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2 | P a g e
April 2015
The following is a compilation of the major activities/events undertaken during this
period in support of Mississauga Halton LHIN’s strategic directions;
Accessible and Sustainable Health Care
Improve access to services to improve consumer flow, quality and safety
Support consumers, families and health care professionals to navigate the health care
system
Improve sustainability of the health care system
Family Health Care When You Need It
Improve access to family health care
Increase linkages between family health care and other health care providers to improve
communication, coordination and integration across the continuum of care
Enhanced Community Capacity
Enable people to stay in their homes longer
Provide integrated services that bring care closer to home
Optimal Health – Mental and Physical
Increase healthy habits and prevention of disease
Build partnerships for healthy communities
High Quality Person - Centred Care
Support and foster a quality culture across the continuum of care
Value people’s experiences to support system improvement
Apply a health equity lens for the delivery of health care services
CONTENTS: MINISTRY OF HEALTH AND LONG-TERM CARE UPDATE 3 ANNUAL BUSINESS PLAN PRIORITIES 2015/16 5 Highlights 6 Accessible and Sustainable Health Care 7 Family Health Care When You Need It 12 Enhanced Community Capacity 14 Optimal Health – Mental and Physical 19 High Quality, Person-Centred Care 21 ACCOUNTABILITY 23 Ministry-LHIN Accountability Agreement 23 COMMUNITY ENGAGEMENT 26 COMMUNICATIONS 27
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April 2015
MINISTRY OF HEALTH AND LONG-TERM CARE UPDATES
Long Term Care Redevelopment
On October 28, 2014 the Associate Minister of Long Term Care and
Wellness announced the Ministry of Health and Long-Term Care (the
ministry) is engaging the Long-Term Care (LTC) sector to deliver on
a number of components that will enable the success of the Enhanced
Long-Term Care Home Renewal Strategy.
Across the province there are approximately 30,000 beds, located in
over 300 homes that have been identified for redevelopment. For the
Mississauga Halton LHIN this equates to a total of 10 homes and
1,336 beds.
The ministry is committed to working with stakeholder in the LTC
sector throughout this process and has actively engaged and sought
advice from the Stakeholder Advisory Committee.
As a part of the process the ministry has sent out an “Enhanced
Strategy Survey” to all eligible LTC home licensees/approved
operators for municipal homes. This survey was issued in order to
gauge redevelopment interest and project readiness within the sector.
Respondents have been asked to complete the survey by May 1, 2015.
The ministry will be scheduling meetings with each LHIN to review
the homes that responded to discuss specific issues/plans identified in
the surveys.
On April 20, 2015 the Mississauga Halton LHIN met with ministry
representatives to have an in-person educational session by the
ministry to provide an overview of the renewal strategy. Priorities
and updates of the Mississauga Halton LHIN were shared with the
ministry. The topics covered by the ministry included:
1) Overview and current status of Enhanced Long-Term Care
Home Renewal Strategy including:
• Updates to the Construction Funding Subsidy (CFS) Policy
• Design Standards (including the review process for
variance requests)
2) Licencing 101
Budget Update
The Provincial Budget has now been tabled in the legislature and it
aligns with the previous information and directions that had been
communicated to the Board. The growth in the Health component of
the Budget will still be less than the combined effects of inflation,
population growth and aging. Specific funding allocations will be
available within the next 3 to 4 weeks as the Ministry begins the roll-
out process. We have already been informed of our Health Links
allocation and can begin our own work on delineating the 2015-16 use
of those funds.
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April 2015
Home and Community Care Report
The Report of the Expert Panel has been released for public comment
and feedback and has been generally very well received. The
Ministry anticipates that they will be in a position to shortly release
their response to the Report. Discussion of the implications for the
LHIN will form part of future Board discussions as the Chair of the
panel, Gail Donner, will be the guest speaker at the Board Retreat in
June.
Capacity Planning Report
The Joint Seniors Capacity Planning process with Central West LHIN
is now complete. We have prepared a summary version of the report
that presents the high level findings as well as some of the Policy
implications for the changes in emphasis and direction that are
recommended. The report and methodology has been presented to all
of the other LHINs and received very positive feedback. We have
entered into discussions with the Ministry of Health on some of the
province-wide implications for the methodology.
Pan LHIN activities
The 14 LHINs have been actively pursuing a joint strategic agenda for
common priorities. These have been identified and have now been
cross referenced with the guidance provided by the Assistant Deputy
Minister on Ministry priorities for the upcoming IHSP process. The
concept of common priorities is that the LHINs will conduct some
collective work in these priority areas and then share that as better
practice across all LHINs. We believe this will accelerate the process
of improving Health Services across the province. The list of Pan
LHIN Priorities and CEO Leads is as follows:
PanLHIN Priorities CEO Leads
1. Mental Health Louise Paquette / Bruce Lauckner
2. Health Links Paul Huras / Laura Kokocinski
3a. Home & Community Care Laura Kokocinski / Gary Switzer
3b. Long Term Care Deb Hammons / Donna Cripps /
Bruce Lauckner
4. End of Life/Palliative Care Bill MacLeod / Gary Switzer
5. Patient Experience Kim Baker / Gary Switzer /
Michael Barrett / Jill Tettmann
6. Population Health Scott McLeod / Camille Orridge
7. Innovative & Sustainable
Service Delivery
Bill MacLeod / Chantale LeClerc
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April 2015
PROGRESS ON ANNUAL BUSINESS PLAN PRIORITIES 2015/16
ACCESSIBLE AND SUSTAINABLE HEALTH CARE FAMILY HEALTH CARE WHEN YOU NEED IT ENHANCED COMMUNITY CAPACITY OPTIMAL HEALTH – MENTAL AND PHYSICAL HIGH QUALITY PERSON-CENTRED CARE
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April 2015
REPORT HIGHLIGHTS
Ministry commits to working with LHINs and engaging
stakeholders for a successful in the new Long-Term Care renewal
strategy implementation.
