Fact 1: Senior Population and Socioeconomic Status Differ by Health Link Region Total % Seniors % Seniors LHIN Health Link Name % Age 65+ Population Age 85+ Low SES Dufferin Area 72,860 13% 10% 8% NE-M-WW 214,170 14% 13% 28% Central Bramalea and Area 257,928 9% 8% 11% West Brampton and Area 315,029 9% 11% 12% Bolton - Caledon 39,969 11% 11% 2% Halton Hills 61,801 12% 11% 3% Milton 94,626 8% 12% 1% Oakville 191,476 13% 14% 5% Mississauga Northwest Mississauga 332,148 9% 13% 5% Halton Southwest Mississauga 81,768 14% 11% 8% East Mississauga 300,335 13% 11% 21% South Etobicoke 116,022 17% 17% 11% 33
Fact 2: Senior Population Growth Varies Within and Across LHINs 34
Fact 3: Health Care Resources per Senior in MHCW LHINs are Among the Lowest in the Province
Fact 4: Health Care Resources per Senior in the MHCW LHINs Will Likely Fall in the Future Because of Faster Population Growth than in Other LHINs 36
Five Facts 1. Senior population and socioeconomic status differs by Health Link Region. 2. Senior population growth: • in MHCW LHINs are among the highest in the Province. • varies within MHCW LHINs. 3. Health care resources per senior in MHCW LHINs are among the lowest in the Province. 4. Health care resources per senior will likely fall in the future since the senior population is increasing faster than in other LHINS. 5. The next cohort of seniors is different from past cohorts of seniors What to do? 37
What to do? Traditional Asset-Based Needs Assessment Capacity Assessment What don’t we have? How can we strengthen and make best use of what we have? 38
Asset Based Plan: A Case Study of Brazil’s HIV/AIDs Epidemic • In 1990, the World Bank predicted that Brazil did not have the resources to resist HIV infections and would have 1.2M cases of HIV/AIDS by 2000; instead it had 0.5M World Bank World Bank Brazil Brazil Questions Conclusions Questions Response • • • • What resources are Brazil needs a How can we: Used over 600 NGOs, needed to: sophisticated, churches, and other • integrated national Reduce costs to community care • Provide treatment health care system provide treatment to organizations to patients? all in need? • • Brazil cannot afford Nurses drew pictures • • Manage drug the resources to Communicate drug on pill bottle labels therapies for manage treatment therapy routines to and helped poorest illiterate patients? compliance homeless, illiterate people connect with patients? NGOs and churches • • Assure compliance Brazil’s limited that offered free food • with drug associated resources should be Ensure greater food • nutrition? focused more on compliance by linking Prevention education prevention than people with delivered when • Implement an treatment; it will charities/food banks/ people go to effective prevention take a long time to churches? hospitals/clinics for program? end the epidemic treatment • Achieve prevention goals while treating all currently infected? Adapted from Zimmerman (2010). Getting to Maybe: Nurses as Social Innovators 39
Asset Based Capacity Assessment: Connecting Communities in Need to Available Resources Other community assets include: • pharmacies • physicians • religious institutions • schools • libraries 40
Community Asset Plan: Connecting Seniors to Local Assets ? 41
Expected Project Outcomes Understand Population Health Project Outcomes Need Describe and Quantify How to Assess Community Assets Meet Population Need 42
Approach: Client Segmentation Home Care Service Groups Short-Stay: Acute Short-Stay: Rehab No RAI Assessment Community Independence Chronic Complex End-of-Life Children 43
Segmentation by Care Setting, Service and Health Status: MH LHIN Site Group % Seniors MH CCC All 0.7% LTC Intact Cognition 0.5% LTC Moderate Cognitive Impairment 1.4% LTC Severe Cognitive Impairment 1.3% ALSH All 1.3% Community IP Mental Health 0.2% Community Acute IP with Rehab 1.1% Community Acute IP with ED 4.5% Community Acute IP with HC 4.9% Community Acute IP Other 1.2% Community Home Care and living alone 0.4% Community Home Care, not living alone 5.7% Community At least one ED visit 12% Community At least one physician visit, 0 chronic conditions 6.2% Community At least one physician visit, 1-2 chronic conditions 36% Community At least one physician visit, 3 chronic conditions 17% Other 5.2% All Seniors 138,836 Source: DAD, NACRS, OMHRS databases, CCRS, RAI-LTC, RAI-HC, NRRS, Statistics Canada, ALSH statistical data; Fiscal year 2011/12.
