The following are highlights of the Champlain Local Health Integration Network (LHIN) Board of Directors meeting held in Ottawa, Ontario on May 25, 2016.
Regional Planning and Community Engagement
Sub-Acute Capacity Plan – Decision
The Champlain LHIN has developed a long-term plan to maximize the use of sub-acute services, both in hospital and in the community. Sub-acute care, a crucial part of the health system, helps to improve patient outcomes.
There are 871 sub-acute hospital beds in the Champlain region for patients who have completed acute-care treatment and are then transferred to rehabilitation or other forms of inpatient and outpatient care. These services benefit patients such as stroke survivors, those with acquired brain injuries, amputees, and older people who have become de-conditioned following illness or injury.
The plan was developed in collaboration with the Sub-Acute Capacity Steering Committee. The steering committee’s co-chairs, Cameron Love (Chief Operating Officer at The Ottawa Hospital) and Dr. Shaun McGuire (Chief of Staff at Bruyère Continuing Care), presented to the Board. Champlain LHIN Senior Director of Health System Integration, Cal Martell, also provided a detailed summary of the initiative.
“We spent an extensive amount of time engaging with patients, family members, experts across the field, and front-line program managers to get their opinions,” said Mr. Martell. Challenges cited by those who gave input include the need for better coordination of care, inadequate access to services, and serious gaps in living options for certain patient populations.
The plan makes a number of wide-ranging recommendations that will be implemented over the next few years. They include the following:
- Put in place early-identification and prevention strategies to help people avoid illness and future hospitalizations. At the same time, prevent hospital-acquired disabilities so that patients can go home earlier and healthier.
- Make significant investments in home-therapy supports, ambulatory services and other community-based sub-acute resources.
- Redistribute in-patient sub-acute beds across the region to align with patient needs based on demographic realities.
- Increase the number of in-patient rehabilitation beds and consolidate highly specialized rehabilitation at a single site in Ottawa, distributing higher-volume, less specialized rehabilitation at other regional hub sites.
- Reduce the length of stay for people in complex continuing care beds to match the provincial average. (Complex continuing care is for medically complex patients with long-term illnesses or disabilities who typically need skilled medical care). The aim is to ensure as many patients as possible are able to return to their own homes or community alternatives.
- Maximize the use of convalescent units in long-term care homes.
Proposed sub-acute care investments are $5.6 million for inpatient care, mainly for more intensive rehabilitation, and $11.3 million for community-based services.
The Champlain LHIN Board of Directors approved the directions contained in the plan. As a next step, it directed LHIN staff and partners to develop a detailed implementation plan to move forward on the recommendations.
This work aligns with the Champlain LHIN’s strategic direction of integration: improving the patient and family experience across the continuum of care.
French-language designation: Canadian Mental Health Association (Champlain East) – Decision
The Canadian Mental Health Association (Champlain East) serves roughly 1,400 clients a year in the counties of Stormont, Dundas & Glengarry and Prescott-Russell, providing a range of services such as community support, client sessions, peer support, intensive case management and mental-health promotion.
The Champlain LHIN Board approved a revised plan submitted by the Canadian Mental Health Association (Champlain East) as a fully designated agency under the French Language Services Act. This submission was previously approved by the Board of the French Language Health Network of Eastern Ontario (Le Réseau), and reviewed by the LHIN Board’s French Language Services Committee.
According to a new accountability measure established in 2014 by the Ontario Office of Francophone Affairs, all French-language designated agencies must attest to their compliance with their designation every three years. This is the first organization in the Champlain region to participate in this new process.
The work aligns with the Champlain LHIN’s strategic priority of providing culturally and linguistically appropriate care.
Reducing MRI Scan Wait Times – Update
MRI wait times continue to pose a challenge in the Champlain region. Two years ago, wait times for this diagnostic scan decreased significantly after the LHIN worked with hospitals to redistribute MRI patient referrals from hospitals with long waits to those with shorter waits. However, increasing demand has outstripped existing MRI capacity in Champlain and across Ontario. To reduce waits, the Champlain LHIN has boosted funding to conduct MRI ‘blitzes,’ but that has offered only a short-term solution.
It is important to note that people who need an emergency or urgent MRI receive one quickly. The longer waits are for less urgent scans.
A few years ago, the LHIN assigned The Ottawa Hospital to take a leadership role on this issue. The Ottawa Hospital’s President & CEO Dr. Jack Kitts gave a presentation to the LHIN Board, summarizing the findings of a recent third-party review.
The hospital commissioned this review with the aim of improving patient access to MRI scans. Four recommendations were outlined in the report:
- Implement central intake and triage for MRI referrals to even out wait lists at hospital sites across Champlain. The plan is to put in a place a manual central intake system, as an electronic tool would be prohibitively expensive. It is expected this system will be put in place in the coming months.
- Manage appropriate use of MRI services: Anecdotally, local radiologists in Champlain have estimated that 5-10 per cent of MRI requests are unnecessary or inappropriate. Maximizing the use of decision-support tools and evidence-based guidelines will assist in alleviating this problem.
- Improve efficiency in MRI bookings: Although Champlain hospitals are already extremely efficient in the number of scans done per hour, further efficiencies can be achieved by better planning for cancellations and no-shows, and optimizing staffing schedules.
- Fund additional operating capacity: The existing 13 MRI scanners in the Champlain region can offer sufficient capacity with extra funded hours, as long as these hours are allocated at sites where they will have the most impact on wait times.
Champlain LHIN Board Chair Jean-Pierre Boisclair agreed that such a scarce resource should not be burdened by inappropriate scan requests. “I’m really glad to see that the path forward includes reference to both supply and demand,” he explained.
Mr. Boisclair also commended regional hospitals for working collaboratively to ensure equitable access across the region to MRIs. “We have to look at the system as a whole and not at the pieces inside it. We’ve reached the point that sustainability of a quality health system requires that.”
The LHIN Board will closely monitor the progress of this work during 2016-17.
This initiative is aligned with the Champlain strategic direction of access: ensuring health services are timely and equitable.