OCAN Education
Training for OCAN Users
Day 2
Objectives
Learn how to:
• Complete staff assessment
• Interpret and make use of information from
OCAN in a number of ways
• Introduce Shared Assessment model in your
health service provider (HSP) organization
• Introduce assessment, re-assessment
guidelines
• Introduce OCAN into business process
OCAN Training Agenda - Day 2
• Welcome & Introductions
• Objectives
• Unit 2
– Application of OCAN cont’d
– Staff Assessment – Scoring Activity
• Unit 3
– Outputs-Actions, Referrals, Reports
• Unit 4
– Timelines and Reassessment
• Unit 5
– Business Process
• Unit 6
– Shared Assessment
3
• Next Steps
• Evaluations
Unit 2 Continued
Staff Assessment
OCAN Part II: Staff Assessment
Score Need
Score Help
5
OCAN Part II: Staff Assessment
Key Points
• In each of the 24 domains the staff is determining scores
for need and help and recording these
• For every met or unmet need, the help score must be
completed
• If there is no identified need, a help rating is not required,
but the extra questions in the domain should be completed
• Action and comments fields should be completed as
robustly as possible when indicated
• Information gathered is important to inform the ongoing
work with the consumer and is reflected in reports
6
OCAN Part II: Staff Assessment
Key Points cont’d
Many reasons can cause an increase in consumeridentified unmet needs from assessment to
reassessment including:
• consumer’s perceived decline in these areas
• consumer’s journey of recovery allows them to
identify different or new unmet needs as their
horizons expand
7
OCAN Part II: Staff Assessment
Key Points cont’d
Need in Relation to Help
• No Problem / No Need
– Help is not provided
• No/Moderate Problem due to help given / Met
need
– Help is provided
• Serious Problem / Unmet need
– Help is or is not provided
8
Pop Quiz!
1.
2.
3.
4.
What does OCAN stand for?
What are the 4 steps of OCAN?
Who can help complete the Self-Assessment?
What if a Consumer does not wish to complete
a Self-Assessment?
5. If informal or formal help is scored as 3, what
does that mean?
6. If a score of 1 is given for need, what could that
mean?
9
Practice: Scoring OCAN
Practice Module includes:
• Self assessment
• Dialogue
• OCAN Part 2-staff
assessment with
collateral information
10
Practice: Scoring OCAN Debrief
1. How can you use a recovery focus to talk about
variances (differences) between the consumer selfassessment and the worker assessment?
2. How do you dialogue about successes when the
consumer has indicated that there is “No Need”?
3. How can you use a recovery focus to talk about
unmet needs that both you and the consumer
identify?
11
LUNCH
Unit 3
Outputs
Summary of Actions
• At the end of the assessment, actions will be
summarized in a table that looks like the following:
14
Priority Domain
Action
1
Submit application for
supported housing
Accommodation
Summary of Referrals
• At the end of the assessment referrals and status of the
referral can be documented in this chart
• This working tool is helpful to track referrals on an
ongoing basis
• An outcome of the Summary of Referrals is the
identification of gaps in service
15
Optimal
Referral
Specify
Actual
Referral
Specify
Reason for
Difference
Status of
Referral
Drop down of
functional
centres
Name Program
Drop Down of
functional
centres
Name Program
See Data
Elements
See Data
Elements
Individual Assessment Reports
1. Individual Need Rating Over Time
2. Needs Over Time
3. Summary of Actions and Comments
4. Staff Workload
16
Unit 4
Timelines and
Reassessment
Reassessment
What is reassessment?
• a structured, documented review using OCAN
• an opportunity for consumers and providers to regularly
review needs, identify accomplishments and inform next
steps
• consists of the consumers self assessment, the staff
assessment and information from other sources e.g.
providers and family members
18
Assessment on a ‘Heartbeat’
Initiating the “Heartbeat”
Start Date
End Date
Start Date
End Date
Assessment
1
May 1
Assessment
1
May 30
Assessment
2
November 1
Assessment
2
November
30
30 Days Max
30 Days Max
6
M O N T H S
Once the start date is chosen, the end date is 30 days from the start date. The next assessment happens 6 months
from the start date of the previous assessment.
Sustaining the “Heartbeat”
Assessment 1
May 1 2008
Reassessment 1
at 6 months
November 1 2008
Reassessment 2
at 12 months
May 1 2009
Other Assessment 1
Significant Change
Reassessment 3
at 18 months
November 1 2009
Other Assessment 2
Client Request
Regardless of any “Other” assessment completed between the “heartbeats”, the assessments continue every 6 months .
19
BREAK
Assessment on a ‘Heartbeat’
Resetting the “Heartbeat”
Assessment 1
Core Ax or
Core + Self Ax
May 1 2008
Reassessment 1
at 6 months
November 1 2008
Other Assessment 1
November 15, 2008
Referral to Housing or
agency that completes a
Full OCAN
Heartbeat is Reset
6
M O N T H S
15 DAY GAP
6
Reassessment 1
May 15, 2009
6 month heartbeat
continues to
accommodate Full
OCAN schedule
M O N T H S
6
Reassessment 2
November 15, 2009
6 month heartbeat
continues to
accommodate Full
OCAN schedule
M O N T H S
The heartbeat is reset when service begins with a Health Service Provider that completes a Full OCAN –
also known as the fullest dataset.