Approach: Population Segmentation Examples of Senior Segments 1. Healthy with Minimal or No Health Issues and Needs 2. Acutely ill, with likely return to health 3. Chronic conditions, with generally "normal" function 4. Significant but relatively stable disability, including mental disability 5. "Dying" with short decline 6. Limited reserve and exacerbations 7. Frailty, with or without dementia Our segmentation approach expands the current methods to include: 1. People in need that did not access service 2. Health information accumulated across different settings , including CCAC, Long Term Care homes, hospital emergency, inpatient, rehabilitation, mental health and complex continuing care 3. Clinical segmentation that combines our constructed health profiles according to purpose . In particular the segments themselves are flexibly defined depending on the outcome that is being measured and managed. Based on: Lynn J, Straube BM, Bell KM, Jencks SF, Kambic RT. Using population segmentation to provide better health 45 care for all: The “Bridges to Health” model. The Milbank Quarterly. 2007 June;85(2):185-208.
Our Approach Literature and Data Project Approach Consultations Experience Review Analysis Community Assets Population Health Describe and Quantify Approach to Meet Population Need 46
Steering Committee Members Community Capacity Planning Steering Committee Membership LHIN Position Bill Macleod CEO, Mississauga Halton LHIN Scott Mcleod CEO, Central West LHIN (Co-Chair) Liane Fernandes Senior Director, Health System Development & Community Engagement, MH LHIN David Colgan Senior Director, Health System Integration Central West LHIN CCAC Caroline Brereton CEO, Mississauga Halton CCAC (Co-Chair) Cathy Hecimovich CEO, Central West CCAC Jim Wright Vice President, Corporate Services, Mississauga Halton CCAC Alan P. Iskiw Vice President , Finance & Technology, Central West CCAC Community Support Services Sushil Sharma Senior Program Manager, India Rainbow Ray Applebaum Executive Director, Peel Senior Link Valerie Quarrie Administrator, Dufferin Oaks Home for Seniors Citizens Angela Brewer Chief Executive Officer, Acclaim Health Community Mental Health and Addictions Services Radhika Subramanyan CEO CMHA Halton Nurse Practitioner Lori Brown Coordinator & NP NPSTAT, NP LTC Rapid Response Team, Trillium Health Partners Physicians Dr Samir Sinha Director of Geriatrics Primary Care Lead Central West LHIN, Chief Family Practice, Osler, FHT family doctor, Dr Frank Martino President Ontario College of Family Physicians Dr Dante Morra Chief, Medical Staff, Trillium Health Partners Public Health Units Joyce See Director, Community Health Services, Halton Region Health Department Janette Smith Commissioner of Health, Region of Peel 47 Safia Ahmed Executive Director, Rexdale Community Health Centre
Consultations We held 56 sessions, including roughly 200 participants Sample of session groups: 1. Senior centre users 2. Central West Palliative Care Network 3. Mississauga Halton Transportation Working Group 4. Caregiver First Collaborative 5. Peel Emergency Medical Services 6. Mississauga Halton Behavioural Working Group 7. Central West Cultural Services / Diverse Communities 8. Family Health Teams 9. Health Links 10. Ontario Association of Non Profit Homes and Services for Seniors 11. Community Health Centres 12. Mississauga Halton Adult Day Services At all sessions, participants: 1. Were engaged and enthusiastic 2. Provided clear and relevant information 3. Suggested innovative ideas 48
