Board Meeting Highlights
The following are highlights of the Champlain Local Health Integration Network (LHIN) Board of Directors meeting held in Ottawa, Ontario on April 27, 2016.
Regional Planning and Community Engagement
Mississippi River Health Alliance – Facilitated Integration Decision, under Section 25(2)(a) of the Local Health System Integration Act, 2006
The LHIN Board of Directors voted unanimously to support a facilitated integration decision between two rural hospitals in the Champlain region. This decision creates a formalized relationship between Carleton Place and District Memorial Hospital and Almonte General Hospital called the Mississippi River Health Alliance. A committee with membership from both hospitals has been established, and by this September, the hospitals will share a joint CEO.
The LHIN works to integrate the local health system in many ways, including supporting providers seeking opportunities to integrate among themselves. Carleton Place and District Memorial Hospital and Almonte General Hospital have been working together for the last few years to better serve both communities, and make the best use of their resources by finding opportunities to partner with each other. LHIN support of their efforts has included providing guidance and some funding to bring in external expertise to help the hospitals explore integration possibilities.
“We feel this alliance is in the best interest of these communities, as it seeks to make the best use of the talent, skills, resources that are available in both organizations, and leads to greater value for the funds invested in both hospitals,” said LHIN CEO, Chantale LeClerc. “Existing economic and demographic pressures mean it is increasingly difficult for individual organizations to meet their community’s needs. This alliance leverages the strengths of each organization to sustain and potentially grow the services available in both communities.”
Each hospital was represented at the meeting by several Board members and their CEOs, including Board Chairs, Paul Virgin (Almonte General Hospital) and Marcel Pinon (Carleton Place and District Memorial Hospital) who spoke about their support for the integration.
“It’s delightful to see providers take initiative and come forward in alignment with LHIN health system goals – congratulations,” said LHIN Board Chair, Jean-Pierre Boisclair.
Vision Care Plan - Decision
Vision challenges can profoundly affect a person’s independence, physical and mental health, and quality of life. In this region in 2014-15, approximately 14,000 patients required one or more vision-care procedures.
Recently, a provincial vision-strategy task force made strategic recommendations for maintaining and enhancing Ontario’s ophthalmology service delivery.
In response, the Champlain LHIN developed a regional Plan for Vision Care. This Plan outlines the current status, and immediate and future needs for the delivery of eye care in the region. It was developed by the Champlain Vision Care Network Committee, and informed by input from numerous stakeholders, including patients and their families.
Dr. Steve Gilberg, Head of the Department of Ophthalmology at The Ottawa Hospital, co-chaired Champlain’s Vision Care Network Committee with Jeanette Despatie, CEO of Cornwall Community Hospital. Dr. Gilberg presented highlights from the Plan to the LHIN Board. Key findings included:
- The delivery of vision care services in Champlain operates extremely successfully under a “hub and spoke” model (termed after a wheel with its hub and multiple spokes centrally connected, this model means having several sites provide care where the “hub” is the anchor site of the specialty area and the “spokes” are connecting secondary sites serving that specialty).
For Champlain’s vision care, The Ottawa Hospital is the hub serving adults with complex needs, while the Children’s Hospital of Eastern Ontario is the hub serving children with complex needs. Community hospitals are the spokes providing people with cataract surgeries and access to non-complex vision care services close to the patient’s home. As well, each spoke-hospital acts as a hub for adjacent hospitals that do not provide ophthalmic care.
- Pediatric patients are under-served, and wait times for some pediatric and adult conditions exceed targets and compare unfavourably with other LHINs
- Patient complication-rates are low, and compare favourably with other LHINs.
Some of the plan’s key recommendations include:
- Improve access to pediatric services by recruiting pediatric ophthalmologist(s) to address current and future patient needs
- Improve communication among institutions/providers by developing an integrated electronic medical record across the region and province
- Enhance vision screening for children and high-risk groups.
The Plan and its recommendations, which are aligned with the provincial vision-care strategy, were approved by the LHIN Board. It will now be submitted to the Ministry of Health and Long-Term Care (Ministry) for consideration. The LHIN will use the Plan to guide quality improvement efforts and strategies to strengthen access and sustainability of the regional vision-care system.
