Master Class Implementing Integrated Care By: Dr. Walter Wodchis, Associate Professor, Institute of Health Policy, Management and Evaluation at the University of Toronto Dr. Ross Baker, Professor, Institute of Health Policy, Management and Evaluation, University of Toronto Dr. Frances Morton-Chang, Postdoctoral Fellow, University of Toronto Ms. Jodeme Goldhar, Chief Strategy Officer, Strategy and Planning, Community Care Access Centre Dr. Carolyn Steele Gray, Scientist, Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Bridgepoint Collaboratory Dr. Kerry Kuluski, Investigator, Lunenfeld-Tanenbaum Research Institute, Sinai Health System Dr. Jay Shaw, Physiotherapist and Scientist, Institute for Health System Solutions and Virtual Care, Women s College Hospital s Dr. Jenna Evans, Staff Scientist, Enhanced Program Evaluation Unit, Cancer Care Ontario Dr. Agnes Grudniewicz, Assistant Professor, Telfer School of Management, University of Ottawa Dr. Mylaine Breton, Assistant Professor, Université de Sherbrooke Dr. Jean Louis Denis, Professor, l ÉNAP, Department of Administration, Université de Montréal Dr. Yves Couturier, Professor, School of Social Work, Université de Sherbrooke Dr. Denis Roy, Professor, Université Laval Many healthcare providers, organizations, and policy-makers are keen to work together with older adults with complex health conditions to implement integrated care programmes to meet patients functional and health care needs. This master class is offered to those who seek to understand effective approaches to implement integrated care programmes. Presenters have studied integrated care internationally and have most recently conducted extensive case studies of the implementation of integrated care in Quebec, Ontario and New Zealand as part of the implementing Integrated Care for Older Adults with Complex Health needs (ICOACH) program. This master class will provide an interactive learning opportunity for researchers, policy-makers, organizations, providers, and patients to assess their own environments vis-à-vis key factors that we have learned are essential to effective implementation, scale and spread of integrated care initiatives. Integrated care programs cannot operate in isolation and the direct consideration of context including funding and policy, organizational values and leadership, inter-organisational and inter-sectoral relationships will be discussed with suggestions for how to measure and implement these mechanisms. Our studies have also reinforced the importance of patient-centred care and how this is operationalized among successful programs including both patients and informal caregivers. Key approaches to implementation of policies, organisational and inter-organisational structures and practices as well as provider activities and engagement will be examined. How these activities are implemented variously across different programs will also be presented. Participants will have the opportunity to learn and use some of the key tools emerging from the research in active and engaging sessions. The master class will include specific sessions and activities that include: 1. Policy, financing and regulatory considerations; 2. Organisational assessment and identification of strengths and gaps; 3. Provider engagement strategies and varied approaches to organizing teams and models of delivery with and across non-traditional sub-systems; and 4. Approaches to involving patients and caregivers in the development, implementation and evaluation of integrated care programmes. In each session, participants will learn of key features from international research; engage in self-assessment and small-group discussions; and engage in open discussion forums. The master class will be relevant and useful to policy-makers, organizational leaders, providers,
individuals and organisations representing patients and caregivers as well as researchers seeking to understand evaluation considerations for integrated care. Throughout the Master Class, participants will learn from each other about different policy and organisational environments and varied approaches to implementing integrated care. Master Class Objectives: To summarize the international context for integrating care for older adults. To summarize how selected international jurisdictions have pursued policies to support community and primary care services in general and specifically integrated care for older adults. To introduce a framework to understand key organisational factors such as leadership and readiness for implementing integrated care. To understand how mechanisms for integrating care play a key role in the success of implementing models of integrated care. To understand the centrality of patient-centeredness in how we design and deliver integrated models of care and how this has been implemented in various contexts. Presenter Biographies Dr. Walter Wodchis, Associate Professor, Institute of Health Policy, Management and Evaluation at the University of Toronto Dr. Walter Wodchis is Associate Professor at the Institute of Health Policy, Management and Evaluation at the University of Toronto. He is also a Research Scientist at the Toronto Rehabilitation Institute and an Adjunct Scientist at the Institute for Clinical Evaluative Sciences. He is co-lead for icoach (implementing Integrated Care for Older Adults with Complex Health Needs). He has previously lead case studies of integrated care in 7 countries. These programs have developed foundational knowledge on the characteristics of integrated care programs but also on the conditions for implementing integrated care. Dr. Wodchis is the Principal Investigator for the Health System Performance Research Network focused on evaluating health system performance and interventions that improve integration of care for complex populations across multiple health care sectors. Dr. Wodchis research interests include health economics and financing, health care policy evaluation, and long-term care. Past significant publications include quality of life measurement for older populations, incentives and government payment for physicians and long-term care including pay for performance, and the relationship between quality and cost. Dr. Ross Baker, Professor, Institute of Health Policy, Management and Evaluation, University of Toronto G. Ross Baker is a professor in the IHPME at the UofT and Program Lead for the MSc. Program in Quality Improvement and Patient Safety. Dr. Baker has carried several major studies of patient safety events in acute care, home care and pediatric hospital care. Recent research has focused on examining the implementation challenges and successes for patient safety interventions. Ross has also led the icoach Ontario team s organizational
analysis, focusing on identifying and measuring factors underlying the development of successful community based primary care organizations. Ms. Jodeme Goldhar, Chief Strategy Officer, Strategy and Planning, CCAC Jodeme has held clinical and strategic leadership positions in healthcare for over twenty years. She joined the Toronto Central CCAC's leadership team in 2010 as the Lead for Health System Integration for Complex Populations and Primary Care. Jodeme served as the Chief Strategy Officer at Toronto Central CCAC until 2017. She now serves as the Executive Lead for Strategy, Innovation and Global Partnerships at the Change Foundation. Jodeme has positively impacted the care delivery, experience and outcomes for some of the most complex need populations who live at home and in their communities. The impact of her involvement in driving integration has informed new models of care, influenced policy and is sought to inform care delivery in other countries. She is adept at leading complex change in complex adaptive systems and shares her thought leadership across North America and beyond. With a focus on leading integrated care, the Toronto Central CCAC has been recognized by the Minister of Health and Long Term Care with the 2013 Minister's Medal Honour Roll for Excellence in Health Quality and Safety for Integrated Care for Older Adults, and the 2014 Minister's Medal for the Integrated Palliative Care program and the Canadian Home Care Association as the 2014 National High Impact Practice. Jodeme has been recognized by Patient Commando as one of the Ten Canadian Woman Transforming Health Care. She is President, Institute for Health Policy, Management and Evaluation (IHPME), Society of Graduates and Adjunct Lecturer at the University of Toronto, as well as Principal and Co Principal Investigator for a number of research projects focused on integrated care in partnership with the Li Ka Shing Knowledge Institute, York University, BRIDGES and the University of Toronto. Jodeme holds Masters Degrees in both Social Work and Health Science in Health Policy, Management and Evaluation and is a graduate of the Advanced Health Leadership Program from the Rotman School of Management. Dr. Denis Roy, Professor, Université Laval Dr. Denis A. Roy holds a community medicine specialty and is a Harkness Fellow of the Commonwealth Fund in Health Policy. Since May 2015, he serves as Vice-President, Science and Clinical Governance at Institut national d excellence en santé et services sociaux. He is also Acting President of the Canadian Association of Health Services and Policy Research (CAHSPR / ACRSPS). From 2009 to 2015, as Vice-President, Scientific Affairs, he has been responsible of the Institut National de Santé Publique du Québec comprehensive scientific program on the determinants of population health. Dr. Roy has also been president of the Board of l'initiative sur le Partage des Connaissances et le Développement des Compétences, a province-wide capacity building consortium aimed at health system improvement. He is the proud co-author of a reference book on health networks management and governance. Previously, Dr. Roy has occupied three other executive leadership positions at l Agence de la Santé et des Services Sociaux de la Montérégie, at the Quebec Health and Social Services Ministry and at the Montreal Public Health Department.
