ARCHIVED - Management Response and Action Plan (MRAP) - Audit of Primary Care - Nursing Services
October 2010
| Recommendations | Planned Management Actions | Deliverables | Expected Completion Date | Accountability |
|---|---|---|---|---|
| 1. It is recommended that the Assistant Deputy Minister of First Nations and Inuit Health Branch and the Assistant Deputy Minister of Regions and Programs Branch establish an integrated model of primary health care with a clear accountability framework. | Document articulating roles and responsibilities with respect to recruitment and retention of nurses between First Nations and Inuit Health Branch (FNIHB), Regions and Programs Branch (RAPB), and Corporate Services Branch (CSB). | Document outlining the roles and responsibilities | December 2010 | Assistant Deputy Ministers of FNIHB (lead), RAPB and CSB |
| Document will be communicated to Health Canada staff. | Communication of roles and responsibilities to staff by FNIHB and RAPB | January 2011 | Assistant Deputy Ministers of FNIHB and RAPB | |
| Authorities Renewal process will result in a revised Program Activity Architecture and Terms and Conditions to reflect an integrated model of primary health care. The scope of Clinical and Client Care model will be clearly defined within a new Primary Care sub-activity of the program activity architecture. This will be one of three components of a Primary Health Care Activity. | Revised Program Activity Architecture Approved Terms and Conditions. |
March 2011 | Assistant Deputy Minister of FNIHB | |
| Continue with the Nursing Innovation Strategy to investigate and pilot new models of primary care in remote and isolated First Nation communities. The results of these pilots will inform the Clinical and Client Care model as appropriate, as will actions outlined in the response to recommendation 2 dealing with delivery models and standards. |
Formative evaluation report on the Nursing Innovation Strategy (first part) | April 2011 | Assistant Deputy Ministers of FNIHB (lead) and RAPB | |
| 2. It is recommended that the Assistant Deputy Minister, First Nations and Inuit Health Branch and the Assistant Deputy Minister, Regions and Programs Branch develop an operational plan with measureable objectives which are aligned to a budget that better reflects the actual cost for the delivery of services. | Complete analysis to inform the Clinical and Client Care model with respect to services to be provided in nursing stations; the delivery and staffing models; and associated standards (based on comparability to provincial services while recognizing the uniqueness of remote and isolated nursing stations). | Defined services, delivery and staffing models and standards in health facilities | June 2011 | Assistant Deputy Ministers of FNIHB (lead) and RAPB |
| Use the developed standards as the basis for carrying out a gap analysis with respect to remote and isolated communities. | Gap analysis document | March 2012 | Assistant Deputy Ministers of FNIHB (lead) and RAPB | |
| To address the gap on an annual basis the department has sought additional funding through the Budget process. Management will continue to address the funding gap in this way. | Submission seeking funding to address program integrity gap | March 2011 (subject to timing for Budget 2011) | Assistant Deputy Ministers of FNIHB (lead) and RAPB | |
| 3. It is recommended that the Assistant Deputy Minister, First Nations and Inuit Health Branch, the Assistant Deputy Minister, Regions and Programs Branch and the Assistant Deputy Minister Corporate Services Branch, continue efforts to develop and implement an integrated national and regional nursing recruitment and retention strategy. | Address nursing recruitment and retention issues through Health Canadas Northern Nursing Task Team. The Task Team will, building on regional initiatives and in consultation with regions, assess a number of options to improve recruitment and retention; develop a long-term strategy based on that assessment; and, plan for implementation of the strategy. Among other things, development of the strategy will include:
|
Approved Nursing Recruitment and Retention Strategy | July 2011 | Assistant Deputy Ministers of CSB (lead), FNIHB and RAPB |
| 4. It is recommended that the Assistant Deputy Minister, First Nations and Inuit Health Branch develop a training program for new nurses that adequately prepares them to work in remote and isolated locations with the support of the Assistant Deputy Minister, Regions and Programs Branch who will have to provide access/time for nurses to receive initial and ongoing training. | Implement the National Education Strategy to address education concerns among external recruits and internal staff. | Implemented National Education Strategy | January 2011 (first cohort) | Assistant Deputy Ministers of FNIHB (lead) and RAPB |
Over the course of the five year initiative will undertake a number of activities including:
|
Evaluation of the National Education Strategy | August 2013 | ||
