Together with a highly engaged group of Health Service Providers (HSPs) the Central West LHIN has been a significant driver of healthy change since 2005. As the Central West LHIN carried out IHSP 3, significant investments improved access to programs and services across all areas of the local health care system. Highlights include:
The Central West LHIN was one of the first of Ontario’s 14 LHINs to fully implement Health Links across its entire geographic area. Thanks to the collaborative work of Health Links and a significant group of HSPs and community partners, Central West LHIN has increased the capacity of primary care providers to care for the needs of the most complex patients through comprehensive care planning among local partners in order to improve outcomes. The Central West Primary Care Network has worked to develop engagement strategies and partnerships among local primary care practitioners, particularly in relation to Health Links.
Community-based specialist physician care also improved. In partnership with Headwaters Health Care Centre and Caledon Community Services and funding from the Central West LHIN, the Caledon Specialist Clinic has paved the way for excellent community-based care by offering local residents access to on-site specialist consultation services and through the use of onsite Ontario Telemedicine Network (OTN) videoconferencing equipment.
The Diabetes Regional Coordination Centre became fully integrated within Central West LHIN operations. The active client caseload for Central West LHIN residents attending local diabetes education programs has increased and, despite having the third highest prevalence rate of diabetes in Ontario, rates of unnecessary ED visits and readmissions to hospital due to complications associated with diabetes have decreased.
Patients with Chronic Obstructive Pulmonary Disease (COPD) and Congestive Health Failure (CHF) are now self-managing their care from the comfort of home thanks to a highly successful Telehomecare program. Results demonstrate the ability of patients to better self-manage their conditions within their local communities, avoiding and preventing unnecessary use of hospital services.
Following recommendations laid out in “Open Minds, Healthy Minds: Ontario’s Comprehensive Mental Health and Addictions Strategy’, Mental Health Nurses were introduced through the Central West CCAC into area public schools, and Nurse Practitioners were added to the Eating Disorders Clinic Team.
An investment of $3.7M resulted in reduction of the existing combined wait list by expanding long-term case management and early intervention; enhancement of family support and expansion of social rehabilitation/recreation, as a systemic way to support client access and movement between services as needed; augmentation of front-line practitioners for short-term case management; and, efficient use of known housing stock to provide support within housing to additional individuals.
In addition, offering residents with an alternative to repeated use of the Emergency Department (ED), and to better identify when it is necessary to visit the ED, introduction of the Short-Term Emergency Department Diversion (In-STED) program has provided clients with immediate short-term case management often while still at the ED.
As an identified best practice in seniors care, the Central West LHIN increased funding to assisted living programs, adding 205 assisted living spaces in Shelburne, Orangeville, Brampton, Etobicoke and Woodbridge, and bringing the total number of funded places to 629.
Enhancements were made to Assess and Restore units at Headwaters Health Care Centre and William Osler Health System by adding care coordination capacity and purchasing equipment.
The Nurse-Led Outreach Team (NLOT) received funding which supported an increase in the annual volume of Long-Term Care home residents being served and reductions in transfers from LTC homes to hospitals.
The Alzheimer Society of Dufferin County and Alzheimer Society of Peel received funds to expand joint “First Link” programs which support individuals and their families living with dementia.
New base funding was designated to expand adult day program hours, home care, respite programs, caregiver support programs, and Tele-Check programs. At the Peel Manor Adult Day Program, community funding was used to extend the hours of operation to accommodate an additional 10 seniors per day. There are now nine Adult Day Programs in the Central West LHIN, with a capacity to serve 248 seniors.
The Central West LHIN invested $1.4M to help seniors with complex medical conditions that have experienced a recent loss of strength or mobility. The LHIN made multi-year Assess and Restore money available to the Central West CCAC’s Home Independence Program (HIP), which provides targeted rehabilitation services to frail elderly in their homes.
In support of enhanced access to physiotherapy services, the Central West LHIN provided the Central West CCAC with a base funding allocation of $1.3 million to coordinate expanded home physiotherapy services for 2,036 additional physiotherapy clients, implementing 149 exercise and falls prevention classes in 36 locations across the Central West LHIN.
In 2014 an evaluation was conducted on the Central West Behavioural Supports Ontario (BSO) program. This evaluation showed that the 23 behavioural support champions embedded in each of the Long-Term Care (LTC) homes, along with the 7 psychogeriatric resource consultants, were able to reduce the number of responsive behaviours of identified clients by 47%. In addition, the rates of Long-Term Care home assessments that trigger worsening behavioural symptoms have declined, with a noted substantial decline in the reported use of physical restraints.
Central West LHIN Health Service Providers (HSPs) are now 100% complete for implementation of the Integrated Assessment Record (IAR). Providers include the Central West CCAC, 11 Community Support Service Providers, 7 Mental Health Service Providers and 23 Long-Term Care homes. The IAR provides for client assessments supporting the smooth movement of clients from one Health Service Provider to another, and allowing participating Health Service Providers to upload and view the information from consenting clients. This enables Health Service Providers to collaborate in order to effectively plan and deliver care. The tool also streamlines patient information so there is less duplication and faster access to services.
