mississauga halton lhin css and mh&a sector …...the provincial context: evolution of abi life...

Mississauga Halton LHINCSS and MH&A Sector Meeting

September 25, 2009

AgendaIntroductory Remarks Angela Jacobs 10 min

e-Health / IT•Blackberry Project Update•Software – Support and Housing Halton

Andrew HussainKaren Cutmore

20 min

CSS/MH&A Agency Profile•Peel Halton Acquired Brain Injury Services (PHABIS)

Carol WiliamsPHABIS

20 min

Shared Spaces Conference Ian Stewart 10 min

Mississauga Halton LHIN Quality Network•Project and Skills Inventories•Triple Aim

Angela Jacobs 15 min

Finance Update Paulette Zulianello 20 min

Break 10 min

Mississauga Halton LHIN Strategic Priorities•Update•Discussion

Narendra Shah15 min30 min

Accreditation Update Narendra Shah / Metamorphosis 15 min

ASSIST Update Ray Applebaum 15 min

Questions

Blackberry Project Update Andrew Hussain

CIO

Support and Housing Halton

Karen CutmoreManager, Finance and Administration

Support and Housing Halton

Information Technology Update

Embracing today’s availabletechnology

Background

HRIS Advisory Working Group

eHealth Advisory Committee

eHealth / OneMail

SHH response

SHH Response

Utilization of CCIM portalsGP, HRIS

eHealth OneNetworksecure100% managed

mobile connectivityBlackberry / BES synchronization

data securitydaily / weekly / off-site backups

Proposed Future

secure data centre

cost savings

computer training

offering of service hosting

? Questions ?

[email protected] 845 9212, x24

mailto:[email protected]

Peel Halton Acquired Brain Peel Halton Acquired Brain Injury ServicesInjury Services

Mississauga Halton LHIN Sector MeetingMississauga Halton LHIN Sector Meeting

September 25, 2009September 25, 2009

Presentation OverviewPresentation Overview

The Provincial ContextThe Provincial ContextCurrent (2006) Incidence of ABICurrent (2006) Incidence of ABIEvolution of ABI ServicesEvolution of ABI ServicesService NetworkService Network

PHABIS History and ServicesPHABIS History and ServicesAgency Development TimelinesAgency Development TimelinesSeniorsSeniors’’ Programme StatisticsProgramme StatisticsCase Studies: Service Integration/continuumCase Studies: Service Integration/continuum

The Problem: Provincial Incidence The Problem: Provincial Incidence Rates of Brain InjuryRates of Brain Injury

Nearly 500,000 Ontarians live with ABI (traumatic and nonNearly 500,000 Ontarians live with ABI (traumatic and non--traumatic causes)traumatic causes)ABI is more prevalent than breast cancer, HIV/AIDS, spinal cord ABI is more prevalent than breast cancer, HIV/AIDS, spinal cord injury and injury and multiple sclerosis COMBINED!multiple sclerosis COMBINED!Cost estimates: $2Cost estimates: $2--billion annually in Ontariobillion annually in Ontario27,000 children and youth in schools without proper help27,000 children and youth in schools without proper helpIn 2006 17,482 people sustained traumatic BI. 19,311 sustained nIn 2006 17,482 people sustained traumatic BI. 19,311 sustained nonon--traumatic traumatic BIBI53% of the homeless have ABI history. 70% Prior to homelessness53% of the homeless have ABI history. 70% Prior to homelessnessAs a group, the eight community agencies are currently providingAs a group, the eight community agencies are currently providing 51% of the 51% of the support to nonsupport to non--residential clients and 29% to residentialresidential clients and 29% to residential44% of the people in corrections have ABI44% of the people in corrections have ABIABI is a life long chronic disability that requires life long suABI is a life long chronic disability that requires life long support and pport and resource commitmentresource commitment

Committee on Traumatic Brain Injury, Institute of Medicine of thCommittee on Traumatic Brain Injury, Institute of Medicine of the National Academies, Evaluating the HRSA Traumatic Brain Injurye National Academies, Evaluating the HRSA Traumatic Brain Injury

Program Program 2006: the National Academies Press, Washington, D.C. / 2006 Cens2006: the National Academies Press, Washington, D.C. / 2006 Census, Statistic Canadaus, Statistic Canada