Important Topics from the Consultations 1. Long Term Care 2. Home Care 3. Informal care, including respite care and caregiver supports 4. End of life and palliative care 5. Housing 6. Transportation 7. Adult Day Programs 8. Medication management 9. PSW training and skill, particularly related to dementia and behaviours 10. Coordination of care between providers, including transitions 11. Chronic disease management and prevention 12. Needs of people with mental health conditions 13. Needs of people with developmental disabilities 14. Social connections 15. Matching programs and services with client’s cultural preferences 16. Service boundaries 17. Technology and telemedicine 18. Information exchange between providers 19. Built environment 20. Home modifications and renovations 49
How are we using the information from the consultations? For all topics, the report will: 1. Summarize what we learned from the consultations 2. Summarize what is known from the grey and peer reviewed literature 3. Include statistics from our data collection The steering committee chose priority topics for additional data analysis: 1. Long Term Care 2. Assisted Living and Supportive Housing 3. Home Care 4. End of Life 5. Informal Care 6. Transportation 7. Adult Day Programs The data analysis will: 1. Analyze services, population segments, and assets 2. Estimate the size and cost of service gaps by segment and geography 3. Inform recommendations for resource allocation 50
Some Themes of Focus For the rest of the presentation, we will highlight some of our findings on these topics: 1. Informal Care 2. End of Life 3. Long Term Care Substitution 4. Home Care Population Based Planning 51
End of Life: Changes in End of Life Use of Hospitals by LHIN 2008/09 to 2012/13 Actual to Expected Hospital Inpatient Days for Decedents 65+ LHIN 2008 2012 Central West 0.89 0.90 Mississauga Halton 0.95 1.18 Ontario 1.0 0.94 Source: RPDB 2011/12, 2012/13; DAD 2008/09 to 2012/13 Expected days are standardized using the 2008/09 inpatient days per capita and each Health Link’s standardized mortality ratio Across the province, standardized inpatient days for deaths fell by 6 percent Mississauga Halton LHIN’s days increased substantially 52
End of Life: Health Link Variation in Death Setting: By Diagnosis Cancer Setting 2012/13 Acute LTC Other Deaths Central West LHIN 1,179 66% 3% 31% Oakville 318 42% 3% 55% Northwest Mississauga 403 67% 3% 31% Mississauga Halton LHIN 1,912 56% 2% 41% Provincial Average 24,507 55% 3% 42% Source: 2012/13 RPDB, DAD, RAI-LTC The proportion of deaths by setting varies by LHIN, Health Link, and diagnosis Compared to Mississauga Halton , Central West’s cancer decedents have a higher probability of dying in hospital and a lower probability of dying in a community setting 53
End of Life: Simulating Out of Hospital Deaths Under Better Practice Decrease in Deaths by Setting Decrease in Acute IP Days Health Link Acute LTC Other (beds) Central West LHIN 461 -78 -383 6,588 (20) Oakville -3 -23 26 -55 Northwest Mississauga 153 -17 -136 2,923 Mississauga Halton LHIN 434 -151 -283 7,908 (24) CW and MH LHIN Total 896 -229 -666 14,497 (44) At the practice of the reference LHINs, Central West would have had 461 fewer deaths in hospital, 78 more deaths in LTC, and 383 more deaths in the community. Central West decedents would have used 20 fewer acute IP beds. Some Health Links in both LHINs are very near the distribution of the reference LHINs. 54
