Volunteers Engaged to Enhance Reintegration: Supporting independence - - PowerPoint PPT Presentation

Mich Michell lle Ne Nels lson

• n, PhD

hD Principal Investigator; Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute Assistant Professor, Institute for Health Policy, Management and Evaluation, University of Toronto Michelle.nelson@sinaihealthsystem.ca

Volunteers Engaged to Enhance Reintegration:

Supporting independence and wellbeing post hospital discharge: partnering with volunteers & the third sector

http://healthydebate.ca/opinions/hospital-volunteers

Why Volu lunteers?

“Human resources for health include individuals working in the private and public sectors, those working full-time or part-time, those working at

• ne job or holding jobs at two or more locations, and those who are paid
• r
• r provide services on a volunteer basis

is.”(WHO, 2009)

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Why Volu lunteers?

• Many third sector organizations are already providing support focused on promoting

independence at home.

• Help at Home Services
• Home from Hospital Programs (e.g. Red Cross, RVS, AgeUK)
• Care Coordination (see: Abendstern et al, 2018)
• Social Prescribing (e.g. Elemental)

Despite increase attention to the third sector, and increasing participation in the provision of services, we do not have a strong empirical understanding of the role of the NGOs/volunteers in the delivery of ‘public’ services.

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IADL support and social isolation are key issues, and people do not want to ‘burden’ family, friends and neighbors (Nelson et al). Patients vulnerable at discharge - “post hospital syndrome” (Krumholz, 2014) with

• ngoing support

needs (medical, social). Volunteers ‘humanize’ health care environments but contributions to patient experience &

• utcomes are

understudied (Beryl Institute, 2016).

Stu tudy Rationale

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Program Comparison

• IADLs support and/or social isolation as inclusion criteria
• A small number of volunteers support large numbers of clients
• High Degree of Variability
• ‘purpose built’ or evolved program
• services provided
• funding and staffing levels
• Evaluation and ‘outcomes of interest’

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Types of Support

Inter-Sectoral Navigation

→ Assessment of support needs → Risk assessments → Signposting to services and resources

Instrumental Activities of Daily Living

→ Shopping → Light housework → Collecting prescriptions → Transportation to appointments → Gardening → Meal preparation

Social and Emotional Support

→ Befriending → Peer support → Caregiver support

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Programmatic Common Elements

Key Program Attrib ibutes and Valu lue

‘Safety Net’ Imp Improved Ou Outcomes Psycho- Soc Socia ial Sup Support Brid Bridgin ing the he Ga Gap “It gave me peace of mind… Because I just knew that they would send you someone that you could trust.” (Client 1, Age UK) And the family is always pleased to see that you are going to make sure that their relative is looked after and safe.” (Volunteer).” “One client had been discharged and was still a bit confused. So I made a few calls to make sure that she had the supports re-established. I just wish I could have helped before she was discharged “ (Volunteer Coordinator ). GG runners assessed the achievement of positive outcomes for their ‘coaches’: Improved mental wellbeing, (self reported) ability to stay in their own house longer; and inspiration to take up new activities (Evaluation Report). Home from Hospital Services reported:

• Decreased falls, lower rates of

readmission, increased attendance at scheduled appointments, and timely signposting to community agencies.

Strengths and Chall llenges

Strengths

• Leverages the unique contributions of volunteers and voluntary sector
• Skilled volunteers can have a positive impact on older adults’ experiences
• May be a cost effective approach to support at home (Bauer et al, 2016)
• Reduces perceived burden on social network
• Evaluation suggest some impact on readmission rates and positive health outcomes

Challenges

• Approach is dependent on collaboration between health, social and voluntary sectors
• ‘Professionalization of Volunteers’ – may reduce the benefit of volunteer/patient interaction
• Overlap with paid roles and unionized environments
• Program set up requires dedicated resources

Program Benefits Client, Family, Volunteer, & System

• A comprehensive risk assessment
• Personalized services to meet actual needs
• Increased confidence going home from hospital
• Peace of mind - volunteers had been ‘vetted’
• Reduced social isolation, loneliness and improved life satisfaction
• Reduced stress for caregivers
• Decreased missed medical appointments
• Reduced readmission rates

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Ben enefit its for Volu lunteers Sense of connection to community – “giving back” Psychological benefits of volunteerism Primary Prevention?

Conclusions

• Volunteer Supported CRP are a promising interventions
• Programs must be ‘personaliz-able’ - start prior to discharge.
• Programs should be developed collaboratively (health, social and voluntary

sectors) and funding should follow correspondingly (no task shifting)

• Service requires organizational commitment, skilled program managers and

knowledgeable volunteers.

• Barriers to volunteer engagement with vulnerable populations - risk,

privacy, liability, confidentiality - can be reduced with policies, education and training.

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Next Steps – The DASH Program

The DASH Program is our corresponding integrated care program designed to support improved community reintegration (focusing

• n both patients and their caregivers).

Implementation sites are being recruited.

Jo Join in our r Th Thir ird Se Sector in in In Integrated Care Network!

Join Us! SIG Meeting at ICIC19 Tuesday April 2nd @ 8 am Twitter: @voluncaring

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Thank you!

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