Veterans Affairs Committee on June 7th, 2012

[Marie-Claude Morin, NDP, Saint-Hyacinthe—Bagot, QC]

Thank you.

Hi, everybody. It's nice to meet you. I want to offer you my apologies because my English is not very good. I will ask my question in French because it's easier for me to ask questions in my native language.

My first question is for Ms. Murray or the National Case Management Network of Canada representatives. You can decide who is better suited to answer.

I would like to know how your training ensures that case managers make the right decisions. If a negative determination is made by mistake, a whole administrative and legal process is required to correct that one bad decision by a case manager.

How does your training limit the inconvenience that might be caused to veterans when the wrong decision is made or prevent such situations in the first place?

[Nancy Murray]

In terms of training, you have to look at a long process. You have to look at an orientation that would give them the overview. They would have to be trained properly in terms of the tools that they use. As well, there would be a mentorship program. Case management is very complex and novices grow in their work to become professionals and experts. It's best to have some mentorship arrangement. I have taught those tools. Those tools are separate and distinct from the certificate program that we offer. In terms of enhancing their practice, that would come with more understanding of what the profession is.

You asked about mistakes and issues in terms of decision-making. Again, if there is mentorship and support for the case manager who is learning, it's the same as in any new job or profession. You meet indicators of success as you move along. It's a long process. Similar to what Joan mentioned earlier, it is a long and complex process. To understand and to be experienced that way, and to be able to look at the gestalt and understand the big systems, and how it applies does take time to learn.

It's the same as in any profession. There are no guarantees. Hopefully, it's the support that you get in that mentorship program.

[Joan Park]

For me to help with that decision-making, it is the strength of networking. That's why we are called a network. Anybody in his or her job gains experience from networking with mentors, as Nancy's talking about, and with others. When we started writing our standards of practice, we held a round table of 40 people across the country. VAC case managers and rehab case managers told their stories. We had the same issues. There is so much we can learn from each other a lot more quickly than trying to find the answer in a book.

[Nancy Murray]

One final point is the research that's being done. “The Nature of Insight” looks at exactly that. There is the novice and the expert, and there are differences. It is a continuum of learning.

[The Chair, Conservative, Greg Kerr]

Thank you very much. We allowed it to go a minute over because of the technical difficulties, but that is the end of the time.

We're over five minutes, so, Mr. Trottier, you have whatever time is left, which will be very brief.

[Bernard Trottier, Conservative, Etobicoke—Lakeshore, ON]

That's okay.

Thank you, Mr. Chair.

You're doing a very good job today.

Thank you, witnesses, for coming in today.

I want to talk briefly about productivity. When you talk about case management, what's getting behind a lot of that is productivity, being able to do more with less. What goes into productivity are systems, to be sure, but there are procedures, and what you mentioned, the idea of networking among interdisciplinary teams and sharing know-how. In fact, it's the history of human progress. If you think about 150 years ago, over 90% of the population was engaged in agriculture. Now it's less than 2%, and yet we produce more and more food. It's the same thing for manufacturing. In medicine, cardiologists can treat many more patients than they could 20, 30, or 40 years ago, because of all the know-how that has spread around the world, and also because of increased use of technology.

If you think about case management, what does that mean in terms of the ability of case managers to do more, in terms of their output, but also of a higher quality, with a greater consistency, and better customer service? Can you describe how that applies?

Then, if we have some time, I'd like to hear from our veterans how they might see that from their end, as clients.

[Joan Park]

I think it is building that body of knowledge. We are a relatively new field. We're not as old as medicine, but we can learn from those examples. By building that body of knowledge and working together and sharing resources, that's how we're going to work smarter, not necessarily work harder. We're going to have to share the knowledge that we have. That's going to be the trajectory that gets us to making smart decisions.

[Bernard Trottier, Conservative, Etobicoke—Lakeshore, ON]

To our veterans, thank you for coming in, and thank you for all your service.

From a client point of view, somebody who has worked with case managers or heard stories of people who have worked with case managers, what do you see in case management compared to 10 or 20 years ago? How does that affect the service and the amount of service you're able to receive?

[Ray Kokkonen]

This is rather an awkward question for me. I am not a client of VAC.

[Bernard Trottier, Conservative, Etobicoke—Lakeshore, ON]

No, but you talk to people who might receive those services, right? Are there any stories?

[The Chair, Conservative, Greg Kerr]

It will have to be very brief, please. We're just about on the clock.

[Ray Kokkonen]

Would you state that question again?

[Bernard Trottier, Conservative, Etobicoke—Lakeshore, ON]

What's the impact of case management on the ability for—

[Ray Kokkonen]

From what I've listened to—just to give you a short answer—I think it's positive. I think a complete study of that particular science is what's required. It may solve some of the problems that VAC has with client interface.

[Bernard Trottier, Conservative, Etobicoke—Lakeshore, ON]

Okay.

Thank you very much.

[The Chair, Conservative, Greg Kerr]

Thank you.

We are at the end of our time today. Thank you for your patience in light of what happened upstairs.

To all the witnesses, thank you for coming.

The meeting is adjourned.