Mississauga Halton LHIN CSS and MH&A Sector Meeting September - - PowerPoint PPT Presentation

Mississauga Halton LHIN CSS and MH&A Sector Meeting September 25, 2009

Agenda

Introductory Remarks Angela Jacobs 10 min e-Health / IT

• Blackberry Project Update
• Software – Support and Housing Halton

Andrew Hussain Karen Cutmore 20 min CSS/MH&A Agency Profile

• Peel Halton Acquired Brain Injury Services (PHABIS)

Carol Wiliams PHABIS 20 min Shared Spaces Conference Ian Stewart 10 min Mississauga Halton LHIN Quality Network

• Project and Skills Inventories
• Triple Aim

Angela Jacobs 15 min Finance Update Paulette Zulianello 20 min Break 10 min Mississauga Halton LHIN Strategic Priorities

• Update
• Discussion

Narendra Shah 15 min 30 min Accreditation Update Narendra Shah / Metamorphosis 15 min ASSIST Update Ray Applebaum 15 min Questions

Blackberry Project Update

Andrew Hussain CIO

Support and Housing Halton

Karen Cutmore Manager, Finance and Administration Support and Housing Halton

Information Technology Update

Embracing today’s available technology

Background

HRIS Advisory Working Group eHealth Advisory Committee eHealth / OneMail SHH response

SHH Response

Utilization of CCIM portals

GP, HRIS

eHealth OneNetwork

secure 100% managed

mobile connectivity

Blackberry / BES synchronization

data security

daily / weekly / off-site backups

Proposed Future

secure data centre cost savings computer training

• ffering of service hosting

? Questions ?

kcutmore.SHH@haltonhealthworks.ca 905 845 9212, x24

Peel Halton Acquired Brain Peel Halton Acquired Brain Injury Services Injury Services

Mississauga Halton LHIN Sector Meeting Mississauga Halton LHIN Sector Meeting September 25, 2009 September 25, 2009

Presentation Overview Presentation Overview

• The Provincial Context

The Provincial Context

• Current (2006) Incidence of ABI

Current (2006) Incidence of ABI

• Evolution of ABI Services

Evolution of ABI Services

• Service Network

Service Network

• PHABIS History and Services

PHABIS History and Services

• Agency Development Timelines

Agency Development Timelines

• Seniors

Seniors’ ’ Programme Statistics Programme Statistics

• Case Studies: Service Integration/continuum

Case Studies: Service Integration/continuum

The Problem: Provincial Incidence The Problem: Provincial Incidence Rates of Brain Injury Rates of Brain Injury

• Nearly 500,000 Ontarians live with ABI (traumatic and non

Nearly 500,000 Ontarians live with ABI (traumatic and non-

• traumatic causes)

traumatic causes)

• ABI is more prevalent than breast cancer, HIV/AIDS, spinal cord

ABI is more prevalent than breast cancer, HIV/AIDS, spinal cord injury and injury and multiple sclerosis COMBINED! multiple sclerosis COMBINED!

• Cost estimates: $2

Cost estimates: $2-

• billion annually in Ontario

billion annually in Ontario

• 27,000 children and youth in schools without proper help

27,000 children and youth in schools without proper help

• In 2006 17,482 people sustained traumatic BI. 19,311 sustained n

In 2006 17,482 people sustained traumatic BI. 19,311 sustained non

• n-
• traumatic

traumatic BI BI

• 53% of the homeless have ABI history. 70% Prior to homelessness

53% of the homeless have ABI history. 70% Prior to homelessness

• As a group, the eight community agencies are currently providing

As a group, the eight community agencies are currently providing 51% of the 51% of the support to non support to non-

• residential clients and 29% to residential

residential clients and 29% to residential

• 44% of the people in corrections have ABI

44% of the people in corrections have ABI

• ABI is a life long chronic disability that requires life long su

ABI is a life long chronic disability that requires life long support and pport and resource commitment resource commitment

Committee on Traumatic Brain Injury, Institute of Medicine of th Committee on Traumatic Brain Injury, Institute of Medicine of the National Academies, Evaluating the HRSA Traumatic Brain Injury e National Academies, Evaluating the HRSA Traumatic Brain Injury Program Program 2006: the National Academies Press, Washington, D.C. / 2006 Cens 2006: the National Academies Press, Washington, D.C. / 2006 Census, Statistic Canada us, Statistic Canada

The Provincial Context: The Provincial Context: Evolution of ABI Evolution of ABI

• Life saving technology in the 70

Life saving technology in the 70’ ’s and 80 s and 80’ ’s s

• Saving them to what? Absence of rehab beds lead to U.S.

