www.i-can.org.au Samuel R.C. Arnold Ralph Forbes I-CAN v4.3 CAN - - PowerPoint PPT Presentation

: A Transdisciplinary Support : A Transdisciplinary Support

22nd PANDDA Conference

Owning our Practice: “Learn from yesterday, live for today, hope for tomorrow”

3rd & 4th November 2011, Parramatta NSW

www.i-can.org.au

: A Transdisciplinary Support : A Transdisciplinary Support Planning Tool Planning Tool

Samuel R.C. Arnold Ralph Forbes

I-CAN v4.3 CAN v4.3

www.i-can.org.au

I CAN DO IT! I CAN DO IT!

Samuel Arnold Vivienne Riches Vivienne Riches Trevor Parmenter Roger Stancliffe Gwynnyth Llewellyn Jeff Chan Gabrielle Hindmarsh

How happy are you? How happy are you?

In comparison to the happy times in your life, how happy were you in the past two weeks?

• were you in the past two weeks?
• Proxy

Respondent

How healthy do you feel? How healthy do you feel?

In comparison to the times in you life when you felt healthiest, how healthy have you felt in the

• how healthy have you felt in the

past two weeks?

In Today’s Presentation In Today’s Presentation

• A Brief Introduction to I-CAN
• Examples of I-CAN as used by DD Nurses and
• ther Allied Health

– Outcome measurement – Outcome measurement – Assessment of ‘Support Needs’ in mental health needs context – Resident ‘Compatibility’

• Continually Improving I-CAN

– Findings from trialing ‘Version 5’ of I-CAN – Reliability data and outcome sensitivity – Predicting costs

What is the I What is the I-CAN? CAN?

The Instrument for the Classification and Assessment of Support Needs (I-CAN) “a support needs assessment designed to assess and “a support needs assessment designed to assess and guide support delivery for people with a disability including mental illness. It provides a support services and family friendly holistic assessment, conceptually based upon the internationally recognized WHO ICF framework.”

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I-CAN v4.3 CAN v4.3 Domains Domains

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Individual Support Needs Report Individual Support Needs Report

An I can statement An I can statement

• Instead of writing ‘Bob can’t make

breakfast’ (an I can’t statement)

• Simply try ‘Bob can make his breakfast

with prompts to remember each step in with prompts to remember each step in sequence’

I-can’t: (name) cant (do this) I-can: (name) with (type of) support can (do this)

Let’s turn those I can’t Let’s turn those I can’t statements upside down! statements upside down!

• ‘John can’t tie shoelaces’
• ‘Judy can’t catch the bus unless she has

been on it before’ been on it before’

• ‘Robert can’t dress himself’

"You're not disabled by the disabilities you "You're not disabled by the disabilities you have, you are able by the abilities you have." have, you are able by the abilities you have."

Oscar Pistorius aka ‘Blade Runner’ ‘The Fastest man on no legs’

Courtesy of wikipedia

I-CAN Online Functions CAN Online Functions

Track Track Changes Changes Compare Compare Needs Needs

Outcome Measurement

• Relative newness of ‘Support Needs’ as an

indicator

• Study currently underway to determine

‘Sensitivity’ ‘Sensitivity’

• Increase versus Reduction of ‘Support Needs’
• Increase versus Reduction of ‘Support Needs’
• Usefulness of the assessment for :

Showing change Illustrating ’effectiveness’ Prioritisation Funder perspectives Resource allocation

Quantitative Output from I-CAN Assessment

*Thanks to Marie Cameron

• f HISA and Royal Rehab,

and to Jennifer Hennessy, Royal Rehab, for their crucial support

I-CAN v4.3 CAN v4.3

• Broader conceptualization of support
• Web based assessment
• e-Health, telemedicine, telepsychology
• Comprehensive supports planning & profiling tool
• Intake or discharge assessment
• Additional online functions include:
• Additional online functions include:
• Upload a photo!
• Compare scores & track changes over time
• Custom Summary Report
• National Minimum Data Set (NMDS) export
• Excel export (import into SPSS)
• Cost Estimation Tool
• Resource Allocation
• Outcome Measurement / Service Quality

Concurrent / Multiple Ratings

• Usually you will only complete one rating and will not

have to give it a name.

