PATIENTS FIRST UPDATE The LHIN s role in creating integrated health service delivery systems February 7, 2018
Overview 1. Review of five goals of Patients First 2. South West LHIN committees, alliances and tables supporting Patients First 3. South West LHIN projects and initiatives 4. Organizational updates Update on mission, vision, values Annual Business Plan CEO recruitment 2
Five goals of Patients First 1. Effective integration of services and greater equity through subregions 2. Timely access to and better integration of primary care 3. More consistent and accessible home and community care 4. Stronger ties to population and public health 5. Services that address the needs of Indigenous people 3
AN UPDATE ON SOUTH WEST LHIN COMMITTEES, TABLES AND ALLIANCES SUPPORTING PATIENTS FIRST 4
Supporting Patients First 5
Patient and Family Advisory Committee (PFAC) Group of 16 members who will advise, collaborate and co-design an approach to patient involvement in transforming the health care system The committee had its inaugural meeting on October 18, 2017 Co-chairs Nadia Tahir from London Middlesex and Barb West-Bartley from Grey Bruce were appointed in December 2017 A total of 10 committee members are also members of a Sub-region Integration Table Five other committee members will be part of the Health System Renewal Advisory Committee 6
A culture of patient engagement Through the input and direction of the Patient and Family Advisory Committee, the South West LHIN will work to develop a culture of patient engagement within three layers: System Level: Patients, families and caregivers are involved and engaged in making strategy and system design decisions. Operational Level: Organizations demonstrate the needs of patients, families and caregivers in their process designs. Patient Level: Health care providers focus their care on the individuals and not the disease. They see patients as a whole person and respect lived experiences. 7
A culture of patient engagement The Patient and Family Advisory Committee next meeting will be on February 9, 2018 Members will be sharing their vision of what it would look like or feel like if the LHIN achieved the goal of embracing a strong culture of patient engagement Members are also working on understanding what current patient engagement activities are occurring across the South West LHIN and identify future patient engagement opportunities to advance this work. The Committee will also be exploring mechanisms / processes to broadly engage with specific communities such as the indigenous and francophone communities 8
Sub-region Integration Tables Sub-regions are smaller geographies where LHINs are working with partners to improve patient experience, health outcomes, provider experience, and ensure the system is sustainable There is a Sub-region Integration Table representing each of our five subregions: London Middlesex, Elgin, Oxford Norfolk, Huron Perth, and Grey Bruce Tables will enable, enhance and champion collaboration between patients, providers and other system stakeholders locally. All tables had their inaugural meeting on October 5, 2017, and meet monthly 9
Roadmap for Sub-region Integration Table priority setting 10
Highlights from sub-region draft priorities Proposed priority Improve access to inter-professional resources through partnerships Sub-region Oxford Improve care journey for complex patients discharged from hospital through improved provider partnerships Improve access to assisted living and supportive housing through information sharing and accountability Create shared understanding of current programs and resources to improve the patient experience and journey through the system Expand and coordinate best practices to create more health care resources Huron Perth Coordinate mental health and/or addictions service delivery to create more health care resources Support patients and caregivers throughout their journey Ensure that individuals are getting culturally sensitive care, specifically the Anabaptist population 11
Highlights from sub-region draft priorities Proposed priority Create shared understanding of current programs and resources to improve the patient experience and journey through the system Sub-region London Middlesex Improve care journey for complex patients discharged from hospital through improved provider partnerships Spread and coordinate existing care to ensure people are receiving the right care when and where they need it Use existing resources to ensure patients are receiving culturally safe care Improved access to specialized resources for seniors who are frail and/or have a number of medical conditions Enable patients to receive the right level of care through home and community care services, supportive housing, assisted living, hospital or longterm care home Elgin Support providers in understanding how to access specialized mental health services 12
Highlights from sub-region draft priorities Proposed priority Spread Indigenous cultural safe care in organizations through policy and education tools Sub-region Grey Bruce Support recommendations from the South West LHIN mental health and addictions capacity report Improve information sharing and the use of programs/services that support prevention management of chronic conditions 13
Our pathway toward to maturity in Sub-Regions 14
Strengthening care communities in sub-regions 15
Sub-region Primary Care Alliances A Primary Care Alliance has been established in each sub-region of the South West LHIN A core representative group of the community of primary care providers within each sub-region Members represent the broader primary care sector in the sub-region Number and mix of representatives may differ from sub-region to sub-region based on the unique primary care landscape Each Primary Care Alliance will be supported by two co-chairs: the South West LHIN Sub-region Clinical Lead a representative elected from the sub-region Primary Care Alliance by the members The elected co-chair will represent the identified needs, interests and opinions of their local primary care sector 16
Clinical Quality Table Represents a partnership between the South West LHIN, Health Quality Ontario (HQO) and other key health system partners in the region The table is focused on advancing clinical quality improvement in support of the South West LHIN s Integrated Health Service Plan and HQO initiatives After the Patients First Act, the Clinical Quality Table was refreshed within the South West LHIN, and had its inaugural meeting on January 25, 2018 17