Mississauga Halton LHIN endorsed Trillium Health Partners
(THP) combined Stage 1 Proposal and Stage 2 Functional
Program of the proposed Courtyard Project.
To inform the development of integrated community hubs,
Mississauga Halton LHIN will create neighbourhood profiles to
help identify regions that may be underserviced and have barriers
to accessing health and social services.
Addiction and Mental Health Adult Services Central Intake
initiative one-Link, moves ahead with plan-do-study-act (PDSA)
cycles at THP and Halton Healthcare Services including internal
testing of new common referral forms, tools and processes.
The Honourable MPP Kevin Flynn, Minister of Labour kicks off
Every Door is the Right Door, a Mississauga Halton LHIN event
dedicated to Customer Service Training in healthcare with a focus
on the eight (8) No Wrong Door Principles.
The second annual Primary Care Clinic day was held on March
27, 2015 with over 160 delegates registering for the event.
The Mississauga Halton LHIN hosted its second annual Health
Equity Symposium on Monday March 23, 2015 at the Centre for
Health and Safety Innovation.
MPP Flynn announces $2 million in mental health and addictions
funding for Mississauga Halton LHIN
UPCOMING EVENTS
Event
Date
Milton District Hospital Groundbreaking May 25, 2015
Governance to Governance Session
June 8, 2015
CGCG Meeting
June 8, 2015
Community Quarterly Sector Meeting
June 18, 2015
Board Retreat
June 19/20, 2015
Pan Am Games
July 10-26, 2015
Parapan Am Games
August 7-15, 2015
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April 2015
ACCESSIBLE AND SUSTAINABLE HEALTH CARE
Life or Limb & Repatriation Policy Evaluation
The provincial life or limb policy is a “no refusal” policy for patients
with life or limb threatening conditions with the guiding principles of
the policy being triggered when a patient is life or limb threatened and
therapeutic options exist, which are needed within four (4) hours.
The Provincial reports are populated into the Mississauga Halton
LHIN Performance Scorecard System to inform, trend and monitor
performance. The system performance includes:
Follow-up letters for defined cases within two (2) business days
Weekly Life or Limb Reports
Hospital Performance
System Response Reports
Monthly Life or Limb Summary Reports.
The Mississauga Halton LHIN has collaboratively engaged in ongoing
communication, meetings and evaluations with the hospitals since the
inception of the policy in January 2014. The Mississauga Halton
LHIN’s performance is aligned to the provincial targets and is
trending well.
Mississauga Halton Life or Limb System Indicators April 2014 – March 2015
( Halton Healthcare Services and Trillium Health Partners)
System Indicators Year to Date (YTD)
Number of Requests for Consult 560
Number of Cases Referred 460
Number of Cases Confirmed as Life or
Limb
250
Percentage of Patients Arrived at
Designated Site Within the 4 Hour
Timeline
96.5
Mississauga Halton Repatriation June 2014 - February 2015
System Indicators Total Cases (YTD)
Repatriation – Sending 140
Repatriation – Receiving 72
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April 2015
Emergency Preparedness and Management
In preparation for the Toronto 2015 Pan Am/Parapan Am Games
2015, the Mississauga Halton LHIN actively participated with the
Ministry of Health, Regions, Hospitals and LHINs in a three day
“Celebratory Spirit Exercise” from April 14 – 16, that tested our
emergency preparedness. Over 40 hospitals along with 3 Community
Care Access Centres (CCACs), Public Health Units, LHINs,
paramedic services, and other organizations participated in mock
scenarios such as tornados, train derailment, outbreak, and heat, where
a newly implemented emergency management communication tool
(EMCT) was tested. As the Mississauga Halton LHIN further
prepares for the Games beginning July 10, 2015 and the beginning of
athlete arrival in June, emergency preparedness for all HSPs is a top
priority.
Regional Access and Flow
The Mississauga Halton LHIN is responsible for planning,
coordinating and allocating resources to hospitals and community to
ensure patients receive the right care based on their needs in the right
setting, and to heighten patient flow and transition through the
continuum of care across the region. To help facilitate patient flow
and transition, the newly revised Regional Access and Flow
Committee has included in the proposed terms of reference, a patient
first philosophy of care with a focus on seamless transitions within
and throughout the health care continuum. This will be achieved by
implementing a responsive, flexible, system-wide approach that
fosters a culture of regional collaboration, transparent communication,
system integration and accountability.
Connecting GTA (cGTA)
cGTA is a regional solution that supports the delivery of provincial
electronic health records by linking and integrating electronic patient
information from across the care continuum and making it available at
the point-of-care to improve the patient and clinician experience.
There are currently 16 data contributing sites across multiple LHINs
that are part of the early adopter phase of the project. The second
phase will expand to other data contributing sites and Health Service
Providers who will gain view only access to the cGTA data. Trillium
Health Partners (THP) is part of the early adopter phase and Halton
Healthcare Services (HHS) will be a data contributing site within the
expansion phase. Additionally within the expansion phase, four of
our HSPs will gain view only access. Kick off meetings took place in
Q4 2014/15 with our participating organizations. Planning activity is
underway and will continue into the fall of 2015.
Resource Matching and Referrals (RM&R) Clusters
Resource Matching and Referral Business Transformation Initiative
(RM&R BTI) program provides a way to streamline the complex
patient referral environment across Ontario.
