A practical, effective approach to change and continuous improvement.
P.I.E.C.E.S. is a best practice learning and development initiative that provides an approach to understanding and enhancing care for individuals with complex cognitive and mental health needs; it is a Model for Changing Practice.
P.I.E.C.E.S. provides a systematic approach to the common issues, diagnosis and challenges of older persons at risk including those with aggressive behaviour. P.I.E.C.E.S. offers a practical framework for assessment and supportive care strategies using a comprehensive interdisciplinary client-centred approach. Also included in the approach is a practical tool that promotes team dialogue and shared-problem solving.
P.I.E.C.E.S. conveys the individuality and importance of the various factors in the well-being, self-determination, and quality of life of the older person and his or her caregivers. P.I.E.C.E.S. provides a framework for understanding why a person behaves the way he or she does and what resources are available to build on.
- The first three letters P-I-E, represent an individual's Physical, Intellectual, and Emotional health.
- The C is the centre-piece or focus in care, i.e., maximizing Capabilities which promotes the achievement of the highest quality of life as possible for an individual.
- The E-S represent the environment that an individual interacts with (physical as well as the emotional environment) and the person's Social self (cultural, spiritual, "life story") and support network.
"Putting the P.I.E.C.E.S. Together" represents Physical, Intellectual, Emotional, Capabilities, Environment, Social, and are the cornerstones of the philosophy and care of the P.I.E.C.E.S. approach.
What is the P.I.E.C.E.S. Philosophy?
The P.I.E.C.E.S. approach embodies a holistic and enabling philosophy:
- person-centered, evidenced-based, and humanistic care is critical to well-being
- health is beyond the absence of disease, and includes quality of life, independence, and self-determination
- prevention of problems and early intervention is preferable to late
- care and service should be available where the older person resides, and relocation should be avoided; failing this, every effort made to return the older person to their place of residence through effective, timely intervention (i.e. the right service, for the right reason, at the right time)
The approach in this education program is to:
- Provide a common set of values; a common language for communicating across the system; and a common, yet comprehensive, approach for thinking through problems to enhance the capacity of those providing care, services, and support to older adults with complex physical and cognitive/mental health needs and associated behaviours.
What are the P.I.E.C.E.S. goals?
A Comprehensive and Best Practices Approach to Assessment and Care Planning
- The P.I.E.C.E.S. approach promotes the understanding of the older person with complex physical, cognitive/mental health needs and associated behavioural issues through a common vision, common language, and common approach.
Risk Management
- The P.I.E.C.E.S. approach increases the detection of risk and the identification of supports to address risk management issues.
Implementation of Current and Emerging Best Practices
- The P.I.E.C.E.S. approach provides strategies that enable individuals, teams, programs, organizations, and systems to share best practices and knowledge from various fields of study now and in the future. This continuous improvement approach includes health promotion and disability prevention.
Interdisciplinary Care
- The P.I.E.C.E.S. approach provides a practical way to promote and implement interdisciplinary care and shared solution-finding through its framework, complementary and supportive assessment tools and education. P.I.E.C.E.S. helps the team minimize unnecessary disability.
Integration and Collaborative Care (Shared Care)
- The P.I.E.C.E.S. approach provides strategies and tools to enhance communication, collaboration, and sharing of information and data at multiple levels. The approach will move us towards a collaborative shared care process pivotal to an interdisciplinary shared care which is the foundation for Primary Care Reform.
These five goals support the fundamental core values of the person and family at the centre and a team approach to assessment and care planning.
