Handout from Addressing Day to Day Risk with the Teams, November 2015 Framing a Conversation About Risk with the Team Who to talk to? What impact would there be if the risk is not addressed? Opportunities lost: What will be missed if we dont support the person to take the risk? What alternatives might be available? The person Family and friends The community The provider organization Developed by: Michelle Livesley - hsa Person Centred Risk Webinar Handout from Addressing Day to Day Risk with the Teams, November 2015 Happy/ Safe Grid Identifying Risk Strategies to Balance Important To and Important For Developed by: Michelle Livesley - hsa Person Centred Risk Webinar SAFE- Important For HAPPY Important To UNSAFE- Conflicts with Important For UNHAPPY Conflicts with Important To Strategies to be taken forward What it would take to make sure that the person stays safe What it would take to make the person least unhappy Strategies not to be taken forward Handout from Addressing Day to Day Risk with the Teams, November 2015 4 +1 Question Tool 1. What have we tried? 2. What have we learned? 3. What are we pleased about? 4. What are we concerned about? +1 Based on this, what do we do next? TLC-PCP 2013 www.learningcommunity.us Handout from Addressing Day to Day Risk with the Teams, November 2015 Person's Perspective Parents Perspective Staffs Perspective TLC-PCP 2013 www.learningcommunity.us Addressing Day to Day Risks With the Team Fall, 2015 Risk Mitigation Conversation Guide for Teams Risk Mitigation Conversation Guide for Teams The following Guiding Questions will assist the team in evaluation of developing risk mitigation strategies and plans prior to implementation. The Guiding Questions in the left hand column are to provide structure for planning. The Probes in the center column are additional Probes for discussing information and planning for risk mitigation. The right hand column allows space for the team to use in planning activities. Due to the unique nature of individual risk experience, not all Guiding Questions or Probes will apply to every situation. Guiding Questions Probes Team Responses What risks have the team identified? Have prior assessments, data and documentation been analyzed to determine risks factors? Have the risks been analyzed for severity and immediacy? Does the persons ISP contain mitigation actions for identified risks? Are there corresponding mitigation actions in the ISP for each identified risk? Where and how are the risk factors addressed and documented in the ISP? Do the mitigation strategies include specific actions? Are the mitigation strategies measurable? (How will the team know that actions are successful?) Are timelines set for actions? Do mitigation plans identify the responsible person(s) and actions they need to take? Are the actions doable? Are necessary resources available? Does the person responsible have authority to implement planned actions? Does the person responsible support the mitigation actions? Does the individual support the mitigation actions? How will the actions and strategies be monitored? Is there an objective system in place to monitor the implementation and effectiveness of the mitigation actions? If the mitigation strategies are implemented, what is the likelihood of incident/event recurrence? Have past mitigation actions been effective in reducing risk and should past actions be considered for continuation? Have all successful elements of previous risk mitigation strategies been implemented? If linked to a health issue, is medical/ clinical assessment or follow-up needed? Was assessment or follow-up provided? Documented? Were additional risks identified that need to be addressed? If linked to a behavioral issue, is clinical/behavioral assessment or follow-up needed? Was assessment or follow-up provided? Was assessment or follow-up documented? Were additional risks identified that need to be addressed? Addressing Day to Day Risk With the Team Fall 2015 Incident Response Conversation Guide for Teams Incident Response Conversation Guide for Teams The following steps will assist the team when responding to an incident or problematic event. The Steps listed in the Left hand column are intended to guide you through the process. The Probes in the Center column provide structure for team conversations on understanding the incident or event and planning for responding. Not all questions will be applicable to every situation. Steps Guiding Probes Responses Insure the safety of the person Is the person safe now? Is first aid/medical treatment needed? Being provided? Are other risks evident (e.g., fire/safety hazard, lack of adequate food, shelter, water, or heat, broken adaptive equipment, sanitation)? What interim measures have been taken to protect the person? Other persons (as appropriate)? Notify legally required entities (as appropriate) Child, Adult, or Older Adult Protective Services ODP AE Family/Guardian/Advocate SC Provider Licensing Police Check for completeness of information Have the who, what, when, and where questions been answered? What aspects of the incident need to be further explored? Inquire into inconsistencies Are there unanswered questions about this incident? What additional information is needed to clarify these conflicts? Document details Has the documentation of the incident or event, including clarification of inconsistencies been completed? Have risk mitigation actions and developed strategies been documented within the ISP? Explore causes of the incident or event Have all why questions been answered? What factors may have contributed to the incident/event? (staffing or persons providing supports, other people receiving supports, equipment, leadership, resources, policy, communication systems)? Has the person had related experiences? Can a pattern be identified? Is other input needed for analysis (e.g., nurse, physical therapist, behavior analyst)? Have significant changes in the persons life been explored? Note necessary additions/revisions to Mitigation Actions Any risk mitigation actions already in place? Are they effective? Has long-range planning been conducted to minimize risk to this person or others? Track actions for follow-up Is there a tracking system for timely follow-up actions? How will the team determine effectiveness of mitigation actions?