Title: Managing Change, Transforming Health Care A South West LHIN Webcast on our Refreshed Integrated Heal
1Managing Change, Transforming Health CareA South
West LHIN Webcast on our Refreshed Integrated
Health Service Plan andHealth Service Blueprint
ProjectApril 30, 2009 930am to 1100am
A Healthier Tomorrow
2Questions
- Questions are welcome at the end of the Webcast
- You can
- email southwest_at_lhins.on.ca
- call 1-888-789-9572
- Ask moderator for South West LHIN
3Topics to Discuss
- Welcome
- LHIN Planning and Accountability
- Health System Trends
- The Integrated Health Service Plan 2010 to 2013
- The Health Service Blueprint Initiative
- The Blueprint Framework A Work in Progress
- Alignment of the Emergency Department Study to
the Blueprint and IHSP - Community Engagement
- Priority Setting Framework
4LHIN Planning and Accountability
- Mandate to provide leadership and management of
the local health system - Accountable to the Ministry of Health and
Long-Term Care - Integrated Health Service Plan is a tool to guide
improvements to the system - Blueprint Project and other studies will inform
the IHSP - Next IHSP will identify actions and outcomes
related to our priorities to ensure quality,
access and sustainability
5LHIN Planning and Accountability Framework
6The 2010 - 2013 IHSP will outline the South West
LHIN system level goals and mechanisms to achieve
system level results
7The Importance of Understanding Health System
Trends
- Health Service Providers and the Public need to
have an awareness and knowledge of these trends
to collectively shape strategies for building a
desirable and sustainable health system - Understanding and anticipating trends assists us
in deciding what we need to focus on in the
short-term and long-term - Skate to where the puck is going, not where it
has been
--Wayne Gretzky
8Health System Trends (MOHLTC, Health System
Strategy Division, January 2009)
- Person-Centred Care
- Sustainability, Productivity, and Innovation in
the Health Care System - Chronic Disease Prevention and Management
- Health Human Resources Management
- Mental Health and Addictions
9Health System Trends (MOHLTC, Health System
Strategy Division, January 2009)
- E-Health
- Public and Population Health
- Disparities in Health
- Consumerism in Health Care
- Health Care Facility Infrastructure
10The Integrated Health Service Plan for 2010 to
2013
11Our First IHSP
ACCESS QUALITY SUSTAINABILITY
Health Human Resources - e-Health
IMPLEMENTATION IMPERATIVES
Accessing the Right Services in the Right Place
at the Right Time by the Right Provider
Strengthening Improving Primary Health Care
Transportation Promotion and Prevention Mobilizi
ng Partnerships Evaluation, Research, Education
Knowledge Dissemination Standardization
Best Practice
Building Linkages Across the Continuum
Seniors and Adults with Complex
Needs
Health Human Resources - e-Health
Preventing Managing Chronic Illness
Integration Priorities Enabling Priorities
12IHSP Requirements and Assumptions
- Describes priorities, strategies, proposed
outcomes for the local health system and
implementation steps for the next three years
(2010-13) - Focuses on strategies to integrate the local
health system - Aligns with provincial priorities
- Builds on the work of our first IHSP, Priority
Action Teams and Strategic Alignment Map - Health Service Blueprint will be a central
component of our next IHSP
13Provincial Priorities
- lmprove access to emergency care by reducing the
amount of time that patients spend waiting in the
emergency department - lmprove access to hospital care by reducing the
amount of time that patients spend waiting for an
alternate level of care (ALC) - lmprove access to integrated diabetes care by
supporting the roll-out of the Ontario Diabetes
Strategy
14IHSP Table of Contents
- Introduction
- Summary
- LHIN Vision for local health care system
- Overview of current health care system
- Framework for planning (resources and local
conditions) - Priorities and strategic directions for the local
health system, including specific goals - Rationale for strategic directions
- How success will be demonstrated and measured
- Supporting documents (research and documentation)
15IHSP and Blueprint Content Alignment
- Introduction
- Summary
- Provincial Priorities
IHSP
- Blueprint
- Overview of current system
- Framework for planning
- Priorities, directions, goals
- Rationale for directions
- How will success be measured
3-year. action plans and expected outcomes
Vision and Strategic Alignment
16The Health Service Blueprint Initiative
17Why a Health Service Blueprint
- Response to first IHSP priority to ensure access
to the right services, in the right place, at the
right time, by the right provider - Need for a detailed understanding of current
services to develop ideas about how the system
