FRENCH-LANGUAGE HEALTH SERVICES PLANNING GUIDE For Eastern and South-Eastern Ontario Updated: November 2012 1
TABLE OF CONTENTS WHY IS A FRENCH-LANGUAGE HEALTH SERVICES PLANNING GUIDE NECESSARY?... 3 1) Background... 3 2) Anticipated results from the French-language health planning guide... 5 3) The Francophone lens: a framework to incorporate the Francophone perspective in the planning of French-language health services... 6 4) Proposed use of the planning guide - Guidelines... 6 5) Questionnaire for LHIN health services planning teams... 7 Questions for each planning stage... 9 Stage 1 : Identifying health services needs... 9 Stage 2 : Documenting the health situation... 10 Stage 3 : Identifying shortfalls between the current situation and the desired situation. 11 Stage 4 : Identifying goals and objectives for the health planning process... 12 Stage 5 : Developing an offer of health services or a service continuum... 13 Stage 6 : Identifying health services priorities... 14 Stage 7 : Developing an action plan to address health services priorities... 15 Stage 8 : Assessing the risks of implementing the action plan... 16 Stage 9 : Determining the conditions for success... 16 Stage 10 : Evaluating the implementation of the action plan... 17 Conclusion... 18 Who are we?... 19 Bibliography... 20 2
WHY IS A FRENCH-LANGUAGE HEALTH SERVICES PLANNING GUIDE NECESSARY? The goal of this French-language health services planning guide is to equip the Champlain and South-East Local Health Integration Network (LHIN) health services planners and health services providers to incorporate the Francophone lens into their integrated health services planning processes. We hope that this will help to improve the offer and the quality of French - language health services in Eastern and South-Eastern Ontario. The guide includes the following sections: Background Anticipated results of the planning guide Definition of the Francophone lens and the presentation of an impact analysis framework Guidelines on including the Francophone lens in planning processes A questionnaire for including the Francophone lens in all health services providers and LHIN health services planning processes 1) Background On January 1, 2010, a new regulation issued under Section 16 of the Local Health System Integration Act came into effect. The regulation is intended to encourage effective and coordinated involvement of Francophone communities on French-language health services issues. French-language health planning entities advise the Local Health Integration Networks on the following issues: methods of engaging Francophone communities in the region; the health needs and priorities of the region s Francophone community, including the needs and priorities of diverse groups within that community; the health services available to the Francophone community in the region; the identification and designation of health service providers for the provision of French-language health services in the region; strategies to improve access to, accessibility of and integration of Frenchlanguage health services in the local health system; and the planning for and integration of health services in the area. 3
For Eastern Ontario, the Ministry of Health and Long-Term Care designated the French Language Health Services Network of Eastern Ontario (the Réseau) as French-Language Health Planning Entity with the mandate of advising the Champlain and South-East LHINs on French health issues. The Réseau and the Champlain and South-East LHINs created a joint action plan for 2011 2012. During this process, all parties agreed that the Réseau should develop a Frenchlanguage health services planning guide for the LHIN planners in an effort to share their expertise. This guide may also be of use to health services providers. 4
2) Anticipated results from the French-language health planning guide Interim result. LHIN planners and Health Service Providers incorporate the Francophone lens in all planning processes using the FLHS Planning Guide s checklist. End result The Francophone communities of Eastern and South-Eastern Ontario have access to quality health services in French thanks to a planning that incorporates the Francophone lens. 5
3) The Francophone lens: a framework to incorporate the Francophone perspective in the planning of French-language health services The Réseau proposes an impact analysis framework: the Francophone lens. This framework is designed to take into account the impact of linguistic barriers when it comes to decision-making pertaining to health and to health planning processes of Frenchlanguage health services. The framework is essential when it comes to: Considering the impact of the language barrier on health service delivery for Francophone minority communities with the aid of quality indicators and a rationale based on research; Identifying the systemic and organizational obstacles to the active offer 2 of quality French-language health services 1. 4) Proposed use of the planning guide Guidelines The Réseau recommends that the LHIN and health services providers incorporate the Francophone lens in all planning processes. To that end, this guide may be used in a number of ways, including the following: Leads of any health services providers and LHIN planning process may use the questions in the guide to incorporate the Francophone lens into the process. For this purpose, health services providers and LHIN planners are provided with a checklist outlining the guide s basic questions. 2 At the launch of any new LHIN planning process, the LHIN s Frenchlanguage services advisor may consult this planning guide or invite a Réseau representative to present the tool. The Réseau can provide the LHIN and health services providers with a brief PowerPoint presentation at the initial planning stages of any new health initiative. 1 French Language Health Services Network of Eastern Ontario/Réseau des services de santé de l Est de l Ontario, French Language Services, A Factor in the Quality of Health care Services, Rationale and Impact Analysis Framework for Local Health Integration Networks (LHINs) and Health Services Providers (HSPS) of Eastern and South-Eastern Ontario, Ottawa, November 2012. 2 The checklist is available on Réseau s Website : www.rssfe.on.ca 6
Note Use of this guide is not limited to just one type of traditional integrated and effective planning process. The Réseau questionnaire can easily be applied to project management processes or business plans. Given that no planning process can be systematically linear, and that a certain amount of back-and-forth is to be expected (e.g. prioritization of solutions), it is essential to consider the impact of any change to the planning process on access to health care services by Francophones. 5) Questionnaire for LHIN health services planning teams This questionnaire on the inclusion of the Francophone lens may be applied at each stage of a LHIN or a health service provider s health services planning process, to help improve the offer and the quality of French-language health services in Eastern and South-Eastern Ontario. A planning process usually includes the following stages 3 : 1. Identifying a health problem or a health service needs; 2. Documenting the health situation (health status, use of and access to services); 3. Identifying shortfalls between the current situation and the desired situation; 4. Identifying the goals and objectives for the health planning process 5. Developing an offer of health services, a program, or a service continuum; 6. Identifying health services priorities; 7. Developing an action plan to address health services priorities; 8. Assessing the risks of implementing the action plan; 3 Government of Ontario, The Health Planner s Toolkit, Health System Intelligence Project 2006. Note that the Réseau also referred to planning tools used by the Champlain LHIN. 7
9. Determining the conditions for success; 10. Evaluating the implementation of the action plan. 8
QUESTIONS FOR EACH PLANNING STAGE Stage 1: Identifying health services needs Are the health services needs of the Francophone community in its diversity being considered in identifying health service issues or needs? If yes, how? If no, what measures are proposed to consider the nature of health service needs of the Francophone community? Does the identification of health services needs involve evidence-based data that is specific to the Francophone community? Has the Francophone community been involved in defining health issues or health services needs? If yes, how? (e.g., did Francophone resources or organizations come into play?) If no, why not? Do the effects of a health issue on the community as a whole take into account the possible impacts on the Francophone community? If yes, how? 9
Stage 2: Documenting the health situation (health status, use of and access to services) Is the definition of the Francophone community being applied in the documentation of the health issue, particularly in the context of surveys 4? Does the planning process include data on the health status of or use of services by the Francophone community? If data on Francophones is not available, what methods are being used to include the Francophone community in the data collection? 4 In 2009, the Ontario Office of Francophone Affairs adopted a new, inclusive definition of Francophone (IDF), which covers the diversity of the Francophone community and is not based solely on mother tongue. This new inclusive definition captures those whose mother tongue is neither French nor English, but who have a particular knowledge of French as an Official Language and use French at home, including many recent immigrants to Ontario. http://www.ofa.gov.on.ca/en/ 10
Stage 3: Identifying shortfalls between the current situation and the desired situation Does analysis of the shortfalls between the current health situation and the desired health situation consider the impact of language barriers on the quality of health services in French? Does analysis of the shortfalls between the current health situatio n and the desired health situation make it possible to identify shortfalls specific to the Francophone community? The Réseau s discussion paper, French Language Services, a Factor in the Quality of Health care Services, Rationale and Impact Analysis Framework for Local Health Integration Networks (LHINs) and Health Services Providers (HSPS) of Eastern and South-Eastern Ontario, notifies the impact of language barriers on the provision of health services for the Francophone community and can guide health services planners in identifying shortfalls 5. 5 See Note 1 11
Stage 4: Identifying goals and objectives for the health planning process Are there specific planning goals and objectives that take into account the health needs of the Francophone community? (e.g.: access to quality health services offered in French) Will identified health goals and objectives contribute to improving access to French-language health services? (e.g.: Was the impact of the language barrier considered when identifying health goals?) Will identified health service goals and objectives contribute to improving the quality of French-language health services? 6 Will identified health service goals and objectives contribute to improving the active offer of French-language health services? 7 Do health service goals and objectives address issues that are specific to the Francophone community? (See Stage 1: Identifying health service needs) Are shortfalls specific to the Francophone community being considered in identifying health service goals? (See Stage 3: Identifying shortfalls between the current situation and the desired situation) 6 Refer specifically to quality indicators developed by the Réseau in French Language Services, a Factor in the Quality of Health care Services, Rationale and Impact Analysis Framework for Local Health Integration Networks (LHINs) and Health Services Providers (HSPS) of Eastern and South-Eastern Ontario, Ottawa, November 2012. 7 The active offer is the capacity of an organization to provide clients and citizens with a clear and consistent indication that, regardless of where they are, they can receive quality French-language health services. This means that designated organizations should create an environment that is conducive to demand, anticipates the specific needs of Francophones and their community, and guarantees service of the same quality as that offered to Anglophone clients. Source: adapted from the Annual Report 2009-2010 of the Ontario French Language Services Commissioner 12
Stage 5: Developing an offer of health services, a program, or a service continuum Is access to quality health services for the Francophone community being considered in developing an offer of health services (or a continuum of health services)? Will the development of an offer of health services (or continuum of health services) contribute to ensuring an active offer 8 for the Francophone community along the entire health service continuum? Is the diversity of the Francophone community being considered in developing an offer of health services? (e.g.: rural Francophones and urban Francophones; new immigrants who speak French) Is the capacity 9 of health organizations to provide services in French being considered? If yes, how? Other questions on the offer of French-language health services: Is the importance of the use of French in the provision of quality health services acknowledged in the offer of services? Are there plans to improve/develop an active offer of French-language services? 10 Does the LHIN plan to involve the Francophone community in developing an offer of French-language health services or a health service continuum? (e.g.: group consultations through the Réseau, Réseau participation in LHIN planning discussions ) 8 See Note 7 9 Capacity to provide services in French refers to human resources and organization of services in French. 10 See Note 7 13
Stage 6: Identifying health services priorities Are the positive and negative impacts of each identified priority on the health of the Francophone community being assessed? Are the positive and negative impacts of each priority on the Francophone community s access to health services being assessed? Are the positive and negative impacts of each identified health priority being assessed in terms of Quality 11 and Practices relating to active offer in French 12 11 See Note 6 12 See Note 7 14
Stage 7: Developing an action plan to address health services priorities Have specific actions been identified to ensure that the health needs of the Francophone community are considered? Are the actions designed to guarantee access to quality French-language health services? Are the actions designed to guarantee quality French-language health services along the entire health service continuum? Do feasibility, cost and efficiency/effectiveness analyses of the action plan take into account the positive and negative impacts on the Francophone community? (e.g.: Will a health services integration project harm or promote delivery of French-language health services?) Have justifications for not including specific actions for the Francophone community been documented and shared with the Réseau? 15
Stage 8: Assessing the risks of implementing the action plan Has the LHIN planning teams or health service provider identified any risks specific to the Francophone community? (e.g.: Has the impact of not offering a new service in French where verbal communication is critical to the therapeutic relationship been assessed?) Have the impacts on the Francophone community been evaluated in the documentation of the risks and impacts of the implementation or nonimplementation of a service? Do the descriptions of actions and processes designed to monitor or manage risks consider the Francophone dimension? Are strategies being developed to limit the risks or impacts to the Francophone community? Stage 9: Determining the conditions for success Are Francophone-specific conditions for success being developed? o (e.g.: Access to primary health care services in French may enable health matters to be addressed more promptly, thereby avoiding the necessity for long-term specialized services. Has this effect been considered?) 16
Stage 10: Evaluating the implementation of the action plan Does the evaluation process allow for the assessment of actions on access to French-language health services? Do the evaluation tools include quality indicators that take into account the situation ofthe Francophone community? For example: o Enhanced care experience for Francophone patients: access, continuity, quality, safety and reliability; o Improved health of Francophone communities; o Efficiency and effectiveness of the health-care system for Francophone patients. Is the impact of the action plan being assessed in terms of acces to quality French-language health services? Are corrective measures being developed and implemented if the action plan did not produce the expected results for the Francophone community? Are directors and professionals in charge of LHIN funding priorities and accountability processes aware of the potentially negative impacts on the Francophone community if, for example, a new service is not offered in French? 17
CONCLUSION This guide is intended as a tool to help LHIN planners and health service providers incorporate the Francophone lens into their integrated health services planning processes, which will contribute to improving the offer and the quality of French-language health services in Eastern and South-Eastern Ontario. The Réseau is mandated with advising the LHINs on all issues affecting the health of the Francophone community of Eastern and South-Eastern Ontario. To that end, the Réseau s French-language services planning team is available to offer their support to the LHINs and to health services providers on French services matters. 18
WHO ARE WE? The French Language Health Services Network of Eastern Ontario (the Réseau) is a Francophone organization that engages the health-care community and the Francophone community in all its diversity to improve the offer and the quality of French-language health services in Eastern and South-Eastern Ontario. On July 1, 2010, the Réseau was formally recognized by the province as French- Language Health Services Planning Entity for Eastern and South Eastern Ontario. As Planning Entity, the Réseau has a mandate to provide advice to the regional health authorities, the Champlain LHIN and the South-East LHIN, on all health issues affecting the region s Francophone community. 19
BIBLIOGRAPHY French Language Health Services Network of Eastern Ontario/Réseau des services de santé de l Est de l Ontario, French Language Services, a Factor in the Quality of Health care Services, Rationale and Impact Analysis Framework for Local Health Integration Networks (LHINs) and Health Services Providers (HSPS) of Eastern and South-Eastern Ontario, Ottawa, November 2012. Government of Ontario, The Health Planner s Toolkit, Health System Intelligence Project 2006. Ontario Office of Francophone Affairs/ Offices des affaires francophones de l Ontario, http://www.ofa.gov.on.ca/en/ 20