The Provincial Context: The Provincial Context: Evolution of ABIEvolution of ABI

Life saving technology in the 70Life saving technology in the 70’’s and 80s and 80’’ssSaving them to what? Absence of rehab beds lead to U.S. Saving them to what? Absence of rehab beds lead to U.S. SolutionsSolutions19871987--1992 ~ 125 Ontario patients with ABI sent to U.S. Annual 1992 ~ 125 Ontario patients with ABI sent to U.S. Annual OHIP costs rose from $4.4 million to $29.8 million in 1998/99 OHIP costs rose from $4.4 million to $29.8 million in 1998/99 1994 passage of Long Term Act 1994 passage of Long Term Act Repatriation Round 1 (mid 1990Repatriation Round 1 (mid 1990’’s): 65 applicants, 13 agencies s): 65 applicants, 13 agencies selected for vetting, 8 preferred providers identified, PHABIS selected for vetting, 8 preferred providers identified, PHABIS rated #1rated #1Repatriation Round 2 (2002) Repatriation Round 2 (2002) –– 2 agencies funded for Complex 2 agencies funded for Complex Hard to Serve Hard to Serve

The Provincial Context: Provincial The Provincial Context: Provincial Hospital Service NetworkHospital Service Network

Hamilton Health Science Centre (General Hospital Hamilton Health Science Centre (General Hospital -- ABI)ABI)St JosephSt Joseph’’s Centre for Mountain Health Services (Psychiatric s Centre for Mountain Health Services (Psychiatric Services)Services)West Park Healthcare Centre (ABI Behaviour Services)West Park Healthcare Centre (ABI Behaviour Services)Sunnybrook Health Sciences Centre (Trauma Centre)Sunnybrook Health Sciences Centre (Trauma Centre)University Health Network (Toronto Western Hospital University Health Network (Toronto Western Hospital ––Neuroscience Centre)Neuroscience Centre)Toronto ABI Network Toronto ABI Network –– Toronto Rehab.Toronto Rehab.

Regional Hospitals:Regional Hospitals:

(Trillium Health Centre, Credit Valley (Trillium Health Centre, Credit Valley

Hospital, William Hospital, William OslerOsler

Health Centre, Halton Healthcare Health Centre, Halton Healthcare Services)Services)

The Provincial Context: The Provincial The Provincial Context: The Provincial Community Service NetworkCommunity Service Network

Brain Injury Community ReBrain Injury Community Re--Entry, NiagaraEntry, NiagaraBrain Injury Services of HamiltonBrain Injury Services of HamiltonBrain Injury Services of Northern ON (Thunder Bay)Brain Injury Services of Northern ON (Thunder Bay)Brain Injury Services of Brain Injury Services of SimcoeSimcoe County (Barrie)County (Barrie)Community Head Injury Resource Services of TorontoCommunity Head Injury Resource Services of TorontoDale Brain Injury Services (London)Dale Brain Injury Services (London)Peel Halton Acquired Brain Injury ServicesPeel Halton Acquired Brain Injury ServicesRegional Community Brain Injury Services (Kingston)Regional Community Brain Injury Services (Kingston)Vista Centre (Ottawa)Vista Centre (Ottawa)

PHABISPHABISIncorporated in 1992 to provide Assisted Living and outreach Incorporated in 1992 to provide Assisted Living and outreach services for adults with ABIservices for adults with ABI1996 Expanded Assisted Living (7 beds) and Day Services1996 Expanded Assisted Living (7 beds) and Day Services2002 Expanded Assisted Living for complex clients (9 beds)2002 Expanded Assisted Living for complex clients (9 beds)2009 Senior2009 Senior’’s Program (Day Services, PSIT, Specialized s Program (Day Services, PSIT, Specialized consultation)consultation)Currently serves:Currently serves:

15 treatment beds (PHABIS West + TRSL) 15 treatment beds (PHABIS West + TRSL) –– MOH FundedMOH Funded12 Supported Living beds across three sites (24 hour support)12 Supported Living beds across three sites (24 hour support)5 clients in S.I.L. 5 clients in S.I.L. -- Partnership with Participation House (24 Partnership with Participation House (24 hour from P.H. Case Management from PHABIS)hour from P.H. Case Management from PHABIS)157 Community programming clients (PSIT)157 Community programming clients (PSIT)201 Day Service Participants (includes psychological and 201 Day Service Participants (includes psychological and neuropsychiatricneuropsychiatric consultation)consultation)