Health System Renewal Advisory Committee The Health System Renewal Advisory Committee will advise the South West LHIN on system-wide implementation of Patients First and the Integrated Health Service Plan, as well as future strategic directions This group will be directly accountable to the LHIN CEO and will represent the cultural, linguistic, and geographic diversity of the South West LHIN The Committee will be chaired by Kelly Gillis, VP of Strategy, System Design and Integration and Dr. Cathy Faulds, Chief Clinical Lead Members have been appointed, and their inaugural meeting will be on February 8, 2018 A memo with further details on this committee will be sent out in the coming days 18
AN UPDATE ON KEY PROJECTS AND INITIATIVES 19
Initiatives to address personal support worker capacity challenges As a LHIN we are actively working with local providers and our provincial colleagues to develop strategies to address these challenges. We are also working with our internal teams on both immediate short-term, as well as long-term action plans to ensure care is meeting the needs of patients and is being provided in the most safe, efficient and effective way. Provincially, the Ministry of Health and Long-Term Care has established a workgroup with representation from all LHINs to look at improving the supply of personal support workers across Ontario. Many LHINs are also developing initiatives to recruit and retain personal support workers. 20
Care Coordination Model Care coordinators are an integral part of our home and community care service delivery model. They work directly with patients, their families and other providers to identify patient care needs and develop care plans to meet these needs. We are currently in the process of improving our care coordination model with two goals in mind: Aligning our care coordination model with clinical best practices to allow for more time spent in the community with patients Improving care coordination connection/relationships with primary care physicians and other system partners 21
South West LHIN Health Links update Health Links is an approach to care focused on improving coordinated care for those with many health care needs This approach ensures that patients with high care needs are well supported and are receiving timely care in the right settings, while avoiding unnecessary ED visits Each sub-region is currently using a Health Links approach to coordinated care planning We have supported more than 2200 people from across the South West with Health Links including: Huron Perth - 334 people London Middlesex - 917 people Grey Bruce - 611 people Oxford - 203 people Elgin - 153 people 22
Individuals with Complex Needs Strategy The Ministry of Health and Long Term Care has made significant investments through LHINs to support individuals with complex needs including: Behavioural Supports Ontario, Health Links, Assess and Restore, Hospice Palliative Care, Mental Health and Addictions, Senior Friendly Hospitals, Chronic Mechanical Vent, Medically Fragile Technology Dependent Implementation planning for Patients First has highlighted the opportunity to integrate our approach for these shared populations within a larger strategy with multiple streams of work The goal is to better address and respond to the needs of patients, while improving sustainability and affordability of the health care system 23
Frail Seniors Strategy Ongoing work to advance this element of the Complex Needs strategy includes: St. Joseph s Health Care has been identified as the lead agency for the Frails Seniors Strategy They are establishing a Terms of Reference for a Frail Seniors Steering Committee, which will include cross-sector, LHIN-wide representation One of their first deliverables will be to work with the South West LHIN on a capacity plan for a dementia care An Executive Committee will also be struck to provide overall guidance to the Individuals with Complex Needs Strategy. 24
Mental Health System Re-design and Integration Access to and flow through acute and community mental health programs have been experiencing greater pressure due to increased demand for services and increasing acuity of people accessing services The South West LHIN procured KPMG to undertake a detailed analysis of access issues and in October 2017 a final report was released with recommendations. The LHIN is now in the process of establishing a governance and operational structure to plan and implement strategies to address the report s findings 25
Mental Health System Re-design and Integration As part of implementation of these recommendations, four work streams have been identified: 1. Mental Health Procedures and Process: Implement standard pathways and consistency of service across the continuum 2. Mental Health Care Coordination/Case Management/Coordinated Access: Expand role of home and community care into mental health. Redesign case management and implement collaborative care planning across sectors 3. Mental Health Crisis Services, Primary Care: Redesign crisis services, including improving availability, service model, and cross sector links. Shared care model in Primary care 4. Child and Youth Mental Health: Implement standard pathways and consistency of service across the continuum, as well as improve access to inpatient beds 26
Indigenous engagement and inclusion The South West LHIN continues to work in partnership with Indigenous health leaders and communities through the Indigenous Health Committee to co-design A Roadmap for Indigenous Inclusion and Reconcili-ACTION The Roadmap outlines the process for Indigenous inclusion/ consultation to inform the work of Patients First during the period of LHIN renewal and change, and also throughout the period of planning and implementation. There are four key priority areas of focus related to Indigenous Inclusion and Reconcili-ACTION in the South West LHIN: 1. Enhancing Indigenous inclusion and engagement in Patients First in the South West LHIN 2. Enhancing home, community and primary care 3. Advancing Indigenous Cultural Safety 4. Collaborating: Indigenous Mental Health and Addictions 27
Indigenous Palliative Care Outreach Team A Readiness Assessment Report on Indigenous Hospice Palliative Care Planning (May, 2016) commissioned by the South West LHIN outlines the need for culturally safe palliative care services for Indigenous people, particularly those who live on reserve. The South West LHIN is working with the Southwest Ontario Aboriginal Health Access Centre (SOAHAC) and other system partners to develop an Indigenous Palliative Care Outreach Team focused on meeting the care needs of Indigenous people A pilot outreach team is being developed in London Middlesex offering a 24/7 on-call support to identified Indigenous palliative patients. The aim is offer culturally safe care with coordinated care planning implemented collaboratively. Launch of the pilot will be in March 2018 28
French Language Services in the South West A key element of Patients First is the inclusion of Indigenous and Francophone voices in health care planning. Initiatives in development: Community of practice for bilingual staff: Focused on creating a positive and supportive online community for future and existing bilingual health and wellness information. It will be a platform for exchanging tools, best practices, work and training opportunities, as well as recognizing and supporting bilingual health services. Cultural linguistic competency training: Online training for LHIN and health service provider board and staff members to increase awareness of Francophone communities and French language services. 29
French Language Services in the South West Initiatives in development (cont d): Francophone community social and health hub: Collaborative pilot project bringing together a number of health and social organizations to create a central point of access to information, programs, and system navigation for Francophone individuals. The pilot is being launched in London Middlesex. OZi reporting tool: The Ministry of Health and Long-Term Care in collaboration with the French Language Services Network of Eastern Ontario will deploy Ozi, a web based portal that will collect quantitative data regarding the availability of French language services throughout Ontario. It will allow health service providers to fulfill their French language health services requirements. 30
Musculoskeletal care in the South West LHIN Patients in the South West LHIN experience very different wait times for hip and knee replacement surgery depending on the hospital and surgeon they are referred to. Patients in the South West LHIN referred to spine surgeons often wait an extended period to be told they are not surgical candidates. Aligned with Patients First, the Access to Specialists and Specialty Care Strategy, we will be centralizing the intake of all musculoskeletal referrals from primary care to a surgeon. Patients will have a clinical assessment within 14 days of referral to determine if they require surgery, and will be offered the shortest wait time appointments. Non-surgical patients will be connected with community programs, including self-management support to manage their condition. 31
Musculoskeletal care in the South West LHIN A local project governance structure has been developed (Steering Committee, Clinical Advisory Board and Working Group) with all tables launched in December 2017 Engagement strategies with primary care, community support services, allied health professionals, and surgical teams are in development. Early engagements are taking place to shape how these key groups will influence and inform LHIN local direction Novari e-request has been confirmed as the central intake software for this and future coordinated access models in the South West LHIN Provincial work is underway to expand the use of ereferral from primary care to facilitate referrals for patients to specialist and community resources Musculoskeletal care has been identified as a priority pathway for early ereferral implementation 32
SOUTH WEST LHIN ORGANIZATIONAL UPDATE 33
Updated Mission and Vision and Values Mission Statement Working with our communities to deliver quality care and transform the health care system. Vision Statement A healthier tomorrow for everyone. Values & Value Statements Respect: We will treat everyone with dignity and kindness, valuing everyone s opinion and perspective. Integrity: We will be fair, consistent, and transparent in all that we do and will follow through on our commitments. Compassion: We will be empathetic and recognize that our decisions impact people. Courage: We will amplify the patient s voice, challenge the status quo, and make the hard decisions. Innovation: We will be creative and embrace new ideas to respond to the changing needs of our communities. 34
A12 Annual Business Plan 2018/19 Key component of the ministry/lhin accountability framework Outlines our plans for delivering on the priorities in the Minister s 2018/19 Mandate letter, our Integrated Health Service Plan, as well as other key provincial priorities and legislation To be successful as a new organization and to drive the agenda of Patients First, our Annual Business Plan outlines three overall strategic priorities: 1. Improve the patient and family experience across the health system 2. Deliver high quality home and community care 3. Strengthen the new LHIN organization to drive the goals of Patients First 35
Improve the patient and family experience across the health system Goal 1: Ensure primary health care is strengthened and integrated with the broader health care system aligned with a sub-region focus Goal 2: Strengthen mental health and addictions coordination and collaboration of services with other partners Goal 3: Provide culturally and linguistically appropriate care for Indigenous and francophone people Goal 4: Advance integration to achieve seamless transitions of care for individuals with complex needs Goal 5: Quantify capacity needs of home and community care and longterm care to support proactive plans to enhance services and supports Goal 6: Improve access to specialist care 36
Deliver high quality home and community care Goal 1: Evolve the care coordination model Goal 2: Optimize service provider capacity to enable us to meet the demand for home and community care services Goal 3: Address inequities in access to home and community care for Indigenous and francophone populations Strengthen the new LHIN organization to drive the goals of Patients First Goal 1: Increase the effectiveness of how we develop and manage our organization. Goal 2: Grow a thriving workforce during times of change. 37
CEO Recruitment The South West LHIN Board of Directors has formed a Search Committee and selected Odgers Berndtson to recruit a new CEO The Board hopes to secure a new CEO as soon as possible, and will commit to updating all stakeholders regularly In the interim, Kelly Gillis and Donna Ladouceur will continue to work as Interim Co-CEOs. We appreciate our partners support and patience in this interim period 38
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