Diabetes and Other Chronic Diseases
Chronic Disease Self- Management Programs
New Program Offers Workshops for Chronic Disease Sufferers. Visit Living Healthy Champlain for more information.
The Champlain LHIN is investing in programs to support chronic disease self-management, a key component to improving health of people living with chronic conditions.
In 2008, the LHIN funded the Élisabeth Bruyère Research Institute to undertake a literature review of chronic disease self-management, an environmental scan and needs assessment of Chronic Disease Self-Management (CDSM) in our region.
Literature Review (26 pages) (pdf)
Executive Summary Literature Review (4 pages) (pdf)
Environmental Scan(pdf)
A need was identified to improve access to chronic disease self-management programs for people in their local communities. Currently there are two CDSM pilot projects being evaluated in both rural and urban settings. In July 2009, the Champlain LHIN funded a two-year program to provide central coordination of CDSM programs available in our region. Self-management programs may be delivered in a variety of settings, including community health centres, community support service organizations, hospitals, non-profit associations, community centres and others. To learn more about self-management support programs through the Champlain Health Line, click here.
Educating and supporting health professionals about CDSM is important. Dr. Patrick McGowan, a leading expert in chronic disease self-management programs in Canada presented his knowledge at a full-day, skills-building workshop held in 2008, with over 130 participating health care providers. More sessions are being planned for the upcoming year.
With these investments, the Champlain LHIN needs to know whether we are making a difference in people’s lives, as they manage their chronic conditions. To this end, Élisabeth Bruyère Research Institute will be conducting an evaluation of CDSM programs in Champlain to determine their effectiveness, and provide us with insights into how to make them better.
For information about the Champlain CDSM Program, please contact Erin Rae, CDSM Project Coordinator at erae@bruyere.org.
Champlain Diabetes Strategy
As in the rest of the province and Canada, diabetes is a large and growing health problem in the Champlain region. In July 2008, the Ontario Ministry of Health and Long-Term Care (MOHLTC) announced a four-year commitment to an Ontario Diabetes Strategy. The goal is to improve the health of Ontarians living with diabetes. For more information on the Strategy and diabetes resources, please visit the Stand Up to Diabetes site.
The Champlain LHIN is working to implement changes necessary to improve diabetes care and services in our local region. People with pre-diabetes and diabetes are a population-of-focus for the Champlain LHIN over the next three years (see Champlain Integrated Health Service Plan 2010-2013)
A Champlain Diabetes Strategy Advisory Committee advises the LHIN on ways to improve the health system for people with pre-diabetes and diabetes. The Champlain Diabetes Network is comprised of a broad range of health care providers from across the region, and meet every year to share information and discuss programs and services for people with diabetes.
Champlain Diabetes Strategy
Champlain Diabetes Strategy Advisory Committee
Presentations from the Champlain Diabetes Network Forum April 6, 2010
Central East LHIN presentation (pdf)
Community Risk Assessment Models and CHAP (pdf)
Cultural Perspective (ROMHC) (pdf)
Integrating Diabetes Education Services in Renfrew County (pdf)
Integrating Diabetes Services in the Halton Region (pdf)
T2DM Family Based Approach (pdf)
Chronic Disease Prevention and Management
Chronic diseases are among the most common and costly health problems facing Canadians; they are also among the most preventable.
Through engaging the community locally, we expect to identify means that will encourage healthy living and that will support best practice management of complex conditions along the continuum of care from prevention and early detection to the end of life.
The Champlain LHIN is working with our partners to improve chronic disease prevention and management in our region through the following initiatives:
• Cardiovascular Disease Prevention Strategy
• Champlain Diabetes Strategy
• Chronic Kidney Disease Program
• Lung Health Resources
• Chronic Disease Self-Management Programs.
Cardiovascular Disease Prevention Strategy
The Champlain Cardiovascular Disease Prevention Network is leading the implementation of a five-year Cardiovascular Disease Prevention Strategy within the Champlain region.
This Strategy seeks to:
1) reduce the burden of heart disease and stroke; and
2) ensure the residents of the Champlain region are the most heart healthy and stroke-free in Canada.
Health care and community partners in primary and specialty care, public health, community health, and research settings from across the Champlain region have designed and are implementing six key population health initiatives in our region:
1) Smoking Cessation Network
2) Healthy School Aged Children Initiative
3) Get with the Guidelines Initiative
4) Improved Delivery of Cardiovascular Care (IDOCC)
5) Community Heart Health Survey
6) “Give Your Head a Shake” Sodium Reduction Campaign
Chronic Kidney Disease Program
An Ontario Renal Network has been set up for the province that will:
• establish a regional model for planning of coordination, and delivery of services
• improve quality and equitable access for people living with renal conditions, along the continuum from early detection, education, prevention, to renal therapies, inclusive of end-of-life care
• promote home modalities where appropriate; and, support and encourage self care/self management and autonomy
The Champlain Chronic Kidney Disease Network, made up of clinicians and administrators from our two Regional Dialysis Programs and other key partners, work together on regional planning for dialysis.
Peritoneal Dialysis in Long Term Care Homes in Champlain
In 2005, the MOHLTC launched the Provincial Peritoneal Dialysis (PD) Initiative. The goal of the PD Initiative is to increase PD use in Ontario to 30% by 2010. One strategy to help achieve the 30% target is to increase access to PD treatments in long-term care (LTC) homes.
At this time, The Ottawa Hospital (our largest Chronic Kidney Disease Regional Program), Bruyère Continuing Care and the Community Care Access Centre (CCAC) are working on plans to reach these targets.
Chronic Kidney Disease Prevention and Management Project
The Ottawa Hospital has embarked on a quality improvement initiative designed to improve access and coordination of services for people who need renal services and to increase self-management supports.
Lung Health Resources
The Champlain Lung Health Network, with support from the Champlain LHIN, have published Breathing Easier – A Guide for Asthma and COPD Patients in the Champlain Region. This new, innovative tool is intended to help patients in the Champlain region access health education, rehabilitation, smoking cessation, oxygen therapy, financial assistance, home care, and palliative care services.
CDPM Collaborative
A CDPM Collaborative was formed in 2008 to provide a forum for knowledge exchange and innovation among key Champlain CDPM Community of Practice Networks. Key networks working in cardiovascular disease, stroke, diabetes, cancer, lung health, chronic kidney disease and others meet to:
• exchange ideas, information and quality improvement learning
• identify and support areas of collaboration along the continuum of care.
The Champlain CDSM Program has been a key area of focus for this group.