They learned from their rural colleagues and their clients.

Home Care in Saskatoon Health Region has undergone some major shifts in the past year, the most significant of which has involved the way Home Care workers in Saskatoon are assigned to clients. 

A house and stethoscope “We’re a large operation in the City of Saskatoon, and our size was getting in the way,” said Alan Buckley, Director of Home Care for the Saskatoon Health Region.

Home Care employees care for approximately 4,000 clients in the City of Saskatoon, and staff complete about 1,700 visits every single day.

Previously, Home Care divided Saskatoon into four quadrants, and had staff assigned to those quadrants. However, due to the large number of staff needed for each of those quadrants, clients weren’t getting to know the people caring for them. Each month, some clients were seeing up to 20 different caregivers. Clients weren’t happy with that, and neither were staff.  Staff also felt they were spending too much time driving during their shifts.

“All that needed to change,” Buckley said. “Consistency of care just wasn’t there, and no one felt good about that.”

The big change was trying to make Home Care operations in Saskatoon smaller.

“Home Care operations in the city actually learned from the rural areas. We aspired to work like they did, so we took what they were doing and applied it,” said Buckley.

A cellular model was applied to Saskatoon. Clients in close proximity to one another were organized into cells, and staff members assigned to those cells.  This had the dual benefit of increasing consistency of care, while decreasing mileage for staff.

Home Care started experimenting with this model a year ago, Buckley said, and so far it’s working well.

“We were so big, we weren’t client or staff centred,” he said. “Now that we’re smaller, we have small groups of clients with dedicated groups of staff.”

The clients really like it, he indicated, as the consistency of care has improved. The number of caregivers they encounter every month is in the single digits.

The staff also like the changes so far, though scheduling is still labour intensive.

To further cut down on driving, under this model, staff meet at locations near the clients they are serving for their huddles, instead of meeting at Idylwyld Centre, where central operations for Home Care are located.

Two other big shifts in Home Care in Saskatoon Health Region have also taken place in the past year.

First, the Region received funding from the Home First program of the Ministry of Health. This funding is focused on enhancing services to seniors, above and beyond what Home Care usually provides, in order to help them stay in their homes longer.

“We look at providing extra services that people need,” Buckley explained.

They’ve developed a quick response system for seniors who are leaving the emergency department after a health crisis, those in an alternate level of care within acute care, and those who are still at home but are gradually needing more and more care. Just this fall, this funding has also allowed Home Care to work collaboratively with the new Convalescent Unit at Saskatoon City Hospital.

Since receiving the funding in November 2013, they’ve had over 1,000 referrals to this program, Buckley reported.

Another pilot project is aimed at improving communications with Home Care caregivers. Smart phones have been provided to Continuing Care Aides so that they can receive their schedules for the day, and review client assessment information easily. It’s also meant to cut down on paper use. This one-year pilot began in April of 2014 and will end in March of 2015.

“We deployed 27 phones to staff in both rural and urban areas – primarily rural, as we wanted to test the coverage in those areas, and ensure the phones would work. And they do,” Buckley said, adding that a business case for continuing this project is circulating now.

All of these improvements were made using Lean methods, Buckley added. They examined the issues they were experiencing, and used Lean tools to arrive at solutions.

“The cellular model especially was a one-year, longitudinal Lean improvement,” Buckley said.