Saving them to what? Absence of rehab beds lead to U.S. Solutions Solutions

• 1987

1987-

• 1992 ~ 125 Ontario patients with ABI sent to U.S. Annual

1992 ~ 125 Ontario patients with ABI sent to U.S. Annual OHIP costs rose from $4.4 million to $29.8 million in 1998/99 OHIP costs rose from $4.4 million to $29.8 million in 1998/99

• 1994 passage of Long Term Act

1994 passage of Long Term Act

• Repatriation Round 1 (mid 1990

Repatriation Round 1 (mid 1990’ ’s): 65 applicants, 13 agencies s): 65 applicants, 13 agencies selected for vetting, 8 preferred providers identified, PHABIS selected for vetting, 8 preferred providers identified, PHABIS rated #1 rated #1

• Repatriation Round 2 (2002)

Repatriation Round 2 (2002) – – 2 agencies funded for Complex 2 agencies funded for Complex Hard to Serve Hard to Serve

The Provincial Context: Provincial The Provincial Context: Provincial Hospital Service Network Hospital Service Network

• Hamilton Health Science Centre (General Hospital

Hamilton Health Science Centre (General Hospital -

• ABI)

ABI)

• St Joseph

St Joseph’ ’s Centre for Mountain Health Services (Psychiatric s Centre for Mountain Health Services (Psychiatric Services) Services)

• West Park Healthcare Centre (ABI Behaviour Services)

West Park Healthcare Centre (ABI Behaviour Services)

• Sunnybrook Health Sciences Centre (Trauma Centre)

Sunnybrook Health Sciences Centre (Trauma Centre)

• University Health Network (Toronto Western Hospital

University Health Network (Toronto Western Hospital – – Neuroscience Centre) Neuroscience Centre)

• Toronto ABI Network

Toronto ABI Network – – Toronto Rehab. Toronto Rehab. Regional Hospitals: Regional Hospitals: (Trillium Health Centre, Credit Valley (Trillium Health Centre, Credit Valley Hospital, William Hospital, William Osler Osler Health Centre, Halton Healthcare Health Centre, Halton Healthcare Services) Services)

The Provincial Context: The Provincial The Provincial Context: The Provincial Community Service Network Community Service Network

• Brain Injury Community Re

Brain Injury Community Re-

• Entry, Niagara

Entry, Niagara

• Brain Injury Services of Hamilton

Brain Injury Services of Hamilton

• Brain Injury Services of Northern ON (Thunder Bay)

Brain Injury Services of Northern ON (Thunder Bay)

• Brain Injury Services of

Brain Injury Services of Simcoe Simcoe County (Barrie) County (Barrie)

• Community Head Injury Resource Services of Toronto

Community Head Injury Resource Services of Toronto

• Dale Brain Injury Services (London)

Dale Brain Injury Services (London)

• Peel Halton Acquired Brain Injury Services

Peel Halton Acquired Brain Injury Services

• Regional Community Brain Injury Services (Kingston)

Regional Community Brain Injury Services (Kingston)

• Vista Centre (Ottawa)

Vista Centre (Ottawa)

PHABIS PHABIS

• Incorporated in 1992 to provide Assisted Living and outreach

Incorporated in 1992 to provide Assisted Living and outreach services for adults with ABI services for adults with ABI

• 1996 Expanded Assisted Living (7 beds) and Day Services

1996 Expanded Assisted Living (7 beds) and Day Services

• 2002 Expanded Assisted Living for complex clients (9 beds)

2002 Expanded Assisted Living for complex clients (9 beds)

• 2009 Senior

2009 Senior’ ’s Program (Day Services, PSIT, Specialized s Program (Day Services, PSIT, Specialized consultation) consultation)

• Currently serves:

Currently serves:

• 15 treatment beds (PHABIS West + TRSL)

15 treatment beds (PHABIS West + TRSL) – – MOH Funded MOH Funded

• 12 Supported Living beds across three sites (24 hour support)

12 Supported Living beds across three sites (24 hour support)

• 5 clients in S.I.L.

5 clients in S.I.L. -

• Partnership with Participation House (24

Partnership with Participation House (24 hour from P.H. Case Management from PHABIS) hour from P.H. Case Management from PHABIS)

• 157 Community programming clients (PSIT)

157 Community programming clients (PSIT)

• 201 Day Service Participants (includes psychological and

201 Day Service Participants (includes psychological and neuropsychiatric neuropsychiatric consultation) consultation)

Community Community Treatment/Support: Treatment/Support: Neurobehavioural Neurobehavioural Model Model

Neurobehavioural Neurobehavioural Model Key Model Key Components Components

• Integrates Cognitive and Behaviour needs into physical

Integrates Cognitive and Behaviour needs into physical care routines. Specially trained care routines. Specially trained Neurobehavioural Neurobehavioural Support Workers (Client Programme Facilitators) Support Workers (Client Programme Facilitators)

