Check out the DECEMBER 2012 edition of BSO eNews to connect, share, participate and learn about new resources, project updates, events and stories from the field.
connect, share, participate & learn
 BSO eNews December 2012 

Providing the RIGHT CARE at the RIGHT TIME and in the RIGHT PLACE, Behavioural Supports Ontario (BSO) enhances the health care services of seniors across Ontario, their families and caregivers, who live and cope with responsive behaviours associated with dementia, mental illness, addictions and other neurological conditions, when they require it and wherever they live, at home, in long-term care or elsewhere. To learn more...

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 Happy Holidays      

Happy Holidays 
At this time of year, perhaps more than any other, people often find themselves taking stock of what has been achieved. And so, as another calendar year comes to an end, BSO can be proud of the great deal it has achieved in 2012; more than 475 new front-line staff have been hired across the province, in-house behavioural supports have been increased in hundreds of long-term care homes, specialized training in techniques and approaches applicable to behavioural supports has been provided to an estimated 14,000 new and existing front-line staff and, BSO has presented at the conferences and symposia for 23 provincial, regional and national associations.

More importantly, this is a time of year that offers everyone a chance to stop and consider friends and family. The BSO project is often likened to a family; a very large and extended family. And so, from all of us at the BSO Coordinating and Reporting Office to all of you, the extended BSO family - THANK YOU!  The success of BSO could not happen without your ongoing dedication, commitment and monumental effort in support of a common vision.

To you, your families and friends ...


 Sustainability Planning Begins -  As 2012 wraps up, sights have been set on the new and exciting opportunities that lay on the road ahead through 2013 and beyond. The project phase of BSO is winding down and the next step is to ensure behavioural support services continue to improve and grow in your LHIN. We’ve been transforming the system in 2012; now it’s time to sustain the gains and carry our momentum to new improvements.

To ensure our success, LHINs have recently been asked to complete a “sustainability plan.”  To do so, LHINs will be engaging health service providers early in the New Year to help describe the steps and mechanisms that will make the BSO transformation and make it self-sustaining within each region.  These plans will then be presented to the BSO Provincial Resource Team (PRT) for feedback, and shared at a provincial knowledge exchange event to enable cross-pollination of ideas and identification of provincial support mechanisms.
The best of BSO is truly yet to come!  As the project evolves toward the goal of sustainability the “best” of BSO will require more collaboration across all sectors of the health system, engagement of strategic partners and ongoing expansion into primary care and the community services sector. Our work has just begun and it is an exciting time for BSO!

  Supporting People Living in the Community The community services sector is vital to the sustainability of Behavioural Supports Ontario and while there are many efforts already underway to support the BSO population... wherever they live, this information is not universally known or shared. As a result, 67 professionals from across the province came together in November, under the auspices of collaboration and partnership, to further a common vision; by working together we can change the system of care for seniors across Ontario, their families and care partners who live with responsive behaviours associated with dementia, mental illness, addictions and other neurological conditions. Specifically, the goals of this knowledge sharing event were to learn about existing innovations in the community, how best to integrate the community sector into current LHIN plans and to what extent resources are needed to ensure we work together across the province to enable and create system change. It was a true collaboration between sectors, organizations and LHINs.

Themes and keynote presenters for this event included Primary Care (Jane McKinnon, Geriatric Systems Coordinator, Trellis), Managing Transitions (Laurie Fox, Implementation Project Lead, HNHB LHIN), Person-Centred Care (Shawn Souder, Regional Director of Behavioural Support Services, Providence Care (SE LHIN) and Integrated Care / Cross Sector Collaboration (Jodeme Goldhar, Lead for Health System Integration for Complex Populations and Primary Care, Toronto Central CCAC).

Many common threads were identified including the poignant reminder that everyone is accountable. There is a need for common language across all sectors, for technology integration in order to communicate and share provincially and to share/client/patient information; a need for meaningful service measurement/evaluation, to build in more education, address the financial burden of care and notably, to develop leadership at the provincial level.

Overall, a majority of participants felt that they now better understand what others are doing, can identify clear next steps for collective collaboration and believe this event proved to be a valuable knowledge exchange oppo0rtunity. Many action steps were developed during the event that will require more collaboration between LHINs and provincial support. The Alzheimer Knowledge Exchange, Health Quality Ontario and Behavioural Supports Ontario are working to ensure LHIN and project leads have the tools, resources and opportunity to implement these action steps and also. to provide a way for participants to stay connected through


SPREAD THE WORD and tell everyone about the great things happening at BSO. Share your story about the great work your doing and lessons learned 'in the field' and we'll spread the news.  

"Angels Among Us" - The goal of the BSO System Navigators in the Erie St. Clair LHIN is to improve the care experience by making care more accessible; providing a smooth journey through the system by ensuring clear communication and strong engagement both among providers and between providers and care recipients.
“It's like being an angel... a guardian angel,” said Jillian Heard, BSO System Navigator.  “I advocate for those who cope with responsive behaviours, while guiding and watching over caregivers who are on their respective journeys through an often complex, complicated and un-coordinated system.”
Jillian recently advocated on behalf of a caregiver who felt quality of life was not taken into consideration for either her husband or family, when developing the care plan.  Frustrated and unable to move forward with important client-centred decisions, Jillian brought together multiple service providers, including the Alzheimer Society, to collaboratively consult on the case, provided support to the caregiver and family, and educated all parties involved  on possible interventions that would help with advanced responsive behaviours. 
“The patient was not transferred to another facility, which would have created a financial and transportation hardship for the caregiver and her family,” said Jillian.  “Not only did the client need more time to adjust to medications, the caregiver and family needed more time to understand all of the options in order to make informed decisions.  Collective decisions were made and most importantly, the client, his primary caregiver and family were treated with the dignity and respect they deserved.”