Dr. Roy holds an MD from Laval University. In addition, he earned a Master of Public Health at University of California, Berkeley, and a Master of Science (Epidemiology) at McGill University. A fellow of the Royal College of Physicians in Community Medicine, he has been honoured with some prestigious awards, including an Excellence Award by the Quebec Association of Community Health Physicians. He is currently the only Canadian to have received twice the Canadian Health Research Advancement Award, which he obtained due to his outstanding work with two different teams, in the Montréal and Montérégie regions. Dr. Jay Shaw, Physiotherapist and Scientist, Institute for Health System Solutions and Virtual Care, Women s College Hospital s Jay Shaw is a physiotherapist and Scientist at Women s College Hospital s Institute for Health System Solutions and Virtual Care. Jay worked as a physiotherapist in the home care sector for 2 years before completing his PhD work on fall prevention for older people in the community, proceeding on to study transitions out of hospital and community-based integrated care for older people with complex health needs in his postdoctoral research. As a Scientist, Dr. Shaw brings together his practical experience seeking to work in integrated ways as a physiotherapy in the home health care side of the health system with his academic expertise in health policy and implementation science. Drawing on social science methods to understand why and how health and social care providers can better work together, his research helps to inform practical approaches to integrating care at policy, organizational, and provider levels. He has ongoing collaborations with researchers and practitioners in home health care, primary care, and rehabilitation care. Dr. Carolyn Steele Gray, Scientist, Research and Innovation, Lunenfeld- Tanenbaum Research Institute, Bridgepoint Collaboratory Dr. Carolyn Steele Gray is a Scientist at the Bridgepoint Collaboratory in Research and Innovation at the Lunenfeld-Tanenbaum Research Institute, as well as an Investigator with the Health System Performance Research Network at the University of Toronto. Dr. Steele Gray is a health services researcher with a PhD in Health Policy from the University of Toronto (2013), and a Master s in Public Policy and Administration from Ryerson University (2008). Prior to her current role as a Scientist Dr. Steele Gray was a postdoctoral fellow working at the University of Toronto and the Health System Performance Research Network. Dr. Steele Gray s program of work focuses on the role of health information technology in supporting patient-centred care delivery for patients with complex care needs. Among the areas of focus are to explore how technology can be leveraged to enable implementation and sustainability of innovative models of care as a means to support health system transformation. As part of this work she has been developing and evaluating new technologies, most notably the electronic Patient Reported Outcome (epro) mobile application and portal, and is developing change management and implementation frameworks to support implementation of new and existing technologies. Dr. Steele Gray additionally founded and leads the multi-national ehealth Research Partnership for patients with Complex Chronic Disease and Disability (the eccdd Network).The network includes an international group of researchers and policy makers who are seeking ways to adopt new technologies to support patients with complex care needs. The network has recently published their foundational
work in Healthcare Quarterly which outlines the opportunities and challenges in adopting ehealth technologies in Canada, the US and Scotland. Dr. Steele Gray has published work in the areas of ehealth and mhealth technologies for patients with complex needs, organizational change, health policy and patient-centred care delivery, as well as spoken at national and international conferences. She has taught Health Policy at York University and delivered invited lectures on organizational change, research methods, and program evaluation at the University of Toronto and Ryerson University. Dr. Kerry Kuluski, Investigator, Lunenfeld-Tanenbaum Research Institute, Sinai Health System Dr. Kuluski is an Investigator at the Lunenfeld-Tanenbaum Research Institute, Sinai Health System (Bridgepoint Hospital site), Assistant Professor at the Institute of Health Policy, Management and Evaluation (University of Toronto) and Research Affiliate at the Centre for Education and Research on Aging and Health (Lakehead University). She is an Applied Health Services Researcher and a Social Worker by training. She received her PhD in Health Services and Policy Research from the University of Toronto in 2010 followed