CommunityCommunity Treatment/Support: Treatment/Support: NeurobehaviouralNeurobehavioural

Model Model

NeurobehaviouralNeurobehavioural

Model Key Model Key ComponentsComponents

Integrates Cognitive and Behaviour needs into physical Integrates Cognitive and Behaviour needs into physical care routines. Specially trained care routines. Specially trained NeurobehaviouralNeurobehaviouralSupport Workers (Client Programme Facilitators)Support Workers (Client Programme Facilitators)Clients have Clients have limitedlimited ability to direct own careability to direct own careGoal orientedGoal orientedClient FocusedClient FocusedBehavioural/Functional/Empirical approach to Behavioural/Functional/Empirical approach to Care/RehabilitationCare/RehabilitationPromotes IndependencePromotes Independence

Basic guiding principlesBasic guiding principles::

Clients need structureClients need structureClients need consistencyClients need consistencyClients need engagementClients need engagement

SeniorsSeniors’’

ProgrammeProgramme

Purpose:Purpose:

To Increase Community Capacity to To Increase Community Capacity to support seniors with ABI. To help address support seniors with ABI. To help address ER/ALC pressures.ER/ALC pressures.

Components:Components:

Behavioural Consultation and ABI educationBehavioural Consultation and ABI educationSeniors Day ProgrammingSeniors Day ProgrammingStaff AugmentationStaff Augmentation

SeniorsSeniors’’

StatsStats

Funding Approval January 2009Funding Approval January 2009First Referral March 2009First Referral March 2009Number of Referrals Number of Referrals –– 1616Number of ALC/Hospital Referrals Number of ALC/Hospital Referrals –– 66Number of LTC Referrals Number of LTC Referrals –– 77Number of Community Referrals Number of Community Referrals –– 33Number of ALC Transitions Number of ALC Transitions –– 1 (one on the way)1 (one on the way)Number of LTC Transitions Number of LTC Transitions –– 11Number of Aging at Home Clients Number of Aging at Home Clients -- 22

Case StudyCase Study

Background/Rehab. HistoryBackground/Rehab. HistoryPHABIS SeniorsPHABIS Seniors’’ Programme Involvement in Programme Involvement in LTCLTCLarger Service System Resource MobilizationLarger Service System Resource Mobilization3 Month Assessment Period 3 Month Assessment Period -- PWPWTransition to Assisted LivingTransition to Assisted LivingAssessment regarding gradual return to homeAssessment regarding gradual return to home

HighlightsHighlights

Client Mobility due to incomplete rehabilitationClient Mobility due to incomplete rehabilitationNeed for flexibility in terms of staffing resourcesNeed for flexibility in terms of staffing resourcesLarger System Problem SolvingLarger System Problem SolvingLimitations of LTC legislation, philosophy of Limitations of LTC legislation, philosophy of care and resourcescare and resourcesFunctional Rehabilitation/Skill focused Functional Rehabilitation/Skill focused approach (Recognizing Rehab. Potential)approach (Recognizing Rehab. Potential)Long Term Residential bed opening Long Term Residential bed opening

Shared Spaces Conference Ian Stewart

Executive Director ADAPT

Co-Location Project

• Promote service integration with access to a range of services under one roof

• Include services to address housing , employment, family and financial supports

• Share resources, reduce overhead

Who’s at the Table• 7 Mental Health and Addiction programs:

• ADAPT• CMHA Halton• PAARC• Support and Housing Halton• Schizophrenia Society of Ontario• Summit Housing and Outreach• STRIDE

• Project Management – DTZ Barnicke

MH&AMH&A

MH&A

MH&A

SocServ

Soc Serv

Primary care Close to public transportation

Physically accessible

OfficesWith ‘drop down’

OfficesWith ‘drop down’

Centralized Information /Referral & Intake

Comfortable,waiting space w/private areas

Childcare / Children’s services

Meetingspace

Meetingspace

‘Green space’-Community Garden

Retail/Cafe

Shared Space Forum

• Sept. 18th Forum – 100 people attended

• Presentations from successful projects

• Peel Human Services • Toronto Centre for Social Innovation• Family Violence Project for Waterloo Region• Lang Farms