Types of Assessment
• Assessment types are chosen in OCAN and
include:
–
–
–
–
–
–
–
22
Initial OCAN
Reassessment
(Prior to) Discharge
Significant Change
Review
Re-key
Other
Initial OCAN
• An “Initial OCAN” is only completed by the
OCAN Lead when the person participating is
new to the Community Mental Health system or
is re-entering the Community Mental Health
system more than 90 days after a previous
discharge.
23
Reassessment
• OCAN is completed every 6 months.
• This is referred to as the “heartbeat”
• The “Reassessment” is chosen for clients who
have completed a prior OCAN or they are
existing clients for whom this will be their first
OCAN
• Completed by the OCAN lead
24
(Prior to) Discharge
• Discharge for the purposes of OCAN is planned
discharge from the mental health system. This
assessment type is completed by the OCAN Lead. For
details, please refer to the guidelines below:
• (Prior to) discharge – REQUIRED
• Client is leaving the Community Mental Health System
(planned discharge)
• (Prior to) discharge – NOT REQUIRED
• Client “drops out” of Community Mental Health Services
(unplanned)
• Transfer of a client from one Community Mental Health
program / HSP organization to another*
25
Significant Change
• A Significant Change OCAN does not change
the “heartbeat”
• It is completed by the OCAN Lead
• OCAN can also be completed when there is a
significant change in the person’s life that may
require closer assessment to ensure that the
most current needs are identified
26
Review
• A Review OCAN does not change the
“heartbeat”
• When information from one HSP organization’s
assessment is updated or changed as part of a
review process before entering it into another
HSP organization’s automated solution, the staff
will choose “Review” as the reason for
assessment
27
Re-key
• A Re-key OCAN may or may not be completed
by the OCAN Lead and it does not change the
“heartbeat”
• Re-key OCAN is conducted when an HSP
organization receives an OCAN from another
HSP organization and does not update any of
the fields when they enter it into their own
system
• HSP organizations may choose to re-key when a
paper copy is not needed
28
Other
• An “Other” OCAN is completed by the OCAN
Lead but it does not change the ‘heartbeat’
• One examples of an other reason for
assessment could be ‘consumer request’
• For any “Other” reason for assessment, the staff
person records the reason
29
Unit 6
Shared Assessment
Vision
Current Situation
Multiple assessments for same
consumer
Vision
One assessment and one
submission of CDS per consumer
Single Framework (CDS – OCAN)
Assessment Part I:
Assessment Part II:
Consumer Self
Staff Assessment
Assessment
Consumer Information Summary
Service Use
31
Goals of Shared Assessment
• A single OCAN submitted across the mental
health system for any one consumer
• Collective contribution by all providers
working with the client into one OCAN
32
Benefits of Shared Assessment
• Collaborative approach focuses on needs of the
consumer
• Integration and co-ordination of services
provides better consumer support and clear
roles for staff
• All health service providers are given credit for
the support they are providing to same
consumer
• Access to reports by all orgs involved in services
to same consumer
33
Business Process
6 Months
Self Ax
CM Ax
6 Months
Self Ax
CM Ax
Self Ax
Housing
Ax
Self Ax
CM Exit
Input*
Input
Input
Input
Input
Input
Input
Input
Housing
Club
House
Housing
Club
House
Peer
Support
Housing
Club
House
Peer
Support
OCAN Lead
34
6 Months
Contributing CMH
Providers
New OCAN Lead
*Input for Assessments to the
OCAN Lead can be communicated
anytime between Assessments
Roles
Consumer:
– consents to share OCAN
- involved in choosing who completes OCAN
OCAN Lead:
–completes and submits one OCAN in agency with input
from other staff (contributing providers) involved in
providing services to consumer
Contributing Provider:
- Participates in assessment process
35
OCAN Lead
Activity:
Determine OCAN Lead in your agency
• Discuss and develop some guidelines for
choosing who would be OCAN lead when two of
your programs are involved with the same
consumer.
• What would be their responsibilities in
completing an OCAN?
36
Three Types of Reporting Structures
Organizations
that have
consumers
who see
multiple
providers
OCAN
OCANand
and
Sharing
Sharing
OCAN and
No Sharing
No OCAN
Non-HICs
37
Results in
multiple
instances
of OCAN
and CDS
Results in
multiple
instances
of CDS
(highest
aggregate
level)
Unit 5
Business Process
Business Process
What is an HSP organization Business Process?
• A series of connected steps / actions / tasks to
achieve an outcome
• It is what you do in your agency from the time a
consumer enters your agency up to planning
services for him\her
• Business Process Mapping is a diagram
showing how work flows through your agency
39
Business Process
INTAKE
ORIENTATION
TO HSP ORG
• Where does OCAN fit?
• What can it replace?
40
ACCEPTANCE
TO
SERVICE
SERVICE
PLANNING
Business Process
Think about how your agency will use OCAN in
your current business process.
Questions:?
Will OCAN replace part of current assessment?
Will OCAN replace current assessment?
Will OCAN be added to current assessment?
41
Available Resources & Supports
Resources
• Your Change Team
• Kick-off binder
• OCAN 2-day training user binder
• Co-ordinator training binder
• Quick reference guides
• Consumer support materials
Supports
• Portal(s)
• Project Support Centre (CMH CAP)
• OCAN Knowledge café
• IT services
42
Next Steps
• Supported training
• Sign-up sheets
• Evaluations
43
Thank You!