Informal Care: What we learned at the consultation sessions What did we hear about informal care during the consultations? 1. Informal care can delay admission to LTC 2. Caregivers need more support, including 1. More respite care, both in-home and short term residential 2. Better access to adult day programs for care recipients 3. More social connections 3. Caregivers need training, particularly on caring for patients with dementia, Alzheimer’s, and behaviours 55
Informal Care: Relationship of Caregiver Who provides informal care? Share of Total Informal Hours Relationship of Primary Mississauga Central West Caregiver to Recipient Halton Child 54% 48% Spouse 35% 41% Other Relative 9% 10% Friend/Neighbour 2% 2% Source: RAI LTC 2012/13 Compared to Mississauga Halton, a higher proportion of total informal care is provided by the children of clients in the Central West LHIN Variations in the share of informal hours by relationship to client will have implications for the future supply of informal care 56
Informal Care: Health Link Variation in Informal to Formal Care Ratios Informal Care Informal Hours per Health Link PSW Hours Hours Formal Hour Dufferin Area 68,153 227,091 3.3 NE-M-WW 269,306 1,227,235 4.6 4.2 Central West LHIN 784,753 3,306,466 Milton 53,181 163,761 3.1 Oakville 246,517 381,404 1.5 2.6 Mississauga Halton LHIN 1,430,680 3,685,224 57
Informal Care: Formal and Informal Care Gaps: Now and in the Future 58
Informal Care: Closing the Gaps: Estimated Costs by LHIN Mississauga Central West Current Formal Care Halton 2012/13 CCAC Cost of PSW Hours $23,500,000 $42,900,000 Future Formal Care Cost to Care for 2032 Population at 2012 PSW $58,400,000 $107,200,000 Hours per Person 2032/33 Future Formal Care Gap $34,900,000 $64,300,000 Future Informal Care Forecast 2032 Demand in Informal Care (hours) 8,200,000 9,200,000 Forecast 2032 Supply of Informal Care (hours) 5,500,000 6,600,000 2032/33 Future Informal Care Gap (hours) 2,700,000 2,600,000 CCAC Cost to Close Informal Care Gap $81,900,000 $78,600,000 To close the gap in formal care and assuming 1,600 hours per year per PSW: • Central West LHIN will need 730 more PSWs in 20 years • Mississauga Halton wiil need 1,330 more PSWs in 20 years 59
Informal Care: Increasing the Supply of Informal Care A Start: Bill 21 60
Informal Care: How can the gaps between demand and supply be reduced? Sample of ways to reduce demand and supply gaps in formal and informal care 1. Substitute formal for informal care by providing more CCAC funded PSW hours 2. Increase use of privately funded PSW care 3. Increase supply of informal care hours through initiatives to: a. Increase the number of informal caregivers b. Increase hours per caregiver 4. Reduce demand through: 1. Use of technology 2. Primary and secondary prevention 3. Care coordination and system navigation 4. Chronic disease management 5. Delaying disease onset 61
Long Term Care Substitution: Community Transitions • Many jurisdictions have implemented policies to increase the number of seniors that return to the community following LTC home admission • For example, States with mature nursing home transition programs have managed to relocate 25% to 35% of their nursing home residents to assisted living* • Two important policy components: • identify people who could be transferred back to the community • ensure that care needs are met after the transition *Susan C. Reinhard Health Affairs, 29, no.1 (2010):44-48 Diversion, Transition Programs Target Nursing Homes' Status Quo 62
Long Term Care Substitution: Low Care • Most MH LTC homes are below the provincial average Low Care prevalence • Low Care prevalence varies across CW and MH LTC homes 63