• Clients have

Clients have limited limited ability to direct own care ability to direct own care

• Goal oriented

Goal oriented

• Client Focused

Client Focused

• Behavioural/Functional/Empirical approach to

Behavioural/Functional/Empirical approach to Care/Rehabilitation Care/Rehabilitation

• Promotes Independence

Promotes Independence

• Basic guiding principles

Basic guiding principles: :

• Clients need structure

Clients need structure

• Clients need consistency

Clients need consistency

• Clients need engagement

Clients need engagement

Seniors Seniors’ ’ Programme Programme

Purpose: Purpose: To Increase Community Capacity to To Increase Community Capacity to support seniors with ABI. To help address support seniors with ABI. To help address ER/ALC pressures. ER/ALC pressures. Components: Components:

• Behavioural Consultation and ABI education

Behavioural Consultation and ABI education

• Seniors Day Programming

Seniors Day Programming

• Staff Augmentation

Staff Augmentation

Seniors Seniors’ ’ Stats Stats

• Funding Approval January 2009

Funding Approval January 2009

• First Referral March 2009

First Referral March 2009

• Number of Referrals

Number of Referrals – – 16 16

• Number of ALC/Hospital Referrals

Number of ALC/Hospital Referrals – – 6 6

• Number of LTC Referrals

Number of LTC Referrals – – 7 7

• Number of Community Referrals

Number of Community Referrals – – 3 3

• Number of ALC Transitions

Number of ALC Transitions – – 1 (one on the way) 1 (one on the way)

• Number of LTC Transitions

Number of LTC Transitions – – 1 1

• Number of Aging at Home Clients

Number of Aging at Home Clients -

• 2

2

Case Study Case Study

• Background/Rehab. History

Background/Rehab. History

• PHABIS Seniors

PHABIS Seniors’ ’ Programme Involvement in Programme Involvement in LTC LTC

• Larger Service System Resource Mobilization

Larger Service System Resource Mobilization

• 3 Month Assessment Period

3 Month Assessment Period -

• PW

PW

• Transition to Assisted Living

Transition to Assisted Living

• Assessment regarding gradual return to home

Assessment regarding gradual return to home

Highlights Highlights

• Client Mobility due to incomplete rehabilitation

Client Mobility due to incomplete rehabilitation

• Need for flexibility in terms of staffing resources

Need for flexibility in terms of staffing resources

• Larger System Problem Solving

Larger System Problem Solving

• Limitations of LTC legislation, philosophy of

Limitations of LTC legislation, philosophy of care and resources care and resources

• Functional Rehabilitation/Skill focused

Functional Rehabilitation/Skill focused approach (Recognizing Rehab. Potential) approach (Recognizing Rehab. Potential)

• Long Term Residential bed opening

Long Term Residential bed opening

Shared Spaces Conference

Ian Stewart Executive Director ADAPT

Co-Location Project

• Promote service integration with access to a range of services under
• ne roof
• Include services to address housing , employment, family and

financial supports

• Share resources, reduce overhead

Who’s at the Table

• 7 Mental Health and Addiction programs:
• ADAPT
• CMHA Halton
• PAARC
• Support and Housing Halton
• Schizophrenia Society of Ontario
• Summit Housing and Outreach
• STRIDE
• Project Management – DTZ Barnicke

MH&A MH&A MH&A MH&A Soc Serv Soc Serv

Primary care

Close to public transportation Physically accessible Offices With ‘drop down’ Offices With ‘drop down’

Centralized Information / Referral & Intake Comfortable, waiting space w/ private areas Childcare / Children’s services Meeting space Meeting space

‘Green space’-

Community Garden

Retail/ Cafe

Shared Space Forum

• Sept. 18th Forum – 100 people attended
• Presentations from successful projects
• Peel Human Services
• Toronto Centre for Social Innovation
• Family Violence Project for Waterloo Region
• Lang Farms

Moving forward

• Participants identified:
• Value of shared space
• Current need
• Vision of the Possibilities
• Increased interest in the project
• If interested in finding more information, please contact

Ian at istewart@haltonadapt.org

Mississauga Halton LHIN Quality Network

Angela Jacobs Senior Lead, Performance and Integration

Membership:

• Co-Chaired by: Bill MacLeod and Susan Kwolek CVH
• Representatives from all of our funded healthcare sectors:
• LTC Homes
• Hospitals
• CCAC
• CSS – Lorena Smith – Senior Life Enhancement Centre
• Joanne Bamford – March of Dimes
• Mental Health – Charlene Winger – North Halton Mental Health

Clinic and Radhika Subramanaya CMHA Halton

• Addictions – was Carol Wilkinson CVH – looking for a new

member

Several Deliverables:

• Amongst many deliverables, I require your assistance for:
• Inventory of Quality Projects in MH LHIN
• Inventory of Quality Resources in the LHIN
• Completed for hospitals and now need other sectors
• Think about what your organization is doing and what

sort of skill sets your staff have.

• I will be e-mailing out a template to all our CSS and

MH&A HSPs shortly.

Learning about:

About the Triple Aim Initiative

• The Triple Aim is a new international learning initiative from the

Institute for Healthcare Improvement (IHI)

• IHI is an independent not-for-profit organization helping to lead the

improvement of health care throughout the world.

• Founded in 1991 and based in Cambridge, Massachusetts.
• IHI works to accelerate improvement by building the will for change,

cultivating promising concepts for improving patient care, and helping health care systems put those ideas into action.

“No Needless List”

• IHI works with health professionals across the world to accelerate the

measurable and continual progress towards the health care system

• bjectives related to: Safety, Effectiveness, Patient-Centeredness,

Timeliness, Efficiency, and Equity. This is called the "No Needless List": No needless deaths No needless pain or suffering No helplessness in those served or serving No unwanted waiting No waste No one left out

Quality and Patient Experience

Triple Aim: The Simultaneous Pursuit of

• Population Health,
• Enhanced Individual Care, and
• Controlled Costs for a

Population

How Not to Do It…

The Triple Aim

IHI believes that new designs can and must be developed to simultaneously accomplish three objectives, or aims

Improve Population Health Enhance Patient Experience (e.g. quality, access) Reduce, or control, per capita cost

• f care

Current Triple Aim Sites

Triple Aim is a System of Improvement:

Triple Aim Design Components:

Design of a Triple Aim Enterprise

Define “Quality” from the perspective of an individual member

• f a defined population

The “Triple Aim” Health care Public health Social services Per capita cost reduction Integration System-Level Metrics $ E PH Definition of primary care

1

Patients and families Population health management

Concept of “Macro-Integrator”

Triple Aim Interest is Growing in Ontario

• In Ontario great interest from The Change Foundation and The

Centre for Healthcare Quality Improvement (CHQI) and the LHINs.

• Central East LHIN the pioneer in exploring Triple AIM concepts:
• Save 1,000,000 hours spent by patients in hospital emergency

departments by 2013

• Reduce impact of vascular disease by 10% by 2013
• All LHINs are now considering / using / applying (to varying

degrees) the triple AIM concept

• Most LHINs are involved in further training with IHI

We have always implicitly Triple Aim without knowing and acting on it explicitly…

Triple Aim Themes

• Involving families

and caregivers

• Self-management
• Improving the

patient experience in access & quality

• Integration
• Measurement

Triple Aim Themes

• Population health
• Partnerships with
• ther sectors
• Self-management
• Measuring the

patient experience in access, quality & equity Our Vision A seamless health system for our communities – promoting

• ptimal health and delivering

high quality care when and where needed.

Improving Access, Quality and Sustainability of the Health System Improving Access, Quality and Sustainability of the Health System Prevention and Management

• f Chronic Conditions

Prevention and Management

• f Chronic Conditions

Integrating Mental Health and Addiction Services Integrating Mental Health and Addiction Services Enhancing Seniors’ Health, Wellness and Quality of Life Enhancing Seniors’ Health, Wellness and Quality of Life Accessible Accessible Effective Effective Efficient Efficient Safe Safe Person Centred Person Centred Integrated Integrated Appropriately Resourced Appropriately Resourced Focused on Population Health Focused on Population Health Strengthening Primary Health Care Strengthening Primary Health Care

MH LHIN Strategic Directions

Attributes of a high performing health system

Improving Access, Quality and Sustainability of the Health System Improving Access, Quality and Sustainability of the Health System Prevention and Management

• f Chronic Conditions

Prevention and Management

• f Chronic Conditions

Integrating Mental Health and Addiction Services Integrating Mental Health and Addiction Services Enhancing Seniors’ Health, Wellness and Quality of Life Enhancing Seniors’ Health, Wellness and Quality of Life Strengthening Primary Health Care Strengthening Primary Health Care Accessible Accessible Effective Effective Efficient Efficient Safe Safe Person Centred Person Centred Integrated Integrated Appropriately Resourced Appropriately Resourced Focused on Population Health Focused on Population Health

Population Health Patient Experience Cost Control

Strategic Directions

MH LHIN Focus

• Looking at Opportunities to integrated the Triple AIM

concepts into our work vis-a-vis the IHSP

• Start small – pick a few existing initiatives to incorporate

the concepts

MH LHIN Finance Update

Paulette Zulianello Senior Lead, Funding and Allocation

OHRS Phase 3 - MIS Q2 reporting due Oct 30th

• Test environment Sept 14 – 30th
• Production environment Oct 2 – 30th
• CSS OHRS volunteer mentors
• Fee for Service resources

