700 Dorval Drive, Suite 500 Oakville, ON L6K 3V3 Tel: 905 337-7131 Fax: 905 337-8330 Toll Free: 1 866 371-5446 www.mississaugahaltonlhin.on.ca Management Report to the MH LHIN Board of Directors April/May, 2011 I MOHLTC Updates Mr. Alex Bezzian has been appointed as the ADM, Health System Accountability and Performance Division. He replaces Ken Deane. Mr. Bezzina has been with Ontario Public Service for many years as an ADM in Ministry of Children and Youth Services, Government Services and Education. The LHINs interface with the LHIN Liaison Branch which reports to this ADM. II Progress on Annual Business Plan Priorities Mental Health and Addiction (MH&A) Services Common Protocol Transitional Aged Youth The MH LHIN, in collaboration with its Mental Health & Addictions health service providers, is currently piloting a Transitional Aged Youth Protocol. The protocol is aimed at ensuring transitional aged youth 16-24 years receive seamless care when transitioning from the youth health care system to adult care. There are 22 adult and child and youth MH&A health service providers participating in the four month pilot which begins in May. The two pilot sites are Mississauga and Halton. Eating Disorders The Ministry funded for a Paediatric Nurse Practitioner for Eating Disorders at the Credit Valley Hospital (CVH). This will enhance the development of a regional eating disorder program MH LHIN Mental Health and Addiction Client Satisfaction Survey There were 9 participating agencies in the 2010 annual survey with 605 client surveys completed. Respondents had a high level of overall satisfaction of service delivery and appreciated the high level of dedication and creativity of staff meeting their needs. In addition, respondents felt that the programs they accessed addressed their needs. They also indicated that wait times had decreased significantly. These ratings were consistent when compared to 2009. Overall, the clients were focused on achieving their program goals and viewed these agencies and their staff as a source of support in achieving their goals.
MH LHIN Palliative Care Initiative The Palliative Care Supports and Services in the MH LHIN resource guide was released in April to all health service providers; hospitals; MH LHIN physicians and nursing agencies; clients, and community support agencies. This resource guide is very useful to clients and their families seeking palliative and support services and was a recommendation from our Palliative Care Family Focus Group. This guide is also located on the following websites: http://mhlhin.on.ca/uploadedfiles/public_community/for_community_members/ccac%20palliative%20care%20services %20Book.pdf http://mhpcn.ca/patients_and_families/contacts The Palliative Care Implementation Team held an Education Workshop with the MH CCAC nursing agencies to develop a Palliative Care Education Plan. An Advanced Care Planning Education Workshop was held on March 31 st for palliative care frontline staff to help facilitate discussions with clients on end-of-life decisions. A Learning Essential Approaches to Palliative and End of Life Care (LEAP) Program on advanced palliative care training for nurses and physicians will be held in early June by our Palliative Care Physicians and Advanced Practice Nurses. Chronic Disease Prevention and Management Ontario Diabetes Strategy (ODS) Self-Management Project As part of the Ontario Diabetes Strategy, the MOHLTC provided $85,300 in one-time funding to support the implementation of self-management within the Mississauga Halton LHIN. This funding will support the Ontario Diabetes Strategy goal of improving health outcomes for Ontarians living with diabetes and those at risk of developing diabetes through the provision of self-management education and skills training for individuals with and at risk of diabetes, and their health care professionals. Halton Healthcare Services (HHS) is the host agency for the Mississauga Halton Regional Diabetes Coordinating Centre and has been identified as the lead agency for this project. HHS will work with the Mississauga Halton Self-Management Advisory Committee to further develop, implement and evaluate initiatives pertaining to selfmanagement in the MH LHIN. MH LHIN Chronic Obstructive Pulmonary Disease (COPD) Outreach Project As part of the Year 3 Aging at Home investments, the MH LHIN is implementing a LHIN-wide 6 month COPD nursing outreach pilot project. The goal of the project is to improve the quality of care of individuals, and their families living with COPD and reduce avoidable ER visits and hospital readmissions. Objectives: To improve the knowledge, skills and self-efficacy of individuals with COPD and their families To improve access, integration and coordination of care, based on clinical best practice guidelines, across the continuum of care To decrease the number of avoidable exacerbations for individuals with COPD and to improve the management of exacerbations in the community setting versus the ED Increase early screening and detection of COPD in the ED To obtain knowledge on the root causes of avoidable COPD related ED visits. The project will be completed on May 31, 2011. L:\2011 Governance\Board of Directors\Board Templates\Management Reports\2011\April/May 2011 Page 2 of 7
