ceo report to the board - mississauga halton lhin · 2015. 4. 7. · mississauga halton lhin in the...

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CEO REPORT TO THE BOARD Mississauga Halton LHIN

February 2014

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The following is a compilation of the major activities/events undertaken during this period in support of the 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 2013/14 6 Accessible and Sustainable Health Care 6 Family Health Care When You Need It 11 Enhanced Community Capacity 14 Optimal Health – Mental and Physical 17 High Quality, Person-Centred Care 18 MEASUREMENT AND PERFORMANCE 20 Ministry-LHIN Performance Agreement Targets 20 NOTABLE SECTOR ENGAGEMENT 21 Accountability Agreements 21 COMMUNICATIONS 23

MOHLTC Updates Annual Business Plan Priorities

Measurement and Performance

Notable Sector Engagement Communications

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MINISTRY OF HEALTH AND LONG-TERM CARE UPDATES

Physiotherapy

Community Exercise and Falls Prevention As of February 1, 2014 the Mississauga Halton LHIN have a total of 33 exercise and falls prevention sites up and running. It is anticipated that an additional 8 sites will be serving clients by the end of February. The LHIN in collaboration with March of Dimes our Health Service Provider (HSP) and ptHealth our contracted service provider, continue to source out additional locations and populations particularly in the Milton, Georgetown and Acton areas. We are working to increase the number of sites to ensure Ministry targets are met. The breakdown of current sites by region is as follows: Etobicoke: 6, Georgetown: 2, Milton: 2, Mississauga: 22, Oakville: 11.

Long-Term Care Homes – Physiotherapy Long-term care homes have received a template to report on physiotherapy services and exercise class activities in their respective homes. The first reporting period was August 22, 2013 – December 31, 2013 for physiotherapy and August 1, 2013 – December 31, 2013 for exercise classes. Reports were submitted by January 31, 2014 and will be required on a quarterly basis thereafter.

Community Based Clinics The Ministry of Health and Long-Term Care (MOHLTC) is currently working to send out all funding letters and Transfer Payment Agreements to the new clinics across the LHINs. Approval letters and agreements for the Mississauga Halton LHIN will be sent out within the next month (anticipated). Until such time the Mississauga Halton LHIN is unable to confirm the successful clinics. Letters will be sent by the MOHLTC to those that were and were not successful in their applications. Physiotherapy in Primary Health Care Primary care applications to receive physiotherapy funding have been reviewed and decisions have been made. Neither successful nor non successful applicants have been informed as to the status of their application as of yet due to the fact that approval packages are undergoing internal review at the ministry and are awaiting final sign off. All applicants will be notified of the status of their submission when the internal requirements at the Ministry have been completed.

Provincial Life or Limb Policy

The provincial life or limb policy is a “no refusal” policy for patients with life or limb threatening conditions. The guiding principles of the policy are:




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1. The Life or Limb Policy is triggered when a patient is life or limb threatened and therapeutic options exist, which are needed within 4 hours;

2. A patient’s life or limb threatening condition is a priority and the identification of beds is a secondary consideration;

3. No patient with a life or limb threatening condition will be refused care;

4. Repatriation within a best effort window of 48 hours once a patient is deemed medically stable and suitable for transfer, and;

5. LHIN geographic boundaries will not limit a patient’s access to appropriate care in another LHIN.

On January 30, 2014 the Mississauga Halton LHIN hosted The Provincial Life or Limb and Repatriation Policy Regional Engagement Workshop followed by a presentation to the Mississauga Halton LHIN Quality Committee of the Board on February 13, 2014. On both dates, the status of the Mississauga Halton LHIN’s participation was identified. The following provides an update on status of implementation:

1. Mississauga Halton LHIN is participating on the GTA Life or Limb Working Group of Stakeholders

2. Engagement was held in October and November between the Mississauga Halton LHIN and hospitals

3. Each hospital is committed to a collaborative implementation approach between them, the Mississauga Halton Community Care Access Centre (CCAC), and CritiCall

4. The Provincial Life or Limb Policy was activated on January 13, 2014

5. A Regional Workshop was held on January 30, 2014 with a diverse stakeholder group from the hospitals, CCAC, EMS, Mississauga Halton LHIN Medical Leads, CritiCall

6. LHIN-facilitated weekly webinars are being conducted to enable the Repatriation Working Group to meet the baseline target of an April 1, 2014 as a “GO Live” date.

Assess and Restore One-Time Funding

The Ministry of Health and Long-Term care has provided one-time funding in the amount of $439,000 for Assess and Restore projects. This funding is in support of the Seniors’ Strategy to assist frail seniors to access further services enabling better opportunities for recuperation. The allocation was based on the proportion of frail seniors in our LHIN relative to the provincial total. We have allocated funds to the projects listed in the chart below.




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Assess and Restore One-Time Funding Project Title Funding Recipient “Enhanced Service Delivery for Complex Assess and Restore (A&R)Clients”: To increase services available (speech language pathology, a kinesiologist, nutritional education and support, and increased social worker hours) to those clients who would benefit from and A&R program

Cooksville Care Centre: RESTORE program

“Funding for Home Adaptation for Assess and Restore clients”: Support the purchase of assistive devices and rehabilitative aids to support a safe and early transition from the Convalescent Care Unit (CCU) to home

Post Inn Village: Convalescent Care Program

“Enhanced Rehabilitation for Stroke Patients to Support Community Transition”: opportunity to work towards achieving the best practices outlined by the Stroke Network through the addition of physiotherapy (PT), occupational therapy (OT), and Speech Pathology resources. With increasing numbers of stroke patients in a constrained bed environment, service augmentation, to facilitate earlier transition is critical. Working to augment the rehabilitative care process for these patients an enhanced team of PT, OT and Speech will facilitate the restorative care and successful transition to the community earlier with ongoing support in an ambulatory environment. Based on best practice as outlined and identified by the GTA Stroke Network

Halton Healthcare Services &

Trillium Health Partners

“Early Discharge and Enhanced Service (Assess & Restore)”: To provide increased supports and services in the community that will assist patients who are waiting in hospital for assess and restore rehab, convalescent care programming, and/or individuals that would benefit from early discharge from hospital and require an assess and restore rehabilitation approach. This will reduce the length of stay in hospitals, influence the hospitals ability to reduce Alternate Level of Care (ALC) rates, reduce the current wait list for Assess & Restore programming in the community and reinforce a Home First philosophy.

CCAC




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PROGRESS ON ANNUAL BUSINESS PLAN PRIORITIES 2013/14 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

ACCESSIBLE AND SUSTAINABLE HEALTH CARE

Quality Based Procedures (QBP) The Health System Funding Reform Local Partnership (HSFR LP) Committee agreed to utilize a decision-making framework to help determine whether there is necessity to form regional group related to a QBP. All QBPs will be evaluated using the Decision-Making Framework and QBP Performance Dashboard. The HSFR LP Committee received analyses for Congestive Heart Failure and Chronic Obstructive Pulmonary Disease. The Committee committed to focus on the regional improvement of QBP for congestive heart failure. The Mississauga Halton LHIN is planning a regional engagement session with related clinical and physician leads to determine a regional approach focused on quality and performance improvement.

Mississauga Halton LHIN Holiday Surge Strategy Evaluation of the Holiday Surge strategy is underway. Initial consultation with health service providers and primary care physicians has yielded positive feedback. Health service providers reported that their consumers liked the communication tools developed. Work will commence in the spring to build off the successes and lessons learned, and work towards a year round surge strategy.




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Capital Developments Halton Healthcare Services Halton Healthcare Services received confirmation of support for the functional program stage submission for the Milton District Hospital Redevelopment project. The hospital can now progress to stage 3 block schematics, project specific output specifications and request for proposal evaluation criteria. Trillium Health Partners Trillium Health Partners had submitted a pre-capital proposal to the Mississauga Halton LHIN in the fall, which was endorsed by the Mississauga Halton LHIN. They continue to develop their Master Program and hope to move quickly along the capital planning stages to address the needs of local residents, particularly from an acute care capacity. Regional Hospice Palliative Care Hospice Palliative Care Provincial Steering Committee (HPCPSC) The seventh meeting of the provincial steering committee was held in January 2014 and members validated the work already underway or undertaken by the shared collaborative leadership members (LHINs, Ministry and Coalition) on the five priorities that were identified in a previous survey.

A governance structure has been developed which will help identify the linkages with the working groups and the clinical council. The council’s main objective is to provide clinical input to the steering committee.

The three working groups have provided their updates. The Communication and Awareness Working Group is focusing on developing a work plan based on three main deliverables: inventory of asset management, public and provider awareness and advance care planning.

The Residential Hospices Working Group has been set up to advance one of the key commitments identified in the Declaration of Partnership and Commitment to Action. The Residential Hospice Working Group will provide analysis and input to the Ministry, the LHINs and the Coalition through the HPCPSC to inform the Ministry’s development of community-based residential hospice policy; LHIN integration and service options in the future; and sector implementation of best practice delivery aligned with Ontario’s Declaration document.

The data and performance group has been conducting an inventory of the indicators used to measure palliative care across the 14 LHIN regions. They have collected over 700 indicators and have selected a National Quality Framework to regroup the indicators in six domains. The final list of indicators will be validated nationally and internationally.

Regional Hospice Palliative Care Steering Committee The steering committee and its sub-committees are continuing the work as per their strategic work plan aligned with the Declaration document. The steering committee has received permission from Dr. Keri Thomas (physician lead for the Gold Standards Framework (GSF),




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UK) to make changes to the GSF Prognostic Indicator Guidance tool to customize the tool for Mississauga Halton LHIN. This tool will be aimed at family physicians, specialist physicians and nurse practitioners and will be tested in the Learning Essential Approaches in Palliative (LEAP) session in March 2014 with Oakville primary level providers.

Further to the new model for hospice palliative care, (i.e. three levels of care based on patient/client needs for these levels), work is being undertaken to develop current state and future state of a central registry as part of the Central Intake Clinical and Business Mapping.

Long-Term Care (LTC) Palliative Care Working Group Members of the LTC Palliative Care Working Group reviewed, approved and provided feedback on the 19 project charters for the champion LTC homes (LTCHs). A few LTCHs have submitted their final project charters, which have been approved. The Mississauga Halton LHIN has provided funding to each of the 19 LTCHs to implement palliative care in the homes. The funding envelope has been developed as one-time funding for the period ending March 2014. This work will be acknowledged at the Hospice Palliative Care Ontario Conference in April 2014. Michelle Collins and Shehnaz Fakim, Senior Leads, Health System Performance will be presenting at this conference.

Regional Program for Rehabilitative Care A brief update on the Rehabilitative Care work was provided to the Mississauga Halton LHIN Clinical Integration Program Oversight Committee (CIPOC) on January 17, 2014. The fourth Mississauga Halton Rehabilitative Care Steering Committee was held on February 11, 2014. The committee is comprised of key stakeholders representing organizations involved in the delivery of rehabilitation services within the LHIN. The steering committee has finalized the terms of reference and the charter is focused on the initial priority of reviewing the LHIN’s bedded levels of rehabilitative care in order to make recommendations for system change.

Two clinical sub-committee working groups were initiated in January 2014 for Stroke and Elective Joint/Fractured Hips. Membership includes health service providers delivering rehabilitative care. The initial focus is addressing patient flow through best practices for:

1. Optimizing bedded levels of care 2. Targeted length of stay 3. Goals based admissions.

The work of the sub-committee will incorporate the Mississauga Halton Rehabilitative Care conceptual model, derived from recommendations of the Rehabilitative Care Alliance Definitions group through five levels of care: Slow to moderate progress,




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moderate to rapid progress, rapid progress, lifelong conditions and preventative programs.

The work of the provincial Rehabilitative Care Alliance is addressing concerns cited in the first annual Auditor General’s Report on Rehabilitation Services at hospitals released in December 2013 which calls for a better coordinated system for hospital rehabilitation services.

The provincial Rehabilitative Care Alliance Steering Committee held its third quarterly meeting in February 2014. Progress has been made on the work of the Alliance regarding the four priority initiatives: Definitions, Frail Senior/Medically Complex, Outpatient/Ambulatory data, and Capacity Planning and System Evaluation.

The Definitions Task Group of the Rehab Care Alliance has developed draft standardized definitions for bedded levels of rehabilitative care (i.e. hospital-based inpatient beds that are not coded as acute care as well as convalescent /restorative care beds within LTCH). At this stage, the Definitions Task Group is seeking further input from Health Service Providers across all LHINs to determine how well existing rehabilitative care programs in bedded levels of care fit within the proposed levels of care in the new definitions framework.

A new special task group of the Rehabilitative Care Alliance called the Rehab/CCC Bed Re-designation Task Group is creating a decision making framework to support the development of a

recommendation regarding a standardized approach to the re-designation of CCC to inpatient rehab beds in Ontario. This framework will identify the risks and benefits of re-designation within the context of clinical outcomes, financial, data availability and policy implications. It will also identify potential mitigation strategies.

Enhancing Access to Mental Health and Addictions Services A review of clinical and business case practices to support the System Access Model (SAM) sustainability is currently underway. This review will identify both current state and future state opportunities. The co-lead organizations, Halton Healthcare Services and Trillium Health Partners, are working closely with key mental health and addiction service providers with the implementation of SAM.

Mississauga Halton LHIN Telemedicine Strategy The Mississauga Halton LHIN Telemedicine Advisory Committee welcomed two new clinical champions that will support capacity building for telepsychiatry. Summit Housing and Outreach Programs have opened a new telemedicine site in Halton Hills to all local service providers in support of clinical, training and educations sessions.

Seniors’ Strategy A framework for a comprehensive Seniors’ Strategy is in development and in alignment with Dr. Sinha’s Living Longer, Living Well report. The goal is to ensure a seamless continuum of care for all seniors in the Mississauga Halton LHIN. Consultations with key




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service providers are underway to determine strategic areas of focus that will formulate goals and activities for identified improvement projects. ConnectingGTA On January 10, the Clinical Solution Team and Clinical Working Group experienced the first Portal Preview. Feedback indicated the preview was well-received and the initial functionality reflects what clinicians have asked for. Due to challenges with code developments in December, the timing and approach to the Limited Production Release (LPR) is being adjusted. ConnectingGTA is still committed to beginning the LPR by fiscal year-end and still tracking to the Full Go-Live timeline. Adjustments are taking place in the LPR pilot phase.

Resource Matching and Referrals (RM&R) Cluster 2 A “close out” session was conducted at the end of January with Halton Healthcare Services (HHS) who participated in the implementation of the Acute to Community Care Access Centre (CCAC) Provincial Referral Standard (PRS). HHS provided feedback on the process and the provincial standard which will be taken into consideration when releasing the final version of the PRS for this pathway. The implementation within two units of the Oakville Trafalgar Memorial Hospital was accomplished through their Hospital Information System (HIS). Trillium Health Partners (THP) will be implementing the same PRS (Acute to CCAC) in the new fiscal through an integration between their HIS and the Mississauga Halton CCAC’s CHRIS system. Project plans will be developed over the next couple of months to demonstrate how all remaining Provincial Referral Standards will be implemented with HHS and THP




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FAMILY HEALTH CARE WHEN YOU NEED IT

Improving Transitions Through Electronic Hospital and Emergency Discharge Initial stakeholder engagement session with hospital, primary care and Mississauga Halton Community Care Access Centre (CCAC) partners was held in February 2014. The goal of the group is to create a technological notification to primary care and/or Mississauga Halton CCAC upon either admission or discharge for patients at Halton Healthcare Services. This technology communication platform and process is currently in practice at Trillium Health Partners. Health Links Health Links – Provincial Work – Coordinated Care Tool Collaborative tools developed at the Provincial level (with assistance from a group of approximately 40 participants from across all 14 LHINs) will soon become available to our Mississauga Halton Health Links. Our first Health Link (East Mississauga) will be reviewing options as to how to utilize/incorporate the Provincial Care Coordination Plan Template into their existing plan. Options may be considered for a potential interim solution to assist in the communication of the care plan between the health service providers within the established care model. The current target time frame for participating in the Care Coordination Tool (demonstration phase)

will be Q1/Q2 2014. The Care Coordination Tool will share the information within the template in an automated solution across the health service providers within the care model. Connecting the Health Links With the confirmation of all the Health Link Leads, the inaugural meeting of Connecting the Health Links was held on January 29, 2014. This forum has been developed to collaborate on common issues that impact all Health Links in the Mississauga Halton LHIN. Through knowledge translation, successes and lessons learned will be shared, along with leveraging best practices. It will ensure Health Links are aligned with the work of regional programs. Opportunities to work collaboratively on issues and standardize key processes will be optimized. East Mississauga Health Link The East Mississauga Health Link continues to develop and refine the care coordination model for individuals with complex needs. Over 30 patients, from both hospital and community setting, have been served by the East Mississauga Health Link. A dedicated Health Link Coordinator has been hired and members of the Health Link are participating in the IDEAS program (Improving and Driving Excellence Across Sectors) through the Institute for Health Policy and Management Evaluation in Toronto. This quality improvement




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initiative is targeting improved access to primary care practice for Health Link patients. Halton Hills Health Link Halton Hills Health Link, under the leadership of Halton Hills Family Health Team and Links2Care are launching work on their business plan pending approval of their readiness assessment. South Etobicoke Health Link The South Etobicoke Health Link, under the leadership of LAMP Community Health Centre, has begun developing their business plan. A meeting of all the Collaborating Partners is scheduled for February 21 to engage them in the planning process. South West Mississauga Health Link The South West Mississauga Health Link, led by the Mississauga Halton CCAC, submitted their readiness assessment to the Ministry of Health and Long-Term Care in early January. A robust primary care engagement strategy has been implemented and planning is underway for the development of the business plan. North West Mississauga Health Link The North West Mississauga Health Link held their inaugural meeting in January and has begun developing their readiness assessment. It is anticipated that the readiness assessment will be completed by early March.

Oakville Health Link The OakMed Family Health Team and Acclaim Health are the lead partners for this health link. Planning has begun for the inaugural meeting of this health link in March. Milton Health Link The Prime Care Family Health Team and Summit Housing & Outreach Programs are the lead partners for this health link. Completion of the readiness assessment has commenced and the inaugural meeting of this health link is scheduled for March. Rapid Response Nurses (RRN) The Mississauga Halton CCAC and Trillium Health Partners have developed a new strategy to implement the Rapid Response Nurse across the Mississauga Halton LHIN geographical areas. The program has had a slow start in its initial stage focusing on specific patient population and hospital floors. The Mississauga Halton CCAC is currently looking at the challenges and mitigation strategies for this program. The role of the Rapid Response Nurses are being realigned and focused to the specific Health Links in the region. Primary Care 60 Second Foot Screen Process As part of the Mississauga Halton LHIN overall Diabetes Foot Care Strategy, funding has been provided to Trillium Health Partners and Halton Healthcare Services Diabetes Education Programs to deliver educational opportunities for Primary Care. These opportunities will focus on diabetes foot care best practices and the implementation of




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60 second foot screening. Education sessions will be held by March 31, 2014. Electronic Medical Record (EMR) Implementation As of December 31, 2013, the Mississauga Halton LHIN EMR implementations reflect a 75% adoption rate by family practices. This is 4% above the provincial average, and an increase of 4% from the previous quarter. In November 2013, OntarioMD hosted an information session on Hospital Report Manager targeting the physician audience within our LHIN. The session was held at the Oakville Trafalgar Memorial Hospital and was a great success. Results of information sessions like this will continue to increase our adoption percentage.

Hospital Report Manager (HRM) Halton Healthcare Services (HHS) has shifted their target Go Live date to March 2014. Trillium Health Partners (THP) is experiencing some challenges connecting to HRM through the ConnectingGTA Health Information Access Layer (HIAL). THP is working closely with the ConnectingGTA team to resolve this issue. Projected Go Live date will be communicated in the next CEO Report to the Board.




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ENHANCED COMMUNITY CAPACITY Caregiver ReCharge Program The program continues to bring on service recipients with over 398 caregivers currently receiving services from the Mississauga Halton LHIN’s three service providers. The hiring of the Respite Advisors for the overall Caregiver Re-Charge Program should be completed by the end of February 2014. The Respite Advisors will support caregivers by ensuring that all the caregivers on the program are accessing all services in the Mississauga Halton LHIN Caregiver Respite Program (Adult Day Services, Education and Counseling, Emergency Respite, Short Stay, In-Home Respite). They will also guide the caregivers in the use of their hours in the In-Home Respite services area. The services listed under the overall program for Respite are continuing to be developed and refined. The Caregiver Re-Charge Program received further funding from the Mississauga Halton LHIN for the upcoming fiscal year which is allowing further caregivers to come into the program.

Enhanced Nursing Support to Long-Term Care Home Residents Due to some staffing changes the “Acute Change in Condition Project” was put on hold. A report will be done on accomplishments and recommendations for the period that the project was operational. This will assist with building capacity at the bedside to all 28 long-term care homes which is one of the outcome measures of this Nurse Led Outreach Team (NLOT) initiative.