• Front End Excel tool to enable Quarterly WERS

Reporting

• Brings together the CAP’s budgets and Schedule “E” into
• ne report.
• Access your specific information more easily

(No more endless scrolling through worksheets)

• Automated forecasting and analysis
• Edit checks built in

CAT Transition Flat File.xls Data Only

UPLOAD from HSP

CAT Transition Flat File.xls Data Only

Ministry Report

Populated from Transition File

EXPORT UPLOAD

The Health Service Provider input (YTD Actual directly into the CAT model

IMPORT

DOWNLOAD to LHIN

HSP to LHIN Process Flow

DOWNLOAD

New: Automated Forecasting

• HSP can select from a “menu”
• f forecast methods
• Allow for manual forecast input or one time entry in

a forecast

• YOUR Forecast

What if I See this Error Message?

Sept 15th E-mail

1)GENERAL INSTRUCTION SETUP

Create a new folder on your computer or network where you will be saving your Quarterly reports as required in your MSAA agreement. Give the folder any name you

• prefer. Within this folder create 3 additional folders named: Q2, Q3, and Q4.

2) EXCEL V2003 OR V2007 MACRO SETUP 3) ILLUSTRATED FOLDER CREATION

MHLHIN Training Sessions:

• Wed. Oct 21 (CSS)
• Wed. Oct 28 (SH and CMH&A)
• 9am to 12 MHLHIN Large Boardroom
• not quite 1/2 Registered to date
• Bring your own memory stick, keyboard and mouse

In Year Re-allocations

• Q3 WERS (CAT Tool) reporting deadline Feb 5, 2010

(Too late for CSS in-year recoveries)

• Year-end forecast (A@H and remainder) by Dec. 15
• Must identify expected year-end surpluses early to

avoid Ministry recoveries

Break!

10 Minutes

MH LHIN Strategic Priorities

Narendra Shah COO, MH LHIN

Mississauga Halton LHIN Integrated Health Service Plan 2010 - 2013

September 2009

Service Delivery Performance Improvement By Health Service Providers delivering, integrating, and improving services … Transformation & Integration

Reduce ER treatment time and provide alternate care

• ptions

Prevention and promotion are an intrinsic part of the health care experience Improve appropriate use of hospital beds by providing discharge options for ALC patients Transform community capacity so people receive the services they need, where they need them, when they need them Improve quality of care and patient satisfaction Drive results through information and transparency of reporting Meet performance standards and hold each other accountable Improve transitions from acute to community care Improve access to integrated diabetes services Improve access to integrated mental health and addiction services Improve access to primary health care Improved access to specialized services across the LHIN

Through enablers that will support our success …

Partnerships for Collaboration E-Health Transportation Engaged public about their personal health Health Human Resources Capacity Increase

We will work together as a system …

Engage communities and providers to seek their feedback to shape and improve the health system Value the skills and talents

• f the healthcare workforce

Partner broadly to improve health and quality of life in

• ur LHIN residents

A seamless health system for our communities – promoting optimal health and delivering high quality care when and where needed.

By focusing on health system priorities…

Integrating Mental Health & Addictions

Transform the health system , improve outcomes, and ensure sustainability with a focus on:

Primary Health Care Prevention & Management Chronic Conditions (Diabetes, CKD) Enhancing Seniors’ Health, Wellness, Quality of Life Access & Sustainability (ER Wait Times & ALC)

We will move towards

• ur vision …

Improved health Access to primary health care Improved

• utcomes

Timely access

That meet the diverse population’s needs for …

Efficiency & affordability

What How

Aging at Home Investments Hospitals (PCOP)

By Health Service Providers delivering, integrating, and improving services … Service Delivery

Reduce ER treatment time and provide alternate care options Prevention and promotion are an intrinsic part of the health care experience Improve appropriate use of hospital beds by providing discharge

• ptions for ALC

patients Improve access to primary health care

By Health Service Providers delivering, integrating, and improving services … Service Delivery

Reduce ER treatment time and provide alternate care options Prevention and promotion are an intrinsic part of the health care experience Improve appropriate use of hospital beds by providing discharge

• ptions for ALC

patients Improve access to primary health care

Enable hospitals to focus on their core services Improve & increase community sectors capacity

By Health Service Providers delivering, integrating, and improving services … Service Delivery

Reduce ER treatment time and provide alternate care options Prevention and promotion are an intrinsic part of the health care experience Improve appropriate use of hospital beds by providing discharge

• ptions for ALC

patients Improve access to primary health care

Transformation & Integration

Transform community capacity so people receive the services they need, where they need them, when they need them Improve transitions from acute to community care Improve access to integrated diabetes services Improve access to integrated mental health and addiction services Improved access to specialized services across the LHIN

By Health Service Providers delivering, integrating, and improving services … Service Delivery