Alternate Level of Care (ALC) Home First As part of the LHIN Collaborative (LHINC), a provincial Home First working group was established to support the implementation of this approach across the LHINs. The co-chairs of this working group are Narendra Shah, COO, MH LHIN and Louise Paquette, CEO, NW LHIN. The Working Group has developed a Home First Implementation Guide and Tool Kit with input from a wide range of sectors, including: LHINs, CCACs, hospitals, community support services, primary care physicians and long-term care. A copy of this report is located on the MH LHIN website at: http://www.mississaugahaltonlhin.on.ca/uploadedfiles/home_page/home%20first%20implementation%20guid e%20and%20toolkit.pdf Attached is a copy of the letter sent to all our HSPs which includes a letter of endorsement from the Ontario Hospital Association (OHA), Ontario Association of Community Care Access Centres (OACCAC) and Ontario Community Support Association (OCSA). (See attachment A) III Integration Activities IV Notable Sector Engagement MOHLTC and OACCAC Initiative for Palliative Care: ICCP- Palliative Care The MH LHIN and Mississauga Halton Community Care Access Centres (MH CCAC) are working with the MOHLTC and the Ontario Association of Community Care Access Centres (OACCAC) to be one of three provincial spotlight communities for an Integrated Client Care Project for Palliative Care. The second planning workshop is to be scheduled for May. Three year Multi-Sector Accountability Agreement (M-SAA) Update with Community Agencies As of April 18, 2011 MH LHIN has received 34 signed M-SAAs out of the 44 required for our community Health Service Providers (HSPs). For the remaining 9 HSPs, we have received written notification from each HSP s senior management that there are no issues with the M-SAA and are recommending the approval to their Board. The delay is due to their Board is meeting in late April or in May. We expect no issues with any of these 9 M- SAAs and they will be all signed by the last week of May. Community Service Sector (CSS) and MH&A Quarterly Sector Meeting This is a regular meeting that the MH LHIN hosts with all of its community HSPs Executive Directors and senior management. It is an opportunity for the LHIN to update the community providers on provincial initiatives, LHIN initiatives and to facilitate communication amongst the providers, sectors and LHIN. The next quarterly meeting will take place on April 27 th. L:\2011 Governance\Board of Directors\Board Templates\Management Reports\2011\April/May 2011 Page 3 of 7
The Arthritis Society Provincial Program Effective April 1, 2011, the provincial funding agreement with The Arthritis Society for the provincial Arthritis Rehabilitation and Education program has been assigned to the MH LHIN. Under LHSIA, the Mississauga Halton (MH) is required to develop a service accountability agreement with The Arthritis Society by June 30 th to be effective July 1, 2011. The Ministry of Health has initiated the devolution of a number of provincial programs to be managed by the LHINs. In consultation with LHIN CEOs, a model with one lead LHIN to manage a service accountability agreement on behalf of all LHINs was identified. An agreement has been signed by the other 13 LHINs agreeing to the MH acting as the lead LHIN. The Arthritis Rehabilitation and Education program receives $4.9 million in funding to provide rehabilitation services for individuals with stable, severe arthritis to support them to reintegrate into regular activities and learn how to manage their condition. Education is also provided to health care professionals and referrals are made for clients to receive specialist services. V Community Engagement MH LHIN Community Engagement Plan for 2011-12 In February 2011, a new Community Engagement Guidelines Toolkit, approved by the Ministry of Health and Long-Term Care (MOHLTC), had been shared with all 14 LHINs to be used in their future community engagement and