Welcome to the Mississauga Halton LHIN Governance to Governance - - PowerPoint PPT Presentation
Welcome to the Mississauga Halton LHIN Governance to Governance Session: Health Links October 3, 2013 Please enjoy something to eat and introduce yourselves to others seated at your table. The session will begin at 6 P.M. Mississauga Halton
October 3, 2013
Please enjoy something to eat and introduce yourselves to others seated at your table. The session will begin at 6 P.M.
October 3, 2013
Helen Angus, Associate Deputy Minister Transformation Secretariat, MOHLTC
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Agenda Item Lead Time Welcome Graeme Goebelle Chair, MH LHIN Board of Directors 2 minutes Introduction of Guest Speaker Bill MacLeod CEO, Mississauga Halton LHIN 3 minutes Provincial Overview of Health Links Helen Angus Associate Deputy Minister, Transformation Secretariat Ministry of Health and Long-Term Care 20 minutes Local Approach and Development Liane Fernandes Senior Director Health System Development & Community Engagement, MH LHIN 15 minutes Our Health Links, Our Opportunity – Facilitated Discussion (including Break) Carie Gall and Susan Swartzack Senior Leads, Health System Development, MH LHIN 55 minutes Report from Community Governance Consultation Group Jeannie Collins-Ardern Co-Chair, CGCG Chair, Links2Care 20 minutes Closing Remarks Graeme Goebelle Chair, MH LHIN Board of Directors 5 minutes
Graeme Goebelle Chair Board of Directors Mississauga Halton LHIN
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Bill MacLeod CEO Mississauga Halton LHIN
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Mississauga Halton LHIN: Governance to Governance October 3, 2013
$Billions
Health care spending since 2003
20 25 30 35 40 45 50 03/04 04/05 05/06 06/07 07/08 08/09 09/10 10/11 11/12 12/13 13/14 14/15
A C T U A L P R O J E C T E D
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Too many people relying on Emergency Rooms
instead of receiving the right care in the community
Too many people are having trouble navigating
the system
Too many ALC patients Too many people being readmitted to hospital
within days of leaving hospital
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To make Ontario the healthiest
place in North America to grow up and grow old
A system focused on wellness Faster access to family health
care that serves as the hub of their health care system
Better integration and
accountability
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Leadership from theSector Enabling Environment
(Government)
Transforming System (Together)
What does it mean for the patient? Better experience Improved outcomes Healthier lifestyles What does it mean for the system? Fiscally sound system Better quality of care
contribute
Health System Redesign allows for more flexible models of health care delivery which promote access and quality but also allows for services to be provided in a fiscally sustainable manner.
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Health System Funding Reform (HSFR): Promotes quality, value and efficiency Better reflects needs of the community Promotes more equitable allocation of health care dollars Optimizes health care investments Adopts and learns from approaches used in other jurisdictions
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Quality-Based Procedures (QBP)
(Price x Volume) + Quality -
evidence based clinical pathways ensure quality standards
Opportunity for process
improvements, clinical re- design, improved outcomes, and enhanced experience
Hip Knee Chronic Kidney Disease Cataract
Health Based Allocation Model (HBAM)
Inform funding allocations to health service providers Management tool to assist with health system service
planning
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Specialized Clinics: ♦ Building on successful community clinics (e.g. Kensington Eye Institute), the Ministry will shift certain procedures (cataracts, colonoscopy, dialysis) into the most appropriate setting to get the best results for patients by expanding community-based Specialty Clinics ♦ Leverage competitive pricing model and quality-based procedure alignment through Health System Funding Reform (HSFR) where funding is based on the services provided through patient-centered care Community Services: Creation of Birth Centres ♦ Providing women with more choice
through two new midwife-led birth centres Care transition for Seniors: ♦ Helping seniors transition home sooner from the hospital while also providing higher levels of care to long-term care residents with complex needs ♦ Repositioning some Long Term Care capacity as short stay centres to manage complex care conditions in the short term before resuming home care
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Model
providers with improving care coordination & integration at the patient level
Target Group
health conditions and seniors.
Initial Success
coverage across Ontario.
Role of LHIN’s
development, and providing oversight for Health Links in their regions.
Looking Forward
patients.
Success
group; typically have 2 key characteristics: – They receive treatment from multiple health care sectors; and/or – They have long lengths of stay in inpatient settings.
episode is similar for high cost and all users. However, high cost users access a larger number of health care sectors
patients/expenses & have the highest average cost per patient.