Reduce ER treatment time and provide alternate care options Prevention and promotion are an intrinsic part of the health care experience Improve appropriate use of hospital beds by providing discharge

• ptions for ALC

patients Improve access to primary health care

Transformation & Integration

Transform community capacity so people receive the services they need, where they need them, when they need them Improve transitions from acute to community care Improve access to integrated diabetes services Improve access to integrated mental health and addiction services Improved access to specialized services across the LHIN

In both community sectors & in hospitals

By Health Service Providers delivering, integrating, and improving services … Service Delivery

Reduce ER treatment time and provide alternate care options Prevention and promotion are an intrinsic part of the health care experience Improve appropriate use of hospital beds by providing discharge

• ptions for ALC

patients Improve access to primary health care

Transformation & Integration

Transform community capacity so people receive the services they need, where they need them, when they need them Improve transitions from acute to community care Improve access to integrated diabetes services Improve access to integrated mental health and addiction services Improved access to specialized services across the LHIN

Examples: Cardiac Vascular Regional Geriatrics Common assessment for SDL

By Health Service Providers delivering, integrating, and improving services … Performance Improvement

Improve quality of care and patient satisfaction Drive results through information and transparency of reporting Meet performance standards and hold each

• ther accountable

Service Delivery

Reduce ER treatment time and provide alternate care options Prevention and promotion are an intrinsic part of the health care experience Improve appropriate use of hospital beds by providing discharge

• ptions for ALC

patients Improve access to primary health care

Transformation & Integration

Transform community capacity so people receive the services they need, where they need them, when they need them Improve transitions from acute to community care Improve access to integrated diabetes services Improve access to integrated mental health and addiction services Improved access to specialized services across the LHIN

By Health Service Providers delivering, integrating, and improving services … Performance Improvement

Improve quality of care and patient satisfaction Drive results through information and transparency of reporting Meet performance standards and hold each

• ther accountable

Service Delivery

Reduce ER treatment time and provide alternate care options Prevention and promotion are an intrinsic part of the health care experience Improve appropriate use of hospital beds by providing discharge

• ptions for ALC

patients Improve access to primary health care

Transformation & Integration

Transform community capacity so people receive the services they need, where they need them, when they need them Improve transitions from acute to community care Improve access to integrated diabetes services Improve access to integrated mental health and addiction services Improved access to specialized services across the LHIN

Applies to all providers

By Health Service Providers delivering, integrating, and improving services … Performance Improvement

Improve quality of care and patient satisfaction Drive results through information and transparency of reporting Meet performance standards and hold each

• ther accountable

Service Delivery

Reduce ER treatment time and provide alternate care options Prevention and promotion are an intrinsic part of the health care experience Improve appropriate use of hospital beds by providing discharge

• ptions for ALC

patients Improve access to primary health care

Transformation & Integration

Transform community capacity so people receive the services they need, where they need them, when they need them Improve transitions from acute to community care Improve access to integrated diabetes services Improve access to integrated mental health and addiction services Improved access to specialized services across the LHIN

Mississauga Halton LHIN Integrated Health Service Plan 2010 - 2013

September 2009

Service Delivery Performance Improvement By Health Service Providers delivering, integrating, and improving services … Transformation & Integration

Reduce ER treatment time and provide alternate care

• ptions

Prevention and promotion are an intrinsic part of the health care experience Improve appropriate use of hospital beds by providing discharge options for ALC patients Transform community capacity so people receive the services they need, where they need them, when they need them Improve quality of care and patient satisfaction Drive results through information and transparency of reporting Meet performance standards and hold each other accountable Improve transitions from acute to community care Improve access to integrated diabetes services Improve access to integrated mental health and addiction services Improve access to primary health care Improved access to specialized services across the LHIN

Through enablers that will support our success …

Partnerships for Collaboration E-Health Transportation Engaged public about their personal health Health Human Resources Capacity Increase

We will work together as a system …

Engage communities and providers to seek their feedback to shape and improve the health system Value the skills and talents

• f the healthcare workforce

Partner broadly to improve health and quality of life in

• ur LHIN residents

A seamless health system for our communities – promoting optimal health and delivering high quality care when and where needed.

By focusing on health system priorities…

Integrating Mental Health & Addictions

Transform the health system , improve outcomes, and ensure sustainability with a focus on:

Primary Health Care Prevention & Management Chronic Conditions (Diabetes, CKD) Enhancing Seniors’ Health, Wellness, Quality of Life Access & Sustainability (ER Wait Times & ALC)

We will move towards

• ur vision …

Improved health Access to primary health care Improved

• utcomes

Timely access

That meet the diverse population’s needs for …

Efficiency & affordability

Performance Highlights Aging At Home Investments 2008/09

Performance Highlights

• 1. Overall, the initiatives had a positive impact in

meeting the intent of the Aging at Home Strategy.

• 2. Many of the initiatives are innovative such as

Restore SDL and use of ABI expertise to manage difficult behavioural cases. These new initiatives undoubtedly take time to gain momentum.

Performance Highlights

• 3. The LHIN’s transformation journey of right care

in the right place at the right time is a cornerstone to an effective patient flow strategy. This major shift in focus has just begun.

Right Person

Right Place

Right Time

• Maple Scores
• Common

Assessments Used

• High Needs Prioritized

Performance Highlights cont…

• 4. The LHIN used the Aging at Home agenda to begin a

major transformation of all sectors to provide integrated

• care. For hospitals, it meant a major re-orientation of

discharge planning to “home first”. Waiting at home or a transitional setting is an optimal solution for many hospitalized seniors who need post hospital care for a number of reasons:

• A reduced risk for hospital acquired infections
• A reduced risk for hospital associated de-conditioning
• The option to wait for a preferred choice of Long Term Care
• Time to optimize functioning post-acute hospitalization prior to

making permanent major housing decisions

• Home provides the best environment to experience the

significant life transition of moving to (in most situations) your final residence, a nursing home.

Challenges

• Slow start
• Referrals & hand-offs – need to improve!
• Communication of new investments critical –

what to access when & how?

• Expect better performance for all in 2009/10

Discussion Using “World Café”

World Café

• Select a scribe for your table. Don’t worry – you won’t have to present – just

write!

• For the next 15 minutes, discuss the question on the next slide (also typed on

the piece of paper being handed out).

• Make notes during this time period.
• At the end of 15 minutes (time will be called) everyone EXCEPT the scribe

moves to other tables. Mix it up!

• The scribe reads out the notes they took and the discussion will continue.
• Scribe to take more notes on the discussion.
• The paper will be handed in to the LHIN for consolidation.
• Move back to your original table.

Café Question:

• Most of the MH LHIN new investments over the last

couple of years has been used to fund community capacity.

• What still needs to be done in the community

to facilitate improved access and flow of clients to services they need?

MH LHIN Accreditation

MH LHIN Accreditation Update

Narendra Shah COO September 25, 2009

Why Accreditation?

• MH LHIN considers it as an important element of overall

quality improvement focus

• Continuous quality improvement should be all providers

core mandate

• All sectors are subject to province-wide accreditation

except the CSS and CMHA sectors

• MH LHIN considered it important enough to make it part
• f the signed M-SAA. The M-SAA states: “That all

HSPs engage with an Accreditation body (provincial or national) with accreditation status to be completed by March 31, 2011.”

Progress Made by Metamorphosis

• Metamorphosis, as a representative of the CSS

and MH&A HSPs volunteered to co-ordinate the investigation into accreditation bodies, consult with MH LHIN HSPs and recommend a process to be followed to ensure accreditation.

• They met with LHIN staff several times and

presented their recommendations on September 17, 2009.

MH LHIN Agreement in Principle

• Accreditation timeline will run from October 1, 2009 to September

30, 2013 using a phased-in approach for our HSPs, due to accreditation capacity.

• There will be additional training for those HSPs who have never been
• accredited. This training will be offered by OCSA and non-

accredited HSPs will be required to participate in at least one course before March 31, 2011.

• By March 31, 2010, HSPs are required to select a reputable

accreditation agency that includes within its accreditation process a leadership and governance review.

• By this date, the HSPs are required to submit a letter to the LHIN

detailing their timeline for accreditation and indicating if and when they will be participating in OCSA training.

MH LHIN Financial Commitment

• Subject to finalizing costs (one-time and base), in

principle, based on the estimates tabled by the group, the Metamorphosis group, LHIN agrees to fund the cost of accreditation

• Once the letter and timeline has been accepted by the

LHIN, the M-SAA agreement will be modified and funding for the accreditation process will be flowed to the HSP.

• A pool of “one-time” money will be created, funded by

the MH LHIN, to support the additional training required for those HSPs who need it throughout the accreditation timeframe.

Accreditation Update

Metamorphosis/OCSA/SHRTN

Purpose

• In support of the MH LHIN’s

strategy to encourage a ‘voluntary commitment to self improvement by HSP’s through an accreditation process’ – John Magill, June 5, 2009 and M‐SAA Obligation: develop a collaborative multi‐year plan to support and build capacity for HSP’s (of all sizes) to achieve accreditation

Action Steps

• Accreditation session held June 5th
• Communiqué

circulated to all CSS/MH&A providers

• Press release circulated August 1st

to announce the launch of the June 5th presentations on the OCSA website

• Communication with accreditation bodies (one
• rganization offered a reduction for multiple agencies)
• Reps from Metamorphosis, OCSA, and SHRTN met with

the MH LHIN (C.A.O. and Senior Performance staff) August 12th

Action Steps continued….