should be structured across programs and
geography - Allows health care providers and the LHIN to plan
for change rather than react to health system
trends, challenges and best practices - To collectively leverage our resources rather
than reacting to single issues faced by one
organization, sector, or discipline
A Healthier Tomorrow
18A 3-Phased Approach to the Health System Design
Initiative
Phase 1 Charter Confirmation (completed)
Phase 2 Current State Assessment Framework
Development
Phase 3 To Be Model Configuration of
Services (Framework Application)
Stakeholder Engagement
Communications / Change Management
A Healthier Tomorrow
19Current State Assessment Framework Development
- Project Objectives
- Develop an inventory of health care programs and
services in the South West LHIN - What services are available
- Where services are delivered
- Utilization profiles
- Service provider profile
- Identification of gaps and duplication
- What services will be needed in the future
(demographics and population health) - Future capacity considerations
- Develop a Health Service Blueprint that focuses
on the configuration and inter-relationships of
health services across the LHIN - Develop an implementation plan for the future
application of the framework to high priority
population and/or clinical areas
20Project Scope
- Hospital and community-based services
- Development of a Blueprint (the mid-level
plan/framework) for health services that clearly
conveys to key stakeholders the future
configuration and inter-relationships of services
that will achieve identified objectives -- what
services at what level (i.e., local, geographic,
LHIN, provincial), not where - Opportunity to identify priority areas to apply
the framework (i.e., determine what
services/where)
21Health System Design Steering Committee
- Michael Barrett, South West LHIN
- Dr. Sean Blaine, Physician
- Mark Brintnell, South West LHIN
- Sandra Coleman, SW CCAC
- Ralph Ganter, Erie St. Clair LHIN
- Kelly Gillis, South West LHIN
- Brent Gingerich, PeopleCare Inc.
- Catherine Hardman, Choices for Change
- Sue Hillis, Dale Brain Injury
- Dr. David Hollomby, London Health Sciences
Centre - Sue McCutcheon, Grey Bruce Health Services
- Tom McHugh, Tillsonburg Hospital
- Caroline Tykoliz, Grey Bruce Health Services
- Sandy Whittall, St. Joseph's Health Centre
- Dr. Nancy Whitmore, St. Thomas Elgin General
Hospital - Andrew Williams, Huron Perth Health Care Alliance
Purpose The purpose of the Health System Design
Steering Committee is to guide decision-making
for health system design by identifying local
needs and capacity and to make recommendations on
strategic direction for achieving an integrated
health system in the South West LHIN.
22The Blueprint Framework A Work in Progress
23The following three lenses form the blueprint
framework and were used as the starting point to
assess the provision of South West LHIN
healthcare services
- Health services should meet needs ranging across
complexity and population demands - Specialized / High Complexity
- Targeted / Moderate Complexity
- General (non-specific) / Low Complexity
Spectrum of Need
- Healthcare services should be provided at the
most appropriate level - Local
- Geographic
- LHIN
- Provincial
Service Delivery Model
Continuum of Care
- Range of healthcare services should meet the
needs along the continuum of care - Promotive/Preventive
- Curative
- Rehabilitatiive
- Supportive
24Service Delivery Model Considerations
- Service delivery model view enables consideration
of the following - Relationship between local characteristics and
provincial services and priorities (e.g. wait
times and critical care strategies) - Relationship between service provision and
accountability across the spectrum - Embeds complexity of care within the levels of
service delivery
25Collection and analysis of comprehensive
inventory, studies, and reports of health
programs across population segments
Within this assessment, we have incorporated
population segment needs to assess the services
in each program across the continuum of care
26Alignment of the Emergency Department Study to
the Blueprint and IHSP
27Emergency Department Human Resource Study
- Increasingly, several hospitals have had
difficulty maintaining emergency department (ED)
coverage due to human resource shortages. - In response to this human resource trend, the
LHIN commissioned a study to obtain accurate,
detailed information about the current state of
its emergency departments in addition to gaining
insights from emergency department health
professionals to help identify the strategies
needed to strengthen our emergency department
system. - This comprehensive look at our ED human resource
challenges and opportunities will contribute to
the Blueprint current state assessment and future
service configuration discussion.
