Board of Directors’ Meeting
Tuesday, January 19, 2016
2:00 to 5:00 pm
Tillsonburg & District Multi-Service Centre – Room H, 96 Tillson Avenue
AGENDA
Item
1.
Agenda Item
Call to Order
Health Service Provider Greetings
Tillsonburg and District Multi Service Centre
 Geoffrey Reekie, Executive Director
Lead
Decision/
Information
Chair
Time
2:00-2:05
2:05-2:35
Woodstock and Area Community Health Centre
 Randy Peltz, Executive Director
 Carly Ann Matos, MSW, Mental Health/Addictions Counselor
 Kendra Wassink, Community Health Outreach Worker
2.
Declaration of Conflict of Interest
Chair
3.
Approval of Agenda
Chair
4.
4.1
Consent Agenda Items
Approval of Minutes:

Board of Directors- December 15, 2015
Board Education Committee Minutes- October 5, 2015
2015/16 Quarter 3 Broader Public Sector Accountability
Act Attestation
2015/16 Quarter 3 CEO Delegation of Authority Report
2015/16 Quarter 3 Enterprise Risk Management Report
Syrian Refugee Resettlement Update
2016/17 Service Accountability Agreements Update
Holiday Surge Summary Report
4.2
4.3
4.4
4.5
4.6
4.7
4.8
5.
5.1
5.2
2:35-2:37
Decision
2:37-2:40
2:40-2:50
Chair
Committee Chair
M Barrett
Decision
Information
Decision
M Barrett
M Brintnell
M Barrett
M Brintnell
M Barrett
Information
Information
Information
Information
Information
Chair
M Brintnell
Decision
Decision
M Brintnell
Decision
2:50-3:20
5.3
Agenda Items for Decision
Board Director Reappointment
2016-19 Long-Term Care Home Service Accountability
Agreement
Use of Remaining 2015/16 One-Time Funding
6
6.1
6.2
Agenda Items for Information/Discussion
Integrated Health Service Plan -2016-19
2016/17 Annual Business Plan
K Gillis/M Brintnell
K Gillis
Information
Information
7.
7.1
7.2
7.3
Governance
Board Chair Report
Board Director Reports
Board Committee Updates
Chair
Directors
Committee Chairs
Information
Information
Information
8.
New Business
Chair
Discussion
4:00-4:15
9.
Closed Session (if required)
Chair
Decision
4:15-5:00
10.
Date and Location of Next Meeting
Tuesday, February 16, 2016, St. Thomas Elgin Memorial Community Centre, 80 Wilson Avenue, St. Thomas
11.
Adjournment
3:20-3:40
3:40-4:00
Chair
5:00
South West LHIN Board of Directors’ Meeting
Board of Directors’ Meeting
Tuesday, December 15, 2015
2:00 to 5:00 pm
South West LHIN, 201 Queens Ave, Suite 700, London – Main Boardroom
Minutes
Present:
Jeff Low, Board Chair
Ron Bolton, Vice Chair
Lori Van Opstal, Vice Chair
Andrew Chunilall, Board Director
Ron Lipsett, Secretary
Gerry Moss, Board Director
Wilf Riecker, Board Director
Aniko Varpalotai, Board Director
Barbara West-Bartley, Board Director
Staff:
Michael Barrett, Chief Executive Officer
Kelly Gillis, Senior Director, System Design & Integration
Mark Brintnell, Senior Director, Performance & Accountability
Ashley Jackson, Director, Communications & Community Engagement
Stacey Griffin, Executive Office Coordinator
1.
Call to Order – Welcome and Introductions
The Chair called the meeting to order at 2:02 pm. There was quorum and 7 members of the
public, which included health service providers, were in attendance for parts of the meeting.
Health Service Provider Greetings
The board heard from Jennifer Gritke, Regional Community Partnerships Coordinator
(SouthWestHealthine.ca) who presented on the regional community partnerships they have with
the SouthWestHealthline.ca. The website’s database helps create connections in the community
that lead to improved project alignment and partnerships.
2.
Declaration of Conflict of Interest
No declarations were declared.
3.
Approval of Agenda
MOVED BY:
Lori Van Opstal
SECONDED BY:
Gerry Moss
THAT the Board of Directors’ meeting agenda for December 15, 2015 be approved as presented.
CARRIED
4.
Consent Agenda Items
MOVED BY:
SECONDED BY:
Ron Lipsett
Wilf Riecker
THAT the consent agenda items be received and approved as circulated in the agenda package.
Agenda item 4.6 Health Service Provider 2015/16 Second Quarter Reports Summary was pulled
from consent for further discussion and added as agenda item 7.5.
CARRIED
5.0
Presentations
5.1 Recognition of Departing Board Director
Board Director Gerry Moss was recognized for his time on the South West LHIN board completing
his second term on December 31, 2015. Gerry’s term on the board started May 17, 2011.
6.0
6.1
Agenda Items for Decision
Integrated Health Service Plan -2016-19
MOVED BY:
Ron Bolton
SECONDED BY:
Andrew Chunilall
THAT the South West LHIN Board of Directors approves the South West LHIN Integrated
Health Service Plan 2016 – 2019.
CARRIED
6.2
Pre-Capital Submission London InterCommunity Health Centre
MOVED BY:
Aniko Varpalotai
SECONDED BY:
Gerry Moss
THAT the South West Local Health Integration Network (LHIN) Board of Directors endorses Part A
of the London InterCommunity Health Centre (LIHC) Pre-Capital submission to the Ministry of
Health and Long Term Care.
CARRIED
6.3
Salvation Army London Village Adult Day Program Redesign – Pre-Capital
Submission
MOVED BY:
Lori Van Opstal
SECONDED BY:
Ron Lipsett
THAT the South West Local Health Integration Network (LHIN) Board of Directors endorses Part A
of the Salvation Army London Village (Salvation Army) Pre-Capital submission to the Ministry of
Health and Long Term Care and confirms that endorsement of the Pre-Capital submission does
not, at this time, include approval of operational funding for the proposed 125 Adult Day Program
spaces
CARRIED
6.4
Integration Policy Revision
MOVED BY:
SECONDED BY:
Aniko Varpalotai
Lori Van Opstal
THAT the South West LHIN Board of Directors amend the Integration Policy as recommended by
the Governance & Nominations Committee with the revision to page 4 to read
 Establish policy direction for integration initiatives in alignment with IHSP.
CARRIED
2
6.5
Board Committee Composition
MOVED BY:
SECONDED BY:
Barbara West-Bartley
Wilf Riecker
CARRIED
THAT the South West LHIN Board of Directors appoint board directors to the committees of the
board effective January 1, 2016 as recommended by the Governance & Nominations committee.
Board Committee membership will be reviewed on an annual basis.
And
THAT Board committee membership changes will come forward to the board when required due to
changes in board director terms of appointment.
7.0
Agenda items for Information
7.1 South West Hospice Palliative Care Update
The board received an update on hospice palliative care (HPC) capacity planning. The LHIN, in
partnership with the HPC Network, is working to understand current state resources and to
determine the need for additional hospice palliative care resources (bedded and community) in a
variety of care locations including hospitals, residential hospice, long-term care and home and
community care.
7.2 Improving Patient Flow – Holiday Surge Preparation
The board was updated on efforts to ensure that patient access is maintained across the health
care system throughout the holiday period. Efforts include developing a regional plan to prepare for
predictable pressures, and maintaining patient access and flow during the holiday season. The
plan includes daily bed huddles throughout the holiday period with participation from chief nursing
executives from all hospitals across the South West LHIN hospitals plus hospitals in Lambton and
Chatham Kent.
A public resource page is available online: holidayaccess.southwesthealthline.ca 7.3
South West LHIN Report on Performance Scorecard & Ministry-LHIN Accountability
Agreement Dashboard 2015/16 Second Quarter
The board received the second quarter results for 2015-16 against our current Integrated Health
Service Plan objectives and the Accountability Agreement (MLAA) performance obligations.
7.4
Office of the Auditor General of Ontario – Annual Report 2015 ( verbal update)
The board heard the Office of the Auditor General (AG) of Ontario released its Annual Report 2015
which included a value-for-money audit of Local Health Integration Networks (LHINs)
The Auditor General’s Office visited four LHINs – Toronto Central, North East, Central and
Hamilton Niagara Haldimand Brant. The report makes a number of recommendations to the
Ministry of Health and Long-Term Care and to the LHINs, focusing on changes that have the
potential to drive system-wide improvement in the areas of performance, accountability, integration
and funding. The AG report also provided important insights into the perception of our HSPs. The
LHINs are working on a workplan to address the recommendations. A written update will be
provided at a future meeting.
3
7.5
Health Service Provider 2015/16 Second Quarter Reports Summary (Agenda item 4.6)
Discussion was held regarding patient complaints and media coverage related to cataract surgery
wait times and hip and knee surgery wait times.
The Board reviewed the New Non-Discretionary (Directed) Funding, Appendix 2 listing all new
directed funding added during Q2 2015/16.
8.
Governance
8.1
Board Chair Report
No report was tabled
8.2
Board Director Reports
Board Directors provided brief verbal reports on their individual activities and observations since
the last meeting of the board. Events attended are included below
 Primary Care Physicians Engagement – Mitchell – November 24, 2015
 Primary Care Physicians Engagement – Owen Sound – November 25, 2015
 Primary Care Physicians Engagement – St. Thomas – November 26, 2015
 Primary Care Physicians Engagement – Ingersoll – December 1, 2015
 Primary Care Physicians Engagement – London – December 2, 2015
 Peer Support for Mental Health Engagement – Stratford – December 4, 2015 - Aniko
Varpalotai and Barbara West-Bartley attended
 Oxford Hospital Group Education Session – December 9, 2015, Lori Van Opstal attended
 Update Meeting with MPP Deb Matthews – December 11th - Jeff and Michael
 Update Meeting with MPP Peggy Sattler – December 14, 2015 – Jeff and Michael
8.3
Board Committee Updates
No reports were tabled.
9.
New Business
No new business was tabled
10.
Closed Session
MOVED BY:
SECONDED BY:
Ron Bolton
Aniko Varpalotai
THAT the Board of Directors move into a closed session at 4:30 pm pursuant to s. 9(5)(a) of the
Local Health System Integration Act, 2006
CARRIED
MOVED BY:
SECONDED BY:
Lori Van Opstal
Aniko Varpalotai
THAT the South West LHIN Board of Directors rise from closed session at 4:55 pm and reported
that the board discussed personal matters.
CARRIED
4
10.
Date and Location of Next Meeting
Tuesday, January 19, 2016, Tillsonburg & District Multi-Service Centre – Room H, 96 Tillson Avenue
11.
Adjournment
The meeting was adjourned by the Chair at 4:55 p.m.
APPROVED:
_____________________________
Jeff Low, Board Chair
Date: _________________________
_____________________________
Ron Lipsett, Board Secretary
Date: ________________________
5
Board Education Committee – South West LHIN Board
Monday, October 5, 2015 – 12:30 to 1:30 pm
Via teleconference
Minutes
Approved by committee December 15, 2015
Present:
Gerry Moss, Committee Co-Chair
Lori Van Opstal, Committee Co-Chair
Andrew Chunilall, Board Director via teleconference
Aniko Varpalotai, Board Director
Staff:
Kelly Gillis, Senior Director – System Design & Integration
Ashley Jackson, Director – Communications & Community Engagement
Marilyn Robbins, Executive Office Assistant (Recorder)
1.
Call to Order
Lori Van Opstal, Committee Co-Chair called the meeting to order at 12:33 pm and quorum
was present. No members of the public were in attendance.
2.
Agenda and Declaration of a Conflict of Interest
Upon review of the agenda no conflict of interest was declared.
3.
Minutes of August 20, 2015
MOVED BY:
SECONDED BY:
Andrew Chunilall
Gerry Moss
TO approve the minutes of the South West LHIN Board Education Committee
meeting held August 20, 2015.
CARRIED
Business Arising – It was agreed that an update on HealthChat.ca would be provided
either by email or at a future meeting of the committee.
4.
Review of Survey Results
The committee reviewed the summary of responses to the survey issued to the board on
their next steps around the five IHSP Implementation Strategies.
5.
Preparation for October 20 Generative Session
The committee agreed that the goal for the October 20 Generative Session is to establish
the boards core knowledge requirements and means to attain them for each of the five
implementation strategies. From this a framework or plan can then be developed.
These items to be circulated to members of the board in advance of October 20…
- Survey results summary
- The implementation strategy section of the draft IHSP (the complete draft will be
circulated as part of the board’s regular meeting package)
- Three discussion questions to be considered for each of the five Implementation
Strategies.
 Do you see any gaps or opportunities?
 What are the core requirements in terms of knowledge/skills?
 How do we achieve the core requirements?
 The Triple Aim White Paper previously circulated.
The following was suggested for the facilitation of the October 20 session…
- Start from a place of what the board’s role is.
- Have the Board Chair and CEO share their ideas on the role of the board in the
IHSP considering their knowledge of other LHINs and previous IHSPs.
- Walk the board through the implementation strategy section with a focus on the
recommendations rather than on wordsmithing.
- Boil down the specific actions and identify the level of knowledge/skill (core or
enhanced) and supports needed by the board.
- Make clear in advance that there will be two IHSP discussions, the first during the
Generative Session to focus on the strategies and a second during the meeting of
the board to approve the whole of the IHSP.
Gerry departed the meeting.
The committee briefly discussed the LHIN governance model and considered
opportunities for a review and discussion of that.
The committee decided that Kelly and Gerry would facilitate the October 20 session.
ACTION: Marilyn to reformat the survey summary for circulation to the board.
ACTION: Kelly to contact Gerry to finalize the agenda, questions, and materials.
6.
Next Meeting and Adjournment
A teleconference to review the October 20 session is scheduled for Friday, October 30 at 3 pm.
The meeting adjourned at 1:30 pm.
2
Agenda Item 4.3
Report to the Board of Directors
2015/16 Quarter 3 Broader Public Sector Accountability Act Attestation
Meeting Date:
January 19, 2016
Submitted By:
Michael Barrett, Chief Executive Officer
Submitted To:
Board of Directors
Purpose:
Information Only
Board Committee
Decision
ATTESTATION
Prepared in accordance with section 14 of the Broader Public Sector Accountability Act, 2010
(BPSAA)
TO:
FROM:
Date:
RE:
The South West LHIN Board (the “Board”)
Michael Barrett, CEO, South West LHIN
January 19, 2016
2015/16, Quarter 3, October 1, 2015 to December 31, 2015
On behalf of the South West LHIN I attest to:






the completion and accuracy of reports required of the LHIN, pursuant to section 5 of the
BPSAA, on the use of consultants;
the LHIN’s compliance with the prohibition, in section 4 of the BPSAA, on engaging lobbyist
services using public funds;
the LHIN’s compliance with all of its obligations under applicable directives issued by the
Management Board of Cabinet;
the LHIN’s compliance with its obligations under the Memorandum of Understanding with
the Ministry of Health and Long-Term Care; and
the LHIN’s compliance with its obligations under the Ministry LHIN Accountability
Agreement/Ministry LHIN Performance Agreement in effect,
The LHIN's compliance with the "Principles for LHIN-Managed (QBP) Volume
Movement': per the QBP Volume Management Instructions and Operational Policies for
Local Health Integration Networks that are issued by the ministry."
during the Applicable Period.
Report to the Board of Directors 2015/16 Quarter 3 Broader Public Sector Accountability Act Attestation
Page 2
In making this attestation, I have exercised care and diligence that would reasonably be expected of a
Chief Executive Officer in these circumstances, including making due inquiries of LHIN staff that have
knowledge of these matters.
I further certify that any material exceptions to this attestation are documented in the attached Schedule
A.
Dated at London, Ontario this January 19, 2016
Michael Barrett, CEO, South West Local Health Integration Network
I certify that this attestation has been approved by the board of the South West LHIN on
January 19, 2016
Jeff Low, Board Chair, South West Local Health Integration Network
Report to the Board of Directors 2015/16 Quarter 3 Broader Public Sector Accountability Act Attestation
Page 3
ATTESTATION
Prepared in accordance with section 14 of the Broader Public Sector Accountability Act,
2010 (BPSAA)
SCHEDULE A
South West Local Health Integration Network
For the Applicable Period: 2015/16, Quarter 3, October 1, 2015 to December 31, 2015
1. MEMORANDUM OF UNDERSTANDING
Non-Compliance. The LHIN has determined that the terms and conditions on which all fourteen LHINs
acquired insurance breach the LHINs’ obligations under LHSIA, the Financial Administration Act, the
MOU and possibly the MLPA. The LHIN continues to work to resolve this accidental breach by seeking
a practical solution on appropriate terms and conditions.
2. MINISTRY LHIN ACCOUNTABILITY AGREEMENT/MINISTRY LHIN PERFORMANCE
AGREEMENT
 No known exceptions
3. COMPLETION AND ACCURACY OF REPORTS REQUIRED PURSUANT TO SECTION 5 OF THE
BPSAA
 No known exceptions
4. PROHIBITION ON ENGAGING LOBBYIST SERVICES USING PUBLIC FUNDS PURSUANT TO
SECTION
 No known exceptions
5. COMPLIANCE WITH APPLICABLE DIRECTIVES ISSUED BY MANAGEMENT BOARD OF
CABINET
 No known exceptions
a. OPS PROCUREMENT DIRECTIVE
b. OPS TRAVEL, MEAL AND HOSPITALITY EXPENSES DIRECTIVE
c. OPS PERQUISITES DIRECTIVE
Agenda Item 4.4
Report to the Board of Directors
South West LHIN CEO Delegation of Authority
2015/16 Third Quarter Report
Meeting Date:
January 19, 2016
Submitted By:
Michael Barrett, Chief Executive Officer
Submitted To:
Board of Directors
Purpose:
Information
Board Committee
Decision
Purpose
The purpose of this report is to report on 2015/16 Q3 (October 1 – December 31, 2015) activities
triggered by the CEO through the South West LHIN Delegation of Authority for Funding, Accountability
Agreements, and Routine Reports policy. The LHIN CEO exercised delegation provisions on the four
items noted below.
Item
Mental Health and
Addictions Crisis
Centre
Grey Bruce Mental
Health and
Addictions
Partners
Facilitation
Expanded
Surgical Service
Review
Item Description
Additional one-time funding to further assist
in the readiness and opening of the Mental
Health and Addictions Crisis Centre in
London. Crisis Centre officially opened
January 11, 2016.
The Grey Bruce MH&A partners requested
financial assistance to retain a consultant in
2015/16 to further examine and understand
how services and resources can be further
coordinated to better serve clients.
Grey Bruce Health Services, Hanover and
District Hospital and South Bruce Grey
Health Centre requested financial assistance
to acquire the services of an expert
consultant in 2015/16 to undertake a surgical
services review for the hospitals in the Grey
and Bruce area.
Health Service Provider
Funding
Amount
Canadian Mental Health
Association Middlesex
$30,000
(one-time)
Canadian Mental Health
Association Grey-Bruce
$6,100
(one-time)
Grey Bruce Health
Services
$65,000
(one-time)
Agenda Item 4.5
Report to the Board of Directors
South West LHIN Enterprise Risk Management
2015/16 Third Quarter Report
Meeting Date:
January 19, 2016
Submitted By:
Mark Brintnell, Senior Director Performance and Accountability
Submitted To:
Board of Directors
Purpose:
Information
Board Committee
Decision
Purpose
The purpose of this report is to update the Board of Directors with information about risks and actions
in place to manage identified risks considered within our Enterprise Risk Management (ERM)
approach.
Background
The third quarter ERM risk register is attached as Appendix 1. The risk information is identified,
assessed and managed based on triggers that would indicate likelihood and severity of impact to
LHIN operations, implementation against strategy, or achievement of outcomes.
South West LHIN - Enterprise Risk Management - Risk Register - 2015/16 Q3
Risk Tolerance
12/8/15
24/7 RN Coverage in LTC
homes
Other
Objective: improve Coordination and Transitions of Care for Targeted Populations specifically
for those waiting for a LTC home. Risk: Ministy has identified a number of LTCHs that are
challenged to meet the 24/7 RN coverage requirement. LTCHs will need to address this issue
to avoid delayed or ceased admission which could create hospital flow issues and increase
LTCH admission wait times.
3
3
6
3
PSW Wage Enhancement
6/30/15
Initiative Year Two 15/16
2
5
4
6/30/15
2
4
6
5
7
8
9/18/14
PSW Wage Enhancement
Initiative Year One 14/15
Objective: Improve Coordination and Transitions of Care for Targeted Populations,
specifically: fully utilize ABI Specialized Unit at Kensington Place Long Term Care Home. Risk:
funding for the day program needs to transfer to the LTC home to align with Ministry
legislation. The proposal is now being modified to resubmit to the Ministry along with planning
cash flow so as to not destabilize the day program operation.
IHSP objective
Objective: Recommendations from the Stroke Capacity Asssessment and Best Practice
project have been supported by the South West LHIN Board of Directors for the realignment of
acute stroke services in the South West LHIN. Risk: Financial risks associated with
realignment of acute stroke care in 27 hospitals to 4 hospitals and stroke rehabilitation services
to 4 sites. A large number of hospitals within the South West LHIN are non-QBP hospitals and,
therefore, contribute to the risk identified. Risk Mitigation Strategy: a Business Case has been
submitted to the ministry regarding the funding shortfall.
Provincial Priority
Objective: successfully implement the provincial PSW Wage Enhancement Initiative (wage
increase for personal support workers)in the South West LHIN. Risk: a number of issues have
been identified by HSPs, e.g. wage parity for workers not providing the initiative-eligible
personal support services. Two South West LHIN providers have refused the additional
funding primarily due to the additional cost of providing wage parity.
Patient Flow Pressures at the
9/18/14 London Health Sciences
MLPA
Centre
Objective: reduce ER wait times. Risk: effort to improve ER waits at both LHSC sites are
being hampered as beds are sometimes not available to admit patients. An increase in the
number of ALC patients has driven occupancy over 120% on occasion and patients must be
held in the ER until a bed is available. There has been a recent influx of patients arriving at the
ER requiring mental health care, and often needing to be admitted to a bed.
Access to Care - CCC/Rehab
Bed Realignment Phase 2
Objective: maximize capacity and efficiency in hospitals, Long term care homes and
community based services to drive improvements in quality, equitable access and wait times.
Risk: Phase 2 CCC/Rehab Bed Realignment work with hospital partners is underway and the
Central group of hospitals has identified its first stage of bed shifts, based on CCC/Rehab
Steering Committee recommendations. Further planning needs to occur for the next 2 years to
achieve the recommended number of CCC beds. This requires further reductions in CCC
beds. The risk relates to hospitals’ ability to achieve reductions and to achieve fund transfers
to enable opening of additional rehab beds to the recommended level. Planning has taken
longer than expected and the longer it takes for hospitals to complete this work, the greater the
risk of not achieving the reductions required. There is additional risk related to potential
community concern about bed reallocation. The first component of the bed
reallocation/reduction - a realignment of beds within the Huron Perth Healthcare Alliance group
of hospitals has been completed and did meet with some negative public reaction
7/15/14
IHSP objective
High = 3
3
2
$2,500,000
Base and
One-time
3
$0
3
3
2
3
$0
2
3
2
Medium
High
High
Medium
The pan-LHIN PSW Wage Enhancement group is working with the ministry
to resolve or mitigate HSP issues. Although we have been updated regularly
by the HSPs who have not been able to implement, the mitigation of the
issues will come under the direction of the MOHLTC.
Several measures are being explored including: more timely repatriation from
LHSC to local hospitals, enhanced Home First (home or community HSP
placement for ALC patients), a discharge planning strategy, and applying
LEAN principles (Toyota TOPS program) to ED and Hospital operations from
a flow perspective. A Patient Flow Strategy for the South West LHIN has
recently been completed. Recently the hospital's Victoria site has shown
modest improvement in ED length of stay, the University Hospital site has
improved substantially (+36%) over the 14-15 performance as at November
2015. Regional sharing of mental health bed capacity information (Bed
Board) and bed huddles have been instituted to mitigate the surge of mental
health patients presenting at the ER.
6
Low
6
Stroke Clinical Services
4/9/15
Planning
Other
$0
Low
Medium
4
Medium
5
Long Term Care - ABI
Specialized Unit Approval
Provincial Priority
Objective: successfully implement the provincial PSW Wage Enhancement Initiative (wage
increase for personal support workers)in the South West LHIN. Risk: 5 HSPs were not able to
implement the Year 2 directives. They have been put in the special consideration list and
submitted to MOHLTC. The South West LHIN continues to work with MOHLTC to provide
acceptable solutions.
Low
2
It is expected that hospitals and surgeons work together to ensure elective
surgical procedure volume is planned, performed, and managed througout
the year in a manner that is based on clinical determination and within fiscal
resources. Open communication between all health system partners is
required to ensure tranparent volume planning, delivery and management.
Medium
Low
6
Medium
3
Medium
3
Risk Management Plan
Medium
Objective: increase the value of the health care system for the people we serve. Risk: in
several cases, the total 2015/16 funded allocation for elective QBPs have been completed prior
to the end of the year.
Risk
Management
Capability
Medium
MLPA
Moderate =2
Quality Based Procedure
(QBP) Wait Times
Minor =1
1 12/15/15
Curent
Year Cost
Impact
Medium =2
Primary Objective
Risk to Achievement of Objective
at Risk
# Date
Low =1
Title
Score
Severity
Signficant = 3
Likelihood
Cost
Impact
Base or
Onetime
High
Recruitment and retention of health care personnel has been a challenge in
some parts of the LHIN. This is exacerabated by the tendency for staff to
gain experience in certain sectors and then move to other sectors based on a
number of factors like compensation, community resources etc. This creates
a continuous cycle to recruit and train staff.
South West LHIN continues to work with MOHLTC through the pan LHIN
working group for the PSW wage enhancement to implement acceptable
solutions to ensure compliance.
Will continue to work through the approval process with the ministry; ministry
approval is required to approve the care and funding of the specialized unit.
A Business Case has been submitted to the ministry regarding funding
shortfall. Funding for to support QBP volumes moving from small hospitals
to the District Stroke Centres is most critical - this equates to $1.5 million
starting in 2016/17.
Continue to work with hospital partners to implement Phase 2 service goals
and financial shifts.
1/12/2016
South West LHIN - Enterprise Risk Management - Risk Register - 2015/16 Q3
7/15/14
Woodstock Hospital - New
Facility
CLOSED Patient Flow - Holiday Surge
CLOSED
London Mental Health and
Addictions Crisis Centre
South Bruce Grey Health
CLOSED Centre - Restorative Care
Beds (RCU)
IHSP objective
IHSP objective
MLPA
Other
Objective: maximize capacity and efficiency in hospitals, Long term care homes and
community based services to drive improvements in quality, equitable access and wait times.
Risk: Woodstock General Hospital opened a new hospital in November 2011 with new and
expanded programs and services. Base funding for the incremental capacity built into the new
hospital will be determined by actual volumes recorded (forecast target for achieving volumes
is 2015/16, reconcilation period ends 2017/18). The new hospital capacity must be fully utilized
to provide sustainable funding for the new, larger facility. The hospital is also citing cost in
excess of funding associated with the Design Build Finance Maintain (DBFM) model facilities
maintenance contract. .
TBD
Base
3
3
6
Risk Tolerance
Score
Signficant = 3
Moderate =2
Minor =1
Curent
Year Cost
Impact
High = 3
Primary Objective
Risk to Achievement of Objective
at Risk
Severity
High
9
Title
Medium =2
# Date
Low =1
Likelihood
Cost
Impact
Base or
Onetime
Risk
Management
Capability
Medium
Risk Management Plan
The South West LHIN has been working with the hospital and community
partners to fully utilize the new capacity. Neighboring providers have
capacity pressures (i.e. London Hospitals) and this new hospital capacity can
help alleviate some pressure, while providing care closer to home for
individuals. Recommendations and integrations from the Oxford Joint
Services Plan are in progress to move forward with the opportunities
identified through the planning process. Shifting stroke QBP volumes to the
District Stroke Centres will have a modest negative impact on overall
volume. The issue of un-funded DBFM contract costs is under review by the
ministry's Health Capital Investment Branch. .
NOTE: THIS RISK WAS INCLUDED IN THE 2015/16 Q3 RISK REPORT TO THE MINISTRY
OF HEALTH AND LONG TERM CARE SUBMITTED IN DECEMBER - THIS RISK WAS
SUCCESSFULLY MITIGATED. Objective: maximize capacity and efficiency in hospitals, Long
term care homes and community based services to drive improvements in quality, equitable
access and wait times. Risk: The Holiday Surge Plan is a plan developed by the LHIN and
hospitals to mitigate the risk of long ER wait times during the holiday season, which has been
the trend in recent years. The risk is that the plan will not reduce ER wait times, which would
yield health system risks as well as reputational risk for the LHIN and hospitals.
CAPITAL FUNDING HAS BEEN APPROVED. Objective: reduce ER wait times. Risk: the
London Mental Health and Addictions Crisis Centre is a component of the strategy to reduce
ER wait times. Capital funding is required for development of a permanent location for a Crisis
Centre, the final phase of implementation of the restructuring of crisis services in London
Middlesex. A revised pre-capital submission to redevelop the Canadian Mental Health
Association (CMHA) Middlesex Huron St London location has been filed and is awaiting
approval.
GREY BRUCE HSPs HAVE COOPERATED TO PROVIDE THE EQUIVALENT TO EXISTING
RCU SERVICES. Objective: maximize capacity and efficiency in hospitals, Long term care
homes and community based services to drive improvements in quality, equitable access and
wait times.Risk: The South Bruce Grey Health Centre Board passed a motion to temporarily
close the RCU on May 1, 2015. The LHIN provided $400K to keep the RCU open to
December 31, 2015. Work will continue to complete the restorative care capacity to determine
the best option for restorative care.
1/12/2016
Agenda Item 4.6
Report to the Board of Directors
Syrian Refugee Resettlement
Meeting Date:
January 19, 2016
Submitted By:
Bob DeRaad, Project Lead, Emergency Department
Submitted To:
Board of Directors
Purpose:
Information
Board Committee
Decision
Purpose
The purpose of this report is to update the Board of Directors on the Syrian Refugee Resettlement
work both provincially and from the South West LHIN perspective.
Background
In response to the Syrian Refugee crisis overseas, the Canadian Government committed to taking in
25,000 Syrian Refugees by February 29, 2016. Of the 25,000 Syrian new comers coming to Canada,
80 percent will be Privately Sponsored Refugees (PSR’s) and the remaining 20 percent will be
Government Assisted Refugees (GAR’s). The PSR’s quickly move on to their permanent residences
throughout Canada shortly after arriving in Canada. All refugees, either PSR’s or GAR’s, will arrive
either through Pearson Airport in Toronto or Trudeau Airport in Montreal.
The GAR’s are being housed on temporary basis at 1 of 6 RAP (Refugee Assistance Program)
centres on Ontario for up to 2 to 4 weeks before moving on to their permanent residences throughout
Canada.
The RAP centers are located in:
 Ottawa
 Toronto
 Kitchener
 London
 Windsor
 Hamilton
The Emergency Management Branch (EMB) of the MOHLTC is coordinating the provincial response
for Ontario. The Emergency Medical Assistance Team (EMAT) has been deployed to Pearson Airport
and is on sight in a passive role to receive the refugees once they arrive in the event of medical
issues. Once the RAPs reach capacity, refugees will be housed in local hotels on a temporary basis.
Once this capacity is exceeded, GAR’s will be temporarily housed in one of 5 Interim Lodging Sites
Report to the Board of Directors- Syrian Refugee Resettlement
Page 2
(ILSs) located on 5 Canadian Forces Bases (CFBs) identified by the federal government. These ILSs
will activated in the following sequence should this be necessary:
1. CFB Kingston
2. CFB Borden
3. CFB Trenton
4. CFB Petewawa
5. CFB Meaford
The 14 LHIN’s in the province have been asked to assist in a coordination role for healthcare
services as required in their respective jurisdictions if required to support RAPs and the ILSs.
South West LHIN Actions to Date
The South West LHIN has established a Coordination Table in the Middlesex London with key
stakeholders in the Middlesex London area. The membership of this table includes representatives
from the Cross Cultural Learning Centre, the RAP for London, and the London Inter-Community
Health Centre whose role is to screen all new comers from a healthcare perspective. Representatives
from Acute Care, Mental Health, Public Health and other Community Agencies sit at this table as
well. This table has met twice to date and will meet again on January 26th at the South West LHIN
offices.
As CFB Meaford is in the South West LHIN area, a second Coordination Table has been established
in the Grey Bruce area. The membership of this table includes representatives from Grey Bruce
Health Services, Grey and Bruce EMS, local Public Health and other key stakeholders in the region.
This group meets regularly and has also met regularly with the EMB as this situation unfolds.
To date, CFB Kingston has been activated since December 28th and CFB Borden will be in a state of
readiness by January 18th. (These are planning measures only as no refugees have been received
on to any ILS to date) The plan for ILS activation is should the first ILS reach 50% capacity that will
trigger a conversation to activate the next ILS.
Number of Refugee Arrivals as of January 11, 2016
The South West LHIN has received 308 GAR’s and 31 PSR’s.
See attached appendices for distribution to Ontario communities (The numbers stated on these maps
represent both GAR’s and PSR’s to date)
Agenda Item 4.7
Report to the Board of Directors
2016/17 Service Accountability Agreements Update
Meeting Date:
January 19, 2016
Submitted By:
Mark Brintnell, Senior Director, Performance and Accountability
Submitted To:
Board of Directors
Purpose:
Information
Board Committee
Decision
Purpose
To provide an update on progress towards finalizing the 2016/17 fiscal year cycle of Health Service
Provider (HSP) Service Accountability Agreements (SAA).
Background
SAAs with the hospitals and long-term care homes will be now effective April 1, 2016. SAAs with our
community sector partners will be refreshed for the third and final year of the current agreement
template. Between September 2015 and February 2016, the LHIN Board is being updated on the
progress achieved with the goal of bringing final SAAs forward in March 2016 for LHIN Board approval.
Progress Update
The five shared accountability sessions held with HSPs across the LHIN provided a lot of good
information to assist LHIN staff in co-defining performance expectations (indicators and conditions)
focussed on establishing greater shared accountability and transparency aimed at increasing care in the
community and strengthening mental health and addictions services. Appendix 1 lists the proposed
local performance expectations to be included in the 2016/17 SAA agreements.
Hospital Service Accountability Agreement (H-SAA)
The H-SAA Steering Committee continues to work on a draft H-SAA template and has mapped out a
process and timeline to finalize the template. It is expected that a new H-SAA template will come
forward for LHIN Board consideration within the next few months.
To allow time to complete the new agreement template and have it approved by LHIN and hospital
Boards, the LHIN CEOs have recommended to issue a three month extension to the current H-SAA.
Therefore, the South West LHIN will use a simple extension agreement and work towards the new
template and complete schedules being in place for July 1, 2016.
Report to the Board of Directors- SAA Update
Page 2
Hospitals submitted 2016/17 Hospital Accountability Planning Submissions (HAPS) on November 23,
2015. HAPS analysis and discussion with hospital staff continues and will coincide with preliminary
funding and volume information being released in the next few months. A summary of hospital planning
around service, financial and performance will be shared with the LHIN Board as part of the cycle to put
in place the new agreements.
Multi-Sector Service Accountability Agreement (M-SAA)
Community Sector HSPs submitted their refreshed 2016/17 Community Accountability Planning
Submission (CAPS) on November 23, 2015. Submissions are currently being reviewed and
negotiations are underway by LHIN staff. A summary of community sector planning around service,
financial and performance will be shared with the LHIN Board in February 2016.
Long-Term Care Home Service Accountability Agreements (L-SAA)
LTC Homes submitted their new Long-Term Care Home Annual Planning Submissions (LAPS) on
November 23, 2015. Submissions are being reviewed and negotiations are underway by LHIN staff. A
summary of LTC Home planning around service, financial and performance will be shared with the LHIN
Board in February 2016.
A motion for LHIN Board approval of the new 2016-19 L-SAA templates is presented in Report 5.2
On January 1, 2016, St. Joseph’s Health Care, London received approval as required per the LongTerm Care Homes Act, 2007, for the legal name merger of its two LTC Homes known as Mount Hope
Centre for Long Term Care-St. Mary’s and Marian Villa. The name of the Home will be Mount Hope
Centre for Long Term Care and will operate 394 beds (no change).
As a result of the merger, the number of LTC Homes funded and operating within the South West LHIN
geography is 78 efffective January 1, 2016.
Next Steps
LHIN staff will continue to implement the SAA process and provide updates to the LHIN Board at each
meeting until proposed final SAAs are brought forward in March 2016 for LHIN Board consideration for
approval.
South West LHIN
Impacting System Improvement Through 2016/17 Service Accountability Agreements (SAAs): Local Performance Indicators & Obligations
SAA:
Target?
N= obligation
Y= indicator
ALC or
MH&A
Alignment
South West LHIN Local Performance Indicators & Obligations
M-SAA
H-SAA
Hospitals
CCAC
CHCs
L-SAA
CMH&A
CSS
LTC
Homes
Notes/Considerations
Proposed Cross-sector/ Shared Accountability Indicators and Obligations to Increase Care in the Community and Strengthen Mental Health & Addiction Services
H-SAA Performance
Measure in
2016/17
Y
ALC
ALC Rate (total)
Y
ALC
Adult Day Program (ADP) Occupancy
n/a
N
ALC
# of residents with responsive behaviours that the LTC home
has discharged (including a refusal to accept resident back to
LTC home following an ED visit or hospital admission) and
reasons for the LTC home discharge
n/a
Y
ALC
% eligible patients in CCC/Rehab beds
Y
MH&A
30 day ED revisit rate for a) Mental Health & b) Substance
Abuse --TBD
MH&A
1:1 staffing to support residents with responsive behaviours (#
unique residents, total 1:1 hours, % supported by HINF or BSO
embedded staff or nursing envelope)
MH&A
Coordinated Access--% of all clients screened using an
assessment tool from the Global Appraisal of Individual Needs
(GAIN) Suite of evidence-based instruments.
N
Y
Core M-SAA
Measure in
2016/17
n/a
STEGH (HSAA);
WGH & LHSC
(MSAA)
Core M-SAA
Measure in
2016/17
Core M-SAA
Measure in
2016/17
n/a
n/a
n/a
select ADPs
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
target <25% CCC; <5% Rehab
n/a
n/a
provincial classification for H-SAA still TBD for 2016/17;
explanatory indicator for CMH&A in 2016/17
(2015/16) All London & Grey-Bruce MH
and SA HSPs (including LIHC)
LHSC & GBHS
(2015/16)
n/a
Core M-SAA
Measure in
2016/17
n/a
n/a
n/a
n/a
n/a
n/a
HSPs in Oxford,
Elgin, & LondonMiddlesex
n/a
site targets
supported by LTCH Network Council
supported by LTCH Network Council
n/a
Other South West LHIN Local Performance Indicators & Obligations (incl. Sector-Specific, Local Priorities, & Measures Carried Forward from 2015/16)
N
N
Other
Other
healthline.ca--South West LHIN HSPs agree to regularly update,
and annually review April 1st, site-specific programs and
services information, as represented within the the
healthline.ca website
captures consistent information on HSP services and programs
Annual reporting (via Survey Monkey) on the most significant
contribution to advancing or improving integrated hospice
palliative care in the past 12 months and plans for next year.
n/a
n/a
n/a
HPC providers
(hospice visiting
HSPs)
N
N
N
Y
Other
Annual reporting (via Survey Monkey) on the most significant
contribution to advancing or improving best practice palliative
care in the past 12 months and plans for next year.
Other
French Language Services--TBD
Other
Indigenous Cultural Safety Training: annual training plan to
identify and track the # of staff that register and complete the
Indigenous Cultural Safety (ICS) training course.
Other
Percent of Stroke/TIA Patients Admitted to a Stroke Unit
during Their Inpatient Stay – Monthly reporting to the Stroke
CSP – Phase 1: Implementation & Evaluation of the Future State
of Stroke Care Directional Recommendations project team. This
indicator is included as standard explanatory indicator for all
LHINs; this is included as a local indicator to increase the
reporting frequency to monthly and to direct reports to the
project team (templates and reporting destination to be
provided)
n/a
n/a
n/a
District Stroke
Centres
n/a
n/a
n/a
n/a
Examples could include:
• Implementing best practices;
• Adopting early identification tools
• Advanced care planning;
• Participating in HPC network meetings;
• Reviewing regional scorecard;
• Training staff in Fundamentals/APCE/CAPCE;
• Receiving and sharing updated from the local HPC collaborative;
• QIP activities related to HPC;
• Participating in local HPC quality improvement activities;
• Accessing Secondary Level Consultation teams
n/a
2015/16: for Identified London HSPs, develop implementation plan & report on
progress. Work underway provincially on 2 HSP indicators: French Language Services
Human Resources Capacity (performance) & Identification of Francophone Clients
(explanatory) and 1 LHIN-level: Access to FLS (developmental).
n/a
Reporting Obligations: submit a tracking sheet annually on the # of staff that have
taken ICS training by June 30, 2016 (for 15/16 progress) and June 30, 2017 (for 16/17
progress)
n/a
Stroke/TIA Patients (Most Responsible Diagnosis = I60, I61, I63, I64, G45, H34.0,
H34.1) admitted to a Stroke unit at any point during their inpatient stay, multiplied by
100
A stroke unit is a geographical unit with identifiable co-located beds (e.g., 5A-7, 5A-8,
5A-9) that are occupied by stroke patients 75% of the time and has a dedicated
interprofessional team with expertise in stroke care including, at a minimum, nursing,
physiotherapy, occupational therapy and speech-language pathology.
(current performance is 2.5% vs. 62.7% prov benchmark)
Agenda Item 4.8
Report to the Board of Directors
Improving Patient Flow – Holiday Surge Process Update
Meeting Date:
January 19, 2016
Submitted By:
Michael Barrett, Chief Executive Officer
Mark Brintnell, Senior Director Accountability and Performance
Nicole Robinson, Team Lead Performance Improvement
Bob DeRaad, Project Lead (Emergency Department)
Submitted To:
Board of Directors
Board Committee
Purpose:
Information
Decision
Purpose
The purpose of this report is to provide the South West LHIN Board of Directors with an early update
and general reflections on patient access and flow during the recent holiday season.
Background
Based on previous holiday season pressures and as part of an overall effort to improve patient access
and flow, the South West LHIN worked closely with health service providers to maintain patient access
and flow during the holiday period. Although the goal is to involve more stakeholders in the future, the
key partners directly involved in this most recent holiday surge process included all hospitals, the
Community Care Access Centre, Canadian Mental Health Association Middlesex, and the London
Intercommunity Health Centre. Communications were also issued by the LHIN to stakeholders such as
primary care.
In order to maintain patient flow across the LHIN, the following actions were implemented:
1. A South West LHIN Regional Holiday Surge Plan was developed identifying a risk response or
acceptance for key issues.
2. Regional Bed Huddles were held daily from December 21, 2015 through January 2, 2016, with
participation from all hospitals, the LHIN and the CCAC, in order to provide a real time snapshot
of challenges at individual hospitals and within the system, to identify issues and propose a follow
up action plan.
3. A communications plan was developed in order to proactively demonstrate the South West
LHIN’s planning efforts to ensure patient access was maintained throughout the health care
system during the holiday period including: a letter to all primary care providers in advance of the
Report to the Board of Directors- Improving Patient Flow – Holiday Surge Process Update
Page 2
holiday period, social media promotion and leveraging of www.healthline.ca in order to ensure
awareness of patient care options during the holiday period.
High Level Observations
The following high level observations were captured as part of early debrief discussions held on January
8th with the Chief Nursing Executive (CNE) Leadership Forum.





All hospitals, including Bluewater Health (Sarnia), the South West LHIN and the CCAC
collaborated to participate in the daily surge calls, and in daily reporting to support the calls.
During the holiday period, hospital organizations were able to manage identified capacity
challenges internally within their organizations.
The majority of identified issues were identified and problem solved, and collaboratively resolved
within 24 hours.
Huddle participant feedback was captured through survey data and feedback on the process was
overwhelmingly positive. Many suggestions were provided to leverage and build on this process
moving forward.
Early learnings from the regional surge planning and huddles include:
o There is an opportunity for improved accuracy and up front communication of individual
organizational planned closures (programs, services, and emergency surgical coverage),
and coverage,
o Recommended to ensure key Leadership participation in the huddles to support ability for
efficient decision making to support access and flow,
o Regional Bed Huddles can be valuable throughout the year when experiencing a surge,
thus it is recommended that an overall surge protocol and agreement be developed in
order to support ability to trigger the process at any time,
o Primary Care has suggested the need to ensure that private laboratory, and Diagnostic
Services are available to support over the holiday period
Over the holiday period, social media content focused on holiday surge planning where posts performed
exceptionally well in contrast to all other content in 2015. Highlights include:
 Facebook posts on holiday planning reached 6,707 users and received 49 likes, 2 comments, 28
shares and 40 link clicks. (Average post reach is 55 users, 3 like/comments/shares and well
performing posts reach 150 users with 2-5 link clicks).
 On Twitter over 6 posts, holiday planning content received 4,943 impressions with an
engagement rate of 2.6%, including 41 link clicks, 28 retweets, 6 likes and 4 replies. (Our twitter
account averages 1.1% engagement: 5 link clicks/day, 3 retweets/day, 2 likes/day, 5
replies/month)
Next Steps
A formal evaluation of the Holiday Surge Process is underway in collaboration with the CNE Leadership
Forum (pending the availability of outcome based data in late February/March). A more fulsome report
will be provided to the South West LHIN Board of Directors as well as key stakeholders in March 2016.
Recommendations for a longer-term strategy to support improved regional access and flow will be
discussed with the CNE Leadership Forum, and LHIN/Hospital/CCAC CEO Leadership Forum at key
upcoming meetings. This work will include development of an overall Patient Access and Flow Policy,
and Surge Protocol.
Agenda Item 5.1
Report to the Board of Directors
Board Director Reappointment
Meeting Date:
January 19, 2016
Submitted By:
Jeff Low, Board Chair
Submitted To:
Board of Directors
Purpose:
Information Only
Board Committee
Decision
Suggested Motion
THAT the South West LHIN Board of Directors approves the reappointment application for Board Director
Andrew Chunilall who has submitted a signed reappointment application form.
and
THAT the South West LHIN Board Chair sends a letter of recommendation to the Minister of Health and
Long-Term Care with the reappointment application form.
Background
Under Bylaw 1, ss 4.07 Term and Reappointment – the term of a Board Director shall be for up to three
years. A Board Director may be reappointed for a second term at the discretion of the Lieutenant
Governor in Council.
Reappointment Application Process:
If a Board Director is interested in being considered for a reappointment, they must submit their interest in
writing to confirm their willingness to continue to serve the province through a reappointment application.
And
At least three months prior to expirations, the Chair writes a letter to the Minister that lists all appointees
that the Chair supports. This gives the appointment's process sufficient time for the request to be
considered by the Minister and to ensure timely reappointments. The chair would include reappointment
application form from the appointee.
Agenda Item 5.2
Report to the Board of Directors
2016-2019 Long-Term Care Home
Service Accountability Agreement Template
Meeting Date:
January 19, 2016
Submitted By:
Mark Brintnell, Senior Director, Performance and Accountability
Carolyn Ridley, Financial Analyst (L-SAA Lead)
Submitted To:
Board of Directors
Purpose:
Information
Board Committee
Decision
Suggested Motion
That the South West Local Health Integration Network Board of Directors approve the LHIN’s use of the
draft Long-Term Care Home Service Accountability Agreement (L-SAA) templates for 2016-2019 as
presented to this Board
Purpose
Each LHIN Board is being asked to consider the 2016-19 L-SAA template for approval. In areas where
LHINs need to act in together, the Ministry-LHIN Memorandum of Understanding (MOU) requires that
each LHIN must respect and abide by the position approved by a two-thirds majority of LHINs (MinistryLHIN MOU, Section 14.2 b). The approval of the L-SAA template is considered to be an area where LHINS
act together. If a two thirds majority approval is obtained, the LHINs will use the L-SAA templates to
complete the L-SAA process prior to March 31, 2016.
Background
The 14 LHIN Chairs and CEOs meet regularly and have established a process to represent the LHINs in
consultations and negotiations. In this case, the LHIN CEO Council identified an L-SAA Negotiating Team,
consisting of 3 CEOs, which acted on behalf of the LHINs in discussions at the provincial L-SAA Advisory
Committee. This Negotiating team held a series of consultations with sector representatives to negotiate
a new template agreement for 2016-19 as well as a multi-home template agreement for owners of multiple
homes in the same LHIN.
In keeping with governance best practice, the South West LHIN Board needs to consider for approval the
use of the draft L-SAA template (single and multi-home) for 2016-2019. The enclosed attachments outline
Report to the Board of Directors- L-SAATemplate
Page 2
the major changes between the current 2013-16 L-SAA and the proposed 2016-19 L-SAA and include
both the clean and red-lined versions of the two new L-SAA template agreements.
A.
B.
C.
D.
E.
2016-19 LSAA Template_FINAL_EN (clean version)
2016-19 LSAA Template_FINAL_EN (red-lined version)
Summary of LSAA Main Differences_Dec 2015_FINAL_EN
2016-19 LSAA Multi Homes Template_FINAL_EN (clean version)
2016-19 LSAA Multi Homes Template_FINAL_EN (red-lined version)
Next Steps
Pending South West LHIN Board consideration of the suggested motion, confirmation will be
communicated centrally and if two-thirds majority approval is obtained, LHIN staff will begin to prepare
the L-SAA template agreements for our 78 LTC Homes according to our workplan and timelines. LHIN
staff will be bringing forward to the Board in February 2016 additional information stemming from the
Long-Term Care Home Accountability Planning Submission (LAPS) review and negotiation stage and
update the Board on progress being achieved to put in place new L-SAAs with our 78 LTC Homes.
SUMMARY OF MAIN DIFFERENCES BETWEEN THE 13-16 LSAA AND THE PROPOSED 16-19 LSAA
Reference
General
Update
Difference
A variety of changes were made to correct minor errors in
references, use of defined terms, conformance and
formatting.
Background Background introduction revised to reference
implementation of Health Links and emphasize priorities
for the health care system as a whole.
Single SAA The LHINs have made available a version of the LSAA
template that accommodates multiple homes operated
within a single LHIN and by a single licensee. The parties
to this LSAA would therefore be a single LHIN and a single
licensee (HSP). It is comprised of a single LSAA template
agreement with a separate set of schedules for each of the
homes covered by it.
Definitions
Amended. The following
CEO
definitions were amended:
Design Manual
Reason for Change
To correct inadvertent errors and typographical errors.
To reflect current priorities and the scope of
collaboration the LHIN and the HSP that is expected.
This new multi-home agreement reduces
administrative burden and enhances efficiencies
overall for all parties.
Definition was clarified.
Definition was expanded to be more likely to capture
subsequent changes.
HSP’s Personnel and Defined term “HSP’s Personnel” was changed to
Volunteers “HSP’s Personnel and Volunteers” make it highlight
that the definition includes volunteers.
Performance Factor Definition was clarified.
New: The following definition was
added:
3.4
4.2
4.3
December, 2015
PICB This definition was added because the terms is used
in other new parts of the LSAA (i.e. definition of
“Performance Factor” and Section 7.2).
Amendment e-health/Information Technology Compliance The e-Health provisions were amended to reflect the
provision to reflect HSP contribution to implementation of
requirements of the LHINs' accountability agreements
provincial e-health priorities for 2013-15 and thereafter.
with the Ministry.
Revised provision to highlight requirement for compliance
Revisions reflect need to comply with law and policy
with applicable law.
and the requirements of the LHINs' accountability
agreements with the Ministry.
Amended (iv)
Revision requires LHINs to provide notice to funding
adjustments.
Reference
6.5
Difference
Revised Termination of Designation of Convalescent Care
Beds provision (b)
7.2
(c) has been amended.
8.1
Added sub-section (d): Health Quality Ontario
8.2
10.3
(b) has been amended
Updated reps and warranties re governance
Added reps and warranties re 10.3.a.ix
11.3
Updated indemnification provisions. The scope of the
indemnity has been significantly reduced and is
reasonably limited.
All of the insurance provisions have been thoroughly
reviewed and revised, including elimination of noted
duplications.
Revised language
Added email as a means of providing notice. The provision
has been amended so that in all cases, Notices by fax or
email are effective when acknowledged in accordance with
the requirements of the Notices provisions of the LSAA.
11.4
12.4
13.0
Reason for Change
Revisions supports the LHINs’ system planning duties
by providing a more appropriate notice period and
relevant information.
Revision allows either party to include PICB to
contribute to the performance management process.
Revisions result from changes to the LHINs’
accountability agreement with the Ministry.
To clarify drafting.
Revision clarifies that the list of policies and
procedures in the Section is not exhaustive. The HSP
has an obligation to have any other policies and
procedures that the HSP considers necessary.
The revised scope is considered to be adequate for
the purposes of the agreement.
The revised requirements are considered to be
appropriate for the purposes of the agreement.
Clarification.
To update means of notice and to clarify when notice
becomes effective.
Schedules
Schedule A
Schedule B
Schedule C
December, 2015
Combined sections A1-A4 (from the LAPS Forms) into 3
sections for clarity and to avoid duplication. The Structural
Information Section (A3) is a new addition to Schedule A.
Construction funding subsidy section updated.
Removed Reference to Performance Reporting. Included
Quality Improvement Plan Reporting (with a copy to the
LHIN)
To clarify drafting.
To ensure that the language and scope is consistent
with current practice and the enhanced LTC renewal
strategy.
Update to reflect removal of reporting that is no longer
relevant and to include new reporting requirements.
Schedule D
Schedule E
December, 2015
Indicators updated. Targets for both Financial Indicators
adjusted to included performance standards
Revised language
Update
Updated for consistency with MSAA
Agenda Item 5.3
Report to the Board of Directors
Use of Remaining 2015/16 One-Time Funding
Meeting Date:
January 19, 2015
Submitted By:
Mark Brintnell, Senior Director, Performance and Accountability
Submitted To:
Board of Directors
Purpose:
Information
Board Committee
Decision
Suggested Motion
THAT the South West Local Health Integration Network Board of Directors approves the allocation of up to
$5.0 million in one-time funding in 2015/16 from the community sector base increase in support of the
Community Sector One-time Minor Infrastructure Program and the projects identified on Appendix A of this
report.
Purpose
The purpose of this report is to seek approval for the investment of one-time funding in support of several
projects and to conduct the Community Sector One-Time Minor Infrastructure Program (“Program”) in
2015/16 using surplus funds from the community sector base funding increase and LHIN Urgent Priorities
Fund.
Background
In September 2015, the South West LHIN Board approved the 2015/16 Priorities for Investment Plan
allocating new community sector base funding and LHIN Urgent Priorities Fund one-time funding. At that
time, it was identified that the plan did not fully spend all the funding available due to timing of provincial
approvals, local allocation process and decisions, and health service provider start-up. Any unspent funding
by the end of the fiscal year is subject to the provincial reconciliation and settlement process and will be
returned to the provincial treasury.
In order to maximize the appropriate use of the remaining new funds in the current fiscal year, LHIN staff
recommends several projects noted in Appendix A and propose to offer the Community Sector One-Time
Minor Infrastructure Program (Program).
This will be the eighth year South West LHIN has offered the Program to community sector health service
provider partners. Many community sector partners struggle with identifying sufficient fiscal resources to
invest in their infrastructure, equipment and training. The Program gives them an opportunity to access
one-time funds that otherwise would be difficult to access in order to enhance delivery of their LHIN-funded
Report to the Board of Directors- One-Time Funding
Page 2
services and programs. The Program ensures the funds are invested within the community sector
consistent with the original intent of the Ontario government. The Program has been oversubscribed each
year it has been offered, signaling its need and popularity.
Current State
The total one-time funding available to support the projects and the Program is approx. $5.0 million. It is
important to note that almost $2.68 million of the total comes from base investments in initiatives (e.g.
behavioral supports in LTC Home) from the previous year that have yet to become operational due to timing
of policy and certain provincial approvals. Although these initiatives continue to move along, they have yet
to reach an operational state.
LHIN staff recommend the allocation of one-time funding in the amount of up to $440,576 to support 13
projects listed in appendix A and up to $4.5 million for the Program. The projects came forward following
consideration by internal LHIN Portfolio Teams on opportunities to leverage one-time funding to further
enable and advance current initiatives/projects in pursuit of goals of the Integrated Health Service Plan.
One area being considered but not ready at the time of the writing of this report is the potential of Syrian
Refugee resources.
Next Steps
Subject to the Board’s consideration of this request, LHIN staff will action the projects and implement the
Program immediately in order to maximize the appropriate use of the in-year surplus funds.
Appendix A: Recommended projects/initiatives for 2015/16 One‐Time Priorities for Investments Funding Initiative
Name
Funding
Initiative Description
Health Service Provider (receiving
funding)
Improving Coordination and Transitions of Care
1
2
3
4
Stoke Adult
Day Programs
- equipment
and training
Stroke
Educational
Video
Workshop to
support
integration of
Stroke
Services
Kincardine
Outpatient
Physiotherapy
$ 40,844
Enhanced equipment, point of care technology and training to improve
quality of programming in stroke ADPs in Oxford County
VON Oxford
$ 7,500
$10,000
$ 12,500
Develop three short 15 second Public Announcement Videos with local
input to show- case the FAST (Face, Arms, Speech, and Time is Brain)
signs and symptoms of stroke for Middlesex, Huron-Perth and Grey
Bruce. Project is in partnership with local EMS. Evaluation would
include # of calls to 911 prior to video release and # calls post video
release.
This workshop, led by an experienced facilitator, will support
integration work in London and Woodstock necessary as part of the
Stroke Phase 1 Implementation and Evaluation of the Directional
Recommendations for In hospital Stroke Care. We anticipate bringing
together acute, inpatient rehabilitation, outpatient rehabilitation and
community rehabilitation services personnel together.
South Bruce Grey Health Centre (SGBHC) has been tentatively
approved by MOHLTC to provide publically funded outpatient
physiotherapy at its Kincardine site. Timing of funding is still pending,
however, SGBHC is ready to launch program by hiring a
physiotherapist. If MOHLTC approves funding between now and end of
the fiscal year, then LHIN funds would not be required.
London Health Sciences Centre
St. Joseph's Health Care, London
South Bruce Grey Health Centre
Initiative
Name
5
6
Equipment to
support
Rehabilitative
Streams of
Care
Stroke Facilitating
intensive
therapy using
electronic
scheduling
Funding
$101,656
$ 10,576
Initiative Description
Enhanced equipment to support Rehabilitative Streams of Care
including specialized geriatric care (i.e. Transcranial Magnetic Stim),
Stroke Care and Bariatric svc’s (i.e. Bariatric Walker).
To purchase a new electronic patient scheduling system for more
efficient use of existing scheduling resources to support Stroke Quality
Based Procedures and Canadian Best Practice Recommendations for
stroke. Research has demonstrated that patients received greater
amounts of therapy time at sites that utilized a structured scheduling
system for the multiple therapies required in providing best practice
stroke rehabilitation. The proposed electronic scheduling system builds
on the existing Cerner infrastructure (part of the organizational IT plan)
thereby creating further efficiencies for operationalization.
Health Service Provider (receiving
funding)
Huron Perth Health Alliance
St. Joseph's Health Care, London
Increase the Value of our Health Care System
7
8
Functional
Neuromuscular
Electrical
Stimulator for
Upper
Extremities
Functional
Electrical
Stimulator
Cycles
$ 55,000
$ 60,000
To purchase new Functional Electrical Stimulators (FES) for upper
extremities to increase capacity to support patients in the recovery
from Stroke, Acquired Brain Injury and Spinal Cord Injury. The use of
FES to enhance neurological recovery is rapidly becoming standard of
practice in rehabilitation centres throughout North America. With
reduced length of inpatient stays and efforts to maximize recovery
during outpatient visits, equipment such as this will be crucial in
attaining positive patient outcomes and achieving our goals.
To purchase new Functional Electrical Stimulator (FES) cycles to
increase capacity to support patients in the recovery from Stroke,
Acquired Brain Injury and Spinal Cord Injury. The use of FES to
enhance neurological recovery is rapidly becoming standard of practice
in rehabilitation centres throughout North America. With reduced length
of inpatient stays and efforts to maximize recovery during outpatient
visits, equipment such as this will be crucial in attaining positive patient
outcomes and achieving our goals.
St. Joseph's Health Care, London
St. Joseph's Health Care, London
Initiative
Name
9
10
Healthline.ca
enhancements
Cog Wall
development
Funding
$ 40,000
$ 50,000
Initiative Description
To improve thehealthline.ca Information Management System.
Develop standardized templates for the capture of hours/holiday hours
and specialized information for holiday periods; modify display and
create education and training materials. This opportunity was identified
as part of the Holiday Surge Planning work.
To create a “Cog Wall’ for elderly patients in the Hospital. Cog walls
are specifically designed to maintain cognitive functions of the elderly
in a hospital setting. The wall build with devices specifically designed to
address the needs of our older population. It will have fold away and
separate stow away attachments that can be removed and attached to
a wheelchair for wheelchair bound patients.
Health Service Provider (receiving
funding)
South West CCAC
Woodstock General Hospital
Drive Safety through Evidence-based Practice
11
12
13
Critical Care
Nurse Training:
feasibility study
London
Middlesex
Health Equity
Forum and
Workshop
Breathe Easy:
Aboriginal
Community
Education
Toolkit
Fiscal 2015/16
$ 32,500
$ 10,000
$ 10,000
$
440,576
This project will determine the feasibility of training all CC nurses in the
South West LHIN at London Health Sciences Centre (LHSC) is the
only academic critical care (CC) program in the South West LHIN.
LHSC prepares nurses to work in the adult CC units at UH and VH
through a hospital-based CC nursing education program.
Host a London Middlesex Health Equity education workshop for 200
participants from the London/Middlesex Area Provider Table (APT) and
broader health sector providers in London/Middlesex including Primary
Care and also representatives from each of the other geographic APT
tables
Expand printing budget for this project, enabling sharing of the
resource kit already being developed with non-Aboriginal health care
providers. Currently, the project is only funded to print enough copies
of the kit for Aboriginal providers.
London Health Sciences Centre
Dale Brain Injury Services
SOAHAC
Agenda Item 6.1
Report to the Board of Directors
Integrated Health Service Plan (IHSP) 2016 – 2019
Meeting Date:
January 19, 2016
Submitted By:
Kelly Gillis, Senior Director, System Design and Integration
Mark Brintnell, Senior Director, Performance and
Accountability
Ashley Jackson, Director, Communications and
Community Engagement
Submitted To:
Board of Directors
Purpose:
Information Only
Board Committee
Decision
Purpose:
To update the Board of Directors on the final steps taken to prepare for the February release of the
South West LHIN Integrated Health Service Plan (IHSP) 2016-2019.
Update:
At the December meeting, the Board of Directors approved the 2016-2019 South West LHIN Integrated
Health Service Plan with the request to provide more detail in the performance section of the document
(see Appendix 1). In response to this request, wording related to the 4 big dots has been enhanced to
provide more clarity and a table has been added that summarizes what success will look like for each
of the seven priorities. The descriptions in the table will serve to inform the creation of a system
scorecard to enable our ability to monitor our progress over time.
The approved IHSP with the changes noted above has been sent to the designer for final layout and
publication and has also been sent for French translation. In addition, we are working to finalize the
“public facing” document and plan to share it with the Board at the January meeting.
Next Steps:
 February 1, 2016: Public release of IHSP
 At the February Board meeting, the LHIN Board will review and discuss the 2016-17 draft
Annual Business Plan (ABP), the first of three ABPs that align to the 2016-19 IHSP. This will
include a concept of the system scorecard associated with the new IHSP and an opportunity to
discuss reporting formats and frequency to the LHIN Board
Report to the Board of Directors- IHSP 2016-19
Page 2


At the March Board meeting, the LHIN Board will consider approval of the draft 2016-17 ABP to
enable submission to the Ministry by the end of March 2016
January 2016 – June 2016: Continue to develop and implement a communications and
engagement strategy to create awareness of the new IHSP and to ensure health service
provider strategic and operational plans are aligned to the implementation strategies and
priorities of the IHSP. Alignment to the Health System Transformation strategy as outlined in the
ministry’s Patients First discussion paper will be ensured.
Appendix 1
Demonstrating success
The South West LHIN aims to improve people’s health care experience, get timely quality care
for the population, and ensure we receive value for the money spent on care.
The LHIN will continue to measure the performance of the health system to determine if we are
successful in achieving these goals by monitoring big dot outcomes and system measures
aligned to each priority. A complete listing of indicators including those being considered for
other levels of monitoring by project teams have also been identified and can be viewed in
Appendix 3.
Our four big dot outcomes are key drivers within our performance measurement plan and will
allow us to understand progress over time against our system goals. The big dots align to one
or more of our goals and include:
 Self-reported health status (proportion of respondents who reported their health as
'Excellent" or "Very Good")
 Faster access to appropriate care (proportion of access indicators showing faster
access to care when needed). This big dot will include: wait times for mental health
case management services, wait times for Personal Support Worker services, and
percent of patients able to access to primary care on the same or next day when sick)
 Satisfied with how care was provided (proportion of respondents who reported their
most recent experience with their primary care provider as "Excellent" or "Very Good")
 Value realized by reducing hospital visits and days (better use of time and
healthcare resources by avoiding unnecessary visits/readmissions to the hospitals).
1 This big dot will include a focus on avoidance opportunities in the following areas:
readmissions to hospital, Emergency Department visits that are best managed in
primary care settings, and hospitalizations for key conditions.
Additional key indicators have been prioritized as system level measures, based on the
following considerations:
 Shared accountability among health sectors for improvement
 Each of the seven priority areas are measured and measures can align to more than one
of the seven priority areas and key objectives.
 Ministry-LHIN Performance Accountability Agreement measure
The full system-level measurement plan includes the four big dots and twenty-six key measures
that align to each of the seven priority areas. The full set of measures and identified outcomes
(summarized below) informs scorecards and dashboards used to ensure transparency, and that
patients, clients, residents, health service providers and key stakeholders can understand the
progress against our intended outcomes and objectives. These tools will be shared with leaders
and governors who can create a culture of continuous quality improvement within their
organization, within initiatives, and for the system at large.
How will we know we have been successful?
Mental Health and
Addictions
Home and
Community Care
Chronic Disease
Prevention and
Management
Palliative Care
Fewer people returning
to the Emergency
Department due to
better connections to
community supports
Faster access to care
provided by personal
support workers and
nursing in the
community
Improved
transitions of care
following a hospital
stay
More people
with palliative
care needs
being supported
at home
Fewer people needing
to be hospitalized for
mental health
conditions
Fewer people waiting
in hospital for care in
community
Fewer people
needing to be
hospitalized for
chronic conditions
Fast access to mental
health care in the
community
2 Hospital-based
Services
Primary Care
Rehabilitative Care
Faster access to care in
Emergency
Departments
Faster access to primary care when
sick
Fewer people waiting in
hospital for other levels of
care
Faster access to
surgical and diagnostic
procedures
Fewer visits to the Emergency
Department for conditions that are
better managed in primary care
Fewer people dying in
hospital
More people seeing their primary
care provider following discharge
from hospital
Improved cost
alignment to provincial
standard
3 Agenda Item 6.2
Report to the Board of Directors
2015/16 Annual Business Plan Status Report
Meeting Date:
January 19, 2016
Submitted By:
Kelly Gillis, Senior Director, System Design and Integration
Submitted To:
Board of Directors
Purpose:
Information Only
Board Committee
Decision
Purpose:
As part of the development of the 2016/17 Annual Business Plan, it is important to understand the status
of the 2015/16 Annual Business Plan (ABP) key deliverables including the projected timelines to achieve
the identified deliverables.
The information in this briefing and attached status report (attachment 1) is aligned to the content of
Appendix A in the 2015/16 ABP and complements previous information the Board has received such as
South West LHIN Quarterly Reports submitted to the Ministry of Health and Long Term Care and the
LHIN Report on Performance. In addition, 2015/16 marks the final year of the 2013-16 IHSP. To reflect
this milestone, the status report (attachment 1), highlights achievements that occurred within the 3 years
of the IHSP.
Overall Initiative Status:
In Appendix A of the 2015/16 ABP, 16 programs were highlighted that described particular change
initiatives that the LHIN has been striving to advance over the life of the 2013-2016 IHSP.
Over the 3-year life cycle of the 2013-16 IHSP, 90 distinct initiatives were identified. For the Infection
Prevention initiative, sector actions are now monitored through Service Accountability Agreements (SAAs)
and Quality Improvement Plans (QIPs). Of the distinct 89 initiatives/actions remaining in Appendix A, the
magnitude and duration of change is described for each to create a shared understanding of the
complexity or simplicity involved with each change initiative as well as its expected duration. For some
actions, the changes are very complex and the duration is more than 2 years. For other initiatives the
changes are less complex and the duration is less than 2 years. For the 89 initiatives remaining:



25 (28%) initiatives were complete as of March 31, 2016 or sooner
38 (43%) initiatives have advanced progress (51% or more complete as of March 31, 2016)
26 (29%) initiatives have early progress (50% or less complete as of March 31, 2016)
Next Steps
•
•
An early draft of the 2016-17 Annual Business Plan will be brought forward to the Board for review in
February. The 2016-17 business plan will reflect the priorities and initiatives of the 2016-19 Integrated
Health Service Plan that the Board recently approved. Through the Annual Business Planning
process, consideration is being given to the impact of the proposed structural reform initiatives
identified in Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario on the
timelines associated with achievement of the initiatives identified in the 2016-19 IHSP.
In March, a revised draft 2016-17 Annual Business Plan will be brought forward to the Board for
approval and subsequent submission to the Ministry.
2013-16 Status Report
(Attachment 1)
In alignment with the 2013-2016 IHSP, Appendix A of each consecutive Annual Business Plan describes the strategic
direction, program, initiative, associated magnitude of change and projected duration for each initiative. Within each
Strategic Direction of the 2013-2016 IHSP, approximately three quarters of the initiatives were considered to have greater
magnitudes of change associated with them and required more than three years to implement. This is due to the
transformative nature of these initiatives that have a mix of actions focused on cultural and behaviour changes and
changes in business processes that are implemented at multiple health service provider sites. Given the size of the South
West LHIN geography and the number of health service providers involved in change efforts, the LHIN often implements
initiatives in stages using quality improvement methods where a “plan, do, study, act” approach is used for a particular
geography to trial and learn from and then implementation is staggered over time in defined locations.
Over the 3-year life cycle of the 2013-16 IHSP, 90 distinct initiatives were identified. For the Infection Prevention initiative,
sector actions are now monitored through Service Accountability Agreements (SAAs) and Quality Improvement Plans
(QIPs). For the 89 initiatives remaining:



25 (28%) initiatives were complete as of March 31, 2016 or sooner
38 (43%) initiatives have advanced progress (51% or more complete as of March 31, 2016)
26 (29%) initiatives have early progress (50% or less complete as of March 31, 2016)
2013 – 2016 Integrated Health Service Plan Priorities by Program
Access to Care Program Highlights
Assisted Living/Supportive Housing/Adult Day Programs
 Coordinated access fully implemented for Assisted Living/Supportive Housing/Adult Day Programs for high risk seniors and special populations
 New ADP service delivery model and standard client fee of $10/person/day implemented to support improved access and equitability across service delivery locations
 ADPs have seen an improvement (24%) since the fall of 2013 with respect to alignment with quality standards. In the fall, ADPs were 76% in alignment and after Q4
2014 they were 100% in alignment
 Additional Assisted Living Hubs have been operationalized in 5 communities in Phase 1 and an additional 6 communities in phase 2
 8 new Assisted Living spaces have been operationalized for Adults with Complex Needs
Home First
 Home First is now live at all acute hospitals in the South West LHIN as well as Parkwood Hospital
 The Home First initiative continues to see positive results in maintaining the gains made to reduce ALC-LTC numbers
 The Access to Care program and its 3 main streams of work: Home First, CCC/Rehab and AL/SH/ADP are in the Sustainability Phase
1
CCC/Rehab
 Coordinated Access – 73% of hospitals in the South West LHIN are using the Resource Matching & Referral process and CCAC Coordinated Access to CCC/Rehab;
currently only Parkwood Hospital is outstanding with implementation scheduled for the last quarter of 2015/16.
 Bed Realignment – Phase 1 bed realignment has been achieved. Phase 2 stage 1 shifts are effectively complete in terms of bed realignment – LWHA and SHHA still
listing higher ‘current’ bed numbers, but the 2014/15 year end occupancy is very low and the hospitals’ are operating at the Stage 1 bed level in terms of patient days.
The financial reconciliation for this phase and stage is to be completed in the last quarter of 2015/16. Future phases of realignment will be dependent on refreshing the
projection model with more current data and information. Future data refreshes will include information gained through the Evidence Informed Bedded Rehabilitation
Capacity Plan, the Rehabilitative Care Alliance Bedded Definitions Framework Project and impacts of the Stroke Phase I Realignment Recommendations.
Senior Friendly Hospitals
 All Hospitals have representation on the Senior Friendly Task Group and are actively working towards implementation of the strategy. All HSPs have participated in the
ACTION training and webinars have been delivered for front line staff surrounding delirium and functional decline.
Restorative Care
 A regional approach to restorative care has been developed in Grey and Bruce Counties with CCAC coordinating access to restorative beds spread between Owen
Sound (4 beds), Chesley (currently 10 beds, reducing to 5 beds by end of 2015/16) and Hanover (2-3 beds opening April 1 2016). This approach provides care closer to
home and supports a Home First strategy.
Long Term Ventilation
 Long-term ventilated patients in acute and sub-acute care have been able to move to a more appropriate level of care in the community (supportive housing)
 Respiratory Therapy is now incorporated into the model for home care through CCAC. Hospital staff continue to provide training and support to Participation House staff
regarding care of long-term ventilated clients, allowing clients to remain in the community and avoiding hospital readmissions.
Program Success Story
ADP success
story.docx
Initiative/Action
Status at
March 31, 2016*
Planned Completion
Medication Reconciliation
Cluster Care and Virtual Ward
Home First
Senior Friendly Hospitals
CCAC Expanded Role
Implement Redesign Recommendations
Restorative Care
Long Term Ventilation
Early progress
Advanced progress
Complete
Advanced progress
Advanced progress
Advanced progress
Complete
Complete
Beyond 2017-18
2016-17
2014-15
2016-17
2016-17
2017-18
2015-16
2015-16
Behavioural Supports Ontario (BSO) Program Highlights
The South West BSO program strives to create a system of care for older adults living with responsive behaviours due to mental health and addictions, dementia, or other
neurological conditions and those at risk.
People Served – The number of clients served by the BSO program has increased from 2,294 in the third quarter of 2013/14 to almost 3,560 in the fourth quarter of
2014/15. More than 6% of the population aged 65 or older are now being seen through BSO. Between October 2013 and April 2015 there were fewer open alternate level of
care (ALC) cases among those with behavioural specialized needs in the South West LHIN, as well as fewer ALC days.
2
System Coordination and Enhancements - Many agencies/services received enhancements and were tasked with improving the coordination of services offered across
the care continuum. Six Schedule 1 hospitals (i.e., psychiatric facilities designated under the Mental Health Act) received funding to create or enhance Geriatric Mental
Health Outreach Teams to provide assessment, consultation and short-term follow-up, as well as timely education and support to staff working in Long-Term Care (LTC)
homes, hospitals and community organizations, in addition to families and other care partners. 79 LTC homes received BSO Nursing and PSW funding to embed additional
resources in each long term care home. Six Alzheimer Societies added social work/social support staff to assist with caregiver support. Ten adult day programs (ADPs)
established overnight respite services. St. Joseph’s Health Care London supports a LHIN wide project team, geriatric psychiatry and psychologist. The South West CCAC
continues to provide geriatric resource consultants. The result is a shared leadership model across the LHIN that is comprised of the BSO Steering Committee, and BSO
Project Team. In five sub-LHIN areas, Enhanced Psychogeriatric Resource Consultants, Virtual Team Networks and Geriatric Cooperatives work to improve system
coordination and cross-sectoral communication. Partnerships facilitated by the Geriatric Cooperatives have changed the way agencies/services collaborate. This co-created
system has resulted in a decrease in alternate level of care cases among those with behavioural specialized needs and improved client/family perceptions of care. Work
underway to add additional continuum of care option by establishing specialized units in LTC homes across the LHIN.
Education and Capacity Building - Opportunities for capacity development have increased. In 2012/2013, at the onset of the BSO initiative, 34 education
events/presentations related to the care of those with responsive behaviours were scheduled. This increased to 325 in 2013/2014, and then to 410 in 2014/2015. In 2013/14,
more than 1,100 people attended these events. This number increased dramatically in 2014/15, to 7,025 people. Education has included P.I.E.C.E.S. (Physical, Intellectual,
Emotional, Capabilities, Environment, Social), GPA (Gentle Persuasion Approaches), and Montessori. Education to improve care & change practice
Virtual Team Networks - Monthly meetings with LTC Home embedded BSO Team. Education, guest speakers, case reviews, Quality Improvement focus. Very successful,
high level of engagement. Approx. 1000 people participate in these meetings and in other BSO events every quarter.
Enabling Technologies - Technology (e.g., Ontario Telemedicine Network, OTN) is used to support clinical and educational activities. HealthChat, an online forum for
health professionals to share information, communicate and collaborate (www.healthchat.ca), is used as a central repository for BSO-related information and tools (e.g.,
assessment and QI tools, protocols, data collection tools) as well as a communication venue for educational opportunities
Access & Flow/Transitions - Kaizen Events held in each county to map current and future state, transition points. Plan Do Study Act cycles ongoing and being shared at
each Geriatric Cooperative meeting related to system navigation algorithms, Family Health Teams (FHT) an d Emergency Medical System (EMS) pilot, 3 question template
between LTCHs and BSO Mobile Team, and improving communication between ERs and LTCHs,
BSO Website - Healthchat feature, over 250 registered for site.
Program Success Story
Initiative/Action
Status at March 31, 2016*
Planned Completion
Behavioural Supports Ontario
Advanced progress
2016-17
Successtory_BSO2015
.docx
Chronic Disease Prevention and Management Program Highlights




Accountability for the 9 Diabetes Education Programs (DEPs) in our LHIN has been transferred from the Ministry of Health and Long Term Care to the LHIN. All 9 are
providing the LHIN with quarterly financial and activity reports.
The LHIN is working with the DEP health service providers to coordinate access to services to ensure people are receiving the right care as close to home as possible
Approximately 19,000 people with diabetes receive diabetes education and management services from LHIN funded programs
A group of health service providers and the LHIN developed recommendations for a service delivery model for the care of Diabetes foot conditions. This project has
been implemented in London and recommendations developed for spread throughout the rest of the LHIN.
3






The South West Self-Management Program supports people with chronic conditions by providing peer lead workshops on managing a chronic condition and also
provides training for health services providers to develop the skills to encourage and support patients to be able to self-manage their chronic conditions
Approximately 650 people participate in self-management workshops each year
Partnering for Quality continues to support primary care providers and other health professionals through coaching focusing on improving chronic disease prevention
and management (CDPM) and maximizing utilization of EMRs and other e-health technologies to support CDPM. 67 primary care teams have been provided support
The South West Self-Management and Partnering for Quality programs are also providing regional support to Health Links. Efforts have focused on capturing patient’s
experiences with coordinated care planning, and engaging patients and caregivers in the co-design of care planning processes.
The South West Primary Care Network is establishing local networks. Local primary care networks have been established in London/Middlesex, Elgin and Huron/Perth
Tele-homecare is being implemented throughout the LHIN supporting people with COPD and CHF to self-manage through remote monitoring. There were 134
participants within the first three months of implementation.
Program Success Story
CDPM Success
Story.docx
Initiative/Action
Status at March 31, 2016*
Planned Completion
Strengthen links to Health Promotion
Advanced Access
Self-Management
Living Healthy Life with Chronic Conditions
Partnering for Quality
Diabetes Prevention and Management
Diabetes Foot Ulcer
Early progress
Early progress
Early progress
Advanced progress
Advanced progress
Early progress
Advanced progress
Beyond 2017-18
Beyond 2017-18
Beyond 2017-18
2016-17
Beyond 2017-18
Beyond 2017-18
2016-17
Clinical Services Planning Program Highlights




Clinical Services Planning (CSP) has been underway since November 2013. Stroke Phase 1: Planning is complete with the development of a set of Directional
Recommendations for the realignment of Stroke Care from 28 hospitals to 7. These shifts will create a South West LHIN system of care for Stroke survivors and
ensures critical mass that will be better in line with best practice guidelines. These recommendations were endorsed by regional partners and supported by the LHIN
Board in March 2015. Stroke Phase 2: Implementation and Evaluation is underway. Vision Care recommendations were developed and have resulted in three ongoing
projects (Eye Care for Patients with Complex Co-Morbidities, Visual Acuity Testing Post Procedure, Enhanced Screening for Patients with Diabetes). Endoscopy clinical
planning has been completed and has moved into sustainability with the establishment of an Endoscopy Quality Improvement Committee lead by Cancer Care Ontario.
Perinatal Capacity Assessment draft recommendations have been developed and have been shared with the Chief Nursing Executive Leadership Forum and South
West LHIN Hospital/CCAC Leadership Forum. Recommendations will determine next steps into ongoing years.
Phase 1 and Phase 2 of Oxford Hospital Joint Services Planning have been completed, including implementation of recommendations related to pharmacy services,
surgical services, alternate level of care, laboratory services, mental health and addictions, and paediatrics and children’s health services.
A Surgical Waitlist Management System (SWMS) business case was developed and supported by the South West LHIN Hospital/CCAC Leadership Forum in fiscal
14/15. STEGH has been an early adopter hospital and have completed their implementation of the Novari surgical waitlist solution. The Oversight Committee
established in 14/15 has been critical to ensure lessons learned are being shared across the partners and translated into insights to r spread the Novari Solution to
other hospitals and, eventually, primary care. A LHIN–wide implementation approach has been supported by the Oversight Committee and the South West LHIN
Hospital/CCAC Leadership Forum. A Working Group has been brought together to do detailed budgeting and complete organizational readiness assessments to
identify the next wave of hospital sites that are in a position to implement.
4

The Orthopaedic Steering Committee has been reconvened with a mandate to focus on prioritizing and supporting quality improvement initiatives; supporting QBP
implementation and evaluation; supporting wait list management strategies; and supporting a LHIN-wide Orthopaedic System of Excellence. The LHIN continues to
work with our partners to develop strategies to improve the orthopaedic system of care.
Program Success Story
Initiative/Action
Status at March 31, 2016*
Planned Completion
Stroke, Cataracts, Endoscopy
Perinatal Capacity Assessment
Oxford Joint Services Planning
Surgical Waitlist Management
Orthopedic System of Excellence
Advanced progress
Advanced progress**
Complete
Early progress
Advanced progress**
2017-18
2016-17
2015-16
2018-19
2016-17
Connecting and Empowering People Program Highlights
Aboriginal Services Highlights
 The Southwest Ontario Aboriginal Health Access Centre (SOAHAC) has worked to enable better access for Indigenous peoples and their families by re-designing
services towards integrated care teams which include: traditional healing, primary care, diabetes team, mental health and addictions, children and youth services, and
seniors program. These services are available in three sites across the South West LHIN: Chippewas of the Thames First Nation, London, and Owen Sound.
 Exercise Programs and Falls Prevention Classes for Senior’s have been introduced to the Aboriginal communities in three regions: Saugeen First Nation; Chippewas of
the Thames First Nation and London and through SOAHAC.
 The Indigenous Cultural Safety (ICS) training has been adapted for Ontario and has trained over 1,100 people in Ontario since launching in May 2014.
 A series of four data reports were completed to better understand Aboriginal health needs and barriers to access to care. These reports include: the Aboriginal Data
Report for Health Links, Aboriginal diabetes Needs Assessment, Aboriginal Patient Journey Report, and the Aboriginal Education and Training Capacity Report.
 The South West LHIN continues to meet with the Aboriginal Health Committee to advance Aboriginal health priorities.
 Through LHIN-funded services (mental health and addictions services; seniors programs and Traditional Healing), 2,397 Aboriginal individuals have received service in
Q1 and Q2 for 2014/15 (Data included is only for SWRHL, SOAHAC, & Chippewas of Nawash. Excludes data for ICS and Oneida Nation.)
Francophone Services Highlights:
 The advisory committee that was created to inform on the implementation of the French Mental Health and Addiction System Navigation Program developed a work
plan which addresses some of the Community Capacity Refresh Report recommendation`s specific to the Francophone population. Actions in the work plan include;
insuring a bilingual component to MH, A coordinated access, mapping of existing MH, A services available in French to help identify gaps and opportunities as it relates
to FLS.
 Local indicators specific to FLS were included in the SAA`s. Indicators are related to identification of francophone clients and reporting requirements. This information
will help with the establishment of an environment where peoples’ linguistic backgrounds are collected linked with existing health services data and utilized in health
services and health system planning to ensure services are culturally and linguistically sensitive.
 The French Language Services Toolkit that received an honorable mention in the French Language Commissioner Report was distributed to all HSP`s. This Toolkit will
help HSP`s understand the concept and principles of an Active Offer, help improve patients experience and access to quality services in French.
 Exercise program and fall prevention information and workshops are now available in French through the bilingual Community health promotion position at LIHC.
A total of 3 workshops and 1 series of exercise classes were successfully held at the French Community Centre in the summer and fall 2015.
All existing and future health promotion workshops developed by London Intercommunity Health Centre will be available in French and provided in French as requested
(presentation such as; Sleep health, managing your health, Brain health, self- management of diabetes’s and more).
5
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The Erie St. Clair and South West French Language Services (FLS) Liaison committee developed a 3 years Joint Action Plan to guide the collaborative efforts of the
two LHINs and the French Language Planning Entity. This plan has a focus to Improve access to, and accessibility of health services in French for Francophone with
mental illness and addictions issues, those living with chronic conditions and francophone seniors and adults with complex needs.
Community Engagement activities with francophone included; Home Care Community Survey, IHSP4 presentation interview and focus group (with French stakeholder,
French health planning entity, community groups and francophone clients).
Program Success Story
Story of
success.docx
Critical Care Program Highlights

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Initiative/Action
Status at March 31, 2016*
Planned Completion
Optimize Skillsets of Team Members
Indigenous Healers & Healing Methods
Culturally Appropriate Care
Access to Addiction Services including Aboriginal
Interface Improvements
Aboriginal Strategic Primary Care Plan
Chronic Self-Management Programs
French-Speaking Support Staffing
Francophone CCAC Services
Healthline.ca Tool to Support Francophone
Population
Capacity & Efficiency of Teams & Services
French Language Services Requirements
Francophone Sensitive Services Opportunities
Implement Aboriginal MH&A Strategy
MH&A French Language Services
Aboriginal Cultural Competency of HSPs
Distribute & Promote FLS Toolkit to HSPs
Aboriginal Health Planning & Service Delivery
Data Requirements
Creating Aboriginal Health Data Source
First Nations, Metis, Aboriginal Data Collection
Advanced progress
Advanced progress
Advanced progress
Early progress
Early Progress
Advanced Progress
Advanced Progress
Early progress
Advanced Progress
Complete
2017-18
2016-17
Beyond 2017-18
2016-17
2016-17
2016-17
2017-18
2017-18
2017-18
2013-14
Early Progress
Advanced Progress
Early progress
Early Progress
Early Progress
Advanced Progress
Complete
Complete
2017-18
2016-17
2017-18
2017-18
2017-18
Beyond 2017-18
2013-14
2013-14
Complete
Complete
2015-16
2013-14
Critical Care Network Symposium was held in November 2015. The need for enhanced Critical Care training for nurses working in level 2 and 3 ICUs was identified and
dialogue about the Critical Care Nurse Training Fund as a barrier due to restrictions on the clinical hours needed and backfill for those positions in smaller sites.
Balanced scorecards for each hospital were reviewed and improvement opportunities were identified.
CritiCall Ontario PHRS (Provincial Hospital Resource System) Repatriation Tool went live in May 2014 for the South West LHIN. The tool provides hospitals with the
ability to update and view resource availability in the following bed/resource areas: medical/surgical, cardiac, paediatric critical care, neonatal, maternal, ED, and noncritical care. Further enhancements to the PHRS System have been on-going to better meet the needs of providers.
In October 2015, Critical Care Services Ontario (CCSO) in collaboration with CritiCall Ontario hosted an Erie St. