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The Central West LHIN is pleased to publish the February 2015 edition of Working Together for Healthy Change, highlighting work, events and resident stories that support the LHIN's Integrated Health Service Plan - IHSP 3.

In this issue...

 Making the Turn
 Holiday Surge... With Thanks!
 Healthy Change in Action
                A Green Thumb
                Lost and Found 

 Events
                South Asian Community Outreach Forum
                4th Annual, Chronic Disease Prevention and Management Conference 
                Government and Community Services Fair 

 Improving Access to Care
                Chronic Disease Prevention and Management 
                Mental Health and Addictions
                Services for Seniors
                Cancer Services

 Streamlining Transitions & Navigation
                Health Links
                Telemedicine/Telehomecare

                Enabling Technologies

 Drive Quality & Value
                Quality Committee
                Quality Improvement Workshops

  Making the Turn
 
Earlier this month Minister of Health Dr. Eric Hoskins released Ontario’s new Action Plan for Health Care. Appropriately entitled Patients First, it builds on a commitment made in the first Action Plan that places patients, residents, indeed communities at the centre of their health care system.  It is by design that Ontario’s LHINs operate from a similar premise, recognizing that that the health needs of local communities are best understood by those who live and work in them. 

The Central West LHIN will soon turn the corner on the third and final year of its current Integrated Health Service Plan (IHSP 3). Coinciding with this turn, the planning and development of IHSP 4 will begin shortly when community partners, Health Service Providers, residents and health care professionals will once again have an important opportunity to inform the future of their local health care system.

Working together we have made significant progress throughout the course of IHSP 3, but challenges remain and there is much work to be done. One such challenge is a rapidly growing and diverse population. In 1995 the population of the LHIN was shy of 600,000. It is now over 840,000 and by 2031 it is projected to be over one million. This means that, on average, there are over 12,000 new residents moving into the Central West LHIN each year. Estimates also project that the LHIN will experience unprecedented growth in its seniors population. The fastest growing age group are those 65 to 74 years of age, with a projected increase of 38% by 2022. 

As we approach the turn and begin the important process of planning IHSP 4, I would suggest our collective challenge is to start thinking about tomorrow... today!  In so doing, I would invite and encourage all of you and your organizations to become part of this process by actively seeking out local community engagement activities as they unfold. Stay tuned for future updates as to how, where and when these activities will be taking place. The importance of your valuable input cannot be overstated.


I am confident we have the right tools, the right people and the level of community engagement required to collaboratively move this work forward.  As it relates to the planning and development of IHSP 4... when it comes to placing patients first... I look forward to what I am certain will be meaningful contributions from across Central West LHIN communities.

 
Together, we are making healthy change happen!


Scott McLeod, CEO, Central West LHIN

  Holiday Surge ... With Thanks! 

The Central West LHIN Board of Directors expresses its sincere thanks and appreciation for the heroic efforts demonstrated by health care professionals across the LHIN, during the December holiday period and throughout the Flu season.

In December, exceedingly high Emergency Department (ED) volumes across the LHIN placed significant pressures on the local health care system. On average, Headwaters Health Care Centre experienced a 12% percent increase in total ED visits over last year. Etobicoke General Hospital experienced a 30% increase from its daily average of 200 patients per day. Brampton Civic Hospital experienced daily volumes that were 20 to 26% higher than normal, reaching highs of close to 450 patients per day. And, in addition to these extreme ED volumes, during the period December 24 through January 16, 12 of 23 Long Term Care Homes in the Central West LHIN had declared either respiratory or influenza outbreaks.

Despite these pressures, health service professionals and volunteers from across the LHIN rose to the challenge. The development and implementation of well executed contingency plans, coupled with the ongoing commitment of a highly dedicated team of health care professionals, ensured the sustained delivery of exemplary patient-centred care and system flow, particularly during this period.
 

Together, your efforts made a difference… thank you! 
 

                                                                        
Maria Britto, Board Chair, Central West LHIN      Scott McLeod, CEO, Central West LHIN


** For more information specific to cold and flu season, please visit the Central West LHIN Website.


  HEALTHY CHANGE IN ACTION


A Green Thumb

Humber Valley Terrace resident Marnie Horwood is seen here with some of her floral paintings.

As published in the Ontario Long Term Care Association - Morning Report, by Deron Hamel.

