What do you think?
- Why does the client’s perspective on whether their care plan meets their assessed unmet needs matter?
- How might this information be used to inform Continuing Care Health Service Standards 1.0 Standardized Assessment and Person-Centred Care Planning and 2.0 Case Management, and/or related sub-standards?
- Are there differences between zones? Between mainly rural and urban zones? What factors could account for these differences?
Whether you’re a client, family member, provider, or health system administrator, thinking about why these differences might exist can start or inform conversations and lead to solutions for improved quality of healthcare.
Understanding “care plan meeting needs”
In a survey conducted from October 2018 to March 2019, the HQCA asked clients receiving home care:
In the last year, my care plan included….
Clients could choose “Most of the things I needed / Some of the things I needed / Almost none of the things I needed / I have not seen my care plan”
A care plan describes both the professional and personal services that address a home care client’s assessed unmet needs, which means the care plan is informed by the results of a standardized assessment and client’s preferences (e.g., spiritual and cultural).
These results can provide information about:
- How effective the assessment and care planning process is,
- Gaps between assessed unmet need and home care services provided, and
- Gaps between client expectations and home care services provided.
System-level decisions about what types of services can be delivered through the home care program, also known as the ‘basket of services,’ can affect what a care plan includes.
Considerations when viewing the results:
This data reflects the experiences of seniors aged 65+ receiving long term supportive and maintenance care and are among the largest groups of home care clients.
There are a number of factors providers and leaders can consider to better understand and improve client experiences with the care plan meeting client needs. Some questions they could ask before taking action include:
- When clients are thinking about what they need, what services are they reflecting on? Are those services available in home care (part of the basket of services)? If not, how might that impact client expectations and experience?
- Do clients and their loved ones have a good understanding of what is included in the basket of services? How can this understanding be improved? How could having a common understanding of what services can be delivered through home care help improve client experience?
- How are housekeeping, help with instrumental activities of daily living (e.g., cleaning the home, yard work, or shoveling snow), and emotional support prioritized by the home care program versus medical and personal care (e.g., bathing, getting dressed) activities? How might this impact results?
- What can the system learn about the gap between client expectations and the basket of services available from evaluations of clients reporting that they have unmet needs?
- How are case managers empowered and supported to identify or respond to changing client needs, and update the care plan accordingly?
For information about the HQCA’s Alberta Seniors Home Care Client Survey, please visit the HQCA website.
The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. This measure can be used as input to assess home care’s performance in these dimensions of quality:
Dimensions of Quality