MCGILL RUIS FULL TABLE (44 rd meeting)

Transcription

1 MCGILL RUIS FULL TABLE (44 rd meeting) Minutes of the meeting held on Tuesday, September 9, 2008 from 2:00-4:00 p.m. at the MUHC Planning Office, 2155 Guy street, Suite 200 Attendees: Dr. Richard Levin Dean, Faculty of Medicine - Vice-president McGill RUIS Dr. Sam Benaroya Associate Dean, Interhospital Affairs, Faculty of Medicine McGill Coordinator McGill RUIS Ms. Martine Boudreau Clinical Project, Medical Affairs & Physical Health Advisor, Planning & Programming, Nunavik Regional Board of Health and Social Services Ms. Madeleine Boulay-Bolduc McGill School of Nursing Representative Ms. Francine Dupuis Executive Director, CSSS Cavendish Mr. James Gates Acting Director McGill Health Network Office Dr. Harvey Guyda Acting Associate Executive Director - Montreal Children s Hospital of MUHC Mr. Jacques Hendlisz Executive Director, Douglas Mental Health University Institute Dr. Réal Lacombe Directeur de la santé publique et des affaires médicales, ASSS de l Abitibi- Témiscamingue Dr. Tim Meagher Associate Executive Director, Medical Affairs MUHC Mr. Marc Sougavinski Executive Director, CSSS de la Montagne Ms. Caterina Staltari McGill Network Clinical Coordinator Ms. Rita Ziadé McGill RUIS Program Manager Regrets Dr. Louise Ayotte Dr. Michel Bureau Ms. Johanne Desrochers Ms. Celine Doray Dr. Louis Dufresne Ms. Johanne Emmanuel Ms. Mabel Herodier Mr. Jean-Luc Imbeault Dr. Arvind Joshi Mr. David Levine Mr. Roland Lord Director of Medical and University Affairs, ASSS de Montréal Director General, Affaires médicales et universitaires, MSSS Associate Director, RUIS McGill Telehealth Director General, Shriners Hospital for Children Medical Director, Direction des affaires universitaires, MSSS Head of Public & Governmental Affairs, MUCH, Planning Office Executive Director, Cree Board of Health and Social Services of James Bay Directeur administratif par intérim à la Direction des affaires médicales, sociales et des affaires professionnelles, CRSSS de la Baie James (Nord du Québec) Director General & Chief Executive Officer, St. Mary s Hospital Center President Executive Director, ASSS de Montréal Directeur régional des services de santé, ASSS de l'abitibi-témiscamingue Dr. Guy Morissette Chief Executive Officer, ASSS de l Outaouais, Mr. Michel Plouffe Administrative Director of Professional Services Medical, Conseil Cri de la santé et des services sociaux de la Baie-James Dr. Arthur Porter Director General & CEO, MUHC - President McGill RUIS Ms. Ghislaine Prata Executive Director, Constance Lethbridge Rehabilitation Centre Dr. Jean Rodrigue Directeur des affaires médicales, universitaires et des partenariats professionnels, ASSS de Montérégie Ms. Lise St-Amour Présidente-directrice générale de l Agence de santé et de services sociaux de l Abitibi-Témiscamingue Dr. Hartley Stern Executive Director SMBD Jewish General Hospital September 9, 2008 Page 1 of 6

2 AGENDA DATE: Tuesday, September 9, Approval of minutes from previous meeting (June 10, 2008) Pj 1a & 1b 2. Business arising from previous minutes McGill RUIS Health Network Office - Ruptures de services in McGill RUIS Campus santé - Outaouais Visits to the regions 3. McGill RUIS Subcommittees Reports Cardiovascular Sciences Chronic Pain Genetics Mental Health Nursing Oncology Pediatrics - Report: Le dépistage de la surdité Rehabilitation Telehealth Pj 2 4. RUIS McGill Priorities for Reports Regions CSSS 6. Rémunération académique FMSQ 7. Consortium provincial des bibliothèques 8. Varia 9. Next meeting : Tuesday, October 14, 2008 P.j. Pj 1a - Compte rendu Comité directeur RUIS McGill 10 juin, 2008 Pj 1b - Minutes RUIS McGill June 10, 2008 Pj 2_Lettre au MSSS-dépistage surdité (DUSN) September 9, 2008 Page 2 of 6

3 R. Levin chaired the meeting in the absence of A. Porter. 1. Approval of minutes from previous meeting (June 10, 2008) The minutes were approved as submitted. 2. Business arising from previous minutes McGill RUIS Health Network Office - Ruptures de services in McGill RUIS T. Meagher reported that many requests for dépannage were received during the summer, both from intra-ruis and extra-ruis partners. He noted that the McGill RUIS Executive Committee has requested a report with objective information regarding these requests, and regarding the patterns of patient flow in the corridors of service between regional institutions and urban hospital centers. J. Gates will collate the information requested. - Campus santé Outaouais S. Benaroya reported that discussions with the Outaouais region are ongoing regarding the creation of a campus santé in the region. This would entail the development of an integrated clerkship and increase of the number of residency rotations in regional sites. - Visits to the regions A visit to Abitibi-Temiscamingue took place June 11, C. Staltari noted that communication and coordination of services need improvement to facilitate services to patients. A centralized mechanism to identify the needs and improve the process will be put into place. R. Lacombe proposed further visits to Abitibi-Temiscamingue, to be based on thematic issues. A visit to Outaouais will take place in October 29, More details are to be provided at the next meeting. C. Staltari will provide a priority report for A review will take place at the end of the year. R. Ziade will distribute the RUIS McGill activity report, which were previously submitted to the MSSS, to RUIS McGill Full Table Committee members. September 9, 2008 Page 3 of 6

