Advancing Health Care through Integration and Meaningful Partnership

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Advancing Health Care through Integration and
Meaningful Partnership

• 2009 Local Boards Conference
• North Bay
• May 8, 2009
• Judy Sharpe

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What is your vision of health care?

• ?

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How do we get there?

• What do we need to achieve this vision?
• ?
• ?
• ?

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Current Context in Health Care

• ?growing elderly population
• ?complexity of need
• ?pressure (ALC ER Chronic Disease)
• ?competitive environment for resources ( and
  staff)

• of agencies with
• ?governance structures
• ?administrative structures
• ?management structures
• ?IT structures
• ?HR structures/strategies
• ?policies/procedures
• ?services

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Policy Framework

• Integration
• Integration
• Integration

Focus of Health Policy
LHINs funding, accountability, integration Work
together
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Independence vs Interdependence

• In this interdependent 21st century world, were
  all in the same boat. It is not just them who
  make the world the way it is and us who are the
  victims. Indeed it makes very little sense to be
  thinking in terms of them and us.
• M. Bopp and J. Bopp, 2006

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What are the Possibilities?
?
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The Possibilities

• Merger
• Amalgamation
• Shared services/group purchasing
• Shared governance
• Shared administration/separate governance
• Identify core business for each
• ?

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Community

• A community is any grouping of human beings who
  enter into a sustained relationship with each
  other for the purpose of improving themselves and
  the world within which they live
• Many of the problems we face as human beings have
  their origins in the lack of community
• Need to intentionally create community where
  there is none
• Need leadership

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Partnership The Cornerstone to Successful
Integration Making Things Happen

• Voluntary Integration Partnership

A partnership is an agreement to do something
together that will benefit all involved, bringing
results that could not be achieved by a single
partner operating alone, and reducing duplication
of efforts oecd.org/cfe/leed/forum/partnerships
Not a handshake X

• MOU
• Protocols
• Service contract
• Letter of understanding

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Why Partner?

• Synergy 2 2 5
• More efficient use of resources
• Enhance impact and effectiveness of action
  through combined effort
• Promotes innovation
• Achieve administrative/clinical economies of
  scale
• Develop system-wide human resource capacity
• Develop a continuum of service

• Complete a project/activity that cannot be done
  alone
• Build critical mass of expertise
• Eliminate duplication
• Enhance/improve communication
• Establish single accountability
• Standardize processes

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Key Success Factors to Advance Partnerships/Joint
Initiatives

• Shared vision, mission, values and common goals
• Meaningful partnership
• Facilitative leadership
• Communication
• Solid planning
• Dedicated resources

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Shared Vision, Mission, Values, Goals
People learn to nourish a sense of commitment in
a group or organization by developing a shared
image of the future they seek to create and the
principles and practices by which they hope to
get there Peter Senge

• A focus on desired future state and mutual
  purpose
• Common direction
• Common understanding of the business/activity
• Shared values/principles
• Collective goals
• Desired end state

No visionNo development
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Meaningful Partnership

• Leadership
• Partners are equal members
• Share the same vision, values and goals
• Share, risk, responsibility, accountability
  and/or benefits
• Share power/decision-making
• No hidden agendas
• Commitment to meet real and tangible
  goals/objectives
• Good communication/conflict resolution skills
• Partners need to be chosen well.as it is
  difficult to de-partner
• Buy in
• Dedicated resources

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Facilitative Leadership

• Skilled communicator
• Effective motivator
• Painter of visions
• Gifted teacher
• Good synthesizer
• A storyteller
• One who inspires confidence and self-esteem

• Building the bridge as you walk on it
• Robert Quinn, 2004

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Leadership Competencies

• Have passion
• Lead by example
• Generate hope
• Take risks
• Remain focused on the vision this is hard work
• Give a damn!

?
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Communication

• simple
• must be planned
• timely
• formal/informal
• Communicate internal before external
• use multiple options

• Communicate
• Communicate
• Communicate
• Beginning
• Middle
• End

Effective communication is the key to a
successful collaboration Dixon, 2002
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Solid Planning Process
Step 1 Need/Issue Identification
Step 2 Data Collection Analysis
Shared Vision Communication Engagement of
Stakeholders Leadership Dedicated Resources
Step 3 Identify Recommendations
/Assess Feasibility
Step 6 Evaluate throughout the Process
Step 4 Disseminate Findings
Step 5 Implement the Plan
1. Need/Problem Identification
1. Need/Problem Identification
1. Need/Problem Identification
1. Need/Problem Identification
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Need/Issue identification

• Identify the need
• Complete a needs assessment
• Mobilize resources energy, persons, ,
  leadership
• Establish a Steering Committee
• Familiarize the Steering Committee with the
  issue, policy context, community, terms of
  reference
• Develop a collective statement of outcome
• Establish guiding principles and revisit them
  often

• Establish decision-making criteria/process
• Develop a work plan

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Data Collection Analysis

• Quantitative
• Socio-demographic data
• (population, geography, language, education,
  first nations, employment, income, family status)
• Population prevalence
• Funding
• Service inventory
• Utilization data
• Staffing inventory

• Qualitative
• Community consultation
• (focus groups surveys town hall chat forums
  email input lines open houses blogs chat
  rooms on-line forums)
• Case studies

Literature Review
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Identify Recommendations/Assess Feasibility

• Analyze the data (eg. cost/benefit)
• Identify themes
• Identify direction supported by the research
• Confirm feasibility of the project
• Document the findings and make recommendations
  consistent with the findings

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Communicate/Disseminate Findings

• Share findings to build shared vision,
  understanding, develop common direction, access
  , engage support, etc.
• ? report
• ? media release
• ? public/targeted meetings
• ? newsletters
• ? web site
• ? consultations, focus groups, key meetings
• Talk to the public, mobilize opinion, build
  constituency of support, steward the issue
  (private, public, business, govt)

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Implement the Plan

• Make it happen..

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Evaluate

• Consider internal/external evaluation
• Identify what worked/what didnt work
• Learn from your mistakes
• Amend practices

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Can partnership really make a difference?

• insert picture of CTC

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The CTC without Partnerships
One Kids Place
Therapeutic Recreation
Occupational therapy
Specialized clinics
Physiotherapy
Speech therapy
Social Work
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PROVINCIAL SERVICES
Smart Systems for Health
eCHN electronic record

• ONE KIDS PLACE
• 1 door
• 1 phone (476-KIDS)
• 1 intake
• Range of services
• Family-centered practice

Sick Kids
Early Years Drop in
NBPSDHU Formal transfer
CHEO
Nip/Tim PSL Formal Transfer/Lead Agency
ROS Formal transfer
NADY collocation
NBGH Formal Shared services Agreement
ISNC Formal transfer
Mus/Parry Sound PSL Formal Transfer/Lead Agency
NDSSAB Cash flow
Pediatric Centre Co-locationn/specialized clinics
NECCAC
Near North District School Board School readiness
partnership
Ont. Infant Hearing Program
Conseil Scolaire Public Du Nord-Est School
readiness partnership
NOSOM Formal affiliate agreement
Conseil Scolaire Catholique Frano-Nord School
readiness partnership
Community Living North Bay Formal transfer
speech Snoozelin room
Best Start Hub for special needs services (Nip)
OACRS
Nip/Parry Sound Catholic District School
Board School readiness partnership
Shriners
Ont. Blind/Low Vision
Can Child Best practice
Bloorview Kids Rehab
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