The Cedarview Lodge CLe AR Project Success One

The Cedarview Lodge CLe. AR Project Success One Resident at a Time Quality Forum 2015 Paula Rozanski, Manager Ameneh (Amy) Fallahi, RN Peter Marin, RCA 1

Thank You • Ben Ridout BC Patient Safety Quality Council • Deborah Lorimer Director of Residential Care, Coastal Community of Care, VCHA 2

Introduction 89 Beds 22 6 Special Care Beds Respite Beds 3

CLe. AR Call for Less Antipsychotics in Residential Care “The aim of CLe. AR is to achieve a reduction in the number of seniors in residential care on antipsychotic medications by 50% across BC by December 31, 2014 through a province-wide, voluntary initiative that supports participating sites. ” 4

Goals ü Improve care for residents who have BPSD by reducing the number of residents who are on antipsychotics ü Create opportunities for initiatives to work together ü Build new skills and knowledge* for improvement in residential care *Capacity - “Give a man a fish and he eats for a day. Teach a man to fish and he eats for a lifetime” 5

Our Journey 2 r! te har C 4 3 1 Proces s Mapp Roles & 5 onsib ilities ! Resp 8 7 ication f i t n e d I Early Tool ing 6 6

Process Map 7

4 4 r-1 be m be r-1 ce De 4 4 r-1 be m ve No to Oc 4 r-1 be em st -1 70% pt gu 14 80% Se Au y- Ju l 4 14 4 -1 e 1 Ju n 4 -1 4 ay - M ril Ap ch ar M -1 ry ua -1 4 3 100% Fe br ua ry Ja n r-1 be em De c Successes Percent of residents on an antipsychotic 90% 47% improvement 60% 50% 40% 30% 20% 10% 0% 8

4 4 r-1 m be r-1 ce De 4 4 r-1 be m ve No be to Oc 4 r-1 be em 14% pt st -1 16% Se gu Au y 14 Ju l 4 e 1 Ju n 4 14 -1 ay - M ril Ap 4 4 -1 ch ar M -1 ry -1 4 3 20% ua Fe br ua ry Ja n m be r-1 ce De Successes Percent of residents on a PRN antipsychotic 18% 88% improvement 12% 10% 8% 6% 4% 2% 0% 9

4 4 r-1 m be r-1 ce De 4 4 r-1 be m ve No be to Oc 4 r-1 be em 35% st -1 40% Se pt gu Au 14 y- Ju l e 14 Ju n 4 14 -1 ay - M ril Ap 4 -1 ch ar M 4 -1 ry ua Fe br 3 50% ua ry Ja n m be r-1 ce De Successes Percent of residents on regular & PRN antipsychotic 45% 50% improvement 30% 25% 20% 15% 10% 5% 0% 10

Successes Outcome Grouping Scale 2013/2014/2015 2014/2015 Q 4 Q 1 Q 2 Q 3 78% 80% 83% 90% 86% 93% 95% 96% 98% 96% 100% Aggressive Behavior Scale None Depression Rating Scale Low (0 -2) MDS Pain Scale Low (0 -1) 11

Successes CVL - Falls 35 30 25 20 15 10 5 0 Jan Feb Mar Apr May Jun # of falls 2013 Jul Aug Sep Oct Nov Dec # of falls 2014 12

Successes 13

Lessons Learned • • • Leadership Clear vision & goal Unit champions Project & communication plan Dedicated resources 14

Next Steps ü Developed standards of practice to sustain the gains ü Continue to engage families of residents ü Culture change 15

Questions 16