4 3. McGill RUIS Subcommittees Reports Cardiovascular Sciences This committee is focusing its discussion on the organization and distribution of tertiary care cardiology services. Mental Health J. Hendlisz reported that the portfolio of tertiary care services in Mental Health has been further developed and refined. This portfolio is being discussed with the partners of the CSSS. He noted that six different third line programs were being defined and that the mental health budgets for Hospitals and CSSSs are under study. Nursing M. Boulay-Bolduc informed the Committee that the web-based prototype of nursing resources has been completed and now requires testing. Oncology S. Benaroya noted that H. Stern, JGH Executive Director, has substantial expertise in the regional organization of Oncology services, and is interested in providing expertise in this dossier. He will be working with R. Levin, J. Hendlisz and J. Batist to formulate a strategic plan in this regard. R. Lacombe would be interested to meet H. Stern to discuss these issues, as they would apply to Abitibi-Temiscamingue. Pediatrics - Report: Le dépistage de la surdité H. Guyda reported that the INSPQ submitted a report to the MSSS which recommends to screen all newborns for hearing impairment. The RUIS McGill Executive Committee supported the INSPQ report recommendation and has submitted a letter of support to the MSSS. Pending the response from the MSSS, H. Guyda reported that Ste Justine Hospital, the Montreal Children s Hospital and the Royal Victoria Hospital foundations had decided to subsidize the screening of all newborns for one year. Discussion ensued. RUIS McGill Full Table supported unanimously the initiative to screen all newborns. R. Ziadé will send the INSPQ report to M. Boudreau, Nunavik. RUIS McGill has requested of L. Dufresne that this item be further discussed at the next TCN meeting. September 9, 2008 Page 4 of 6

5 4. RUIS McGill Priorities for The RUIS McGill FULL Table Committee members were reminded to submit their priorities for , using RUIS McGill template. The RUIS McGill priorities will be discussed at the next meeting. 5. Reports Regions Abitibi-Temiscamingue R. Lacombe reported on the following issues : CSSS Val D or Shortage of ER and family physicians. Recruitment ongoing. UMF Val D or under development. The first residents are expected for July Recruitment in urology. Entente regarding Urology services. Improvement of communication and coordination regarding patient transfers. Primary care Nurse Practitioner Program roles and remuneration of family physicians. A teleconference will be organized between R. Lacombe, S. Cardinal (UQAT), M. Boulay-Bolduc and H. Ezer (Director of the McGill School of Nursing) to discuss the current status and challenges facing the Program. CSSS F. Dupuis reported that ententes de gestion for clinical services are under discussion between the CSSS de la Montagne and Cavendish, and the three major partner hospitals (JGH, MUHC and SMH). She stated that a major challenge for family physicians working in the community was rapid access to specialized consulated services. It was agreed that this issue would require detailed review, given the lack of human resources. This subject will be brought up at the RUIS Executive Committee meeting. Mental Health: As of October 20, 2008, there will be a transfer of resources from Hospitals to CSSSs as well as reallocation of patients to different territories. 6. Rémunération académique - FMSQ S. Benaroya noted that the FMSQ-MSSS entente will be signed in the near future. Medical specialist will be reimbursed for clinical teaching at all teaching sites within Quebec. Payment is to be retroactive to July 1, A similar arrangement to reimburse clinical teaching by family physicians is under discussions between the FMOQ and the MSSS. September 9, 2008 Page 5 of 6

6 7. Consortium provincial des bibliothèques A business plan for the development of the Provincial Consortium on Library resources is being formulated. 8. Varia No additional items. 9. Next meeting: Tuesday, October 14, 2008 There being no further items on the agenda, the meeting was concluded at 3:45 p.m. September 9, 2008 Page 6 of 6

7 MCGILL RUIS FULL TABLE (45 th meeting) Minutes of the meeting held on Tuesday, October 14, 2008 from 2:00-4:00 p.m. at the MUHC Planning Office, 2155 Guy Street, Suite 200 Attendees: Dr. Arthur Porter Director General & CEO, MUHC - President McGill RUIS Dr. Richard Levin Dean, Faculty of Medicine - Vice-president McGill RUIS Dr. Sam Benaroya Associate Dean, Interhospital Affairs, Faculty of Medicine McGill Coordinator McGill RUIS Ms. Johanne Desrochers Associate Director, RUIS McGill Telehealth Ms. Johanne Emmanuel Head of Public & Governmental Affairs, MUCH, Planning Office Mr. James Gates Acting Director McGill Health Network Office Dr. Harvey Guyda Acting Associate Executive Director - Montreal Children s Hospital of MUHC Mr. Jacques Hendlisz Executive Director, Douglas Mental Health University Institute Dr. Arvind Joshi Director General & Chief Executive Officer, St. Mary s Hospital Center Dr. Réal Lacombe Directeur de la santé publique et des affaires médicales, ASSS de l Abitibi- Témiscamingue Dr. Guy Morissette Chief Executive Officer, ASSS de l Outaouais, Mr. Michel Plouffe Administrative Director of Professional Services Medical, Conseil Cri de la santé et des services sociaux de la Baie-James Ms. Ghislaine Prata Executive Director, Constance Lethbridge Rehabilitation Centre Dr. Jean Rodrigue Directeur des affaires médicales, universitaires et des partenariats professionnels, ASSS de Montérégie Ms. Caterina Staltari McGill Network Clinical Coordinator Ms. Rita Ziadé McGill RUIS Program Manager Regrets Dr. Louise Ayotte Ms. Martine Boudreau Ms. Madeleine Boulay-Bolduc Dr. Michel Bureau Ms. Celine Doray Dr. Louis Dufresne Ms. Francine Dupuis Ms. Mabel Herodier Mr. Jean-Luc Imbeault Mr. David Levine Mr. Roland Lord Dr. Tim Meagher Mr. Marc Sougavinski Ms. Lise St-Amour Dr. Hartley Stern Director of Medical and University Affairs, ASSS de Montréal Clinical Project, Medical Affairs & Physical Health Advisor, Planning & Programming, Nunavik Regional Board of Health and Social Services McGill School of Nursing Representative Director General, Affaires médicales et universitaires, MSSS Director General, Shriners Hospital for Children Medical Director, Direction des affaires universitaires, MSSS Executive Director, CSSS Cavendish Executive Director, Cree Board of Health and Social Services of James Bay Directeur administratif par intérim à la Direction des affaires médicales, sociales et des affaires professionnelles, CRSSS de la Baie James (Nord du Québec) President Executive Director, ASSS de Montréal Directeur régional des services de santé, ASSS de l'abitibi-témiscamingue Associate Executive Director, Medical Affairs MUHC Executive Director, CSSS de la Montagne Présidente-directrice générale de l Agence de santé et de services sociaux de l Abitibi-Témiscamingue Executive Director SMBD Jewish General Hospital October 14, 2008 Page 1 of 6