Two Methods of Population Based Home Care Planning Population Based Planning 1. Demographic Model • Age, Gender and Income • Independent of LHIN CCAC allocation • Does not account for population morbidity beyond demographics • No clinical detail to understand variance within LHIN 2. Clinical Model • Age, Gender, Clinical Characteristics • Independent of LHIN CCAC allocation • Clinical detail to understand variance within LHIN 64
Demographic Model: Risk Groups Source: Home Care Database 2012/13, Statistics Canada Population Data
Demographic Model: Home Care Cost Variance by Age Source: Home Care Database 2012/13, Statistics Canada Population Data 66
Actual to Expected Home Care Costs: Demographic Model Mississauga Halton: 1.05 Central West: 0.84 Only persons aged 65+ Source: DAD 2011/12 to 2012/13, NACRS 2011/12 to 2012/13, Home Care Database 2011/12 to 2012/13 67
Clinical Model: High Home Care Cost Conditions Provincial Home Care Cost, People, 65+, Home Care Cost Principal Problem 2011/12 to 2011/12 per Person 2012/13 MOTOR NEURON DISEASE : ALS $6,254,508 357 $17,520 TRACHEOSTOMY COMPLICATION $2,478,565 236 $10,502 GASTRIC TUBE : MANAGEMENT & REMOVAL $10,076,963 986 $10,220 DIABETES : WITH FOOT ULCER $20,423,931 2,248 $9,085 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA $8,056,090 1,003 $8,032 CARE PROVIDER DEPENDENCY $18,506,971 2,313 $8,001 CHRONIC SKIN ULCER $49,419,972 6,308 $7,834 DIABETES : WITH PERIPHERAL ANGIOPATHY AND GANGRENE $2,039,774 261 $7,815 PARKINSON'S DISEASE $11,940,932 1,624 $7,353 VARICOSE VEINS : WITH DEEP VEIN THROMBOSIS $3,531,176 492 $7,177 OSTEOMYELITIS $8,577,149 1,277 $6,717 POST PROCEDURAL URINARY INFECTIONS $3,446,216 518 $6,653 Sources: DAD 2011/12 to 2012/13, NACRS 2011/12 to 2012/13, Home Care Database 2011/12 to 2012/13 68
Clinical Model Example: Client Severity and Home Care Cost Provincial Home Care Cost, People, 65+, Home Care Cost Principal Problem 2011/12 to 2011/12 per Person 2012/13 DIABETES : TYPE 2 WITHOUT COMPLICATIONS OR WITH MINOR $40,146,508 52,022 $772 COMPLICATIONS DIABETES : WITH PERIPHERAL ANGIOPATHY $23,685,437 17,591 $1,346 DIABETES : WITH NEUROLOGICAL COMPLICATIONS $1,506,161 1,001 $1,505 DIABETES : WITH RENAL COMPLICATIONS $7,281,119 2,660 $2,737 DIABETES : WITH PERIPHERAL ANGIOPATHY AND GANGRENE $2,039,774 261 $7,815 DIABETES : WITH FOOT ULCER $20,423,931 2,248 $9,085 Sources: DAD 2011/12 to 2012/13, NACRS 2011/12 to 2012/13, Home Care Database2011/12 to 2012/13 69
Clinical Model Example: Client Complexity and Home Care Cost Provincial Home Care Home Care People, 65+, Principal Problem Comorbid Clinical Condition or Secondary Procedure Cost, Cost per 2011/12 2011/12 to Person 2012/13 DIABETES : WITHOUT COMPLICATIONS OR WITH MINOR COMPLICATIONS $40,146,508 52,022 $772 None $2,918,140 4,637 $629 Anemia $1,253,359 1,706 $735 Kidney and Urinary System $1,453,556 1,759 $826 Heart $2,650,187 2,057 $1,288 Renal Failure $790,899 273 $2,897 $1,346 DIABETES : WITH PERIPHERAL ANGIOPATHY $23,685,437 17,591 None $1,643,868 1,465 $1,122 Aftercare $1,085,732 799 $1,359 Endocrine, Nutritional and Metabolic System $641,577 326 $1,968 Kidney and Urinary System $1,567,680 471 $3,328 Dialysis $462,215 132 $3,502 Sources: DAD 2011/12 to 2012/13, NACRS 2011/12 to 2012/13, Home Care Database 2011/12 to 2012/13 70
Clinical Model: Summary Statistics Per Person, Ontario Fiscal Years 2011/12 and 2012/13 Clinical People, Home Care LTC Hospital Hospital ALC Group 2011/12 Cost Admissions Days Days 1 5,342 $102 0.00 0.8 0.0 2 34,242 $225 0.00 1.3 0.1 3 180,618 $538 0.01 2.6 0.3 4 98,763 $1,103 0.03 6.2 0.7 5 36,995 $1,779 0.05 10.4 1.2 6 70,906 $2,449 0.07 14.7 2.1 7 40,897 $3,262 0.11 21.3 4.2 8 30,780 $4,368 0.18 26.0 6.9 9 14,938 $4,919 0.30 34.9 13.0 10 6,423 $6,235 0.30 33.6 11.9 11 2,620 $6,918 0.28 33.6 11.5 12 3,739 $7,648 0.28 40.9 13.4 13 1,280 $8,520 0.21 41.7 11.8 14 567 $9,314 0.26 39.7 12.1 15 390 $10,861 0.26 50.4 19.0 Only ages 65+ Sources: RAI-LTC 2011/12 to 2012/13, Home Care Database 2011/12 to 2012/13, DAD 2011/12 to 2012/13, NACRS 2011/12 to 2012/13