Implementation of Home First Evaluation Results Mississauga Halton LHIN/CCAC Service Maximum Program Evaluation Recommendations In 2009, the Mississauga Halton LHIN funded the Mississauga Halton Community Care Access Centre (CCAC) to develop and implement the Wait at Home, Wait at Home Enhanced and Stay at Home services. These services targeted reducing the Alternate Level of Care (ALC) rates in hospitals and diverting patients/clients from potentially inappropriate long-term care placement. These three services were initially known as the Service Maximum Program (as per funding source). Eventually the services were grouped under the Home First philosophy as one of the major initiatives to support the intent that when a person’s acute episode in hospital is completed, adequate resources are available to support the person to be discharged home. As part of its evaluation process, the Mississauga Halton LHIN undertook an evaluation of the Mississauga Halton CCAC Service Maximum Program. In August 2012, Sheracon Associates Inc. was tasked by the Mississauga Halton CCAC to conduct an evaluation of the aforementioned services. A draft report was submitted in May 2013 with recommendations on structure, process and outcomes. The Mississauga Halton LHIN has developed a draft process for operationalizing the recommendations and will be working with the Mississauga Halton CCAC on the next steps.




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Advancement of Community Practice and Building a Regional Learning Centre Engagement sessions have been held for all six areas under the Advancement of Community Practice initiative. The sessions were very well attended and provided valuable information on how the Mississauga Halton LHIN should proceed with the development of each of the six areas. It was determined that the six areas be renamed “Collaboratives” to better reflect their true mandate and the nature of their work. The next step is to confirm the Terms of Reference for each collaborative and send out an expression of interest for membership. The space for the regional learning center is progressing with a target date of completion for the end of March. Progress is being made in the hiring of the four Regional Educators to be stationed within the Regional Training Centre. Community Capacity Study A comprehensive assessment of current and future capacity and need for community-based health services for seniors is currently being conducted by Preyra Solutions for the Mississauga Halton and Central West LHINs. A cross-sectorial steering committee has been established to guide the study and identify additional stakeholder consultations (which are currently in progress). The study includes:

• An inventory and assessment of community health services available to seniors across all care settings

• A service needs assessment for current and future needs (based on a 5, 10, 15 year horizon)

• A gap/excess capacity analysis showing what if any gaps/excess capacity exist in the LHINS

• Identification of tangible implementation options that will enhance existing and/or classify net new services to address the forecasted gap and provide optimal elder care

• Delivery of a framework/tool that can be used for community capacity planning on a cyclical basis by the LHINs. The tool should incorporate the principle of risk adjusted scenario planning as an output

• A report with feasible recommendations that integrate the findings of the assessment and forecasting exercises.

The study and final report will be completed in April 2014.




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OPTIMAL HEALTH – MENTAL AND PHYSICAL

Centralized Intake for Patients with Chronic Diseases The Mississauga Halton LHIN has been working with KPMG over the past month on the Central Intake Clinical and Business Process Mapping and has seen much progress in a relatively short time frame. KPMG has been procured to help prepare and position our Central Intake related projects with robust and potentially collaborative business cases that will be developed in fiscal 2014-15. To-date, KPMG has conducted “current state” Value Stream Mapping

sessions with members from the following groups: Mental Health & Addictions, Diabetes Education Programs, and Palliative – Early Identification. In addition, Information Management/Information Technology Inventory of existing Central Intake related solutions from across the 14 LHINs and nationally has been collected and documented. Progress continues on track as we work our way towards early March for the delivery of their final recommendations.




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HIGH QUALITY PERSON-CENTRED CARE

Mississauga Halton LHIN Health Equity The Mississauga Halton LHIN System Planning Advisory Committee is conducting a survey to identify opportunities for organizational development, and preferred training and educational tools for health service providers to build their capacity and competency in addressing health equity. A LHIN-wide Health Equity Symposium is scheduled to take place at the St. Volodymyr Cultural Centre and Banquet Hall on March 20, 2014.