by a Prestigious Postdoctoral Visiting Fellowship at the University of Oxford where she worked with the Health Experiences Research Group. She has funding from the Canadian Institutes of Health Research, has given over 60 invited talks and has over 25 publications in peer-reviewed journals. Her research focuses on quality and health system performance through the eyes of people with multimorbidity and their caregivers in the contexts of community based primary health care, homecare, hospital care, delayed discharge and transitions between care settings. She draws on both quantitative and qualitative methods to uncover population level trends in care utilization as well as patient and caregiver experiences in the health care system. Her ultimate research goal is to use patient and caregiver experiences to inform quality improvements in the health care system including approaches to care delivery and performance measurement. At the University of Toronto she teaches a foundational course on Canada s Health Care System and supervises a number of Masters and PhD students. Dr. Jenna Evans, Staff Scientist, Enhanced Program Evaluation Unit, Cancer Care Ontario Dr. Jenna M. Evans is a Staff Scientist in the Enhanced Program Evaluation Unit at Cancer Care Ontario (CCO) and a Certified Health Executive with the Canadian College of Health Leaders. She is interested in how characteristics of healthcare organizations, their leaders, and staff contribute to their ability to work collaboratively to implement change and improve the quality and integration of care. In particular, she enjoys exploring social and psychological factors influencing performance using qualitative, survey and mixed methods research. Dr. Evans holds a Bachelor of Health Studies with Honours in Health Management from York University (2008) and a PhD in Health Services Research from the Institute of Health Policy, Management and Evaluation at the University of Toronto (2014). Her doctoral work, entitled 'Health Systems Integration: Competing or Shared Mental Models?' was funded by a Vanier Canada Graduate Scholarship and the Health System Performance Research Network, and received an Outstanding Doctoral Research Award in 2015 from the European Foundation for Management Development and Emerald Group Publishing.
Dr. Mylaine Breton, Assistant Professor, Université de Sherbrooke Dr. Mylaine Breton is an Assistant Professor in the Department of Social Science and Medicine at the University of Sherbrooke. She is also a Research Scientist at the Charles-Lemoyne Hospital Research Center. She received her PhD in Health Service Management from the University of Montréal in 2009, followed by a Postdoctoral at the University of Sherbrooke and McGill University. Her current research focuses on primary health care to better understand promising organizational innovations that improve accessibility and continuity, such as the implementation of a centralized waiting list for patients without a family physician and advanced access. She is a co-lead of the international icoach (implementing Integrated Care for Older Adults with Complex Health Needs) project and the leader of the Quebec team within the project. She had previously analysed case studies on an integrated health network in Québec in the context of mandated reform. She has ongoing collaborations with researchers and practitioners in primary healthcare and health services research. Dr. Jean Louis Denis, Professor, l ÉNAP, Department of Administration, Université de Montréal Jean-Louis Denis is professor of health policy and management at the School of Public Health - Université de Montréal, senior scientist on health system and innovation at the Research Center of the CHUM (CRCHUM) and holds the Canada Research Chair (tier I) on Governance and Transformation in Health Care Organizations and Systems. He is a visiting professor at the Department of Management, King's College London. His current research looks at integration of care and services, health care reforms and health system transformation, medical compensation and professional leadership and clinical governance. In recognition for his academic contribution to the field of health policy and management, he was nominated member of the Academy of Social Sciences of the Royal Society of Canada in 2002 and fellow of the Canadian Academy of Health Sciences in 2009. Recent papers have been published in Journal of Health Politics, Policy and Law, Organization Science, Academy of Management Annals, Milbank Quarterly, Administration and Society, Implementation Science and Journal of Public Administration Research and Theory. Since 2016, he is co-editor of The Palgrave Organizational Behaviour in Healthcare monograph series. To register for this Master Class, click here