Within the Mississauga Halton LHIN, our participating organizations:
THP, HHS and the Mississauga Halton CCAC have successfully
implemented the Provincial Referral Standards (PRS) for all defined
pathways. Work continues at a Provincial level into fiscal 2015/16 to
ensure all pathways have completed their implementation work across
all targeted organizations.
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Community Engagement
Communications
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April 2015
Governance to Governance Collaborations
Governance to Governance (G2G) session held on March 31, 2015
focused Personal Health Information Protection Act (PHIPA)
education and the Board’s role in privacy and data security. The
speaker was Robin Gould-Soil, Director Privacy and Access, and
Chief Privacy Officer, University Health Network who has expertise
in both the private sector as well as with the Office of the Privacy
Commissioner of Canada. She reviewed the PHIPA, provided her
perspective on what the new Privacy Commissioner of Ontario (Brian
Beamish) is focused on, and presented on the current privacy
landscape and the Board’s role in privacy and date security. The
session was well attended and the HSPs appreciated the opportunity to
ask their specific organizational questions throughout the session.
Feedback from this session was excellent as shown by some examples
of comments from the survey:
“The speaker was very knowledgeable and did a great job at
addressing concerns from the audience. It was a great way to
share relevant information.”
“Will serve as a good reference in future governance
discussion.”
“Although my knowledge on the subject matter is very high,
it's helpful to have a third party reiterate what I have been
requesting of my staff.”
“Important topic which could cause a great risk to our
organization if not handled properly”
“Gained a more comprehensive understanding of what is
required and current trends and process required in the
training of staff and recognizing our obligations for
compliance.”
The Community Governance Consultation Group (CGCG) is a LHIN
sponsored group consisting of 12 Board Chairs and Board Members
from our Community HSPs and three Mississauga Halton LHIN
Board members. The group met on March 31, 2015 and provided
very positive feedback on the Privacy and Data Security G2G session
and identified a future consultation to be held on June 8, 2015 on the
Integrated Health Service Plan (IHSP).
Capital Planning and Development
Trillium Health Partners
The Mississauga Halton LHIN provided a letter to the Ministry of
Health and Long-Term Care on January 15, 2015 endorsing the
combined Stage 1 Proposal and Stage 2 Functional Program of the
proposed Courtyard Project.
Community Capital
The Mississauga Halton LHIN has been working at identifying high
needs neighbourhoods using social risk indicators. The creation of
neighbourhood profiles will help to identify neighbourhoods that may
be underserviced, and may have barriers to accessing health and social
services. Profiles for neighbourhoods across the Mississauga Halton
LHIN will be used to inform the development of integrated
community hubs. Early visioning for this model includes a preferred
mix of health, social and recreational services designed to meet the
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needs of the local community. Broader stakeholder input into the
development of neighbourhood profiles will include local community
agencies to validate identified neighbourhoods and the potential
service needs.
Telemedicine
A small working group has been struck to develop strategic priorities
and a revised work plan for 2015-2016. The Group will also look
closely at the purpose and role of the committee members. With this,
new opportunities and technology will also be considered in addition
to the current telemedicine activities within our region.
Health System Funding Reform
In the context of mobilizing effort to implement Health System
Funding Reform (HSFR), a multi-year implementation provincial
funding policy, a regional group of HSPs convenes at the HSFR Local
Partnership Committee to discuss local impacts, implications and risks
associated with the implementation, and related mitigation strategies
for Quality Based Procedures (QBPs). The Committee is developing
its 2015/16 workplan and will incorporate feedback from the annual
evaluation of Committee objectives. Local efforts will include
ongoing performance evaluation of quality based procedures and
opportunities for regional collaboration; volume planning and
management and implementing a data quality framework.
Regional Hospice Palliative Care
The Regional Hospice Palliative Care Steering Committee (RHPCSC)
is considering a “Lead” vs “Host” model. Plans for issuing a “request
for interest proposal” to implement the model were delayed at the
request of the Mississauga Halton LHIN pending further information
from the newly formed Provincial Palliative Care Network (PPCD)
initiative. In the interim, the RHPCSC is working to complete a
palliative care inventory in the Mississauga Halton LHIN.
The Mississauga Halton LHIN invested in the Learning Essential
Approaches in Palliative Care (LEAP) with four courses presented in
late 2014-2015. There are now nine trained facilitators in place
delivering a consistent course. Ninety-three individuals completed the
LEAP course (including 35 MDs, 45 RNs). Mississauga Halton
LHIN is now working with Dr. Bob Sauls on a business case to
continue the investment in this important training.
Acclaim Health, Heart House Hospice and Dorothy Ley Hospice’s
business case for a regional Spiritual and Bereavement Service
Delivery Program was LHIN approved and funded. Full
implementation of the program will continue to progress through
2015/16.
The LHIN attended the annual Hospice Palliative Care Ontario
(HPCO) conference on April 19 - 21, followed by an all-day meeting
on April 22 with the Provincial End-of-Life Care Network and LHIN
Leads for Palliative Care.
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April 2015
Addictions and Mental Health
one-Link
The development and implementation of the Addictions and Mental
Health system access model one-Link continues. Throughout the
winter the new referral form and screening tools began internal testing
cycles at both THP and HHS. The new service resolution protocols
for case collaboration were being trialed and refined. Lean
methodology specialists mapped current intake processes at all ten
addictions and mental HSPs in preparation for upcoming wait list
management integration planning. Peer Support positions were
developed and hired to provide planning support during the
implementation phase and wait list management support. These
continual cycles of testing and refinement throughout the development
and implementation phase ensure that the system will have the
capacity and capabilities to manage the demand when the service is
launched.