planning initiatives to promote consistency across the province. LHINs are required to adopt the new community engagement guidelines into their planning and decision making processes and are required to publish an annual community engagement plan, intended to provide the LHIN community with an overview of activities planned this fiscal year, by April 29, 2011. MH LHIN staff have developed a community engagement plan for 2011-12, which will target specific communities within the MH LHIN, as guided by the Integrated Health Service Plan (IHSP) 2010-13 priorities for health system improvement and the Annual Business Plan 2011-12. The primary goal of MH LHIN s community engagement framework is to engage the community on an on-going basis in the design, delivery and accountability for local health system planning and integration. In the MH LHIN, community engagement activities will be achieved through the community engagement model built on existing networks and relationships with HSPs and other key stakeholders. Attached is the community engagement plan for 2011-12 which has been submitted to the Ministry as required. (See Attachment B) French Language Services French Language Health Planning Entities After signing the Funding and Accountability Agreement with the Entité de planification pour les services de santé en français de Toronto Centre, Centre Ouest et Mississauga Halton (Entity #3) in March, Toronto Central, Central West and Mississauga Halton LHINs are collaborating to meet with the Entity to discuss the next steps of the agreement. French Language Services Assessment Study and Needs Survey A French Language Services Assessment Study and Needs Survey have been developed, in collaboration with Central West LHIN and Le Centre de services de santé Peel et Halton, Inc. (CSSPH). To date, 500 Francophones have completed the survey. Five focus groups were conducted in March 2011 with local community groups such as CSSPH, The Oaks of Righteousness Church/les Térébinthes de la justice and other ethno-cultural groups in Peel and Halton regions. L:\2011 Governance\Board of Directors\Board Templates\Management Reports\2011\April/May 2011 Page 4 of 7
Meeting with Identified HSPs with Respect to French Language Services MH LHIN staff met with the five Identified HSPs in March 2011 to review their last French Language Services Implementation Plan. Most common activities to enhance access to French services in the identified HSPs include: Education sessions on FLS to Boards and staff Translation of materials and brochures in French Evaluation of French capacity among staff, French Language Training for staff Identifying preferred official language of service (English or French) Sharing of best practices and knowledge among identified HSPs and community engagement activity with local francophone groups. The identified HSPs are expected to submit a new HSP Implementation Plan by April 30, 2011. French Language Services Collaborative MH LHIN staff met with the ten (10) Francophone Leaders in March 2011 as part of the quarterly meetings with the Francophones in Mississauga Halton LHIN. The objectives of this collaborative are: Provide strategic advice to guide MH LHIN short and long-term planning for French Language Services (Annual Business Plan and Integrated Health Service Plan) Advise MH LHIN on both local health needs and future health care priorities of the Francophone community across the LHIN Help inform and support local implementation of French Language Services at a local level Collaborate with LHIN in developing and implementing a MH LHIN-wide community engagement plan to effectively engage Francophones at a local level Act as a forum for community engagement with the MH LHIN and Identified Health Service Providers When requested by the LHIN, serve as a resource to local service providers in their francophone planning and engagement needs Facilitate knowledge exchange among committee members, LHIN staff and other Francophones through awareness of MH LHIN FLS related projects Collaborate with the French Language Health Planning Entities for FLS regional activities with CW and TC LHINs. VI Communications Pan-LHIN Communications Plans Extensive 14-LHINs/Ministry communications strategy work is complete on various fronts. The plan includes rolling out various components of the strategy to HSPs, media and the public in May time frame. The Home First communications plan will roll out in late April and May. Annual Report 2010/11 The LHIN is obligated to produce an Annual Report to the Minister on the affairs and operations of the LHIN for the preceding fiscal year. The Annual Report must address the requirements set out in the Local Health System Integration Act 2006 (LHSIA) and include a full audited financial statement. The Annual Report must be signed by the Board Chair and one other Board member. The original signed copy will be used for official tabling in the Legislature (LHSIA 2006, c4.s.1-5). L:\2011 Governance\Board of Directors\Board Templates\Management Reports\2011\April/May 2011 Page 5 of 7