French Language Services The Mississauga Halton LHIN hosted the Liaison committee meeting composed of the French language coordinators from the Central West, the Mississauga Halton and the Toronto Centre LHINs and their respective senior directors. This was an opportunity to discuss the Joint Annual Action Plan (JAAP) 2014-2015. The JAAP is the plan that all parties agree to which sets out the objectives, priorities and actions each LHIN and Entity will undertake in the subsequent funding year. The action items in the 2014-15 JAAP are built on the work done in the 2013-14 Joint Annual Action Plan and in some cases are extensions of the 2013-14 action items. The plan includes the shared objectives of the LHINs and the Planning Entity. The LHINs’ actions or responsibilities will be focused on the priorities outlined in their Integrated Health Service Plan and Annual Business Plan. For the JAAP 2014-2015, three mains objectives were identified:

1. Ensure that the Francophone population has access to appropriate services in French particularly access to a primary health care (PHC) physician close to home

2. Enhance community capacity for francophone by supporting Francophone people staying at home

3. System Navigation by establishing clear connections between FLS health services providers and primary care.

The Planning Entity and the LHINs will develop an Annual Work Plan to operationalize the Joint Annual Action Plan 2014-2015.

Mississauga Halton LHIN Aboriginal Cultural Sensitivity Plan Mississauga Halton LHIN staff and Board will have to opportunity to learn more about indigenous cultural perspectives on health and wellness as introductory training has been arranged for March. This is the first of a series of sessions to be held over the year to help support an increased awareness of the unique needs of Aboriginal with our region.

OCAN and Inter-CHA Shared Assessment (including CCIM and IAR) Reports are just available reporting on regional results of OCAN and Inter-CHA submission and loading to the Integrated Assessment Record (IAR). Review of these reports will inform next steps to be




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taken towards further adoption and implementation of the tools in 2014-2015.

Implementation of Ontario Health Technology Advisory Council (OHTAC) Recommendations: The Cardiac Care Network released a report from their expert panel working group titled “Strategy for Community Management of Heart Failure in Ontario” on February 13, 2014. The Mississauga Halton LHIN staff will be reviewing this strategy and how it aligns with our plans for chronic disease prevention and management (CDPM) strategy as well as the OHTAC recommendations on heart failure clinics. Care Information Management (CCIM) - Integrated Assessment Record (IAR) Work is progressing as the Integrated Assessment Record (IAR) rolls out within our Long- Term Care Home facilities. Of the 27 homes, 12 have completed and the remaining 15 are all in progress. The target

date for completion is end of March 2014. Additional work on reports that will be submitted to the LHIN for analysis on adoption by all participating Health Service Providers (HSPs) will be delivered by end of fiscal.




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MEASUREMENT AND PERFORMANCE

Ministry-LHIN Performance Agreement (MLPA) Targets 2013/14 Q3 Stocktake report is in progress, expected to be submitted to the Ministry of Health and Long-Term Care (MOHLTC) March 3, 2014. Preliminary performance highlights include:

Mississauga Halton LHIN (LHIN) was within the acceptable range (10% corridor) in 12 of 15 performance indicators 3 indicators fell outside the acceptable range (detailed in chart below)

Indicator MLPA Target

Stocktake Q3

Stocktake Q2

Comments

Percent of Priority 4 Cases completed within access target for MRI 45% 40% 32%

-25% improvement between Q2 & Q3 -improvement directly attributed to infusion of MRI hours in Q2 -shortfall to MLPA target is directly related to population demand and # of available MRI hours -Proposal being developed by the LHIN and hospital partners for MOHLTC consideration to increase infrastructure/capacity to meet projected demand

90th Percentile wait time from community for CCAC in home services – application from community setting to first CCAC service (excl. case management)

21 days 42 days 44 days

-performance is attributed to Mississauga Halton Community Care Access Centre’s (MH CCAC) cost containment strategies to offset the 2012/13 deficit. -The MH CCAC achieved a balanced financial position in Q2 13/14; improvement is expected in this wait time in the latter half of FY2013/14 -5% improvement from the previous quarter

Repeat unscheduled emergency visits within 30 days for substance abuse conditions 21% 27.0% 31.5%

-first quarter in 8 cycles where the performance has exceeded the MLPA significantly; average of the last 7 quarters is 21.7% -Contributing factors include: changing substance preferences; patient/client demographics (homeless); limited alternative access to locations other than the emergency department; and limited ability/desire to self-manage planned interventions -planning is expected in this area in 2014/15 for residential withdrawal management programming

MOHLTC Updates Annual Business Plan Priorities Measurement and Performance


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NOTABLE SECTOR ENGAGEMENT Multi-Sector Accountability Agreement (M-SAA) 2014-2017 To facilitate the continual process of the M-SAA 2014-2017, the following sectors, Community Care Access Centre (CCAC) Mental Health and Addictions (MH&A) Community Support Services (CSS) were invited to engage in two webinar education sessions held on January 28 and January 30, 2014. The sessions provided a general overview of the M-SAA process expectations, changes and next steps. The Mississauga Halton LHIN is working collaboratively with health service providers to finalize the M-SAAs by March 31, 2014. See the timeline map below.