“Every Door is the Right Door” Service System
Peel Addiction Assessment and Referral Centre (PAARC) was
identified as the lead agency to implement system wide (Mississauga
Halton LHIN) adoption of the No Wrong Door principles among the
participating Addictions and Mental Health agencies. This is a
philosophy of care based on eight (8) core principles, namely:
creating a welcoming culture; common practices and standards for
establishing client needs; collaboration and information sharing;
informed consent; shared educational opportunities; informing the
community about wait times, clearly stating eligibility criteria; and
timely service resolution. A charter was created to demonstrate a
commitment to adopting these principles and was signed by all ten
Mississauga Halton LHIN funded organizations. It was also signed by
two non-Mississauga Halton LHIN funded agencies. A celebration
and training event for Addictions and Mental Health organizations
was hosted on March 20 that included some opening and closing
remarks from key individuals from the community and the LHIN, as
well as a keynote from The Honourable MPP Kevin Flynn, Minister
of Labour. A half day dedicated to Customer Service Training in
healthcare was presented with a focus on the eight No Wrong Door
Principles. The participating agencies were acknowledged with a
presentation of a Mississauga Halton LHIN certificate of achievement
for their commitment to this philosophy of care.
Above: Graeme Goebelle (Chair, Mississauga
Halton LHIN)
MOHLTC Updates Annual Business Plan
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Left to right: MPP Kevin Flynn (Oakville), Betty-Lou
Kristy, Graeme Goebelle (Chair, Mississauga Halton
LHIN)
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April 2015
FAMILY HEALTH CARE WHEN YOU NEED IT
Electronic Medical Record (EMR) Implementation
OntarioMD manages the program, which is funded by eHealth
Ontario, and provides assistance to physicians in the adoption and
implementation of funding eligible EMR offerings.
The Mississauga Halton LHIN EMR adoption rate as of March 31,
2015 is 86%. This is 4% higher than the Provincial average. As
Trillium Health Partners gets closer to implementing Hospital Report
Manager (HRM), there should be an increase in adoption of EMRs
since HRM will enable physician EMRs to automatically receive
hospital discharge reports for their patients.
Hospital Record Manager (HRM) Implementation
OntarioMD's HRM enables physicians using EMRs to receive direct
electronic hospital reports into their patient's medical record within 30
minutes of transcription.
HHS has been live with HRM for approximately one year. Initial
delays in testing HRM have led to the decision for THP to hold off
until the fall of 2015 to resume implementation.
Primary Care Integration Strategy
The Primary Care Integration strategy, designed to improve access to
primary care and increase linkages between Primary Care and other
health care providers, is working towards initiatives that will build
awareness of health care system resources and capacity within the
Primary Care sector.
Primary Care Advisors Primary Care Advisors have launched their role and have started
meeting with Primary Care Physicians across the LHIN. Their initial
foci include: introducing their role; promoting the eConsult initiative,
Falls Prevention & Exercise programs, and CCAC’s Advanced
Palliative Care program along with an upcoming Oncology Day.
Primary Care Clinic Day The second annual Primary Care Clinic day was held on March 27,
2015 with over 160 delegates registering for the event. Over the
course of the day, Primary Care Providers learned about: clinical
topics including palliative care, geriatrics and caring for complex
patients; practice related topics such as billing codes and new regional
initiatives such as eConsult, and the eCompendium. The Primary
Care Network held their official launch at the event where keynote
speaker Dave Howlett spoke about breaking down silos and using
networks to enhance patient care. The delegates networked with
colleagues from their subLHIN geographies over lunch through
discussions facilitated by their Primary Care Network core member
and corresponding Primary Care Advisor. Within the exhibit hall,
Primary Care Providers were able to connect with 45 HSPs and
agencies to learn about the services and resources available within our
LHIN. The day was a great success with delegates commenting that
sessions offered practical relevant information that could be applied to
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their practices and the presence of community providers provided a
valuable opportunity to become aware of resources they can access.
MOHLTC Updates Annual Business Plan
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Left to right: Primary Care Advisors: Shellie Diplock, Lindsay Fedchyshyn, Maged Guirguis,
Kristen Raiskums, Dave Howlett (Keynote Speaker at Primary Care Day 2015), Jennifer Tran
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April 2015
ENHANCED COMMUNITY CAPACITY
Seniors’ Strategy
The Seniors’ Strategy Steering Committee met in March to receive an
overview of the results of the Collaborative Community Capacity
Study. Continued review of the results, along with region reports and
provincial reports will be used to help determine the priorities for
2015 - 2016 planning for care for seniors in our communities.
The Senior Friendly Hospital Working Group will be implementing
the new Delirium Indicator as per their HSAAs for each hospital
respectively. The Working Group will continue to meet to further the
Senior Friendly Hospital Initiative, considering the Functional Decline
Indicator next.
The Specialized Geriatric Services program provided a summary from
a regional planning day, held on October 28, 2014. The summary
included:
Next steps from Year 1 (2015/16)
Principles of services design
Defined goals and improvement activities.
Advancement of Community Practice
Respite
The Caregiver Respite Program continues to target caregivers whose
loved ones have high needs/high acuity. Referrals to the program are
made to the Central Registry with one number to call. Respite
Advisors are in place and accessible through Central Registry. They
provide assistance with choice and navigation to the five (5) respite
services available. Some recent accomplishments include:
Development of processes for the newly appointed respite
advisors
Central Registry website is live, allowing for electronic
referrals and a central private information repository
Implementation of monthly minimum usage of eligible respite
hours, and reallocation of funding to support higher needs
clients (80% of funding going to highest needs)
Transformed two recovery beds at OSCR to short stay respite
beds (first clients were in early April, 2015)
Expanded on-site adult day services bathing program in select
sites
Implemented LHIN monthly data collection
Defined the criteria for emergency respite services.