8 AGENDA DATE: Tuesday, October 14, Approval of minutes from previous meeting (September 9, 2008) Pj 1a & 1b 2. Business arising from previous minutes McGill RUIS Health Network Office - Ruptures de services in McGill RUIS Visits to the regions 3. McGill RUIS Subcommittees Reports Cardiovascular Sciences Chronic Pain Genetics Mental Health Nursing Oncology Pediatrics - Report: Le dépistage de la surdité Rehabilitation - Prescribing Technical Aids Telehealth 4. Tables sectorielles: Neurosciences Mental Health 5. Campus santé - Outaouais Unité de médecine familiale, CSSS Gatineau Director of Medical Education Pj 2 Pj 3 Pj 4 6. RUIS McGill Priorities for Pj 5 7. Reports Regions CSSS 8. TCN Report 9. Varia 10. Next meeting : Tuesday, November 25, 2008 P.j. Pj 1a - Compte rendu Comité directeur RUIS McGill 9 septembre, 2008 Pj 1b - Minutes RUIS McGill September 9, 2008 Pj 2 - Mandat Table Neurosciences de la TCN des RUIS Pj 3 - Mandat Table SM de la TCN des RUIS Pj 4 - Min. B. Pelletier inaugure les nouveaux locaux... Communiqué Pj 5 - Priorités du RUIS McGill October 14, 2008 Page 2 of 6

9 1. Approval of minutes from previous meeting (September 9, 2008) The minutes were approved, as submitted. 2. Business arising from previous minutes McGill RUIS Health Network Office In order to make the Pre-RUIS meetings more relevant, meetings will only be held when members indicate their wish to deal with a specific theme. Depending on the theme specific resource individuals will be invited to attend and share their expertise. - Ruptures de services in McGill RUIS It was pointed out that the Agences have been given an increased responsibility by the MSSS in the organization of services to deal with manpower shortages in their regions. In view of this, it was suggested that a future pre-ruis meeting be dedicated to the discussion of the overall management of Bris de services. The previous McGill RUIS organigram and flowchart dealing with Bris de services will be reviewed and updated. J. Gates will organize such a meeting on Bris de services and will report at the Full RUIS Committee. Visits to the Regions The RUIS visit to Outaouais is confirmed for October 29, A preliminary agenda has been distributed. The agenda will deal with issues related to Family Medicine, Mental Health, Nursing, Oncology, and Palliative Care. The list of participants, agenda and details of the visit will be finalized shortly. 3. McGill RUIS Subcommittees Reports S. Benaroya suggested that at future Full RUIS meetings, Chairs of specific RUIS McGill subcommittees be invited to attend. This will allow for a better interchange between the subcommittees and Full RUIS members. In preparation for their participation, the subcommittee chairs will be asked to forward a summary of their subcommittees key priorities and plans of action, as well as appropriate documentation. The following Committee Chairs will be asked to attend in the following priority order: Chronic Pain, Cardiovascular Sciences, Oncology. Chronic Pain G. Prata reported that this Subcommittee continues to work on designation criteria and related documents. October 14, 2008 Page 3 of 6

10 Pediatrics - Report: Le dépistage de la surdité S. Benaroya requested that the subject of le dépistage de la surdité be added to the TCN agenda meeting on October 2, During the report of RUIS McGill at the TCN meeting, S. Benaroya reiterated the RUIS McGill support for a provincial program of universal screening of newborns for hearing impairment. The Chair of the TCN stated that this was not the appropriate venue for discussion of this topic and the appropriate ministerial directorate will review it. R. Lacombe will ensure that this subject will be addressed at a future meeting of Direction nationale de la santé publique. Rehabilitation - Prescribing Technical Aids Letters have been sent to the MSSS from both Nunavik and Territoires Cree requesting ministerial designation of regional physicians who would prescribe technical aids. To date no responses have been received to these letters. This makes it difficult for patients to have access to appropriate technical aids without having to travel to another region. R. Ziadé and S. Benaroya will follow-up with Ms. Marie-Claude Beauchamp, Coordinnatrice Services des personnes handicappées at the MSSS, in regards to this issue. They will report to the next Full meeting. Telehealth PACS: the joint McGill-Montreal RUIS committee identified a major financial risk concerning the site of the 2 nd diagnostic imaging repository, which will act as a backup. The first repository will be housed at the Montreal Technocentre. To help resolve this problem, a letter will be sent by the co-chairs of the PACS committee to the chairs of the McGill and Montreal RUIS. The goal of starting operations in May 2009, remains. Abitibi-Témiscamingue PACS: The go live took place on September 5; the dictation will be integrated into the PACS during winter Outaouais PACS: The go live is planned for November 14, to be completed in mid-december. JGH PACS: being implemented. Lakeshore Hospital PACS: pending. CvSSS: Preparations to begin implementing are underway. An administrative agreement will be signed by the agencies, the MSSS, the project fiduciary and the RUIS. Each institution will also have to ratify an agreement of the same type, which is being developed by a RUIS working group led by the RUIS Telehealth coordinator. National Home Ventilatory Assistance Program. The project has been delayed to a certain extent, but the financial impact is under control. The invitation to tender is now underway, and the technology solution will be selected at the end of October. October 14, 2008 Page 4 of 6

11 Quebec Telehealth Symposium: 6 professionals from the McGill RUIS regions 06, 16 and 17 gave talks that were much appreciated. Visit by Dr. Bureau to the Ontario Telemedicine Network on Oct. 30: J. Desrochers and M. Kalina will accompany him, as well as E. Siderowicz from the Montreal RUIS. Nunavik: Mr. Cotton approved the information resources development plan, which will provide access to videoconferencing to all 14 villages as of January Tables sectorielles Neurosciences The MSSS will be creating a Table sectorielle Neurosciences. Each RUIS has been asked to nominate two representatives. The RUIS McGill nominees are: Dr. Mark Angle, Associate DPS, Montreal Neurological Hospital Dr. Line Jacques, Neurosurgeon, at the Montreal Neurological Hospital The mandate for this Committee was circulated with the agenda. Mental Health The TCN has received a request that a Table sectorielle in Mental Health be created. The draft mandate was circulated with the agenda. J. Hendlisz stated that the mandate will require revision, but that in general, he supported the creation of this Table sectorielle. The Full RUIS Committee members supported the creation of this table. Committee members will forward their comments and suggestions regarding the draft mandate to R. Ziade. Following receipt of this information, R. Ziade will forward a compilation of this feedback to the MSSS, as well as informing the MSSS as to the RUIS McGill support for the creation of this Table. 5. Campus santé Outaouais Unité de médecine familiale, CSSS Gatineau The UMF, CSSS Gatineau, has been renovated and enlarged. This will allow a doubling of number of residents of McGill who will be able to carry out their family residency at this site. A press communiqué to this effect was circulated with the agenda. Director of Medical Education A Director of Medical Education Campus Santé will be named in the near future. October 14, 2008 Page 5 of 6

12 6. RUIS McGill Priorities for Priorities received to date were distributed for information. C. Staltari presented the list of priorities related to her responsibilities (document circulated at the meeting). The priority list will be completed prior to the next meeting. 7. Reports Regions Abitibi-Témiscamingue Good operational links have been established with C. Staltari in order to better coordinate patient transfers; Negotiations regarding the opening of the UMF Val D Or are proceeding well; Oncology consultations visits are occurring according to schedule; Discussions are ongoing with the School of Nursing for the establishing of the Nurse Practitioner Training Program. Territoires Cree: Number of visits by ophthalmology specialists increased; Poste reseau in psychiatry is functioning well; Orthopedic Manpower shortages: Discussions with Abitibi-Témiscamingue. Montérégie Committee dealing with access to specialized services: Work in progress Orthopedics manpower shortages: Patient require transfers to hospitals outside the region; Negotiations regarding the opening of the UMF Anna-Laberge are proceeding well; Suggestion by J. Rodrigue that PREM regulations could be adjusted to facilitate recruitment of residents in local training programs. Outaouais An analysis of Clinical Services provided by Ontario facilities to residents of Outaouais is being undertaken; Orthopedics manpower shortages: Plans of action are being put into place; The organization of Mental Health Services is being reviewed. 8. TCN Report This report has been postponed until the next meeting. 9. Varia No additional items. October 14, 2008 Page 6 of 6

13 10. Next meeting: Tuesday, November 25, 2008 There being no further items on the agenda, the meeting was concluded at 4:05 p.m. October 14, 2008 Page 7 of 6

14 MCGILL RUIS FULL TABLE (46 th meeting) Minutes of the meeting held on Tuesday, November 25, 2008 from 2:00-4:00 p.m. at the MUHC Planning Office, 2155 Guy Street, Suite 200 Attendees: Dr. Arthur Porter Director General & CEO, MUHC - President McGill RUIS Dr. Sam Benaroya Associate Dean, Interhospital Affairs, Faculty of Medicine McGill Coordinator McGill RUIS Ms. Martine Boudreau Clinical Project, Medical Affairs & Physical Health Advisor, Planning & Programming, Nunavik Regional Board of Health and Social Services Dr. Bruce Brown (replacing Dr. Vice-President, Professional Services, St. Mary s Hospital A. Joshi) Dr. Louis Dufresne Medical Director, Direction des affaires universitaires, MSSS Ms. Francine Dupuis Executive Director, CSSS Cavendish Ms. Johanne Emmanuel Head of Public & Governmental Affairs, MUCH, Planning Office Mr. James Gates Acting Director McGill Health Network Office Dr. Harvey Guyda Associate Executive Director - Montreal Children s Hospital of MUHC Mr. Jacques Hendlisz Executive Director, Douglas Mental Health University Institute Ms. Mabel Herodier Executive Director, Cree Board of Health and Social Services of James Bay Mr. Jean-Luc Imbeault Directeur administratif par intérim à la Direction des affaires médicales, sociales et des affaires professionnelles, CRSSS de la Baie James (Nord du Québec) Dr. Réal Lacombe Directeur de la santé publique et des affaires médicales, ASSS de l Abitibi- Témiscamingue Dr. Tim Meagher Associate Executive Director, Medical Affairs MUHC Dr. Guy Morissette Chief Executive Officer, ASSS de l Outaouais, Mr. Michel Plouffe Administrative Director of Professional Services Medical, Conseil Cri de la santé et des services sociaux de la Baie-James Dr. Jean Rodrigue Directeur des affaires médicales, universitaires et des partenariats professionnels, ASSS de Montérégie Ms. Caterina Staltari McGill Network Clinical Coordinator Ms. Lise St-Amour Présidente-directrice générale de l Agence de santé et de services sociaux de l Abitibi-Témiscamingue Ms. Rita Ziadé McGill RUIS Program Manager Regrets Dr. Louise Ayotte Ms. Madeleine Boulay-Bolduc Dr. Michel Bureau Ms. Johanne Desrochers Ms. Celine Doray Dr. Arvind Joshi Dr. Richard Levin Mr. David Levine Mr. Roland Lord Ms. Ghislaine Prata Director of Medical and University Affairs, ASSS de Montréal McGill School of Nursing Representative Director General, Affaires médicales et universitaires, MSSS Associate Director, RUIS McGill Telehealth Director General, Shriners Hospital for Children Director General & Chief Executive Officer, St. Mary s Hospital Center Dean, Faculty of Medicine - Vice-president McGill RUIS President Executive Director, ASSS de Montréal Directeur régional des services de santé, ASSS de l'abitibi-témiscamingue Executive Director, Constance Lethbridge Rehabilitation Centre November 25, 2008 Page 1 of 6

15 Mr. Marc Sougavinski Dr. Hartley Stern Executive Director, CSSS de la Montagne Executive Director SMBD Jewish General Hospital AGENDA DATE: Tuesday, November 25, Approval of minutes from previous meeting (October 14, 2008) Pj 1a & 1b 2. Business arising from previous minutes McGill RUIS Health Network Office - Ruptures de services in McGill RUIS Visits to Outaouais Pediatrics : Le dépistage de la surdité Rehabilitation : Prescribing Technical Aids Table Sectorielle Santé mentale : Mandate 3. McGill RUIS Subcommittees Reports Cardiovascular Sciences Chronic Pain Genetics Mental Health Nursing Oncology Pediatrics - Revised Terms of Reference: Mères, enfants et jeunes Rehabilitation Telehealth 4. Evaluation: RUIS after 5 years Pj 2 5. PREM Reports Regions CSSS 7. Varia 8. Next meeting : Tuesday, February 3, 2008 P.j. Pj 1a - Compte rendu Comité directeur RUIS McGill 14 octobre, 2008 Pj 1b - Minutes RUIS McGill October 14, 2008 Pj 2 - Revised Terms of Reference: Mères, enfants, jeunes November 25, 2008 Page 2 of 6