| Management will undertake a scan of regional education activities, including training new recruits and continuing education. Best practices will be shared across regions. | Environmental scan of training and education activities; shared best practices | March 2012 | Assistant Deputy Ministers of RAPB (lead) and FNIHB | |
| Ministerial Exemption under Section 56 of the Controlled Drugs and Substances Act. | Issuance of Ministerial Exemption | December 2010 | ||
| FNIHB Nursing Station Formulary | Start implementation of the formulary in regions | March 2011 | ||
| Update the Drug Classification System | Revised Drug Classification System | March 2011 | ||
| The Competency Assessment Program for providing controlled substances is being developed as part of the education strategy | Competency Assessment Program | June 2011 | ||
| Proposal for the development of a reporting and compliance monitoring database | Proposal | April 2010 | ||
| 5. It is recommended that the Assistant Deputy Minister, Regions and Programs Branch and the Assistant Deputy Minister, First Nations and Inuit Health Branch address the issues related to occurrence reporting and work quickly to resolve nursing practice issues. | Identify gaps in the automation of the occurrence reporting system and address those gaps considering available resources and other departmental priorities. | Issues identified and addressed on an ongoing basis | March 2011 | Assistant Deputy Minister of FNIHB (lead) and RAPB |
| Raise the importance and benefit of occurrence reporting | Discussion at Regional Directors Forum | August 2010 | Assistant Deputy Ministers of FNIHB (lead) and RAPB | |
| Analyze national trends on an annual basis. | Discussion at Nursing Leadership Committee | October 2010 | ||
| National report (summary of key concerns/trends/issues identified) | March 2011 | |||
| Use the existing system to produce regional level reports analyzing occurrences | Regional Reports | February 2011 | Assistant Deputy Minister of RAPB | |
| Provide feedback to those submitting occurrences through a regional feedback mechanism. | Mechanism feedback mechanisms clarified and strengthened | October 2011 | ||
| Corporate Services Branchs Access to Information and Privacy Coordinator will lead the development of parameters documents for Manitoba, BC and Alberta, to guide nurses when there is a need to inform the College of Registered Nurses of a suspension or termination of a Registered Nurse employed by Health Canada for alleged professional incompetence or misconduct. | Parameters document (Manitoba) | November 2010 | Assistant Deputy Minister of CSB | |
| Parameters documents (BC, Alberta) | March 2011 | |||
| In consultation with the Privacy Working Group, FNIHB will develop tools (protocol/guidelines/policy) to assist health professionals working in the field in determining appropriate actions to take when required to disclose personal information. | Tools (protocol/guideline/policy) | January 2011 | Assistant Deputy Minister of FNIHB | |
| 6. It is recommended that the Assistant Deputy Minister, Regions and Programs Branch and the Assistant Deputy Minister, First Nations and Inuit Health Branch identify facility and equipment needs, and conduct an assessment of nursing stations to identify and respond to areas in which improvements are necessary to support accreditation. | In collaboration with the external accrediting body, accreditation standards are being finalized for remote nursing stations | Approved Standards | March 2011 | Assistant Deputy Ministers of FNIHB (lead) and RAPB |
| A pilot of these standards will be initiated to test standards and their applicability. | Launch pilots | September 2011 | ||
| Update the standardized medical equipment list, linking it to the review and assessment of the primary care model (Clinical and Client Care in recommendations 1 and 2), and outline resource implications. | Standardized medical equipment list | December 2010 | ||
| Presentation to Senior Management for approval | October 2010 | |||
| Note: New facilities are designed to reflect current standards Issues identified in the audit with respect to specific nursing stations will be examined on a case-by-base basis and addressed through the established facility renovation and recapitalization process or through other means as appropriate.(i.e. security and confidentiality of client files, infection control, storage of medications and medical equipment needs) Any lessons learned are shared where appropriate |
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| 7. It is recommended that the Assistant Deputy Minister, Regions and Programs Branch and the Assistant Deputy Minister, First Nations and Inuit Health Branch develop and implement an integrated system for results and performance measurement. | Develop a set of indicators in the new Performance Measurement Strategy. | Updated Performance Measurement Strategy | December 2010 | Assistant Deputy Ministers of FNIHB (lead) and RAPB |
| Develop and implement a system/process to obtain and report on these indicators. As the new system is implemented, new reporting standards will be introduced and communicated to all regions. | Reporting system | April 2012 |
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