Respite Program In-Home Respite Services Research Study
Completion of the University of Waterloo research study on the
Respite Program In-Home Respite Services concluded March 2015.
While the contribution of informal caregivers has been recognized as
a crucial factor in health system sustainability, limited attention has
been paid to how best to support caregivers. The objective of the
research collaborative between the University of Waterloo and the
Mississauga Halton LHIN was to evaluate the Caregiver Respite In-
Home Respite Services in order to identify if the right individuals
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were targeted for the service (high need/high acuity individuals and
their caregivers), if the service provided a positive impact that could
be measured, and if there was a return on investment from the service.
Initial analysis indicates that the Caregiver Respite In-Home Respite
Service has been potentially delaying LTC admission, resulting in an
annual saving to the system of an estimated $1.1 million dollars over
the two years of the program. Further, the analysis suggested that
some of the quality of life indicators experienced by the caregiver
predict care recipient admission to LTC. Results of the study are also
being used to inform interRAI’s ongoing refinement of the interRAI
Caregiver Survey.
The study also included the development of a new caregiver respite
assessment survey which will be trialed internationally.
In summary, the research study demonstrated that the Caregiver
Respite In-Home Respite Service:
Is using appropriate eligibility criteria;
Has been focusing on caregivers with high respite needs (the
targeted group); and
Has a positive impact on caregivers. This is a successful
service that has been enabling the community dwelling frail
elderly to age in place.
The outcome of the research and the return on investment report will
be provided to the Mississauga Halton LHIN in June 2015.
Exercise and Falls Prevention
The Exercise and Falls Prevention Collaborative just completed a very
successful first year, where they began to map out a recommended
Exercise and Falls Prevention Strategy for the Mississauga Halton
LHIN.
The Collaborative developed a vision statement that will be used to
guide the work plans of the collaborative. The focus for fiscal year
2015/16 is the development of a client process map that highlights the
client’s journey through the continuum of care as it relates to Exercise
and Falls Prevention. The consensus amongst the collaborative
members is that an individual's health status as well as the home
environment has an influence the risk of having a fall, which is a
major threat to the health and quality of life of older adults. There
were a number of recommendations made by the collaborative
members that will be included in the development of our regional
Exercise and Falls Prevention Strategy.
Education and Development
The Education and Development Collaborative was developed in
response to the needs identified through the community engagement
sessions and informed through a diverse, multi-participant think tank,
and brainstorming sessions that identified the needs of the community.
The target population is the Mississauga Halton LHIN HSPs and
informal caregivers/family with a focus to strengthen the capacity of
direct care providers (informal and formal caregivers) through
education and focused training to transfer new knowledge and best
practice skills.
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Leadership, education, resource library, and wvaluation were four
areas acknowledged as the foundation for the work/action plan that
aligns with the collaborative’s shared purpose: We will standardize the
methodology for the development and dissemination of evidenced
informed leading practice, aligned with continuous quality
improvement initiatives that advance the skills and
knowledge of HSPs, and informal caregivers/family within the
Mississauga Halton LHIN community.
Regional Learning Centre Update
The Mississauga Halton Regional Learning Centre has been created
for the community as an innovative educational resource to help
educate, train and support HSP staff and management as well as
caregivers in the Mississauga Halton LHIN.
Educational services and sessions began in June 2014. The total
number of educational sessions and participants both on-site and off-
site locations completed by the Community Educators in the first year
of operations at Regional Learning Centre exceeded the expectations
of the Mississauga Halton LHIN with results demonstrated in the
following table:
Continence
Continence Care Collaborative
The purpose of the Continence Care Collaborative will be to improve
the health, wellness and quality of life for Mississauga Halton
residents by improving access to assessment and treatment of
incontinence including urinary incontinence, fecal incontinence and
constipation. The inaugural meeting will be on April 30, 2015.
Mississauga Halton Regional Learning Centre Educational Sessions
June 2014 – March 2015
Session Number
Total number of educational sessions held on-site 99
Total number of educational sessions held off-site 7
Total Sessions 106
Participants Number
Total number of participants for on-site educational sessions 1,022
Total number of participants for off-site educational sessions 168
Total Participants 1,190
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Medication Management
Medication Management Interaction Levels Ranking Scale
(MMILRS) has been developed to determine the degree of
Medication Management (Interaction) in the Community Service
Sector programs for the purpose of developing policies and education
programs for better management of medication for clients on service.
Currently the HSPs are self-identifying their level, by program, using
the new ranking scale. The Collaborative is developing a medication
management framework and will be making recommendations to the
Regional Learning Centre to develop training based on client
interaction levels.
Behaviours
Fiscal year 2014/15 was a very busy year for the Behaviours
Collaborative. The membership consists of representation from every
sector of the Mississauga Halton LHIN and has varying levels of staff,
from front line to senior management, each bringing their own
valuable perspective to the table. With a vision to see “every
individual impacted by a responsive behaviour, has access to
coordinated, quality care and services”, the collaborative focused on
three specific areas:
Knowledge exchange and capacity building
System coordination
Service delivery
The achievements during this year included:
Revising the LTC and Adult Day Program (ADP) clinical
pathway documents
Formalizing the escalation process for complex behaviours
Creating an algorithm for various transfer points
Creation of a glossary of terms related to responsive
behaviours for consistent understanding across the various
sectors and HSPs.
The collaborative is now ready to start their work-plan for 2015/16
which will include:
Analyze and test the revised pathways and algorithms in the
appropriate settings
Creation of a guide book to accompany the revised pathways Development of a process map that will ensure system
navigation and coordination of client movement through the
continuum of care in the context of responsive behaviours
ensuring that we include the lived experience
Test and pilot the newly created algorithms for hospital to
LTC and LTC to hospital.
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Services for People with Development Disability
The Mississauga Halton LHIN, working in collaboration with partners
from Ministry of Community and Social Services (MCSS) and
Ministry of Child and Youth Services (MCYS) funded services, has
worked towards developing more comprehensive health services for
people with developmental disabilities. Establishing a cross ministry
working group with the Central West MCYS MCSS regional office as
well as the Halton Developmental Services Planning table the LHIN
has begun work in the following areas for 2015/16:
Analyze the number of individuals with a developmental
disability in LTC, and assess the need for specialized
education and support in the LTC sector
Pilot a standardized transitional plan for individuals with a
developmental disability to move from community settings to
LTC
Analyze Emergency Department (ED) use patterns of people
with developmental disabilities to develop possible diversion
strategies.
Improved Services for People with Complex Care Needs
The Mississauga Halton LHIN in partnership with its HSPs is working
to provide improved services for people with complex care needs.
Work underway for 2015/16 includes:
Analyze Emergency Department (ED) use patterns of people
living in supported housing, and with acquired brain injuries,
to develop possible diversion strategies
Establishing a Memorandum of Understanding between the
HSPs to create assisted living environments for individuals
with acquired brain injuries and other complex care needs
Enhancement of assisted living services in the community
allowing individuals with complex care needs to age in place
Formalizing Memorandum of Understanding between
Children’s Treatment Centre and Trillium Health Partners to
provide a swallowing clinic for children with complex care
needs, thus eliminating the need for families to travel out of
the Mississauga Halton LHIN for services.
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April 2015
OPTIMAL HEALTH – MENTAL AND PHYSICAL
Myhealth365
Myhealth365 is an integrative and innovative strategy with the focus
on both patient and provider. The strategy will closely follow
Ontario’s Patients First Action Plan for Health Care with a strong
focus on access, connection and information.
Myhealth365 builds on the previous successes of the Mississauga
Halton LHIN’s holiday surge work, namely, the valuable partnerships
across the region. However, in this iteration, it utilizes technology,
such as smartphone apps to make the process of finding care when
you need it user-friendly, cost-effective and quality controlled. The
strategy is also moving from a holiday centric strategy, to a year-long
strategy. In this way, we are reinforcing to residents of Mississauga
Halton their health is important every day of the year.
Most notably, two new aspects of the strategy are the implementation
of patient and provider profiles. With the patient profiles, residents
will now be able to save all their key information (e.g. local
pharmacy, physician’s hours) at their fingertips. Providers will be
able to create a login and update their information as changes occur,
therein, keeping clinic information up-to-date and accurate. This will
address any potential surge periods throughout the year as providers
will be able to update any clinic changes and it will be updated in real-
time. They will also be able to send messages to their patients, for
example, flu-shots or medication refills. Through this strategy
providers and residents alike will be able to be more proactive and
preventative than ever before.
To address the social determinants of health, patients will be able to
search for providers that are in their language of choice, where
parking is accessible and even where there are public transportation
options – removing those frequent barriers to care. The initiative is
currently going through its branding process and will have an official
launch this summer.
Chronic Disease Prevention and Management (CDPM)
The Chronic Disease Prevention and Management (CDPM) Regional
Advisory Working Group met in February after a successful
completion of the Mississauga Halton integrated model of chronic
disease prevention and management. The group has decided to do a
refresh, most specifically, looking at its governance model, terms of
reference, membership and its strategic plan for the 2015-2016 year.
The strategic plan will be aligned closely with the panLHIN strategic
directions for chronic disease prevention and management.
Key priority areas that have been identified in the Integrated Health
Service Plan (IHSP) 2013-2016 will be completed in the CDPM
strategic plan. Membership for the refreshed CDPM group will
include disease-specific sectors as well as the inclusion of community,
public health, persons with lived experience and self-management
with ad-hoc membership (e.g. primary care) as needed.
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Diabetes Central Intake
In November 17, 2014 the new eReferral system went live enabling
eReferrals between the Central Intake Program and the Diabetes
Education Programs. This is providing efficiencies in the internal
referral process between the Central Intake Program and the Diabetes
Education Programs and improved tracking mechanisms for referrals.
The eReferral system continues through the development phase and
launch to primary care is anticipated in Q2 2015/16. There were more
than 6000 Diabetes Education Program referrals processed through
Central Intake in 2014/15 and this represented a 212% increase in
number of referrals processed for the Diabetes Education Programs
versus 2013/14. An article highlighting the new e-referral system
being utilized in Mississauga Halton was published in Canadian
Healthcare Technology in March 2015.
http://www.canhealth.com/2015/03/ereferrals-used-to-manage-
diabetes-education/
Foot Care
The Mississauga Halton High Risk Diabetes Foot Care Program was
launched on May 20, 2014 by HHS with three community locations
(two in Oakville and one in Mississauga). This preventative foot care
program was established to support individuals in Mississauga Halton
with diabetes who are at high risk for complications and otherwise do
not have access to preventative foot care support. The program is
staffed by Chiropodists and Registered Practical Nurses with foot care
expertise. Eight accessible community locations were established in
2014/15. During the first year of the implementation, foot care
services were provided to 415 individuals. This number is expected to
increase with the addition of new sites in 2015/16. Referrals to the
program are only accepted from a Mississauga Halton LHIN Diabetes
Education Program and are processed through the HHS’ Central
Intake Program.