16 1. Approval of minutes from previous meeting (October 14, 2008) The minutes were approved, as submitted. 2. Business arising from previous minutes McGill RUIS Health Network Office - Ruptures de services in McGill RUIS T. Meagher reported that an in-depth discussion of the Bris de services took place at the PRE-RUIS meeting. This issue was reviewed in the context of manpower shortages, the difficulties of attaining a critical mass of physicians in small community hospitals, and the ad hoc arrangements which currently take place. All agreed that this situation requires a more broadly based evaluation involving the key players in the organization of health care services (MSSS, Agences, RUIS, Health Care institutions, Professional Associations, etc.). S. Benaroya will bring up this issue at the next TCN meeting on December 18, 2008, and recommend that such a widely based evaluation take place. Participants in the Pre-RUIS Committee will continue reflection on this subject and will make specific recommendations to the Full RUIS Table. Visits to Outaouais G. Morissette expressed the appreciation of the Outaouais region with respect to the recent RUIS McGill visit. He pointed out that the visit was very positively received. A summary of the visit will be distributed to the Full Table members as soon as it is available. Pediatrics: Le dépistage de la surdité A meeting of the Direction nationale de la santé publique will take place next week. R. Lacombe will ensure that the subject of Le dépistage de la surdité will be addressed at the meeting. Rehabilitation: Prescribing Technical Aids A teleconference took place on November 10, 2008, involving G. Prata, representatives of Nunavik and territories Cree. An action plan was agreed to and is as follows: November 25, 2008 Page 3 of 6

17 Technical Aids - The agencies will: o prepare a needs report in accordance with the aforementioned parameters; o follow up with general practitioners regarding a 14-hour training session that must be completed in order to meet the requirements of the regulation in effect. - The CRCL (Constance-Lethbridge Rehabilitation Centre) will: o verify the payment terms for the technical aids; o follow up on the recommendations with Dr. Benaroya; o continue the discussions underway in order to propose agreements for rehabilitation services and the technical aids. Table Sectorielle Santé mentale: Mandate Comments were received from G. Morissette (Agence Outaouais) supporting the creation of this Committee and suggesting representation from non-university regions. J. Hendlisz reported that the RUIS McGill subcommittee in Mental Health was in the process of analyzing the terms of reference and representation of the proposed committee, and will be reporting to the Full RUIS Table in the near future. This input will be rediscussed at the next Full RUIS meeting, at which time a decision will be made as to the RUIS McGill position on this proposed Table Sectorielle. The conclusions of the McGill Full Table will then be forwarded to the MSSS. 3. McGill RUIS Subcommittees Reports Chronic Pain R. Finlayson has been invited to attend the next Full RUIS meeting on February 3, He will discuss the priorities and activities of the subcommittee on Chronic Pain. Pediatrics - Revised Terms of Reference: Mères, enfants et jeunes The revised terms of reference and information regarding the change of name of this subcommittee were reviewed by H. Guyda (terms of reference previously circulated). Telehealth - PACS: The issue of identifying the site for the 2nd diagnostic imaging repository has been resolved. The site of the old Technocentre on Christophe Colomb Street was selected. November 25, 2008 Page 4 of 6

18 - CvSSS: Preparations to begin implementing are underway. The project team is being developed and should be operational at the start of February, Still no news from the MSSS concerning remuneration for physicians and the associated investments (the latter will be used to cover the "recurring" costs generated by these new services, as well as non-admissible expenses at the Canada Health Infoway and the office of the Quebec Electronic Health Record) which are within the scope of current projects. The strategy that was chosen is to implement the projects regardless and to develop them up to the point where the implementation of the projects cannot continue without a response regarding the coverage of the recurring costs by the MSSS. - National Home Ventilatory Assistance Program: The invitation to tender has been completed and the technological solutions are being evaluated for selection. A response should be known by mid-december. Letters will be sent to the CEOs of the agencies to inform them that the services will be available in the near future. 4. Evaluation: RUIS after 5 years TCN participants have been informed that the MSSS will be carrying out an evaluation of the RUIS concept. L. Dufresne will be circulating a questionnaire to each RUIS as part of this evaluation process. The questionnaire will be distributed to the Full Table Committee members when available. 5. PREM 2009 S. Benaroya summarized several elements of the PREM 2009 including: Creation of specific positions in transplantation; Maintaining a closed envelope in psychiatry for urban centers; More flexible approach to jumelage; Formal study to be made of vacant positions; An evaluation to be made of the FTE concept as it applies to recruitment. 6. Reports Regions Abitibi-Témiscamingue R. Lacombe reported on the following: ID micro: meeting held with RUIS McGill to develop support to the clinical, lab and infection control services provided in the region; Plastic Surgery services in the region; November 25, 2008 Page 5 of 6

19 Update on the development of the UQAT McGill Nurse Practitioner Program; Neurology support to the region. Territoires Cree M. Plouffe reported on the following: Aides techniques; The development of residency rotations in tertiary care specialties; Support for orthopedic services from Amos. Montreal No report. Monteregie J. Rodrigue reported on the following: The orthopedic services in Valleyfield; The creation of an UMF in Chateauguay; The proposed development of a Complexe de santé in Vaudreuil-Soulanges. Outaouais G. Morrissette reported on the following: Development in the educational aspects of Campus santé; The ongoing study of clinical services obtained in Ontario; Continuing Medical Education programs in the region, supported by McGill University. CSSS F. Dupuis reported on the following: Request of the five Montreal RUIS McGill affiliated CSSS to meet with the RUIS McGill Executive Committee; Progress in the Santé Mentale dossier. 7. Varia No items. 8. Next meeting: Tuesday, February 3, 2009 There being no further items on the agenda, the meeting was concluded at 3:45 p.m. November 25, 2008 Page 6 of 6

20 MCGILL RUIS FULL TABLE (47 th meeting) Minutes of the meeting held on Tuesday, February 3, 2009 from 2:00-4:00 p.m. at the MUHC Planning Office, 2155 Guy Street, Suite 200 Attendees: Dr. Arthur Porter Director General & CEO, MUHC - President McGill RUIS Dr. Richard Levin Dean, Faculty of Medicine - Vice-president McGill RUIS Dr. Sam Benaroya Associate Dean, Interhospital Affairs, Faculty of Medicine McGill Coordinator McGill RUIS Dr. Louise Ayotte Director of Medical and University Affairs, ASSS de Montréal Ms. Madeleine Boulay-Bolduc McGill School of Nursing Representative Ms. Johanne Desrochers Associate Director, RUIS McGill Telehealth Ms. Celine Doray Director General, Shriners Hospital for Children Ms. Johanne Emmanuel Head of Public & Governmental Affairs, MUCH, Planning Office Dr. Harvey Guyda Associate Executive Director - Montreal Children s Hospital of MUHC Dr. Arvind Joshi Director General & Chief Executive Officer, St. Mary s Hospital Center Mr. David Levine President Executive Director, ASSS de Montréal Dr. Tim Meagher Associate Executive Director, Medical Affairs MUHC Dr. Guy Morissette Chief Executive Officer, ASSS de l Outaouais, Dr. Joseph Portnoy, (replacing Dr. Director of Professional Services, Jewish General Hospital H. Stern) Ms. Ghislaine Prata Executive Director, Constance Lethbridge Rehabilitation Centre Dr. Jean Rodrigue Directeur des affaires médicales, universitaires et des partenariats professionnels, ASSS de Montérégie Dr. David Rosenblatt Chair, RUIS McGill Genetics Subcommittee Ms. Claire Thibault Ms. Rita Ziadé Invited Guests: Dr. Roderick Finlayson Chairs, Subcommittee Regrets Dr. Gerald Batist Ms. Martine Boudreau Mr. Gilles Boulet Dr. Michel Bureau Dr. Louis Dufresne Senior Advisor, MUHC Pediatric Network, Montreal Children s Hospital McGill RUIS Program Manager Chair, RUIS McGill Chronic Pain Subcommittee Chair, RUIS McGill Oncology Subcommittee Clinical Project, Medical Affairs & Physical Health Advisor, Planning & Programming, Nunavik Regional Board of Health and Social Services Directeur général intérimaire, Régie régionale de la Santé et des services sociaux du Nunavik Director General, Affaires médicales et universitaires, MSSS Medical Director, Direction des affaires universitaires, MSSS Ms. Francine Dupuis Executive Director, CSSS Cavendish Mr. James Gates Acting Director McGill Health Network Office Mr. Jacques Hendlisz Executive Director, Douglas Mental Health University Institute Ms. Mabel Herodier Executive Director, Cree Board of Health and Social Services of James Bay February 3, 2009 Page 1 of 7

21 Mr. Jean-Luc Imbeault Dr. Mimi Israel Dr. Réal Lacombe Mr. Roland Lord Mr. Michel Plouffe Mr. Marc Sougavinski Ms. Caterina Staltari Ms. Lise St-Amour Dr. Hartley Stern Directeur administratif par intérim à la Direction des affaires médicales, sociales et des affaires professionnelles, CRSSS de la Baie James (Nord du Québec) Chair, RUIS McGill Mental Health Subcommittee Directeur de la santé publique et des affaires médicales, ASSS de l Abitibi- Témiscamingue Directeur régional des services de santé, ASSS de l'abitibi-témiscamingue Administrative Director of Professional Services Medical, Conseil Cri de la santé et des services sociaux de la Baie-James Executive Director, CSSS de la Montagne McGill Network Clinical Coordinator Présidente-directrice générale de l Agence de santé et de services sociaux de l Abitibi-Témiscamingue Executive Director SMBD Jewish General Hospital AGENDA 1. Approval of minutes from previous meeting (November 25, 2008) 2. Business arising from previous minutes McGill RUIS Health Network Office - Ruptures de services in McGill RUIS Pediatrics : Le dépistage de la surdité Table Sectorielle Santé mentale : Mandate 3. McGill RUIS Subcommittees Cardiovascular Sciences Chronic Pain Genetics Mental Health Nursing Oncology Pediatrics Rehabilitation Telehealth 4. Presentation by Dr. Finlayson : McGill RUIS Chronic Pain subcommittee 5. Evaluation: RUIS after 5 years 6. MSSS Strategic Plan RUIS Review 7. Proposed dates for RUIS McGill FULL Table meetings 8. Varia 9. Next meeting : Tuesday, March 24, 2009 P.j. Pj 1a Compte rendu Comité directeur RUIS McGill 25 novembre, 2008 Pj 1b Minutes RUIS McGill November 25, 2008 Pj 2a Chronic Pain SC - Summary of activities pdf Pj 2b Sommaire des activités Sous-comité Douleur chronique Pj 3 RUIS McGill Continuum de Services en douleur chronique Rapport final Pj 4 Matrice Douleur version 19 décembre 2008 Pj 5a RUIS Evaluation - RUIS McGill Feedback Pj 5b Évaluation des RUIS - réponse du RUIS McGill Pj 6a RUIS Meeting dates Pj 6b Proposition des dates de réunions du comité directeur du RUIS pour February 3, 2009 Page 2 of 7