Proportion of Ontario Patients Proportion of Costs
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Population Coverage: 5,827,660
Total Number of High Users: 523,230
Over 650 Partners
submitted proposals to ensure full coverage within their boundaries.
Care Coordination and Care Plans
common principles for coordinated care plans so all complex patients in Ontario have the same experience
for complex patients through the expertise of an interprofessional health team Patient Engagement
involvement of patients, families and caregivers in all stages
a part of the development of his/her individual care plan
patient, caregiver and/or family perspectives into the coordinated care design process
Alignment of Initiatives and Resources
existing resources to strengthen and align work
agencies and associations to strengthen
champion the Health Links model
existing infrastructure and assets, and build
innovations EMR / IT
provincial assets for local solutions
electronic health providers to align current assets with Health Links needs
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work together to identify new complex care patients, and provide support within the circle
and participation:
– 9 led by hospitals – 14 FHT led and 1 FHO led (primary care) – 6 CHCs – 3 CCACs – 4 Community Service Organizations
providers will increase, providing many potential access points for users of the health care system
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to work together based on needs of patients and communities
their LHINs
relationships
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Hospital Long-Term Care Homes Specialists Home Care Allied Health Professionals
Health Links
Primary Care Physicians Community Support Services Consistent Province Wide Principles Patient Engagement EMR/IT Mechanisms and Tools Others Coordinated Care
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assist Health Links in developing coordinated care plans
records and add new functionality:
– Allow circle of care to store, modify, share coordinated care plans for patients – Include progress notes for patients – Provide access to organizational and circle of care providers
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Health Links, LHINs, HQO, CCACs, CHCs, FHTs, and other providers
Links in 2014
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Strong involvement of patients, families and caregivers in all stages Making the patient a part of the development of his/her individual care plan Incorporating patients, caregivers and/or families perspectives into the coordinated care design process
Patient Passport Guelph HLt Patient Family and Community Engagement Working Group SE Mississauga HLt Care Coordination Consultation South Georgian Bay HLt
Patient Identification
Labs in Central West)
Provider Collaboration
Patient Engagement
complex patient to a FHT, Hamilton creating care plans for their complex patients
Care Planning
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Provincial Role
Alignment of Resources Indicators & Measurement IT Support Barrier Removal Leadership & Engagement Evaluation & Sharing Best Practices 21
the right supports, but allow local solutions to develop the “how” that can be expanded at scale
adopters
solutions
Creating & Building
Learning & Sharing
province
for patients
relationships across all sectors
Scaling Up & Sustaining
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Governance to Governance Session Presentation
October 3, 2013 Liane Fernandes Senior Director, Health System Development & Community Engagement
in the MH LHIN
priorities
agenda
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A new way of organizing health care services for people with the highest, most complex needs. Focus on improving connections among health providers across the continuum to coordinate care plans for these individuals. Help close the gaps that occur when a patient moves from one provider to another.
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The goals of Health Links are to: 1. Improve care delivery (e.g. appropriate system utilization, coordinated care) 2. Improve patient experience* 3. Deliver better value for money and reduce costs
*Focus initially is on high users of the health care system
Multiple Conditions Frequent access at multiple entry points Sub-optimal, uncoordinated care Duplication of services
Less than positive patient experience
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Population based, integrated health care planning approach within local geographies with a focus on complex and at-risk individuals
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Step 1 Step 2 Step 3 Step 4 Step 5 Step 6
Initial Engagement Readiness Assessment Design and Business Case Health Link Kick Off Link Operations and Monitoring Health Link Evaluation
(South) East Mississauga (early adopter) South Etobicoke Halton Hills South West Mississauga North West Mississauga Oakville Milton 14 14
(Joint accountability among partners)
1. Increase the number of complex patients and seniors with regular and timely access to a primary care provider 2. Ensure the development of coordinated care plans for all complex patients 3. Ensure primary care follow up within seven days of discharge from an acute care setting 4. Reduce avoidable ED visits for patients with conditions best managed elsewhere (CTAS IV and V) 5. Reduce admissions to hospitals 6. Reduce the time from primary care referral to specialist consultations 7. Reduce 30 day readmission to hospital 8. Reduce the time from referral to home care visits 9. Enhance the health system experience for patients with the greatest health needs
health services to patients without compromising the quality of care
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In support of the provincial vision of ‘Making Ontario the healthiest place in North America to grow up and grow old’
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To improve patient experience To improve coordination of care To achieve better value for investment Targeting patients with complex needs (high users)
Milton Health Link Halton Hills Health Link Oakville Health Link North West Mississauga Health Link South West Mississauga Health Link (South) East Mississauga Health Link South Etobicoke Health Link
Accessible & Sustainable Health Care Optimal Health – Mental & Physical Family Health Care When You Need It Enhanced Community Capacity Enablers Shared Purpose MH LHIN Strategic Priorities Health Links Strategic Alignment High Quality Person-Centred Care
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promote knowledge exchange, sharing and scalability
success, with a particular focus on primary care access
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Liane Fernandes
Senior Director, Health System Development & Community Engagement Liane.Fernandes@lhins.on.ca
Carie Gall
Senior Lead, Health System Development – Halton Health Links Carie.Gall@lhins.on.ca
Susan Swartzack
Senior Lead, Health System Development – Mississauga & Etobicoke Health Links Susan.Swartzack@lhins.on.ca
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from receiving optimal care & patient experience?