28Emergency Departments Proposed Strategies
- Human Resource Strategies
- Enhance Recruitment and Retention Capability
- Support Local MD Leadership
- Support RN and MD Workplace satisfaction
- Maximize ED Coverage Within Current Resource
Pool - System Design Strategies
- Distribution of Hospital Resources to ensure
access - Maximize Integration of NPs in Primary Care
29Emergency Department Study Next Steps
- At a local level, hospitals can consider
potential of proposed strategies to address HR
challenges - At a LHIN level, HR strategies will be considered
in the future within the context of potential
health system design directions - System design strategies and future models of
care to be discussed as part of the Blueprint
Project - Further consultations and engagement prior to any
LHIN-wide decisions about the proposed strategies
30Community Engagement
31Engagement Framework
32Stakeholder Engagement Key Informant Interviews
- 45 stakeholder groups have been engaged to inform
the current state assessment - HSPs (executives, providers, Board members)
- HSPs not funded by LHIN (same group as for HSPs)
- Various LHIN groups (steering committees, Board,
staff) - Networks
- Academic community
- Local/provincial/federal government
- Aboriginal, Francophone, Mennonite
33Stakeholder Engagement Symposiums
- Conduct two, 2-day symposiums, June 1-2 (north)
and June 8-9 (south) in the North and South areas
of the LHIN - The purpose of the symposiums is to assist in
finalizing the To Be model (Blueprint
Framework) and seek input on priority populations
and programs/service - Audience for symposiums include LHIN funded and
non-funded health service providers including
Board members - Health System Design Steering Committee will
assist in developing the To Be model and
refinement of the priority programs and
populations
34Stakeholder Engagement Refinement Sessions
- Multiple sessions to occur (9-12)
- Purpose is to
- Communication with Key Stakeholders on Health
Service Blueprint Framework - Seek input from key stakeholder groups to inform
the refinement of the Draft Health Service
Blueprint
35Public Engagement
- In-person engagement sessions in mid-July and
early September. - 17 sessions planned
- July sessions - 3 locations in North, 3 locations
in Central, 5 locations in South. - September sessions 2 locations in each planning
area to provide an opportunity for those unable
to attend in July. - For those who cannot attend the public sessions,
will provide opportunities to provide feedback
through our website or postal mail. - Telephone Survey
- Web Feedback Form
36Objectives of Public Sessions
- Reach a broad cross-section of the community to
raise awareness and receive input on the
Blueprint Project and IHSP - Inform the public about the LHINs mission,
vision and priorities - Educate public about health system trends
- Consult with communities about issues of
importance to them
37Priority Setting Framework
38Goals of the Priority Setting Approach
The proposed decision-making framework draws on
economic principles of value for money and
ethical principles of fair process to help LHINs
- Align resources strategically with system goals
and community needs - Reach publicly defensible decisions based on
evidence and community values - Facilitate constructive stakeholder engagement
around better meeting system and/or
organizational objectives within the constraint
of limited resources - Fulfill their public accountability for the use
of public health service resources
39Recently the LHINs have been working with a
decision tool to help set priorities
40It is important that the priority setting
approach aligns with the South West LHINs System
Level Goals
- Healthier South West LHIN Community
- Equitable Access to Services
- Quality of Care and Service
- Sustainability of the Local Health System
- Integration of Health Care Delivery
41and community values
Community Values
- Compassion We appreciate all our actions have
real implications for people and communities - Courage We will make difficult decisions and
challenge the status quo when required - Evidence Informed Our decisions will be guided
by the best available information - Innovation We will encourage and support new
thinking and the sharing of new knowledge - Integrity We will act in a fair, consistent and
unbiased manner - Trust and Respect We believe in mutual trust and
respect
42IHSP1 Priority Setting Criteria
43New Cross-LHIN Priority Setting Criteria
44Priority Setting Framework Next Steps
- Share framework and criteria with Area Provider
Tables and other key groups (e.g., Steering
Committees) for discussion and feedback on
proposed criteria - Synthesize feedback and modify criteria as
appropriate for final discussion with Health
System Design Steering Committee - Bring recommended criteria to Board of Directors
for approval (May 27, 2009)
45IHSP and Blueprint High Level Timeline
Mar Apr May Jun
Jul Aug Sept Oct Nov
Project Launch
Current State Assessment
Health Service Blueprint Development
Implementation Planning
Current State Inventory Development
Develop To Be Models
Provider Engagement
Public Engagement
Review Findings from Engagement
Refinement
Approval and Public Release
46Thank you and Questions
- Questions are welcome
- You can
- email southwest_at_lhins.on.ca
- call 1-888-789-9572
- Ask moderator for South West LHIN