Hospital Sector Accountability Agreement (H-SAA) The Mississauga Halton LHIN concluded negotiations for all performance indicators and has finalized H-SAA agreements in place for 2013/14. The LHIN issued 60 day notifications to both Halton Healthcare Services and Trillium Health Partners in January 2014 for the 2014/15 H-SAA. The LHIN will commence discussions regarding the hospital annual planning submission (HAPs) in early March 2014.

Community Support Services (CSS) and Mental Health & Addictions (MH&A) Quarterly Sector Meeting The Community Quarterly Sector meeting was held on Wednesday December 11, 2013. Enhanced Community Capacity was the focus of this meeting, one of the five priorities of the Mississauga Halton LHIN Integrated Health Service Plan.

Community Governance Consultation Group (CGCG) The most recent Community Governance Consultation Group (CGCG) meeting took place on February 3, 2014 where the group planned for the next Governance to Governance (G2G) event on February 26, and discussed the RFP for governance training for Health Service Providers (HSPs).




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Governance to Governance (G2G) The next G2G is scheduled for February 26, 2014 and the theme is Quality. Dr. Joshua Tepper, President and CEO of Health Quality Ontario is our special guest.




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COMMUNICATIONS

Press Releases Make sure you Feel Better Faster this winter Oakville (December 18, 2013) – Local health care partners would like to remind residents of the full range of health care options available to them over the winter holiday season. Graeme Goebelle Reappointed Chair of the Board of Directors of Mississauga Halton LHIN Oakville (January 14, 2014) – The Mississauga Halton Local Health Integration Network (LHIN) is pleased to announce the reappointment of Graeme Goebelle as Chair of the Mississauga Halton LHIN Board of Directors, effective January 5, 2014. News Coverage – Mississauga Halton LHIN Engaging with our media partners includes the development and distribution of news stories either through Mississauga Halton LHIN news releases or repurposing information shared by our health service providers or the Ministry of Health. In January and February, some of the stories included:

'Nothing is worse than not being able to catch your breath' – Oakville Beaver, January 8, 2014

Increased funding for Alzheimer/dementia support programs – Burlington Post, January 16, 2014

Goebelle reappointed chair of LHIN - Mississauga News - January 15, 2014

Goebelle remains chair of local LHIN – Independent Free Press – January 15, 2014

Events Government and Community Services Fair 2014 - The Mississauga Halton LHIN, together with Central and Central West LHIN, participated in the 9th Annual Government and Community Services Fair at Cloverdale Mall. Handing out clementines and sharing information, the Mississauga Halton LHIN spoke with local residents about partnering with our communities for a healthier tomorrow. We joined more than 120 exhibitors who filled the community in on the bounty of local activities, business networks, specialty shopping, volunteer opportunities and government initiatives that take place all the time in our local community. The Government and Community Services Fair was hosted by Donna Cansfield, MPP Etobicoke Centre.




http://www.insidehalton.com/news-story/4305693--nothing-is-worse-than-not-being-able-to

http://www.insidehalton.com/news-story/4316964-increased-funding-for-alzheimer-demen

http://www.mississauga.com/news-story/4316106-goebelle-reappointed-chair-of-lhin/

http://www.theifp.ca/news/goebelle-remains-chair-of-local-lhin/

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Reports Annual Business Plan The Mississauga Halton LHIN 2012/13 Annual Business Plan was released and posted publicly on our website in English and French in February 2014. The Mississauga Halton LHIN website: Top four pages viewed after the landing pages during January–February 2014 were: • Careers • About our LHIN • Feel Better Faster • Current Activities Before the end of March 2014 our website will be moved to a new content management system that was selected through a competitive process. A LHIN Web Services Advisory Committee and Working Group composed of Pan-LHIN representation that include communicators, Web Editors, Senior Directors has been put in place to provide guidance on business requirements, as well as how to achieve a standardized approach while allowing flexibility for individual LHINs.




ceo report to the board - mississauga halton lhin · 2015. 4. 7. · mississauga halton lhin in the...

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