Foot care self-management Peer Education Program (PEP) workshops
will be established in collaboration with the diabetes education
programs. PEP is a standardized program created by the Canadian
Association for Wound Care to promote foot care self-management
skills and prevent foot ulcers. These self-management workshops will
support the High Risk Diabetes Foot Care Program. A standardized
screening tool and eligibility criteria for the High Risk Foot Care
Program has been established and extensive training has been
conducted with all diabetes education programs on the referral process
and implementing the 60 second foot assessment as a screening tool
for eligible clients.
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April 2015
HIGH QUALITY PERSON-CENTRED CARE
Health Equity
A key focus for the Mississauga Halton LHIN System Planning
Advisory on Health Equity was on data collection initiatives aimed at
collecting socio-demographic data to apply an equity lens to better
understand health outcomes as well as inform program development
and organizational outreach to marginalized groups. To aid in the
development of understanding health inequities, a work group was
established to review the tri-hospital "We Ask Because, We Care"
report. Key questions were identified to shape a survey on the types
of socio-demographic data currently being collected by HSPs and
community partners in Mississauga and Halton. The findings will be
utilized to design a foundational framework which will help inform
the development and implementation of a standardized data collection
tool and focused implementation sites.
The Mississauga Halton LHIN hosted its second annual Health Equity
Symposium on Monday March 23, 2015 at the Centre for Health and
Safety Innovation. The focus of the symposium was to provide a
better understanding of the why, how and what is behind collecting
socio-demographic client data. This was accomplished via key
presentations, engaging activities, and insightful discussion. The
symposium keynote speaker was Dr. Kwame McKenzie, an
international expert from the Wellesley Institute and the Centre for
Addiction and Mental Health, who provided great insight into the
importance of data collection.
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Above: Health Equity symposium keynote speaker: Dr. Kwame McKenzie
Above: Graeme Goebelle, Chair, Mississauga Halton LHIN
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French Language Services (FLS)
Across the province, Francophones organizations agreed on two
questions to better identify Francophones: 1) What is your mother
tongue? 2) If your mother tongue is neither French nor English, in
which official language of Canada are you comfortable to receive
services?
In order to have a better understanding of how health services
providers in the Mississauga Halton LHIN identify Francophones,
these questions were included in the data collection survey developed
in partnership with the Health Equity Advisory Committee.
FLS Identified and non -Identified organizations in Mississauga
Halton were asked to fill the annual FLS report on how they are
addressing the needs of the Francophone community. The results will
help to understand the French language capacity and the gaps within
the Mississauga Halton LHIN.
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April 2015
ACCOUNTABILITY
Ministry-LHIN Accountability Agreement (MLAA)
The 2015/16 M-LAA has 22 indicators across four (4) Ministry
priority areas aligned with the Patients First Action Plan for Health
Care as follows:
Home and community care
System integration and access
Health and wellness of Ontarians including mental health; and
Sustainability and quality.
Three indicator categories for inclusion in the MLAA include
performance, monitoring and developmental level indicators.
Timelines and determining the target-setting approach are in progress.
Mississauga Halton LHIN Performance Scorecard System
(PScS)
The Mississauga Halton LHIN PScS is a customized software
application that the LHIN introduced in early 2014. The tool allows
us to more effectively manage performance information and have the
results available on-demand to internal staff to support system
development and decision making. The tool has now been rolled out
to hospital and CCAC, Decision Support staff, and will increasingly
be used by HSP program staff (e.g. ED Leaders, Wait Times
Committee, etc.).
While the tool is primarily used to capture hospital data at this point,
the intention is to add more indicators from other sectors (e.g. CCAC,
Community, LTC) as the data becomes available in order to develop a
more complete system perspective.
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April 2015
Service Accountability Agreements (SAA)
Long-Term Care Home Service Accountability Agreement
(L-SAA)
All long-term care homes in the Mississauga Halton LHIN have
received their amended L-SAA. The LHIN continues to work with
the homes to ensure the homes understand the Performance Standard
changes, so as to have the SAA executed by way of signature. As of
April 16, 2015 there were 50 percent signed SAAs with the remaining
awaiting board meetings for signatures.
Multi-Sector Sector Accountability Agreement (M-SAA) The Local Health System Integration Act, 2006 (LHSIA) necessitates
that the LHIN have a SAA in place with each HSP they fund. The
Mississauga Halton LHIN and community based HSPs have entered
into M-SAAs for a three-year period effective April 1, 2014 to March
31, 2017. The planning for the 2014/15 Community Accountability
Planning Submissions (CAPS) and the M-SAA Schedules was
reviewed and updated to incorporate the financial, service
information, and performance expectations for fiscal 2015/16 and
2016/17. This process is defined as the 2015/16 CAPS and M-SAA
Schedule Refresh. We continue to work in collaboration with the
HSPs in the Mississauga Halton LHIN towards the completion
process of the M-SAA Refresh for 2015-16.
Hospital Sector Accountability Agreement (H-SAA)
Both Halton Healthcare Services and Trillium Health Partners have
executed their 2015/16 H-SAA. Both hospital corporations submitted
balanced budgets. The LHIN will continue to work with both
corporations to finalize and update performance targets. The 2015/16
H-SAA included local performance conditions as follows:
Health Equity;
French Language Services; and
Senior Friendly Hospitals.