Moving forward

• Participants identified:

• Value of shared space• Current need• Vision of the Possibilities

• Increased interest in the project

• If interested in finding more information, please contact Ian at [email protected]

mailto:[email protected]

Mississauga Halton LHIN Quality Network Angela Jacobs

Senior Lead, Performance and Integration

Membership:• Co-Chaired by: Bill MacLeod and Susan Kwolek CVH

• Representatives from all of our funded healthcare sectors:

• LTC Homes• Hospitals• CCAC• CSS – Lorena Smith – Senior Life Enhancement Centre

• Joanne Bamford – March of Dimes• Mental Health – Charlene Winger – North Halton Mental Health

Clinic and Radhika Subramanaya CMHA Halton• Addictions – was Carol Wilkinson CVH – looking for a new

member

Several Deliverables:• Amongst many deliverables, I require your assistance for:

• Inventory of Quality Projects in MH LHIN• Inventory of Quality Resources in the LHIN

• Completed for hospitals and now need other sectors

• Think about what your organization is doing and what sort of skill sets your staff have.

• I will be e-mailing out a template to all our CSS and MH&A HSPs shortly.

Learning about:

About the Triple Aim Initiative

• The Triple Aim is a new international learning initiative from the Institute for Healthcare Improvement (IHI)

• IHI is an independent not-for-profit organization helping to lead the improvement of health care throughout the world.

• Founded in 1991 and based in Cambridge, Massachusetts.

• IHI works to accelerate improvement by building the will for change, cultivating promising concepts for improving patient care, and helping health care systems put those ideas into action.

http://www.ihi.org/

“No Needless List”• IHI works with health professionals across the world to accelerate the

measurable and continual progress towards the health care system objectives related to: Safety, Effectiveness, Patient-Centeredness, Timeliness, Efficiency, and Equity. This is called the "No Needless List":

No needless deaths No needless pain or suffering No helplessness in those served or serving No unwanted waiting No waste No one left out

Quality and Patient Experience

Triple Aim:

The Simultaneous Pursuit of

• Population Health,

• Enhanced Individual Care, and

• Controlled Costs for a Population

How Not to Do It…

The Triple Aim IHI believes that new designs can and must be developed to simultaneously accomplish three objectives, or aims

ImprovePopulation

Health

EnhancePatient Experience

(e.g. quality, access)

Reduce, or control,per capita cost

of care

Current Triple Aim Sites

Triple Aim is a System of Improvement:

Triple Aim Design Components:

Design of a Triple Aim EnterpriseDefine “Quality” from

the perspective of an individual member of a defined population

The “Triple Aim”

Health care Public healthSocial services

Per capitacost reduction

Integration

System-LevelMetrics

$E

PH

Definition ofprimary care

1

Patients andfamilies

Population healthmanagement

Concept of “Macro-Integrator”

Triple Aim Interest is Growing in Ontario• In Ontario great interest from The Change Foundation and The

Centre for Healthcare Quality Improvement (CHQI) and the LHINs.

• Central East LHIN the pioneer in exploring Triple AIM concepts:

• Save 1,000,000 hours spent by patients in hospital emergency departments by 2013

• Reduce impact of vascular disease by 10% by 2013

• All LHINs are now considering / using / applying (to varying degrees) the triple AIM concept

• Most LHINs are involved in further training with IHI

We have always implicitly Triple Aim without knowing and acting on it explicitly…

Triple Aim Themes

• Involving families and caregivers

• Self-management

• Improving the patient experience in access & quality

• Integration

• Measurement

Triple Aim Themes

• Population health

• Partnerships with other sectors

• Self-management

• Measuring the patient experience in access, quality & equity

Our Vision

A seamless health system for our communities – promoting optimal health and delivering high quality care when and where needed.