William Osler Health System has implemented Hospital Report Manager (HRM) and is sharing its reports electronically with primary care physicians and specialists. Meanwhile, Headwaters Health Care Centre continues to expand electronic distribution of its hospital reports to primary care physicians and specialists through HRM.
The Ontario Lab Information System (OLIS) has collected more than 80% of the provinces lab test results through connections with hospitals, community labs and public health labs. Headwaters Health Care Centre and William Osler Health System continue to populate OLIS with test results from their labs, and an increasing number of clinicians in the Central West LHIN can now view OLIS data for their patients through their EMR systems.
The Central West LHIN has the highest physician Electronic Medical Record (EMR) adoption rate in the province for Family Practice Physicians at 91% (78% provincially) and the highest rate of adoption in the province for specialists at 63% (30% provincially). This is an extremely valuable accomplishment that enables greater sharing of information electronically across Health Service Providers.
Having identified quality as an important focus in its governance role, the Central West LHIN Board of Directors established a Quality Committee to provide oversight and guidance for implementation of the Central West LHIN Quality Framework. The framework provides a foundation for the development and implementation of targeted cross-sector initiatives designed to build capacity for improvement of quality and safety. All funded HSPs in the LHIN have signed Service Accountability Agreements (SAAs) that detail specific performance expectations to be achieved over the term of the agreements. Both hospital corporations, two Community Health Centres and the Central West CCAC completed and submitted Quality Improvement Plans (QIPs) to Health Quality Ontario, and both hospital corporations, the Central West CCAC, 21 of 23 local LTC Homes and 11 of 25 community-based service providers are now accredited, with work underway to ensure all HSPs are accredited.
In collaboration with LHIN hospitals, the Central West CCAC and LTC Home partners the Central West LHIN launched the Central West Health System Funding Reform (HSFR) Local Partnership. This Partnership has since collaborated on implementing HSFR-aligned strategies including QBP allocation/funding and locally lead QBP practice engagement and implementation.
The LHIN met provincial ED wait time targets, discharging 93% of low-acuity patients within four hours, and 93% of high-acuity patients within eight hours of presenting in the ED. These improvements are largely attributable to the Pay for Results program, now in its seventh year, which targets patience experience in the ED.
To further understand and recognize the importance of cultural competency in relation to Aboriginal health, Central West LHIN staff and Board Members have completed the Indigenous Cultural Competency training program and actively taken part in Métis information and training sessions. Peel Aboriginal Network was recognized as an Indigenous Friendship Centre, and the LHIN will continue to work closely with the Network moving into the next three years.
In partnership with the MOHLTC and Regional Diversity Roundtable, the Central West LHIN introduced use of the Health Equity Impact Assessment (HEIA) tool. Funded HSPs are now using the tool to improve program planning for marginalized populations. Acute care hospitals and community sector providers submitted Health Equity Plans and annual progress is being reported.
The LHIN continues to work closely and collaboratively with Reflet Salvéo, the local French Language Services planning entity, particularly in areas related to engaging the francophone community, capacity building and service planning. Priorities and actions have been identified and outlined in a Joint Annual Action Plan between Reflet Salvéo and the Central West, Mississauga Halton and Toronto Central LHINs. Year-end reporting by each identified French Language Services Health Service Provider, indicated an increase in the number of Francophone residents who requested and were served in French.
2014/15 also saw the development of a collaborative care project between Reflet Salvéo and the Central West LHIN. Known as the Coalition pour les aînés francophones (CAF)de Peel, the CAF brings together the collective efforts of le Club du Bel Âge, la Retraite Active et le Cercle des Aînés Noirs Francophones de l’Ontario to help address both current and future service demands for Seniors from a Francophone perspective. Working together as a collaborative makes it easier for Francophone seniors to become better informed about activities and services offered to them in the community. It also helps to improve overall service delivery. The work of the coalition is supported by the Central West and Mississauga Halton LHINs, Reflet Salvéo and Le Cercle de l’amitié, Well Fort Community Health Services, Oasis Centre des Femmes, l’Équipe de Santé familiale Credit Valley and le Réseau franco-santé sud de l’Ontario.
In 2014/15, the Central West Palliative Care Network applied the Declaration document of 2011 to further develop a local palliative care system. Also in 2014/15, as a founding partner in the development of a joint palliative and end-of-life care “pledge”, the Central West LHIN took a leadership role in advancing the palliative and end-of-life conversation. The “pledge” will act as a commitment to coordinating care in such a way that the whole will be stronger than the sum of its parts.
The Central West LHIN continues to work with the Provincial Council for Maternal Child Health (PCMCH) to improve access to care for children with medical complexities. The LHIN also took an active role in the development of the local Special Needs Strategy for Peel and Dufferin aligning with a provincial strategy to improve services for special needs children and youth.