Variation in Home Care Cost by Clinical Group Ratio of Actual to Expected Home Care Cost Share of Total Mississauga Diagnosis Home Care Cost Central West Halton Aftercare 5% 1.13 1.16 Arthritis And Musculoskeletal 13% 1.04 1.04 Circulatory System 5% 0.84 0.84 Diabetes 5% 0.80 1.18 Digestive System 7% 1.10 1.18 Endocrine, Nutritional And Metabolic System 4% 0.90 1.03 Heart 4% 0.70 0.75 Injuries, Poisoning And Toxic Drug Effects 3% 1.07 1.11 Kidney And Urinary System 12% 0.81 1.09 Malignancy 3% 0.88 0.85 Mental Diseases And Disorders 9% 1.03 1.21 Nervous System 5% 0.79 1.14 Respiratory System 7% 0.73 1.06 Skin And Subcutaneous Tissue 4% 0.81 1.14 Vision And Eyes 3% 0.74 0.63 All Diagnoses 100% 0.89 1.04 Sources: RAI-LTC, Home Care Database, DAD, NACRS 2011/12 to 2012/13 72
Percent PSW and Home Care Cost 73
What’s Next Step Completion Analysis July 2014 Stakeholder Information Sessions July 2014 Report August 2014 Capacity Planning Tool September 2014 74
Primary Care Integration Strategy Carie Gall, Executive Lead, MH LHIN 75
Primary Care Integration Strategy Quarterly Sector Meeting - June 25, 2014 Carie Gall & Lara DeSousa
77
Improve access to family health care Attaching patients; Same/next day appointments; After hours; Home visits; Multi-disciplinary healthcare teams Increase linkages between family health care and other health care providers to improve communication, coordination and integration across the continuum of care Health Links; Improve coordination of care; Increase capacity/access to specialists; Timely information sharing; Leverage technology 78
Current State
Primary Care Integration Strategy Capacity Awareness Access Integration of Primary Care
Primary Care Integration Initiative Primary Care Provider Data Base Mississauga Halton Primary Care Network Primary Care Advisors
Primary Care Data Base Significant demand to communicate with primary care • Need a single resource that can be centrally updated and • maintained but used throughout the LHIN Development of physician profiles will allow individualized • engagement for future activities Question: Beyond the need to communicate with primary care physicians, does your sector have any specific needs related to physician profiles?
Mississauga Halton Primary Care Network Provides the structure to support physician capacity building • and engagement Provides forum to organize the voice of primary care to • articulate regional issues Provides centralized method for reaching out to and • communicating with primary care Opportunity: CSS & MHA agencies can share program information with primary care providers or seek input from providers when developing new programs/services.
Primary Care Advisors Geographically assigned team of 5 members housed at CCAC • Will establish connections with primary care through office visits • and individualized communications Will gain an understanding of physicians’ interests and needs & • support development of appropriate linkages Inform primary care of LHIN wide programs & resources, • primary care focused and system wide initiatives Engage primary care to support achievement of system goals • Question: What opportunities can we leverage to bring these staff up to speed on your program/service offerings? Who is the key contact for your organization?