• Some examples - name each rating in as few words

as possible

– ‘Normally’ vs. ‘During an Episode’ – ‘At the institution’ vs. ‘In a community home’ – ‘At the institution’ vs. ‘In a community home’ – ‘At hospital’ vs. ‘Returning home’ – ‘Now’ vs. ‘in 24 months’ – ‘Home’ vs. ‘Work’ – ‘Support Needed’ vs. ‘Support Received’ – ‘Informal’ vs. ‘Formal’ vs. ‘Funded’ – ‘Staff rating’ vs. ‘Family rating’

3

The I The I-CAN in different contexts CAN in different contexts

Focus on Mental Health

• 26 assessments completed on site
• Involvement of three agencies
• Age 34 - 79 years
• For some this was the first documentation of this

information which had ever occurred for them

• Assessments conducted by two facilitators in

partnership

• Significant input from people who had known each

person for a number of years

The I The I-CAN in different contexts CAN in different contexts

Resident Compatibility

• Three phase assessment process for determining

future accommodation options

• Analysis of the I-CAN data
• ‘Health Care Plan’ information
• Resident friendships and relationships
• Interactions observed between residents
• Social inclusion and participation in recreation and

leisure activities and social groups

• Incompatible relationships
• Barriers/obstacles to the development of friendships

and relationships

Trial of I Trial of I-CAN ‘Version 5’ CAN ‘Version 5’

Design Change User Perspective

Flexibility

• Yes – Definitely increased flexibility
• Worried that you might be missing out

something important Single text box in each domain

• Brief outline at the top of the box might

be helpful

• Nurse might want more boxes – a
• Nurse might want more boxes – a

Social Worker might want just one!! Specific boxes for goals in each domain

• ‘Can Do’ design

Examples of support activities and scoring

• Used these a lot

All demographic information optional

• Need this on first time completion

Trial of I Trial of I-CAN ‘Version 5’ CAN ‘Version 5’

Design Change User Perspective

Area to capture any family / living arrangements

• Having this as a separate area was

definitely an omission previously Addition of 'Medical conditions' separate from 'Disabilities'

• Enables focus on medical treatments –

may be long or short term Health & Support Services domain allows recording of 'percentage' if hours

• f support are shared in a group
• Relevant for some but not all
• Difficult to estimate accurately
• Able to capture the ‘sex and church’

stuff that is sometimes not discussed – because it’s awkward!! ‘Support Received’ section major changes

• Sometimes difficult to find out this

information and identify who might be able to help you get it.

Current research and Current research and development development

• Recent release of ‘Hours of Support’ prediction

algorithm

• Minimum Clinically Important Difference (MCID)
• Allocation of individualised funding
• Allocation of individualised funding
• Further practical utility study
• Field testing and development
• f new version

Reproduced with permission from Shaddock, A. (2007). Mainstream Mindsets for Resilient Services: or, “How to Get into Shape by Getting Rid of Normal Curves”. Intellectual Disability Australia, 28(3), 3-10.

Reproduced with permission from Shaddock, A. (2007). Mainstream Mindsets for Resilient Services: or, “How to Get into Shape by Getting Rid of Normal Curves”. Intellectual Disability Australia, 28(3), 3-10.

DD Nurses DD Nurses as I as I-CAN Facilitators CAN Facilitators

• Health planning skills
• People skills
• Biopsychosocial
• Researchers
• Researchers

Own the practice of facilitating I-CAN interviews

Join I Join I-CAN on CAN on

“You're not disabled by the disabilities you “You're not disabled by the disabilities you have, you are able by the abilities you have.”* have, you are able by the abilities you have.”*

Oscar Pistorius aka ‘Blade Runner’ ‘The Fastest Man on No Legs’*

*Courtesy of wikipedia

i-can.org.au cds.med.usyd.edu.au www.RoyalRehab.com.au