Marnie Horwood has long been a flower aficionado and, since moving into Humber Valley Terrace, staff members at the west Toronto long-term care home have encouraged her to continue pursuing her passion. Horwood has helped design the home’s flower garden. In the spring, she and recreation manager Emily Viray will visit local florists, and the resident will carefully choose the flowers which best suit the garden

“Together, Emily and I decided what flowers looked nice and what would look best (in the courtyard),” Horwood tells the Morning Report, adding it’s important to her to be able to continue her hobby at Humber Valley Terrace. "Gardening has been my life for many years,” she says.

Once the flowers are selected and planted in the Revera Inc.-owned, Central West LHIN-funded long-term care home’s courtyard, Horwood takes it upon herself to maintain the garden. “Humber Valley Terrace has a gorgeous courtyard, and Marnie is in charge of where the flowers go and watering them — it’s an accountability for her to make the courtyard beautiful,” Viray says

It may be winter now and the gardening season on hold until spring, but that hasn’t kept Horwood away from flowers. An accomplished artist, Horwood is now spending much of her time painting flowers on canvases, which she has been selling to staff members, families and fellow residents at minimal cost. One of her paintings even won a prize at the Brampton Fall Fair

Horwood says she’s happy to hear the garden and her paintings are making people happy. She took up painting about 10 years ago and it has become a great way for her to combine her passions. "Most of my paintings are of flowers,” she says. “And that’s because flowers are very important to me.”


Lost and Found

The names and photo used in this story have been changed to protect the privacy of those involved. 

After a lengthy stay in hospital “Mary”, a proud  and independent senior once able to cook and clean for herself and, from time-to-time, look after her young grandchildren, was diagnosed with Alzheimer’s/Vascular Dementia. Her cognitive impairment was sudden and rapid, leaving her daughter with a great sense of loss for the mother she once knew.

“I looked at this woman who outwardly appeared to be my Mother, but her personality, attitude and mannerisms had all changed,” said Cathy. “She was no longer the vibrant mother who, even though I’m in my 40’s, still sought to give me advice and jokingly told me to get a haircut, or the smiling grandmother that played cards with her grandchildren and read them stories.”

Mary began to attend the Kipling Acres Adult Day Program and soon started to come home with stories of days filled with people she had met and activities that she enjoyed including candle making, dancing, singing and spending time with the children who attend the day care facility. Providing her with an invaluable sense of purpose, she calls the Program her “work” and takes great pride in helping others when she is there.

“I have watched my Mother over the months since she has been in the Program,” Cathy continued.  “The program at Kipling Acres has helped me to see a whole new side of my Mother and, while she will never be the same person she once was, she is still a remarkable woman. The Program has given me back my Mother, helping me to see all that I have in her rather than what I had lost.”


  Events


South Asian Community Outreach Forum

Pictured L to R : Back Row - Mark Edmonds (Director, Health System Integration, Central West LHIN), MPP John Fraser (Parliamentary Assistant to the Minister of Health and Long-Term Care), Front Row - Dr. Michael Gagnon (Co-Medical Director, Central West Palliative Care Network), Dr. Naheed Dosani (Co-Medical Director, Central West Palliative Care Network), Yvonne Sinniah (Director, Health System Integration, Central West LHIN), Donna Laevens-Van West (Executive Director, Central West Palliative Care Network), Maria Britto (Board Chair, Central West LHIN), Theresa Greer (Executive Director, Heart House Hospice), Avinash Arora (Director, Nurse Next Door), Nilda Patey (Executive Director, Bethell Hospice), Gurwinder Gill (Director Equity and Volunteer Services, William Osler Health System) and Nirpal Sekhon (Team Lead, SAHARA Respite Program, Punjabi Community Health Services).

Hosted by Bethell Hospice, Heart House Hospice and the Punjabi Community Health Services Maria Britto, Chair of the Central West LHIN Board of Directors was pleased to deliver welcoming remarks at the South Asian Community Outreach Forum.  John Fraser, Parliamentary Assistant to the Minister of Health and Long-Term Care, opened the session which focused on palliative and end-of-life care. 

At the system level, it is an important time for palliative care in Ontario.
 
In 2011 the Provincial Government released the “Declaration” document, which outlined the components of an ideal palliative care system.  What has since followed is a Provincial Auditor’s Review of palliative services across the province, the recommendations of which will act to move the Declaration forward.
 
The Central West Palliative Care Network, of which Bethell Hospice and Heart House Hospice are active members, is applying the Declaration to further develop a palliative care system at the local level.
 
Meanwhile, at the request of the Ministry of Health and Long-Term Care, Health Quality Ontario (HQO) conducted an analysis that provides evidence to guide public policy and improve the approach to end-of-life care across the province.

The session attracted over 160 participants who listened to speakers including Dr. Naheed Dosani, Co-Medical Director of the Central West Palliative Care Network.  In the afternoon, an interactive panel discussion provided  participants with an important opportunity to learn more about what types of palliative and end-of-life services are currently available in their local communities. 

Understanding the important culture-specific aspects of palliative care helps to inform the planning process in order to create a system that is both patient-centred and responsive to culturally-specific needs.


4th Annual, Chronic Disease Prevention and Management (CDPM) Conference

Over 180 participants seen in attendance at the opening of the 4th Annual Chronic Disease Prevention and Management Conference, hosted by William Osler Health System, Wise Elephant family health Team and the Central West LHIN.

Maria Britto, Chair of the Central West LHIN Board of Directors, was pleased to present opening remarks, at the 4th Annual, Chronic Disease Prevention and Management Conference hosted by William Osler Health System, Wise Elephant Family Health Team, and the Central West LHIN. 

With development of the LHIN's fourth Integrated Health Service Plan soon to begin, 190 participants were challenged to use the conference as an opportunity to "start thinking about tomorrow... today," as a forum for information gathering and knowledge exchange that will help to inform the planning process and future of the local health care system.

Focused on patient-experience-based design and Health Links, the conference reaffirmed the LHIN's ongoing commitment to identify complex high needs patients and to ensure they have a patient-centred, integrated, coordinated care plan.  In addition, the LHIN will continue to work with community partners to increase capacity for the self-management of chronic conditions in order to improve the treatment and management of chronic diseases in the community. Efforts made to improve the coordination of regional diabetes services will continue and the expansion of education and self-management programs, including Telehomecare,  for chronic diseases including Congestive Heart Failure and Chronic Obstructive Pulmonary Disease will move forward. 
 
The Central West LHIN is committed to building on the foundations of the Ontario CDPM Framework, leveraging the work of local diabetes programs,  and expanding roles that promote self-management while delaying and/or preventing the onset of complications of chronic diseases.
 
Of particular importance, this work will be aligned with Patients First, placing patients at the center of their health care system by supporting them to self-manage their chronic conditions within the community.  Improving access to community support services ensures better value for service outside the hospital setting.


Government and Community Services Fair

Representatives of the Central, Central West, Mississauga Halton and Toronto Central LHINs photographed with MPP Yvan Baker, Etobicoke Centre while attending the Government and Community Services Fair.

The Central West LHIN was pleased to recently participate in the Government and Community Services Fair at Cloverdale Mall, hosted by MPPs Yvan Baker, Etobicoke Centre and Adam Feldman, Etobicoke-Lakeshore.

This annual event carries on the long-standing tradition of former MPP Donna Cansfield, to help local residents become better educated and informed about the array of services available to them in their local communities.  

This important community engagement opportunity affords the Central, Central West, Toronto Central and Mississauga Halton LHINs a chance to speak directly with local residents... to understand what is important to them, their levels of satisfaction with the local health care system, and to gauge their levels of understanding of LHINs as well. 


  IMPROVING ACCESS TO CARE
 

Chronic Disease Prevention and Management (CDPM) - Exercise and Falls Prevention classes being delivered through the Central West Community Care Access Centre (CCAC) are being used to develop community-based exercise classes designed specifically for the Chronic Obstructive Pulmonary Disease (COPD) patient population.

Staff from the William Osler Health System Pulmonary Rehabilitation Program will provide COPD education and on-site training to CCAC contracted physiotherapists who currently deliver exercise and falls classes.  COPD-specific classes will be conducted at five sites (one per Health Link) at which tailored exercise programs will be delivered to COPD best practice standards.

 

Mental Health and Addictions - Having finalized its provincial distribution methodology, the Ministry of Health and Long-Term Care (MOHLTC) has allocated a total of 60 Mental Health and Addictions housing units to Central West LHIN. Supportive Housing In Peel (SHIP), Family Transition Place and Peace Ranch will be providing housing, rent supplements and support services to 8, 40, and 12 clients over the next three years respectively. 

Services for Seniors - The Ministry of Health and Long-Term Care (MOHLTC) has released guidelines on Assess and Restore (A&R) initiatives for frail seniors.  In conjunction with the release, the Central West LHIN received $376,600 in annual funding.  This funding will be directed to the Central West CCAC to operate the Home Independence Program (HIP). This program ensures patients are supported early and at the first sign of decline within the aging process, preventing further deterioration that often results in longer periods of high-level care, alternate levels of care volumes and increased hospital admission rates. 

The program uses Rehabilitation Therapists to assess the need for personal care support for patients, with the goal of service focused on maximizing people’s long-term independence, choice and quality of life, while minimizing the need for ongoing high levels of support.  Personal support workers’ roles are optimized through training in supporting the patient in carrying out activities of daily living with increased independence, less reliance on others.


Cancer Services - In response to the lower cancer screening rates amongst the ethno-cultural communities, Cancer Care Ontario (CCO) has released Screening Resources for Newcomers and Immigrants as they often experience challenges finding information about cancer screening. These culturally relevant resources aim to support newcomers and immigrants in making a decision about cancer screening, and serve as tools for providers working with them in a variety of settings.  The resources can be found on CCO’s website in the Toolbox section at www.cancercare.on.ca.

Meanwhile, recognizing that primary care providers play a crucial role in participation in cancer screening programs, the Central West LHIN funded $50,000 towards the Physician Office Efficiency Project led by Cancer Care Ontario (CCO) to reach a minimum of 50 family physicians in approximately ten practices to participate in the project.  The project aims to address the issue of poor cancer screening rates in the Central West LHIN by providing onsite, knowledge transfer to primary care practices, with specific educational strategies for physicians, nurses, clinical managers, and office staff.  Barriers will be discussed in the final report to be developed by CCO.


   STREAMLINING TRANSITIONS & NAVIGATION
 
Health Links - A Health Links strategic framework has been translated into formal Health Links Project Charter which focuses on the most complex patients and their primary care providers. Providers will...
  • increase the number of complex patients and primary care providers that are involved directly in Health Links care planning as well as in their involvement in planning tables
  • provide appropriate and timely care for complex patients
  • create a coordinated health system for complex patients
  • measure and improve the experiential elements of patient care.
Telemedicine/Telehomecare - The Central West LHIN’s Regional Telehomecare program has currently enrolled a total of 1,164 patients in the program and has achieved 93% of its April 2015 target of enrolling 1,250 patients.

Enabling Technologies -
Physician Electronic Medical Record (EMR) Adoption - The Central West LHIN continues to have the highest Physician EMR adoption rate in the province for Family Practice Physicians at 94% and the highest rate of adoption in the province for specialists at 63%.  The provincial adoption rates are 82% and 30% respectively.  While the LHIN continues to support the implementation of EMRs by physicians, focus will now shift to EMR interoperability with provincial solutions e.g. eConsult, eNotifications, report standardization and ePrescribing.

Ontario Lab Information System (OLIS) is a cornerstone information system that connects hospitals, community laboratories, public health laboratories and practitioners to facilitate the secure electronic exchange of laboratory test orders and results.  Patient benefits include: 
  • fewer gaps in information as patients move between hospital, practitioner’s office, home care and long-term care settings;
  • effective integration and monitoring of laboratory history and treatment progress to support chronic disease management
  • reduced number of unnecessary laboratory tests due to greater availability and sharing of information
  • timelier and broader access to laboratory test results by practitioners. 
In the Central West LHIN, 316 physicians with eligible EMRs are viewing OLIS data and 67 additional physicians are completing the activities required to view their patient lab data in OLIS.

  DRIVING QUALITY & VALUE
 
Quality Committee - The first Quality Dashboard, designed to monitor progress in the achievement of three "system level aims" has been developed.  Data for two of the three indicators (number of repeat visits to emergency for mental health and addictions and number of Health Links care plans) was available for inclusion in the dashboard. It is expected that the indicators related to measuring patient experience will be selected once the results of the pan-LHIN Patient Experience Survey are released, and will be included in the next dashboard report.

Quality Improvement Workshops - The Central West LHIN collaborated with the Metamorphosis Community Health Network to support the delivery of two half-day workshops on quality improvement for Board members and senior leaders of community-based mental health and addictions services. These workshops were well received by those in attendance. Information shared at the workshops will assist community-based Health Service Providers to better understand their role in quality and will contribute to their completion of quality improvement plans.

Together, making healthy change happen!
 
The Central West Local Health Integration Network (LHIN) plans, funds, integrates and monitors local health care services for the communities of Brampton, Caledon, Dufferin County, Malton, north Etobicoke and west Woodbridge. For more information on your Central West LHIN please contact Tom Miller, Director Communications and Community Engagement – tom.miller@lhins.on.ca - or visit www.centralwestlhin.on.ca.

Copyright © 2015, Central West Local Health Integration Network, All rights reserved. 
Our mailing address is: centralwest@lhins.on.