Improving Access, Quality andSustainability of the Health System


Prevention and Managementof Chronic Conditions


Integrating Mental Health and Addiction Services


Enhancing Seniors’ Health, Wellness and Quality of LifeEnhancing Seniors’ Health, Wellness and Quality of Life

AccessibleAccessible

EffectiveEffective

EfficientEfficient

SafeSafe

Person CentredPerson Centred

IntegratedIntegrated

Appropriately ResourcedAppropriately Resourced

Focused on Population HealthFocused on Population Health

Strengthening Primary Health CareStrengthening Primary Health Care

MH LHIN Strategic Directions

Attributes of a high performing health system







Enhancing Seniors’ Health, Wellness and Quality of LifeEnhancing Seniors’ Health, Wellness and Quality of Life

Strengthening Primary Health CareStrengthening Primary Health Care

AccessibleAccessible

EffectiveEffective

EfficientEfficient

SafeSafe

Person CentredPerson Centred

IntegratedIntegrated

Appropriately ResourcedAppropriately Resourced

Focused on Population HealthFocused on Population HealthPopulation Health

Patient Experience

Cost Control

Strategic Directions

MH LHIN Focus

• Looking at Opportunities to integrated the Triple AIM concepts into our work vis-a-vis the IHSP

• Start small – pick a few existing initiatives to incorporate the concepts

MH LHIN Finance Update Paulette Zulianello

Senior Lead, Funding and Allocation

OHRS Phase 3 - MIS Q2 reporting due Oct 30th

• Test environment Sept 14 – 30th

• Production environment Oct 2 – 30th

• CSS OHRS volunteer mentors

• Fee for Service resources

• Front End Excel tool to enable Quarterly WERS Reporting

• Brings together the CAP’s budgets and Schedule “E” into one report.

• Access your specific information more easily

(No more endless scrolling through worksheets)

• Automated forecasting and analysis

• Edit checks built in

CAT Transition Flat File.xls

Data Only

UPLOAD from HSP

CAT Transition Flat File.xls

Data Only

Ministry ReportPopulated from Transition File

EXPORT UPLOAD

The Health Service Provider input (YTD Actual directly into

the CAT model

IMPORT

DOWNLOAD to LHIN

HSP to LHIN Process Flow

DOWNLOAD

New: Automated Forecasting

• HSP can select from a “menu”

of forecast methods

• Allow for manual forecast input or one time entry in a forecast

• YOUR Forecast

What if I See this Error Message?

Sept 15th E-mail

1)GENERAL INSTRUCTION SETUP

Create a new folder on your computer or network where you will be saving your Quarterly reports as required in your MSAA agreement. Give the folder any name you prefer. Within this folder create 3 additional folders named: Q2, Q3, and Q4.

2) EXCEL V2003 OR V2007 MACRO SETUP

3) ILLUSTRATED FOLDER CREATION

MHLHIN Training Sessions:• Wed. Oct 21 (CSS)

• Wed. Oct 28 (SH and CMH&A)

• 9am to 12 MHLHIN Large Boardroom

• not quite 1/2 Registered to date

• Bring your own memory stick, keyboard and mouse

In Year Re-allocations

• Q3 WERS (CAT Tool) reporting deadline Feb 5, 2010(Too late for CSS in-year recoveries)

• Year-end forecast (A@H and remainder) by Dec. 15

• Must identify expected year-end surpluses early to avoid Ministry recoveries

Break! 10 Minutes

MH LHIN Strategic Priorities Narendra Shah

COO, MH LHIN

Mississauga Halton LHIN Integrated Health Service Plan 2010 - 2013September 2009

Service Delivery

PerformanceImprovement

By Health Service Providers delivering,

integrating, and improving services …

Transformation & Integration

Reduce ER treatment time and provide alternate care

options

Prevention and promotion are an intrinsic part of the health care

experience

Improve appropriate use of hospital beds by providing discharge options for ALC

patients

Transform community capacity so people receive the services

they need, where they need them, when they need them

Improve quality of care andpatient satisfaction

Drive results through information and transparency of reporting

Meet performance standards and hold each other accountable

Improve transitions from acute to community care

Improve access to integrated diabetes services

Improve access to integrated mental health and addiction

services

Improve access to primary health care Improved access to specialized

services across the LHIN

Through enablers that will support our success …

Partnerships for Collaboration

E-Health Transportation Engaged public about their personal health

Health Human Resources

CapacityIncrease

We will work together as a

system …

Engage communities and providers to seek their feedback to shape and

improve the health system

Value the skills and talents of the healthcare workforce

Partner broadly to improve health and quality of life in

our LHIN residents


By focusing on health system priorities… Integrating Mental

Health & Addictions

Transform the health system , improve outcomes, and ensure sustainability with a focus on:

Primary Health Care

Prevention & Management Chronic Conditions

(Diabetes, CKD)

Enhancing Seniors’ Health, Wellness,

Quality of Life

Access & Sustainability(ER Wait Times & ALC)

We will move towards our vision …

Improvedhealth

Access to primary health

care

Improved outcomes

Timely access

That meet the diverse population’s needs for …

Efficiency & affordability

What

HowAging at Home InvestmentsHospitals (PCOP)



Service Delivery

Reduce ER treatment time and provide

alternate care options

Prevention and promotion are an

intrinsic part of the health care experience

Improve appropriate use of hospital beds by

providing discharge options for ALC

patients

Improve access to primary

health care



Service Delivery







patients


health care

Enable hospitals to focus on their core servicesImprove & increase community sectors capacity



Service Delivery







patients


health care


Transform community capacity so people

receive the services they need, where they need them, when they need

them


Improve access to integrated diabetes

services

Improve access to integrated mental health and addiction services

Improved access to specialized services

across the LHIN



Service Delivery







patients


health care




them



services



across the LHIN

In both community sectors & in hospitals



Service Delivery







patients


health care




them



services



across the LHIN

Examples:CardiacVascularRegional GeriatricsCommon assessment for SDL




Improve quality of care and

patient satisfaction

Drive results through information and

transparency of reporting

Meet performance standards and hold each

other accountable

Service Delivery







patients


health care




them



services



across the LHIN









other accountable

Service Delivery







patients


health care




them



services



across the LHIN

Applies to all providers









other accountable

Service Delivery







patients


health care




them



services



across the LHIN

Mississauga Halton LHIN Integrated Health Service Plan 2010 - 2013September 2009

Service Delivery





Reduce ER treatment time and provide alternate care

options

Prevention and promotion are an intrinsic part of the health care

experience

Improve appropriate use of hospital beds by providing discharge options for ALC

patients

Transform community capacity so people receive the services

they need, where they need them, when they need them

Improve quality of care andpatient satisfaction

Drive results through information and transparency of reporting

Meet performance standards and hold each other accountable


Improve access to integrated diabetes services

Improve access to integrated mental health and addiction

services

Improve access to primary health care Improved access to specialized

services across the LHIN

Through enablers that will support our success …

Partnerships for Collaboration

E-Health Transportation Engaged public about their personal health

Health Human Resources

CapacityIncrease

We will work together as a

system …

Engage communities and providers to seek their feedback to shape and

improve the health system

Value the skills and talents of the healthcare workforce

Partner broadly to improve health and quality of life in

our LHIN residents


By focusing on health system priorities… Integrating Mental

Health & Addictions

Transform the health system , improve outcomes, and ensure sustainability with a focus on:

Primary Health Care

Prevention & Management Chronic Conditions

(Diabetes, CKD)

Enhancing Seniors’ Health, Wellness,

Quality of Life

Access & Sustainability(ER Wait Times & ALC)

We will move towards our vision …

Improvedhealth

Access to primary health

care

Improved outcomes

Timely access

That meet the diverse population’s needs for …

Efficiency & affordability

Performance Highlights Aging At Home Investments

2008/09

Performance Highlights1. Overall, the initiatives had a positive impact in

meeting the intent of the Aging at Home Strategy.

2. Many of the initiatives are innovative such as Restore SDL and use of ABI expertise to manage difficult behavioural cases. These new initiatives undoubtedly take time to gain momentum.

Performance Highlights3. The LHIN’s transformation journey of right care

in the right place at the right time is a cornerstone to an effective patient flow strategy. This major shift in focus has just begun.

Right Person

Right Place

Right Time

• Maple Scores• Common

Assessments Used• High Needs Prioritized

Performance Highlights cont…4. The LHIN used the Aging at Home agenda to begin a

major transformation of all sectors to provide integrated care. For hospitals, it meant a major re-orientation of discharge planning to “home first”. Waiting at home or a transitional setting is an optimal solution for many hospitalized seniors who need post hospital care for a number of reasons:

• A reduced risk for hospital acquired infections• A reduced risk for hospital associated de-conditioning• The option to wait for a preferred choice of Long Term Care• Time to optimize functioning post-acute hospitalization prior to

making permanent major housing decisions• Home provides the best environment to experience the

significant life transition of moving to (in most situations) your final residence, a nursing home.

