The following are highlights of the Champlain Local Health Integration Network (LHIN) Board of Directors meeting held in Ottawa, Ontario on January 25, 2017.
Second Quarter 2016-17 Performance Report
The LHIN’s quarterly reports provide detailed summaries of health-system performance in the Champlain region, based on 29 indicators such as wait times for various services and the number of patients in hospital waiting for an alternate level of care in the community.
The LHIN Board discussed and approved the second quarter report for 2016-17. Of the 29 indicators reported, 14 are determined by the Ministry of Health and Long-Term Care (Ministry) and shared by all LHINs. On average, the Champlain LHIN is 84 per cent of the way to reaching the 14 Ministry targets, an improvement from 78 per cent one year earlier.
For the first time, this quarterly report includes a forecast of health-system performance by projecting where indicators will likely stand at the end of the fourth quarter. The report also examined how health-system performance relates to patients’ social and economic status. Brian Schnarch (Champlain LHIN Director of System and Performance Analysis) explained the findings.
Overall, the study found that health-system performance was no worse for people from less affluent neighbourhoods. “I think that would be the key takeaway in the economic analysis,” said Mr. Schnarch. “I would tentatively conclude – 'tentatively' because there are other quality measures not included in the analysis – that health-care quality is the same for rich and poor.”
People living in areas with fewer social supports (measured by rates of people living alone, single-parent families and divorced/widowed individuals) were significantly more likely to be waiting in an acute-care hospital bed for more appropriate care outside the hospital such as home care and community services. It is conceivable this is because individuals with less support at home are not able to leave hospital as readily.
The Champlain LHIN will further review the data to better design and target health services based on population needs. The study is focusing next on how health system performance may vary depending on where people live (sub-regions) and the languages they speak. Board members expressed their appreciation for the data and that they will consider how the information can be used to support their governance and oversight roles.
Community-based Rehabilitation Care for People with Acquired Brain Injury
Acquired brain injury (ABI), also known as traumatic brain injury, is the leading cause of death and disability for individuals in Canada under the age of 35. In the Champlain region, 45,000 people are living with an ABI.
Dr. Mark Ferland (neuropsychologist at the Robin Easey Centre in Ottawa) and Kevin Barclay (Champlain LHIN Senior Integration Specialist) co-presented an overview of services for this client population in Champlain. Enhancing such services is aligned to the LHIN’s three-year strategic plan of improving the patient and family experience across the continuum of care.
|Dr. Mark Ferland (left) and Kevin Barclay (right)
Organizations such as Vista Centre, Pathways, Robin Easey Centre, and the Champlain Community Care Access Centre (CCAC) provide ABI services in different parts of the region. Services consist of rehabilitation, group-home support, assisted living services, personal support, day programs, help with system navigation, and support groups for families.
Dr. Ferland presented a review of existing services across the province and a summary of findings from client focus groups. He outlined service gaps for ABI clients in the Champlain region. They include a shortage of supportive housing and the need for a more integrated approach to service delivery.
The report made several short-term and long-term recommendations, some of which are now being addressed. For instance, a pilot is underway to support clients with an ABI in a more appropriate level of care. Due to training, support and the use of technology, two individuals who were living in 24-hour residential care will soon move to a more independent setting. As well, the LHIN has provided additional funds to expand residential care for people with ABI.
The Champlain LHIN continues to engage with stakeholders, including caregivers, to further explore integration opportunities and ABI service improvements.
The Board passed a motion to consider the report recommendations in future deliberations. “The statistics in the report are very sobering,” concluded Jean Pierre Boisclair, Board Chair of the Champlain LHIN. “It is an important subject.”
Influenza Season – Surge Planning Review
“As predictable as the tides come upon the eastern and western shores of our country, in the winter months, we experience heightened demand in our hospitals,” Cal Martell (Champlain LHIN Senior Director of Health System Integration) told LHIN Board members as he began his presentation on seasonal surge planning for 2016-17.
Specifically, in the fall of 2016, the Champlain LHIN brought together a seasonal surge working group for the first time to develop a more proactive approach to mitigate anticipated health-system pressures due to influenza. Health partners from public health to long-term care worked together to prepare for the annual influenza season by maximizing patient access to care, monitoring health-system performance, and communicating to the public in a consistent, coordinated manner.
The Champlain LHIN also acted strategically after receiving a one per cent provincial funding increase to address hospitals pressures from the Ministry of Health and Long-Term Care in October 2016. Hospital officials were asked to work collaboratively within sub-regions to develop a single plan on how to use the additional dollars to address the annual surge in demand. Plans included adding more hospital beds, improving support in emergency departments and discharge planning, as well as augmenting community services to free up hospital beds for those who need them the most.
Dr. Robin Taylor (Associate Medical Officer of Health for Ottawa Public Health) jointly presented to the LHIN Board, with a focus on its role in collaborative local efforts related to seasonal surge. For example, the agency promotes the influenza vaccine and builds public awareness of infection-control measures like hand-washing. The agency holds immunization clinics, and works with long-term care homes, retirement homes, and shelters to encourage disease prevention and control outbreaks. Importantly, Ottawa Public Health also monitors influenza prevalence and advises physicians on when the disease is expected to hit hardest.
Patients First Update
Champlain LHIN CEO Chantale LeClerc gave an update on activities related to implementation of changes to the LHIN’s mandate outlined in the Patients First Act, 2016, which was passed by the Ontario Legislature in December 2016.
In early January 2017, an external third-party vendor procured by the Ministry of Health and Long-Term Care visited the Champlain LHIN to review transition readiness, provide support to the LHIN, and identify any concerns or risks to implementation.
Ms. LeClerc reported that the Champlain LHIN and Champlain CCAC are working closely on the transition, which is proceeding very well. She commended the staff and management teams at the CCAC and the LHIN for their professionalism, collaboration, and openness during these times of impending change. She noted in particular the strong working relationship that exists with the CCAC CEO, Board Chair, and leadership team.