• Metamorphosis network forum Sept. 9th
• Presentation of endorsed multi‐year plan to

MH LHIN September 17th

• Announcement of Metamorphosis multi‐year

plan approval by MH LHIN at Q2 meeting September 25th

• Suggested to announce multi‐year plan at

Governance to Governance session Sept. 30th

Principles…Continued

• Sectoral

surpluses identified as at December 31st effective 2009 will be considered for allocation in support of the approved multi‐ year allocation plan

• Freedom of choice of HSP’s

to select an accreditation body (provincial or national), utilizing amongst other tools, the Metamorphosis criteria guidelines

Road Map – Key Elements

• Multi‐year phased approach for all CSS/MH&A

HSP’s reflecting capacity/realities of existing accreditation bodies (provincial/national) including new policy of 5 year requirement for CCAC contracted providers

• Utilizing Benchmarks of Excellence as a transition

to Accreditation

• Support for ongoing capacity building for HSP’s,

e.g. quality leadership circles, and workshops

• OCSA/SHRTN/Ontario Health Quality Council

Metamorphosis Multi‐Year Accreditation Plan Framework

• 4 year plan (October 1, 2009 – September 30, 2013)
• 43 HSP’s

to identify utilization of: Participating in Benchmarks of Excellence (approx. 2‐5 months) Skill Development Workshops through Capacity Builders Participating in Accreditation Leadership Circles Identify timeline and selection of accreditation body by no later than March 31, 2010

Quality & Accreditation Learning Proposal

• Two sources of resources from MH LHIN

1.Accreditation fees to base budget for HSP’s 2.Multi‐year learning resources to support and build capacity for accreditation plan facilitated by Metamorphosis & its partners

Quality and Accreditation Learning Proposal Mississauga Halton LHIN Community and Home Care Agencies

• Benchmarks of Excellence for the Community

Support Sector

• Quality and Accreditation Leadership Circles:

Developing Peer Coaching Groups

• Accreditation Skills Development Workshops

Benchmarks of Excellence for the Community Support Sector

• Benchmarks of Excellence for the Community

Support Sector is a process that looks at the health of the whole organization including clarity

• f purpose, producing results, optimizing

resources, ensuring accountability, building collaborations, nurturing innovation and responsiveness and providing a positive and productive work environment.

• The formal assessment will be coordinated and

facilitated by Capacity Builders.

• Cost per agency ‐

$3500

Quality and Accreditation Leadership Circles: Developing Peer Coaching Networks

• Quality and Accreditation Leadership Circles

(QALC) is based upon the recognized educational process of Action Learning whereby the participant studies their own actions and experience in order to improve performance. Action Learning includes ongoing, highly focused meetings among small groups of peers each of whom is committed to meeting real‐life challenges or goals – and learning at the same time. Using this model, Quality and Accreditation Leadership Circles will bring together senior staff responsible for quality management and accreditation from each participating MHLHIN agency into facilitated peer coaching groups of 8 participants who will learn and help each other in incorporating accreditation expectations into their organizations.

• Cost for establishing and creating each QALC ‐

$2400.

Accreditation Skills Development Workshops

• Capacity Builders will offer 4 full day open

registration workshops on skills and knowledge that will support and assist community and home care agencies with the accreditation process and implementation of outcomes. Program topics could include Quality 101, Change Management, Project Management, Process Management, Performance Metrics and Communication Skills. Cost ‐ $149 per participant per workshop. Minimum 20 participants.

Plan Benefits

Overall Multi‐Year Plan Leadership Circles Benchmarks of Excellence Skills Development Workshops

• Provide HSPs with

adequate time to comply

• Assist and support

HSPs in acquiring accreditation status

• Acquire financial

support from the MH LHIN for

• ngoing direct costs

associated with accreditation and

• rganizational

preparation

• Create a culture of

mutual support

• Expert advice at

lower costs

• Sharing of work to

reduce time and energy

• Provide support,

networking and encouragement for

• rganizational

change

• Tested and proven

group process

• Leverages

expertise of resources of Capacity Builders

• Survey forms

completed by boards, staff, and volunteers

• Forms analyzed by

trained and experienced consultant

• HSPs provided

with written report and consultant briefing session with Board and staff to review findings and facilitate plan

• Workshops on

skills and knowledge that support HSPs with accreditation process and implementation of

• utcomes
• Topics include:

quality, change/project/pro cess management, performance metrics, and communication skills

Next Steps

• Present final results at the MH LHIN quarterly

meeting on September 25th

• Survey with HSPs to identify draft timeline,

accreditation selection, and support

Next Meeting – December 10, 2009 9:00 - noon Hilton Garden Inn, Oakville

QUESTIONS?