Redevelopment of the Mental Health Department at Queensway Carleton Hospital: Pre-Capital Submission - Endorsement
The Queensway Carleton Hospital in Ottawa proposed a capital project to renovate and expand its mental health department. This proposal is at the beginning of the Ministry’s capital planning process (pre-capital phase). During this first phase, the LHIN focuses on program and service aspects of the proposal to ensure it meets community needs.
The proposed redevelopment includes:
- Renovating the 24-bed mental health department space, which was built in 1976
- Expanding the mental health department and creating separate areas for inpatient and day program services, and
- Adding an acute day program that could accommodate 2,300 visits annually. The addition of this program would be realized through internal efficiencies, with no increase in hospital operating costs.
A few factors contributed to this proposal:
- Feedback from recent surveys (from patients and Accreditation Canada, and a review by the College of Physicians and Surgeons of Ontario) identified the need for physical improvements to the hospital’s mental health infrastructure
- A 2015 internal review of the hospital’s mental health program indicated the facilities need to be upgraded to meet current and future demands for these services, and
- It aligns with the LHIN’s strategic and regional mental health plans, and received letters of support from health system partners, like the Royal Mental Health Centre.
The potential for increasing bed capacity is being considered, and will be reviewed at a later stage in the capital planning process. The total estimated cost is approximately $9.7 million.
The LHIN Board endorsed the proposal, which means there is sufficient rationale to support further planning. Now the proposal goes to the Ministry for review and approval. Should it advance through the capital planning process, the LHIN will also review the project during future stages.
Third Quarter 2015-16 Performance Report - Decision
The Board approved the performance report for the third quarter of 2015-16, which showed that the LHIN is 80% on its way to meeting its overall performance targets. More work is needed to improve wait times for CT and MRI scans, and first visits for home care through the Champlain Community Care Access Centre (CCAC).
The wait-time challenge for MRI scans is being reviewed by a third party for improvement opportunities. The most recent data related to first visits for home care show wait times are improving, and will be reflected in the next set of performance reports.
The report also provided an overview of indicators used by the LHIN Board to monitor the health of LHIN operations. These include financial and healthy-workplace indicators, such as staff satisfaction and turnover, and all were meeting or exceeding targets.
Board members highlighted the fact that the Champlain LHIN’s operations budget represents only three-tenths of one percent of the funding that the LHIN distributes to health service providers, noting that it is one of the lowest of all LHINs.
Service Accountability Agreements – Update
For the LHIN to distribute funding to a health service provider, a service accountability agreement must be signed between the two parties. Each agreement provides a planning and funding framework, and includes local obligations and reporting requirements.
The LHIN is finalizing its work with its providers for their agreements for fiscal year 2016-17:
- There are 60 LHIN-funded long-term care homes in the region, which are managed by 44 providers. Forty-three providers have signed their 2016-19 agreements for the homes they manage, and the LHIN is working with the remaining provider to complete its agreement.
- The LHIN-funded community sector consists of community mental health and addictions services, community support services, community health centres, and the Champlain CCAC. Of the 97 community agreements, 96 are signed. The outstanding agreement is pending after some planning work is finalized.
- Amendments that extend the existing agreements for all 20 hospitals have been signed and are operational.
Health System Funding Reform – Update
Funding reform supports financial sustainability for the health system. It is about paying for health care services based on patient needs and performance to drive quality, efficiency and effectiveness.
In the five years since the introduction of funding reform in the province, the preliminary results from an Institute for Clinical Evaluative Sciences (ICES) evaluation showed improvement in quality and value. Specifically, while the number of patients being treated has increased, the cost of inpatient care has grown more slowly, and quality indicators have remained steady (hospital readmission rates, for example). In fact, for acute-care cost efficiency in the past year, Champlain LHIN hospitals improved by more than 3%, compared to 1% provincially.
For 2016-17, some hospitals will gain funding, and others will lose (no more than 1%) funding. Overall, this funding reform has resulted in an additional $18.8M for Champlain hospitals, compared to 2015-16.
Departure of Board Member
LHIN Board Chair, Jean-Pierre Boisclair, thanked Alexa Brewer for her six years of dedicated service to the LHIN Board. During her two terms as a board member, Alexa supported all of the LHIN’s work, including its community engagement efforts and its unique role in developing a regional systems approach, where all sectors work together for quality, patient-centred care.