Challenges• Slow start

• Referrals & hand-offs – need to improve!

• Communication of new investments critical – what to access when & how?

• Expect better performance for all in 2009/10

Discussion Using “World Café”

World Café• Select a scribe for your table. Don’t worry – you won’t have to present – just

write!

• For the next 15 minutes, discuss the question on the next slide (also typed on the piece of paper being handed out).

• Make notes during this time period.

• At the end of 15 minutes (time will be called) everyone EXCEPT the scribe moves to other tables. Mix it up!

• The scribe reads out the notes they took and the discussion will continue.

• Scribe to take more notes on the discussion.

• The paper will be handed in to the LHIN for consolidation.

• Move back to your original table.

Café Question:

• Most of the MH LHIN new investments over the last couple of years has been used to fund community capacity.

• What still needs to be done in the community to facilitate improved access and flow of clients to services they need?

MH LHIN Accreditation

MH LHIN Accreditation Update Narendra Shah

COOSeptember 25, 2009

Why Accreditation?• MH LHIN considers it as an important element of overall

quality improvement focus

• Continuous quality improvement should be all providers core mandate

• All sectors are subject to province-wide accreditation except the CSS and CMHA sectors

• MH LHIN considered it important enough to make it part of the signed M-SAA. The M-SAA states: “That all HSPs engage with an Accreditation body (provincial or national) with accreditation status to be completed by March 31, 2011.”

Progress Made by Metamorphosis

• Metamorphosis, as a representative of the CSS and MH&A HSPs volunteered to co-ordinate the investigation into accreditation bodies, consult with MH LHIN HSPs and recommend a process to be followed to ensure accreditation.

• They met with LHIN staff several times and presented their recommendations on September 17, 2009.

MH LHIN Agreement in Principle• Accreditation timeline will run from October 1, 2009 to September

30, 2013 using a phased-in approach for our HSPs, due to accreditation capacity.

• There will be additional training for those HSPs who have never been accredited. This training will be offered by OCSA and non- accredited HSPs will be required to participate in at least one course before March 31, 2011.

• By March 31, 2010, HSPs are required to select a reputable accreditation agency that includes within its accreditation process a leadership and governance review.

• By this date, the HSPs are required to submit a letter to the LHIN detailing their timeline for accreditation and indicating if and when they will be participating in OCSA training.

MH LHIN Financial Commitment • Subject to finalizing costs (one-time and base), in

principle, based on the estimates tabled by the group, the Metamorphosis group, LHIN agrees to fund the cost of accreditation

• Once the letter and timeline has been accepted by the LHIN, the M-SAA agreement will be modified and funding for the accreditation process will be flowed to the HSP.

• A pool of “one-time” money will be created, funded by the MH LHIN, to support the additional training required for those HSPs who need it throughout the accreditation timeframe.

Accreditation Update Metamorphosis/OCSA/SHRTN

Purpose

• In support of the MH LHIN’s

strategy to encourage a ‘voluntary commitment to self

improvement by HSP’s

through an accreditation process’

–

John Magill, June 5,

2009 and M‐SAA Obligation:

develop a collaborative multi‐year plan to support and build capacity for HSP’s

(of all

sizes) to achieve accreditation

Action Steps

• Accreditation session held June 5th• Communiqué

circulated to all CSS/MH&A providers

• Press release circulated August 1st

to announce the launch of the June 5th

presentations on the OCSA

website• Communication with accreditation bodies (one

organization offered a reduction for multiple agencies)• Reps from Metamorphosis, OCSA, and SHRTN met with

the MH LHIN (C.A.O. and Senior Performance staff) August 12th

Action Steps continued….