22 1. Approval of minutes from previous meeting (November 25, 2008) The minutes were approved, as submitted. 2. Business arising from previous minutes McGill RUIS Health Network Office No report. Pediatrics: Le dépistage de la surdité R. Lacombe was to ensure that the subject of Le dépistage de la surdité would be addressed at the meeting of the Direction nationale de la santé publique. R. Lacombe will report at the next meeting. Table Sectorielle Santé mentale: Mandate The RUIS McGill Mental Health Subcommittee pointed out that the mandate proposed by the MSSS for the table sectorielle santé mentale was too broad, and needed to be reviewed and refined. J. Hendlisz and M. Israel would be willing to work with the MSSS on a revised mandate. This feedback will be reported at the next TCN meeting. 3. McGill RUIS Subcommittees Reports The Chairs of the RUIS McGill Subcommittees were invited to attend the RUIS FULL Table meeting, dedicated mainly to RUIS evaluation. 4. Presentation by Dr. Finlayson: McGill RUIS Chrnonic Pain Subcommittee R. Finlayson, Chair of the McGill RUIS Chronic Pain Subcommittee, presented a summary of the activities and priorities for this Subcommittee. Recent developments: A coordinator has been hired. The deadline for submission of the designation document to the MSSS has been extended to the end of March Next steps: Revise and complete the document (clinical continuums, education, research, offer of services). Request letters of support from the Agence de Montreal, RUIS McGill Executive Committee, MUHC, and Constance Lethbridge Rehab Center. February 3, 2009 Page 3 of 7

23 Clinical continuums: A general service network organization plan will implemented by the end of March to meet the designation criteria. The plan will be developed on an ongoing basis thereafter; RUIS McGill Full Table members are invited to contribute to the newly created corridors de service sub-committee; Tertiary care is already available at the MUHC and the CL Rehabilitation Centre, and we are already serving clientele from all regions of the province; The unequal service offer in the first and second lines, often with no possibility of returning patients to the community, contributes to waits of one year or longer for non-priority cases; We propose a hierarchical model that follows the recommendations of the Chronic Pain Advisory Committee (model illustrated in the October 2007 document); With this hierarchical model, it is estimated that only 5% of clientele will require tertiary care. The remainder may be treated by the first and second lines; The development of first-line care is complicated by the systemic lack of general practitioners; The actions taken two years ago, to include patients suffering from chronic pain with high-risk clientele have not been productive; Several initiatives have been planned, to develop first-line care: Training for medical personnel interested in chronic pain; Training for interdisciplinary groups at the primary level; The use of designated nurses to support patients throughout their treatment; Participating in the initiative from the part of telehealth. R. Finlayson pointed out that the establishment of the corridors de service in the entire McGill RUIS region will take several years. He invited those who were interested in participating in a pilot project, to contact the Chronic Pain Subcommittee. D. Levine and L. Ayotte proposed that a letter be sent by RUIS McGill to the MSSS requesting that chronic pain patients be considered clientèle vulnérable. The FULL RUIS Committee agreed with this proposal. S. Benaroya thanked R. Finlayson for his valuable presentation. RUIS McGill partners interested in contributing to the corridors de service pilot project could communicate with the Chronic Pain Subcommittee by at: brian.bradley@muhc.mcgill.ca L. Ayotte, G. Prata, and R. Finlayson will draft a letter for approval and signature by the RUIS McGill President. J. Genest, Chair, RUIS McGill Cardiology Subcommittee, will be asked to attend the next RUIS McGill Full Table meeting. February 3, 2009 Page 4 of 7

24 5. Evaluation: RUIS after 5 years A. Porter introduced the subject, reflecting on the positive aspects related to the RUIS implementation, as well as highlighting the many challenges faced by the partners involved in carrying out the mandates outlined by the law. He thanked the participants for the written comments already submitted and invited the remaining partners to submit their input within the next two weeks. He then suggested that a tour de table take place. All participants should focus on the positive outcomes of the RUIS, the challenges faced by the RUIS, and make specific recommendations as to how to improve the current system. The key points made during the tour de table are summarized below. POSITIVE ASPECTS OF THE RUIS RUIS Concept is fundamentally sound; Certain advantages related to the RUIS advisory role in influencing ministerial decision making; Acceptance of the continuum of services as a key objective; Good Will established ; Collaboration with partners: Networking; Development of regional partnerships; Collaboration and integration in 3 sectors: - Oncology - Mental Health - Meres, enfants et jeunes Working outside of silos; Sharing services eg. psychiatric services in Valleyfield, Cree territories; Opportunities to develop an optimal organization of services; Organisation of adult and pediatric sevices eg. Nunavik; Nursing resource directory; Medical manpower planning; Nursing practitioner program: Abitibi-Temiscamingue, Outaouais; Nursing Stages in the region; Distance education eg. Campus santé Outaouais; RUIS Subcommittees activities and accomplishments; RUIS Tables sectorielles activities and accomplishments; Development of Visio conferencing facilities; Development of Telehealth projects (PNAVD, CvSSS); PACS installation in regional centers. CHALLENGES OF THE RUIS Inappropriate and unrealistic mandates and expectations eg. Dépannage, Ruptures de services ; Ambiguity in its role as an advisory body; Overlapping roles and responsibilities (Agence, CSSS, hospitals, etc); Unclear objectives and lack of indicators; Confusion in underline concept (academic versus clinical roles); Inadequate funding; February 3, 2009 Page 5 of 7

25 Lack of human resources; Lack of authority; 3 RUIS involved in Monteregie. RECOMMENDATIONS MADE BY PARTICIPANTS OF TOUR DE TABLE Mandates and responsibilities require review and clarification; Inappropriate RUIS responsibilities should be eliminated eg. ruptures de service, bris de services; Resources need restructuring and redistribution; Resources need to be in line with mandate; Distribution of resources have to be rational; RUIS role needs clarification : Advisory or decision making; Roles (MSSS, Agence, CSSS, RUIS) need clarification; RUIS role should stress its academic role, to include: Administration of health care and evaluation of services Research, Etmis, transfer of knowledge; RUIS Presidency should reflect the academic mission (D. Levine Agence de Montréal) Training Family physicians and specialists in basic specialties; RUIS should establish priorities while agences should provide support; Promotion of continuum of care, autonomy in regions, and multidisiplinarity. Increase visibility and develop communications strategy A. Porter thanked the participants of this tour de table for their valuable input. He summarized the discussion and stated that a clear mandate was required, clear goals and outcomes needed to be identified, appropriate indicators established, and that the relationship between fiscal support and authority be better aligned. The input of all participants will be compiled and synthesised so as to address the questions posed in the MSSS questionnaire. A cover letter will be drafted summarising key points and recommendations. Both documents will be circulated to FULL RUIS Committee members for validation. The finalized documents will be then forwarded to the MSSS by mid-march MSSS Strategic Plan RUIS Review RUIS McGill Committee members were asked to submit their comments on the MSSS Strategic Plan (previously circulated). Comments received will be transmitted to the MSSS. 7. Proposed dates for RUIS McGill FULL Table meetings The proposed dates for RUIS meetings were approved. February 3, 2009 Page 6 of 7

26 8. Varia S. Benaroya reported that the Table sectorielle en génétique has proposed that institutions be specifically designated with respect to genetics laboratories testing. This subject was reviewed in detail by the McGill RUIS Genetics Subcommittee. The subcommittee approved the Table sectorielle proposals. A letter to this effect was addressed to A. Porter and signed by D. Rosenblatt. The MSSS has requested that the Table sectorielle proposals be validated by the hospitals affected by these designations (MUHC, JGH). T. Meagher and H. Guyda are to validate the proposal for laboratory designation with respect to genetics testing within the MUHC. H. Stern will be asked to validate the proposal at the JGH. The MUHC and the JGH representatives will report on this internal review at the next RUIS McGill Executive Committee meeting. 9. Next meeting: Tuesday, March 24, 2009 There being no further items on the agenda, the meeting was concluded at 4:00 p.m. February 3, 2009 Page 7 of 7

27 MCGILL RUIS FULL TABLE (48 th meeting) Minutes of the meeting held on Tuesday, March 24, 2009 from 2:00-4:00 p.m. at the MUHC Planning Office, 2155 Guy Street, Suite 200 Attendees: Dr. Arthur Porter Director General & CEO, MUHC - President McGill RUIS Dr. Richard Levin Dean, Faculty of Medicine - Vice-president McGill RUIS Dr. Sam Benaroya Associate Dean, Interhospital Affairs, Faculty of Medicine McGill Coordinator McGill RUIS Ms. Johanne Emmanuel Head of Public & Governmental Affairs, MUCH, Planning Office Mr. James Gates Acting Director McGill Health Network Office Dr. Harvey Guyda Associate Executive Director - Montreal Children s Hospital of MUHC Mr. Jacques Hendlisz Executive Director, Douglas Mental Health University Institute Dr. Arvind Joshi Director General & Chief Executive Officer, St. Mary s Hospital Center Mr. David Levine President Executive Director, ASSS de Montréal Mr. Roland Lord Directeur régional des services de santé, ASSS de l'abitibi-témiscamingue Dr. Tim Meagher Associate Executive Director, Medical Affairs MUHC Dr. Guy Morissette Chief Executive Officer, ASSS de l Outaouais, Ms. Claire Pagé President Executive Director, ASSS de Montérégie Ms. Ghislaine Prata Executive Director, Constance Lethbridge Rehabilitation Centre Dr. Jean Rodrigue Directeur des affaires médicales, universitaires et des partenariats professionnels, ASSS de Montérégie Ms. Rita Ziadé McGill RUIS Program Manager Regrets Dr. Louise Ayotte Ms. Martine Boudreau Ms. Madeleine Boulay-Bolduc Mr. Gilles Boulet Dr. Michel Bureau Ms. Johanne Desrochers Ms. Celine Doray Dr. Louis Dufresne Director of Medical and University Affairs, ASSS de Montréal Clinical Project, Medical Affairs & Physical Health Advisor, Planning & Programming, Nunavik Regional Board of Health and Social Services McGill School of Nursing Representative Directeur général intérimaire, Régie régionale de la Santé et des services sociaux du Nunavik Director General, Affaires médicales et universitaires, MSSS Associate Director, RUIS McGill Telehealth Director General, Shriners Hospital for Children Medical Director, Direction des affaires universitaires, MSSS Ms. Francine Dupuis Ms. Mabel Herodier Mr. Jean-Luc Imbeault Dr. Réal Lacombe Mr. Michel Plouffe Ms. Lise St-Amour Executive Director, CSSS Cavendish Executive Director, Cree Board of Health and Social Services of James Bay Directeur administratif par intérim à la Direction des affaires médicales, sociales et des affaires professionnelles, CRSSS de la Baie James (Nord du Québec) Directeur de la santé publique et des affaires médicales, ASSS de l Abitibi- Témiscamingue Administrative Director of Professional Services Medical, Conseil Cri de la santé et des services sociaux de la Baie-James Présidente-directrice générale de l Agence de santé et de services sociaux de l Abitibi-Témiscamingue March 24, 2009 Page 1 of 6

28 Mr. Marc Sougavinski Ms. Caterina Staltari Dr. Hartley Stern Ms. Claire Thibault Executive Director, CSSS de la Montagne McGill Network Clinical Coordinator Executive Director SMBD Jewish General Hospital Senior Advisor, MUHC Pediatric Network, Montreal Children s Hospital AGENDA Tuesday, March 24, Approval of minutes from previous meeting (February 3, 2009) Pj 1a & 1b 2. Business arising from previous minutes McGill RUIS Health Network Office - Ruptures de services in McGill RUIS Pediatrics : Le dépistage de la surdité Table Sectorielle Santé mentale : Mandate McGill RUIS Chronic Pain subcommittee - Letter to MSSS Table sectorielle génétique: Laboratory Designation proposals 3. McGill RUIS Subcommittees 4. Evaluation: RUIS after 5 years Pj 2a, Pj2b, Pj3, Pj 4 5. MSSS Strategic Plan RUIS Review Pj 5a, Pj 5b Pj 6a, Pj 6b 6. Varia 7. Next meeting : Tuesday, April 28, 2009 P.j. Pj 1a Compte rendu Comité directeur RUIS McGill 3 février, 2009 Pj 1b Minutes RUIS McGill February 3, 2009 Pj 2a Evaluation du RUIS-Lettre du RUIS McGill au MSSS Pj 2b Evaluation du RUIS-Lettre du RUIS McGill au MSSS_Eng Pj 3 Evaluation du RUIS-Synthèse des réponses du RUIS McGill Pj 4 Evaluation du RUIS-Compilation des réponses du RUIS McGill Pj 5a Plan stratégique du MSSS Position du RUIS ULaval Pj 5b Plan stratégique du MSSS Position du RUIS ULaval Eng Pj 6a Plan Stratégique du MSSS-Projet Enjeu sur mission universitaire_ Pj 6b Plan Stratégique du MSSS-Projet Enjeu sur mission universitaire_260209_eng March 24, 2009 Page 2 of 6