to achieve the shared purpose of Health Links and improve the patient experience?
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Jeannie Collins-Ardern Co-Chair Community Governance Consultation Group Chair, Links2Care
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responses received.
not identify themselves or their organization.
focus for the next year.
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Answer Options Response Percent Response Count Represent community HSPs with the MH LHIN regarding G2G session development. 70.0% 21 Represent community HSPs with the MH LHIN regarding governance matters. 66.7% 20 Increase your HSP's profile within the MH LHIN. 63.3% 19 Distribute sample governance templates. 46.7% 14 Facilitate sharing among HSPs of resources and best practices for governance effectiveness. 46.7% 14 Provide HSPs with opportunities to participate in presentations and workshops. 43.3% 13 Provide a reference library (or web links) to governance literature. 40.0% 12 Provide governance training. 40.0% 12 Represent community HSPs with the MH LHIN regarding other matters aside from governance. 36.7% 11 Assist HSPs through accreditation by connecting them with similar accredited HSPs, sharing templates, etc. 36.7% 11 Other (Please provide details in the Comments box below.) 6.7% 2 5 30 30 4 Please indicate the roles that your organization would like the CGCG to fulfill. (Check all that apply.) Comments for Questions 4, 5. skipped question answered question
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Answer Options Response Percent Response Count Yes, but we do not have sufficient budget for as much training as we should have. 60.0% 15 Yes, we use United Way training as well as other training courses and seminars. 40.0% 10 Yes, but due to budget constraints training is available only through coaching, not through courses or seminars. 28.0% 7 Yes, board members may take any governance training that they wish at the organization's expense, subject to a board-wide budgetary cap. 20.0% 5 No, we believe that there is enough free information on the web that board members can and should train themselves. 16.0% 4 No, we have neither the budget nor the resources for training the board (but ideally would subsidize training). 8.0% 2 Yes, but we only use United Way training because of cost considerations. 8.0% 2 No, we believe that board members should pay for their own training. 4.0% 1 No, all our board members have sufficient experience to not require governance training. 4.0% 1 Yes, but board members are required to pay at least a portion of the cost. 4.0% 1 5 25 25 9 Do your board members have the opportunity to receive subsidized governance training? (Check all that apply.) Comments skipped question answered question
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Answer Options Response Percent Response Count Yes overall, but some board members do not have sufficient knowledge through training and/or experience. 56.0% 14 No overall, despite some of our board members having sufficient knowledge through training and/or experience. 36.0% 9 Yes, all board members have sufficient knowledge through training and/or experience. 8.0% 2 No, none of our board members have sufficient knowledge through training and/or experience. 0.0% I don't know (please explain in the Comments box below.) 0.0% 2 25 25 9 Comments for Questions 21, 22, 23. skipped question answered question Do you believe that your board has sufficient risk management knowledge?
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* From a selected list of risks provided.
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Response Percent Response Count 24.0% 6 44.0% 11 48.0% 12 12.0% 3 12.0% 3 16.0% 4 24.0% 6 4.0% 1 9 25 25 9 Yes, we can share by coaching. Comments Yes, regarding the quantity of services provided. No, we prefer not to share our service metrics or tools skipped question Yes, we can share by providing samples of metrics, I don't know. Answer Options No, we do not have good service metrics or tools to answered question Yes, regarding the quality of services provided. Maybe (please give specifics in the Comments box Does your organization have any unique service metrics or tools that you would be willing to share with others? (Check all that apply.)
Question: Please indicate how your organization would prefer to interact with the CGCG.
CGCG related MH LHIN staff.
GovernanceGroup@lhins.on.ca
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You can find a copy of this presentation at: www.mississaugahaltonlhin.on.ca For Health Service Providers Governance to Governance
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