• Metamorphosis network forum Sept. 9th

• Presentation of endorsed multi‐year plan to MH LHIN September 17th

• Announcement of Metamorphosis multi‐year plan approval by MH LHIN at Q2 meeting

September 25th

• Suggested to announce multi‐year plan at Governance to Governance session Sept. 30th

Principles…Continued

• Sectoral

surpluses identified as at December 31st

effective 2009 will be considered for

allocation in support of the approved multi‐ year allocation plan

• Freedom of choice of HSP’s

to select an accreditation body (provincial or national),

utilizing amongst other tools, the Metamorphosis criteria guidelines

Road Map – Key Elements

• Multi‐year phased approach for all CSS/MH&A HSP’s

reflecting capacity/realities of existing

accreditation bodies (provincial/national) including new policy of 5 year requirement for

CCAC contracted providers• Utilizing Benchmarks of Excellence as a transition

to Accreditation• Support for ongoing capacity building for HSP’s,

e.g. quality leadership circles, and workshops• OCSA/SHRTN/Ontario Health Quality Council

Metamorphosis Multi‐Year Accreditation Plan Framework

• 4 year plan (October 1, 2009 – September 30, 2013)

• 43 HSP’s

to identify utilization of:Participating in Benchmarks of Excellence (approx. 2‐5

months)Skill Development Workshops through CapacityBuilders

Participating in Accreditation Leadership Circles

Identify timeline and selection of accreditation body by no later than March 31, 2010

Quality & Accreditation Learning Proposal

• Two sources of resources from MH LHIN

1.Accreditation fees to base budget for HSP’s

2.Multi‐year learning resources to support and build capacity for accreditation plan facilitated

by Metamorphosis & its partners

Quality and Accreditation Learning Proposal

Mississauga Halton LHIN Community and Home Care Agencies

• Benchmarks of Excellence for the Community Support Sector

• Quality and Accreditation Leadership Circles: Developing Peer Coaching Groups

• Accreditation Skills Development Workshops

Benchmarks of Excellence for the Community Support Sector

• Benchmarks of Excellence for the Community Support Sector

is a process that looks at the

health of the whole organization including clarity of purpose, producing results, optimizing

resources, ensuring accountability, building collaborations, nurturing innovation and

responsiveness and providing a positive and productive work environment.

• The formal assessment will be coordinated and facilitated by Capacity Builders.

• Cost per agency ‐

$3500

Quality and Accreditation Leadership Circles: Developing Peer Coaching Networks

• Quality and Accreditation Leadership Circles

(QALC) is based upon

the recognized educational process of Action Learning whereby the

participant studies their own actions and experience in order to

improve performance. Action Learning includes ongoing, highly

focused meetings among small groups of peers each of whom is

committed to meeting real‐life challenges or goals –

and learning at

the same time. Using this model, Quality and Accreditation

Leadership Circles

will bring together senior staff responsible for

quality management and accreditation from each participating

MHLHIN agency into facilitated peer coaching groups of 8

participants who will learn and help each other in incorporating

accreditation expectations into their organizations.

• Cost for establishing and creating each QALC ‐

$2400.

Accreditation Skills Development Workshops

• Capacity Builders will offer 4 full day open registration workshops on skills and knowledge

that will support and assist community and home care agencies with the accreditation process and

implementation of outcomes. Program topics could include Quality 101, Change Management,

Project Management, Process Management, Performance Metrics and Communication Skills.

Cost ‐

$149 per participant per workshop.

Minimum 20 participants.

Plan Benefits

Overall Multi‐Year

Plan

Leadership Circles Benchmarks of

Excellence

Skills Development

Workshops

•Provide HSPs with

adequate time to

comply•Assist and support

HSPs in acquiring

accreditation status•Acquire financial

support from the

MH LHIN for

ongoing direct costs

associated with

accreditation and

organizational

preparation•Create a culture of

mutual support

•Expert advice at

lower costs•Sharing of work to

reduce time and

energy•Provide support,

networking and

encouragement for

organizational

change•Tested and proven

group process•Leverages

expertise of

resources of

Capacity Builders

•Survey forms

completed by

boards, staff, and

volunteers•Forms analyzed by

trained and

experienced

consultant•HSPs provided

with written report

and consultant

briefing session

with Board and

staff to review

findings and

facilitate plan

•Workshops on

skills and

knowledge that

support HSPs with

accreditation

process and

implementation of

outcomes•Topics include:

quality,

change/project/pro

cess management,

performance

metrics, and

communication

skills

Next Steps

• Present final results at the MH LHIN quarterly meeting on September 25th

• Survey with HSPs to identify draft timeline, accreditation selection, and support

Next Meeting – December 10, 2009 9:00 - noon

Hilton Garden Inn, Oakville

QUESTIONS?

mississauga halton lhin css and mh&a sector …...the provincial context: evolution of abi life...

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