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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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Page 1: 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

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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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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Facilitated Integration (Integration Decision required)

Required Integration (Integration Decision required)

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.

Stakeholders Interests & Needs Management Strategies

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)

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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 $

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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:

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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

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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

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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

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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

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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

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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

For LHIN Internal Review

_______________________________________________________________________

LHIN Senior Leader

______________________

Date Reviewed

_______________________________________________________________________

LHIN Project Lead

______________________

Date Reviewed

LHIN Performance Lead

Date Reviewed

For LHIN Internal Review

_______________________________________________________________________

LHIN Senior Leader

______________________

Date Reviewed

_______________________________________________________________________

LHIN Project Lead

______________________

Date Reviewed

LHIN Performance Lead

Date Reviewed

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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

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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

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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)

Yes No

If yes, describe: