The following are highlights of the Champlain Local Health Integration Network (LHIN) Board of Directors meeting held in Ottawa, Ontario on July 27, 2016.
Voluntary Integration of Children’s Hospital of Eastern Ontario and Ottawa Children’s Treatment Centre – Decision
The LHIN Board supported a merger of two organizations that serve children and youth in the Champlain region, Children’s Hospital of Eastern Ontario (CHEO) and the Ottawa Children’s Treatment Centre (OCTC).
The Board heard from CEOs from both organizations, Kathleen Stokely (OCTC) and Alex Munter (CHEO), about how the merger came to life, and its goals: for children and their families to have better access to and integration of services, and benefit from a more holistic approach to children and youth health. Specifically, one child, one door, one story, one health record, one health team.
CHEO is one of the few stand-alone pediatric hospitals in Canada, as well as an academic health-science centre. Nearby, OCTC provides specialized care for children and youth with multiple physical, developmental, and associated behavioural needs. These organizations have a long history of working together, and cultures of engaging with the families and youth they serve. In fact, family input led OCTC and CHEO to consider integrating, and families have been members of their decision-making team and co-architects of their joint vision.
Children with complex needs are often patients at both organizations and seen by many providers. Two parents of these children spoke to the LHIN Board about their experiences and support for the integration:
Mindy McHardy’s son, Connor, required care from both organizations for the complex cardiac medical needs he had from birth until he passed away in 2012 at age eight. “It’s about breaking down barriers, integrating institutions like CHEO and OCTC, and everyone working together for the common goal of wellness of that child and family,” Mindy said.
Jennifer Walker’s son, Griffin, was served by CHEO and OCTC since birth, and passed away in November 2015 at age 11. He needed 24-hour care for conditions that included cerebral palsy and a seizure disorder. Across both organizations and beyond, Griffin was cared for by many providers (more than 18) including doctors, therapists, private care, palliative and home care.
“We had care providers that straddled both (CHEO and OCTC). Sometimes you’ll see one physician at two different locations,” Jennifer said. “The overlap and duplication in scheduling and managing these appointments and running here to there getting records sorted between the two organizations can be challenging. Part of the reason we want to recommend they amalgamate – from the voice of the parents - is that a simplified system would serve everyone so much better. Our kids are very complex, but they don’t need to be introduced into a massive, complex organization.”
The Champlain LHIN Board voted to allow the integration to proceed after the legislatively-required, 60-day period. While the organizations will continue to function much as they do today (for example, they will stay in the same buildings and staffing structures), they will share a governance structure that includes existing board members from each organization, and from the community.
This work supports the LHIN’s strategic direction of integration to improve the patient and family experience across the continuum of care.
Champlain Hospice Palliative Care Services – Update
The Champlain LHIN is recognized as a provincial leader in the delivery of palliative care - this was part of an update provided to the Board on the important work being done in our region. The following are examples of how the LHIN has addressed people’s needs and improved quality in palliative care:
- Effectively works with local and regional partners and networks, which have developed local education, symptom-management kits, and a common home-care record.
- Develops and sustains engagement with primary care providers - who are key to effective palliative care – including more than 9,000 consultations that were enabled by our regional eConsultation service.
- Supports innovative and responsive residential hospice models. From 2006-15, the number of these beds increased from 23 to 57.
- More than 3,000 people in 2014-15 received specialized palliative home care, and there were more than 500 admissions to acute-palliative hospital-inpatient beds.
Regionally, the main goals of the Champlain Hospice Palliative Care Program are to improve and expand access to services. Accomplishments in 2015-16 included conducting clinical education and volunteer training, and providing Health Links (below and here) with advanced-care planning and palliative-care resources.
Provincially, the Ontario Palliative Care Network was officially launched in March 2016. The network functions as a partnership between the LHINs and Cancer Care Ontario. Its scope includes system initiatives, provincial coordination, regional program oversight, and performance measurement.
This work supports the LHIN’s strategic priority of enhancing palliative care in settings of choice.
Health Links – Update
Since 2014, the Champlain LHIN has been working to establish and grow 10 Health Links across the region. An innovative model of care, Health Links aims to improve the health care experience for some of the nearly 27,000 people in our region with highly complex needs – those who have four or more chronic conditions (e.g., diabetes, lung health, cardiac, stroke), challenges with living conditions (e.g., income, housing, disability), use high-cost health services, and would benefit from better care coordination.
By the end of 2018-19, the goal is to for 10,000 of these patients to receive care from teams consisting of a family doctor or nurse practitioner and providers from other sectors, such as mental health and additions services, home care, community support services, and social services. Working together, the team engages with the patient and caregivers to coordinate and wrap services around the patient to meet his or her health goals.
Family physician Dr. Jonathon Fitzsimon spoke to the LHIN Board about his experience working within the Arnprior Region Ottawa West Health Link over the last two years. In one example, he described a patient who received medical attention from a member of her Health Links care team while she was at home. As a result, she got the timely care she needed, and avoided being admitted to hospital. “We’ve saved hospital resources, but most importantly, it’s such a better outcome for the patient,” Dr. Fitzsimon said.
In the short term, increasing the number of people cared for by Health Links must be accomplished by leveraging existing resources. A number of strategies are being used, including practicing change management, developing innovative approaches to coordinated care, primary care engagement, and developing electronic solutions for connectivity among Health Link partners.
Expanding Health Links supports the LHIN’s strategic direction of sustainability to increase the value of our health system for the people it serves.
Champlain LHIN Funding Allocations to Advance Strategic Priorities - Update
Champlain LHIN CEO, Chantale LeClerc, gave an overview of how LHIN funds were spent last year. The LHIN’s annual funding ($2.56 billion in 2015-16) is allocated to the providers who manage the roughly 240 health care programs across the region. About $14 million (0.55% of the annual total) was used for priority programs and projects. The priority funding is divided between one-time and ongoing, base funding, with most of it ($11 million) for new investments. The remainder ($3.1 million) was earmarked to complete work begun in previous years.
The LHIN uses its Integrated Health Service Plan, Annual Business Plan, and the Pan-LHIN Priority Setting and Decision-Making Framework to help determine how to spend its priority funds. For example, to achieve the LHIN goal of an integrated health system, we need a strong foundation of home and community-based care. In support of this, the LHIN provided nearly 10% more funding to community support services compared to the year before.
Last year, the LHIN invested across four areas (with examples):
- Changing how health care is provided (e.g. Health Links)
- Providing new or more services to address gaps (e.g. falls prevention)
- Improving infrastructure (e.g. building repairs at Carlington Community Health Centre), and
- Planning to optimize services (e.g. developed practices to support Indigenous people with diabetes).
This work supports all of the LHIN’s strategic directions and priorities in support of our mission: building a coordinated, integrated and accountable health system for people where and when they need it.
Fourth Quarter 2015-16 Performance Report – Decision
The Board approved the 2015-16 fourth quarter performance report, which showed a slight increase from 80 to 81% of overall targets achieved when compared to third quarter 2015-16. This improves Champlain’s position for health system performance to eighth among the fourteen LHINs, whereas it started the year in tenth position.
Up from 97% in the third quarter, the target was achieved (100%) for hospital patients who have completed their treatment and are waiting for a more appropriate alternate level of care. As do all LHINs, Champlain continues to struggle with MRI wait times. While many of our hospitals have efficient MRI processes in place, improvement efforts are ongoing. Patients with the most urgent needs for MRI-scans continue to be served right away. These wait times are for less urgent scans.
This report also included three-year performance trends, since it was the last one related to Integrated Health Service Plan 2013-16. A notable improvement over the three years was shown in wait times for hip replacements: from 79% of target reached in 2013 to 96% in 2016. The improvement was partly due to implementing an efficient central-intake process across the region.
Measuring and monitoring performance supports all of the LHIN’s strategic directions: integration, access and sustainability.