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COMMUNITY ENGAGEMENT
Community Engagement (Patient/Family Committee
Participation)
A Community Engagement Framework has been developed and is
being implemented internally with Mississauga Halton LHIN. A large
community engagement effort will ensue during the months of May
and June to contribute to the development of the Mississauga Halton
LHIN’s Integrated Health Service Plan (IHSP) 2016-2019. Patients
First will be a priority approach to these engagement efforts. Putting
“patients first” means engaging with people within our individual
LHINs so that we fully understand their needs and we can respond
with investments and initiatives to strengthen the local health care
system so that it is more coordinated and a patient can get the right
care from the right providers.
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April 2015
COMMUNICATIONS
Media Relations Several news releases and media stories referenced Mississauga
Halton LHIN from February to April 2015.
News Releases
March 18, 2015 (Oakville) - Investing in Community Mental Health
And Addictions Services In Mississauga Halton LHIN - Ontario
Connecting People With the Care They Need Closer to Home
News Coverage – Mississauga Halton LHIN
Flynn announces $2 million in mental health and addictions
funding for Mississauga Halton LHIN - Oakville Beaver –
March 20, 2015
Those dealing with mental health and addiction will see $2 million
invested in services designed to help them, Oakville MPP and
Ontario Labour Minister Kevin Flynn announced Wednesday.
Publications
The Governance Centre of Excellence (GCE) presented their tenth
issue of Boards, its quarterly official publication and source for
articles, news, announcements and information from the field of
health care and not-for-profit governance.
The February 2015 issue contains an interview with Mississauga
Halton LHIN Vice Chair Ronald Haines (pages 12-13). In
addition, the GCE welcomed our newest board members - Mary
Davies, Patrick Hop Hing, Kimbalin Kelly and Gulzar Ladhani.
(Photo and bios pages 15-16)
To download Boards - February 2015 click here.
Engagements
Website
The Mississauga Halton LHIN website continues to be a primary
vehicle for both communication and engagement with our
stakeholders. Translation of website content into French is complete
and accessed by clicking on the Français tab on the page.
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Reports
Bringing Care Home
Modernizing home and community care is a
priority for the Minister of Health, and a key
element of the 2015 Patients First: Action Plan
for Health Care. In response to the growing
challenge to provide increasingly more
complex care over a longer period of time to
individuals in their homes, the Minister of Health and Long-Term
Care appointed the Expert Group on Home and Community Care with
a mandate to provide input on strategies to address these issues. In
mid- March 2015, the Expert Group on Home & Community Care
released its report.
The report identified 16 recommendations in a few specific areas:
That the planning and delivery be reflective of truly Client-
and Family Centred Care.
Support for Family Caregivers. Caregivers urgently need
respite along with access to information about available
services and how to access them.
Clearly defined, publicly funded “basket of services”.
Capacity Planning - Ensuring that Ontario’s health system
has the capacity and resources to deliver the core “basket of
services” and;
At the strategic level, primary care should be better aligned
with other sectors (primary care providers, hospitals and other
members of the home and community circle of care) and more
accountable for client and system outcomes.
The Expert Group indicated that they had found many pockets of
excellence in home and community care in Ontario through their work
but in many cases the programs were implemented on such a small
scale that they cannot contribute in a meaningful way to system-wide
culture shift needed to ensure the system is both high performing and
client-and family- centred.
Their recommendations are intended to provide a starting point for
beginning the culture change needed to create a truly client and
family-centered home and community care sector. To read the report
and recommendations please click on the following link:
http://health.gov.on.ca/en/public/programs/ccac/docs/hcc_report.pdf
Experiencing Integrated Care: Ontarians’ views of health care
coordination and communication
Health Quality Ontario released a report on
patient experiences of care coordination and
communication. The Experiencing Integrated
Care: Ontarians’ views of health care
coordination and communication report
reveals that Ontario ranks among the best in
Canada and internationally when it comes to certain measures of
coordination of care and communication between older patients and
their health care providers. The report also uncovers where Ontario
could improve.
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The report uses data from the Commonwealth Fund International
Health Policy Survey of Older Adults to compare Ontario’s
performance with the rest of Canada and 10 other countries.
For more findings and to download a copy of Experiencing Integrated
Care visit www.hqontario.ca
Mississauga Halton LHIN Annual Report 2013/14
The Mississauga Halton LHIN 2013/14 Annual
Report, Building Capacity Through Innovation:
Shaping the Future and a Better Health Care System
was tabled in the legislator on April 9, 2015. The
report has now been posted on our website. To read
or download a copy of the report, please click on the following link:
http://www.mhlhin.on.ca/~/media/sites/mh/Primary%20Navigation/A
ccountability/AnnualReports/MississaugaHalton_LHIN_AR_2013-
2014_English_Final.pdf?la=en
Press Conferences
Mental Health Funding Announcement
Support and Housing Halton (S&HH) hosted Oakville MPP Kevin
Flynn as he announced a $2 million investment in local mental health
and addiction for high priority services initiatives. The MPP was
joined by Graeme Goebelle (Mississauga Halton LHIN Chair) and
John Smith (CEO S&HH), along with representatives from all ten
local mental health and addiction agencies.
Left to right: MPP Kevin Flynn (Oakville), John Smith (Executive Director, Support & Housing
Halton), Graeme Goebelle (Chair, Mississauga Halton LHIN).
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Notable Mentions
Awards of Recognition
Congratulations to Dr. Bob Sauls, Mississauga
Halton LHIN RHPCSC Chair (2012-14), who was
recognized by HPCO for his contribution to
advance community palliative care. The Dr. S. Lawrence Librach
Award for Palliative Medicine in the Community is given to a
physician who demonstrates excellence and leadership in palliative
care and advances palliative care in their communities through
mentorship of family physicians.
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Dr. Bob Sauls (center) receives The Dr. S. Lawrence Librach Award for Palliative Medicine in the Community.