The delivery of joint Residents First Behavioral Supports Ontario events has continued throughout the month of November with the Central East, North West and Waterloo Wellington LHINs.  Hamilton Niagara Haldimand Brant hosted one more in December. These joint events have included participants from both long term care and community partners.  

Health Quality Ontario, in partnership with each of these LHINs, hosted a 3 day event which included 2 days of Residents First Quality Improvement Facilitation Training followed by a 1 day Kaizen event.  The 1 day kaizen event successfully leveraged the application of quality improvement knowledge and tools to advance the work of the BSO project in each local area.
The Central East LHIN showcased the incredible effort put forward by their early adopter LTC homes and shared these learning with the next phase of LTC homes who will implement BSO. The focus of the kaizen on day 3 was sustainability and ensuring the right supports are in place to maximize success.  Well done Central East LHN!
The North West LHIN had a phenomenal success with a 3 site OTN delivery model.  Teams attended in Thunder Bay, Dryden and Fort Frances.  HQO Coaches were on site in each location facilitating the training and assisting the teams to work through a kaizen aimed at further developing roles, responsibilities, processes and tools. Keep up the great work NW LHIN!
In Waterloo Wellington teams were focused on the application of quality improvement tools and processes through the use of case studies.  The participants also investigated and directly applied the concepts of change management to the identified case studies. The concepts and strategies learned will be applied to support the momentum of the action plan.  Great creativity and enthusiasm Waterloo Wellington!
Through the November events alone, quality improvement skills have been built in each LHIN with a total of 171 new improvement facilitators across the province.
By the end of December HQO will finish the commitments defined in the 14-LHIN QI work plans.   Over the past 15 months, we have built a substantial cohort of Improvement Facilitators across the province and are confident that their expertise will further the work of BSO.


  BSO Releases  "Capacity Building Suite"

BSO has recently released The Road Ahead, the fourth in a series of high-quality capacity building tools/resources that now form the Capacity Building Suite Whether interested in building capacity as an individual, team or organization, to support person-centred care and enable system change for the BSO population, their families and/or care partners, the BSO project offers a complete ensemble of tools to support the development of core competencies, workforce learning and development programs and better care at the bedside.

The Capacity Building Roadmap helps plan the first 6 months of orientation for new staff. The Road Ahead informs decisions about continuous learning at any career point. Both act as frameworks to organize what staff needs to know, when they need to know it and how they can learn it. Meanwhile, the Behavioural Education Training and Supports Inventory (BETSI) helps to define organizational learning needs and to appropriately spend training budgets by suggesting the right mix of education and training programs at the right time. Rounding out the quartet is the Person and Practice-based Learning (PerPLe) tool, a framework for a learning and development approach for health care teams that helps to apply any learning opportunity in a team-based environment.

To better understand how these tools can work for you, try the 
Capacity Building Decision Tree.  It’s interactive and user friendly, and you can download the tools you need by clicking on the "mouse over" link.

Understanding comes through education and awareness. To this end, AKE and BSO are currently in the process of conducting webinar sessions with our partners and provider organizations to further spread the word about this valuable suite.

Responsive Behaviours and Complex Care 

The Alzheimer Knowledge Exchange’s role within the BSO Project is to facilitate knowledge exchange activities, sharing of resources and promising practices. One way we support this work is through our Resource Centre which serves as the central repository for information,  resources and knowledge exchange opportunities.

We are currently developing a resource page on Responsive Behaviours and Complex Needs. If you have a resource (tool, guide, link, article etc.) that has been useful in your work, please let us know so we can we can share it with the community and arrange to have it posted on the page.


  BSO in the News  
EDUCATE yourself and learn from tools & resources that support your capacity to put promising knowledge into practice.  Send us resources that help you do great work so that we can share them with others.

From the desk of the Provincial Resource Team, we hope the following tricks and tools will help you to make and hold the gains!

  • The CW LHIN is working on developing a cultural guide to address current local gaps in this area. Consider your own context and how you can best support the cultural diversity in your area
  • Central LHIN is engaging their Geriatric Emergency Management (GEM) nurses as a key point for BS) referrals. Consider others in your region that are natural touch-points for BSO referrals.
  • Older adults with serious mental health issues often do not fit into traditional care options. Look to see if this population is a subset of another (e.g. complex continuing care?). Also, consider engaging disease-specific agencies such as the Huntington’s Society to support transitions for these individuals.
 Check Out the Following Resources 


CONNECT ME to people and groups who are sharing knowledge, working and discussing issues that are important to my work.

 Connect me with groups to mobilize resources and support meaningful change

BSO Mobile Teams Collaborative

BSO Primary Care Collaborative
BSO Enhanced Access/Centralized Intake Collaborative
BSO Behavioural Support Units Collaborative
AKE Design and Dementia Community of Practice
SHRTN Mental Health, Addictions and Behavioural Issues Community of Practice
Capacity Building Community of Practice

 Connect with the BSO Knowledge Integration Coordinator and get answers to your questions about the BSO Project.  Send Sarah an email!

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