Advance Care Planning and Health Care Consent Carol Sloan, Director, Acclaim Health
MH LHIN Community Sector Meeting June 25, 2014 Health Care Consent & Advance Care Planning Carol Sloan Director, Palliative Care Consultation Acclaim Health
The Palliative Care Consultation consultants (or Palliative Pain and Symptom Management Consultants as we are known in some areas) help build capacity among all front line service providers in the provision of hospice palliative care. Our program covers the regions of Halton, Peel & Dufferin. We promote hospice palliative care learning among front line health care providers by facilitating the integration of evidenced based knowledge into clinical practice. We do not provide direct care. We collaborate at local, provincial and national levels.
The Fundamentals of Hospice Palliative Care Advanced Hospice Palliative Care Education (AHPCE) for support workers Comprehensive Advanced Hospice Palliative Care Education (CAPCE) for RPNs, RNs, APNs, NPs Assessment and Management of Pain (new pilot program)
• A process ocess of reflection and communication • The communication of wishes shes (verbal, written or otherwise) • A way to let others know your future health and personal care wishes shes • A time to consider who will speak for you when you are no longer capable of directing your care (SDM)
Research has shown that: If you have expressed your wishes in advance, you are much more likely to have your end-of-life care wishes known and followed Your family members will have less stress and anxiety because they will know your wishes You will be more satisfied with your care as will your family and your Substitute Decision Maker(s)
You will have a better quality of life and death Most of us hope that we will be able to communicate until the very end, but in reality most deaths do not occur that way so we need to communicate our wishes now while we can. It also means for us as health care providers that we are providing client centred care. This means that the person is more likely to not have to go to the local ER because they are receiving the care that they want, where and when they want it. It is all about communication!!!
Many people get confused about Health Care Consent requirements and how it interfaces with Advance Care Planning. Do you think that if you plan for care in the future based on your current medical condition it is Advance Care Planning? This is not Advance Care Planning, this is consent. Only the person themselves can advance care plan, Substitute Decision Maker(s) can only interpret the persons prior expressed wishes and provide the health care provider with consent.
Provincially, I have been involved with the Health Care Consent and Advance Care Planning Community of Practice (CoP) now sponsored by Hospice Palliative Care Ontario (HPCO). This Community of Practice has worked collaboratively with the Canadian Hospice Palliative Care Association to adapt their Speak Up- Start the conversation about end-of-life care workbook to an Ontario version which meets with Ontario Health Care Consent law. Laws differ from province to province, so we needed something specific to our laws.
Part of our work was the development of two different PowerPoint's and accompanying facilitation guides to assist in the understanding of Health Care Consent and Advance Care Planning for both the public and the health care provider. Anyone may take these presentations and use them.
These tools can be found on our website http://www.acclaimhealth.ca/menu- services/palliative-care- consultation/resources/advance-care-planning/ HPCO Website http://www.hpco.ca/acp-hcc-hsp/ CHPCA website http://advancecareplanning.ca/making-your- plan/how-to-make-your- plan/provincialresources/advance-care-planning-in- relation-to-health-care-consent-training- materials.aspx
The Health Care Consent and Advance Care Planning Community of Practice worked collaboratively with HPCO who sought out funding to produce some videos for educational purposes. We are fortunate to say that the MH LHIN assisted in sponsoring part of the editing for one of the presentations and funded the production of putting these videos onto DVDs to share with primary care providers for their use.
There are 4 individual video presentations on each DVD: Health Care Consent in Relation to Advance 1. Care Planning for Health Care Providers Advance Care Planning and Health Care 2. Consent in Ontario: Making Your Wishes Known Speak Up Ontario: Train The Trainer 3. Health Care Consent and Advance Care 4. Planning for Health Care Practitioners with a focus for physicians
If at any time you wish for one of the consultants to facilitate an educational session for you please contact us at our office. 905-827-8111
MH LHIN Falls Prevention Strategy Michelle Collins, Senior Lead Health System Performance
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