As required by the Memorandum of Understanding (MOU) and the Ministry/LHIN Accountability Agreement, the LHIN must submit its Annual Report to the Ministry by June 30 th 2011. The MH LHIN draft 2010-11 Annual Report reports on the key accomplishments of the LHIN from the Annual Business Plan activities. The financial details will be updated in the report following LHIN approval. Tabling of the Annual Reports in the legislature has a number of requirements. The Minister of Health and Long- Term Care is required to table the Annual Report with the Legislative Assembly within 60 days of receipt. The Annual Report cannot be released publically until this has been completed. The number of Annual Reports required for the tabling process is 146 English copies and 139 French copies for a total of 285. Once the Annual Report is tabled in the legislature, we will post it on our website after receiving notification from the Ministry. Next Steps: Board members are asked to review the draft 2010-11 Annual Report and provided comments directly to MH LHIN s Communications Lead, Janine DeVito. The final Annual Report incorporating Board comments along with the Audited Financial Statement will be provided for the Board s approval at the June Board Meeting. Mississauga Halton CCAC s Contact Centre Redesign: Better Processes Serve Clients Faster At the Mississauga Halton CCAC, people referred to the Contact Centre are having their first assessment by a case manager faster than ever because of a recent redesign of systems and processes. The Contact Centre redesign was started in April 2010, following the migration to the Client Health Related Information System (CHRIS) from two legacy systems in order to synchronize processes, remove waste and gain efficiencies in the way employees responded to referrals. In September 2009, 62% of referrals were assessed by a case manager within seven days of being made. By December 2010, that number had jumped to 85%. VII Quality Residents First Quality (LTC Homes) Improvement Leading Quality The second webinar for the Mississauga Halton LHIN s Residents First Leading Quality event was held on April 20 th. The topic of discussion was PDSA Your Leadership. PDSA Your Leadership is a method to understand how you can make small behavioural change as a leader and quickly measure the impact of these changes on your team. LHIN staff and the HQO (Health Quality Ontario) GTA QI Regional Lead are interviewing applicants for the HQO MH LHIN position of Quality Advisor for Residents First. This position will provide support to the MH LHIN LTCH Leadership for Residents First. This is a contract position that will end on March 31, 2012. L:\2011 Governance\Board of Directors\Board Templates\Management Reports\2011\April/May 2011 Page 6 of 7
Hospital Quality Improvement Plan (QIP) LHIN hospitals have submitted their quality improvement plans to the Ontario Health Quality Council and MH LHIN as required under Excellent Care For All Act, 2010. With respect to the QIP review, in this first year, LHINs are seeking to strengthen our collective understanding of local system wide trends in quality improvement. To do this, we would propose engaging hospitals in a discussion following submission to the LHINs of the QIPs to explore such questions as: What common improvement initiatives are being implemented throughout the LHIN s hospital? What are the potential implications/impacts for performance improvement and H-SAA indicators (based on Ministry-LHIN Performance Agreement indicators) and the Mississauga Halton IHSP? What are the opportunities to advance organizational collaboration/alignment with these initiatives? What are the opportunities to explore developing regional plans for topics such as ALC, readmission rates and ED wait times where improved results in hospitals depend upon better coordination with CCAC s community service agencies and primary care? MH LHIN staff are reviewing the plans with these questions in mind and will prepare a summary document to be tabled for discussion at the VP Leaders Meeting in June. L:\2011 Governance\Board of Directors\Board Templates\Management Reports\2011\April/May 2011 Page 7 of 7