsible
To whom? List recipients of the information.
What? State what information will be communicated?
How? When? How often? Explain method and frequency.
Who? Identify who will provide information.
Project team Background information
Project status
Project resources posted on Network website
E-mail communications
Regular meetings
Project manager
Members of the Grey Bruce End-of-Life Care Partnership
Periodic requests for input
Project progress reports
Key messages to convey
Final recommendations
E-mails, online surveys, postings on Network website
E-bulletins that can be distributed to home organizations
Reports / discussions at Partnership meetings
Project manager, members of the project team
Grey Bruce Healthcare Chaplaincy Council
Integration of spiritual care expertise into any service enhancements
E-mails, online surveys, postings on Network website
Potential participation in workshops or other discussions
Project manager, Chaplaincy Council lead to the project
External Communications
Identify plan for communicating project status, performance, risks, issues, etc. to external audiences (e.g., public, other health service providers, provincial government). List strategies for ensuring that right information is provided to right audience in most suitable and timely manner. Be sure to identify format and frequency of communication.
Audience Information Format & Timing Responsible
To whom? List recipients of the information.
What? State what information will be communicated?
How? When? How often? Explain method and frequency.
Who? Identify who will provide information.
Members of the Grey Bruce Integrated Health Coalition
Project progress reports
Final recommendations
E-mails, online surveys, postings on Network website
E-bulletins that can be distributed to home
Reports at Coalition meetings
Project manager, members of the project team or Partnership
<insert Project Acronym or No.> Project Charter
Target Project Completion Date: Sep 2011
South West Local Health Integration Network Page 20 of 27
SWLHIN Progress reports and requests for assistance
Final recommendations
Formal reports
Ongoing conversations and informal updates
Network Director, project manager
Various project stakeholders
Project progress reports
Final recommendations
E-bulletins
Opportunities to provide updates at meetings as they arise
Project manager, members of the project team
<insert Project Acronym or No.> Project Charter
Target Project Completion Date: Sep 2011
South West Local Health Integration Network Page 21 of 27
PROJECT RISKS & CHALLENGES
Project Risks
Document high-level project risks apparent at this point that could either positively or negatively impact the achievement of project goals and objectives. Focus on risks that are likely to happen and have a significant effect on project success. Be sure to consider risks associated with people & organization change, knowledge management and transition to operations.
Risk Likelihood of Occurrence
Potential Impact
Organization Capacity to
Manage Risk Mitigation Strategy
Brief description of risk. High, Medium, Low
High, Medium, Low
High, Medium, Low High level strategy to address risk.
Finding qualified staff or consultants to support the project
Medium to Low
High High Work with project team to identify which organizations might be able to free up staff with the necessary skill sets. Generate list of qualified consultants before issuing RFQ.
Project perceived as yet more planning, more money to consultants
Medium to high
High High Involve stakeholders in project charter development
Lack of participation from key partners
Low High High Establish a strong project team with clear roles, drawing from key partners in different sectors
Inability to agree on a recommendation to the LHIN
Medium High Medium to high Ensure that the project engages the services of someone with strong mediation and facilitation skills.
Programs develop that are disconnected from this planning effort
Medium Medium to high
Medium Ask partners to share information about programs they’re developing to make sure there’s not a disconnect
Disagreement over accessing secondary level expertise
Medium High Medium to high Ensure that the project engages the services of someone with strong mediation and facilitation skills.
Can’t agree on lead / governance structure going forward
Medium High Medium to high Ensure that the project engages the services of someone with strong mediation and facilitation skills.
Model developed but doesn’t fully answer the question of how funding should be invested
Low Medium to high
High Explore additional opportunities for service improvement
Unable to establish a Medium Medium to Medium to high Ensure that the project engages
<insert Project Acronym or No.> Project Charter
Target Project Completion Date: Sep 2011
South West Local Health Integration Network Page 22 of 27
Risk Likelihood of Occurrence
Potential Impact
Organization Capacity to
Manage Risk Mitigation Strategy
sense of team around the project
high the services of someone with strong mediation and facilitation skills.
Plan developed then ignored
Medium High Medium Seek commitment from project partners; develop and execute an implementation plan once service enhancement recommendations are approved by the LHIN and funding is flowed
Network not seen as neutral, credible
Medium Medium to high
High Strong emphasis on executing communication plan; demonstrate link with Network’s strategic plan; engage skilled resource people as needed; ensure a strong work plan is developed
Can’t recruit and retain hospice palliative care expertise to support service enhancements
Medium to high
High Low to medium Consider a number of options – draw on experiences from other jurisdictions (particularly rural ones)
Critical Success Factors
Define key factors that are critical to success of the project. These conditions must be satisfied to enable successful completion of project objectives and deliverables. Include significant events or decisions that need to take place. Whenever possible, ensure factors you list are measurable.
Partners are able to work collaboratively
Partners are able to agree on key principles for integrated hospice palliative care at the beginning of the project
Recommendations address process, structure and outcomes
The principal focus remains on improving the experience of patients and families
Assumptions & Constraints
Assumptions are external factors that, at the time of writing the charter, are considered true, real or certain for purposes of planning. Certain unverified or unknown aspects that are likely to happen must be assumed as facts to proceed. Constraints are factors that are outside the control of the project team, that restrict or regulate the project. They limit available options and affect performance of the project.
Assumptions Constraints
List the assumptions made to date. What did you have to assume to be true to complete the charter?
List project constraints. Consider time, budget, scope, quality, availability/skills of resources, priorities, etc.
One-time funding is approved by the LHIN and flowed by April 15, 2011
Network also has responsibility for managing four other projects as part of the implementation of its strategic plan
<insert Project Acronym or No.> Project Charter
Target Project Completion Date: Sep 2011
South West Local Health Integration Network Page 23 of 27
Key partners are willing to commit necessary time and resources (project-related expertise)
Rebuilding of trust will require a big commitment to openly sharing information and keeping stakeholders informed
Strong local sponsorship for the project will emerge from the project team
<insert Project Acronym or No.> Project Charter
Target Project Completion Date: Sep 2011
South West Local Health Integration Network Page 24 of 27
PROJECT REPORTING SCHEDULE <TO BE COMPLETED BY THE LHIN>
Project Status Reports
Based on the Estimated Project Duration of and Target Project Completion Date of [yyyy-mm-dd], Project Status Reports are to be submitted to the LHIN according to the following schedule:
Report Reporting Period [yyyy mm dd to yyyy-mm- d]
eport De dline [yyyy-mm-dd]
1 to
2 to
3 to
to
Project Close-out Reports
Based on the Target Project Completion Date of [yyyy-mm-dd], the Project Close-out Report is to be submitted to the LHIN on the following date:
Please submit Project Status Reports and Close-out Report to [email protected]
This needs to be a signature spot for all HSPs involved in the charter including date submitted to LHIN
South West Local Health Integration Network Page 25 of 27
APPENDIX A: PROJECT RESOURCES FOR EACH HSP REQUESTING FUNDING
LEAD HSP: <ENTER NAME OF HSP>
Human Resources
Provide an overview of the new Human Resources (HR) required to support the initiative beginning with the project start up as well as ongoing project support. As well, consider volunteer resources to be leveraged to support the information and provide information on these resources.
Position Title and Designation Required (if applicable) (e.g., PSW,
Case Manager)
Project Start-up (Number of FTEs)
Ongoing Project Support (Number of FTEs)
Volunteer Services Project Start-up
(Number of Volunteers) Ongoing Project Support (Number of Volunteers)
Services to be provided:
OHRS/MIS Functional Centre Description and/or Code
Individuals to be Served Service Units/Volumes
FUNDING DETAILS
One-Time Funding Budget Comments
Consultation/Training $
Information/Technology $
Staff $
Other (Specify in Comments) $
Other (Specify in Comments) $
Total Funding Required $
Money from Other Funding Sources $
Total Net One-Time Funding Required from LHIN
$
Ongoing Base Funding Year 1 Budget
Year 2 Budget (if
Year 3 Budget (if
Comments
<insert Project Acronym or No.> Project Charter
Target Project Completion Date: Sep 2011
South West Local Health Integration Network Page 26 of 27
applicable) applicable)
Salaries & Wages $
Benefits $
Supplies & Sundry Expenses $
Other (Specify in Comments) $
Other (Specify in Comments) $
Total Funding Required $
Money from Other Funding Sources $
Total Net Ongoing Base Funding Required from LHIN
$
Total Funding Required from LHIN $
In-Kind Contributions
Are there any in-kind contributions? (e.g. office space/furniture, technology)
Yes No
If yes, describe:
PARTNER HSPS: If there are more than 2 HSPs requesting funding, copy and paste a table for each
PARTNER HSP #1: <ENTER NAME OF HSP>
Human Resources
Provide an overview of the new Human Resources (HR) required to support the initiative beginning with the project start up as well as ongoing project support. As well, consider volunteer resources to be leveraged to support the information and provide information on these resources.
Position Title and Designation Required (if applicable) (e.g., PSW,
Case Manager)
Project Start-up (Number of FTEs)
Ongoing Project Support (Number of FTEs)
Volunteer Services Project Start-up
(Number of Volunteers) Ongoing Project Support (Number of Volunteers)
Services to be provided:
OHRS/MIS Functional Centre Description and/or Code
Individuals to be Served Service Units/Volumes
<insert Project Acronym or No.> Project Charter
Target Project Completion Date: Sep 2011
South West Local Health Integration Network Page 27 of 27
FUNDING DETAILS
One-Time Funding Budget Comments
Consultation/Training $
Information/Technology $
Staff $
Other (Specify in Comments) $
Other (Specify in Comments) $
Total Funding Required $
Money from Other Funding Sources $
Total Net One-Time Funding Required from LHIN
$
Ongoing Base Funding Year 1 Budget
Year 2 Budget (if applicable)
Year 3 Budget (if applicable)
Comments
Salaries & Wages $
Benefits $
Supplies & Sundry Expenses $
Other (Specify in Comments) $
Other (Specify in Comments) $
Total Funding Required $
Money from Other Funding Sources $
Total Net Ongoing Base Funding Required from LHIN
$
Total Funding Required from LHIN $
In-Kind Contributions
Are there any in-kind contributions? (e.g. office space/furniture, technology)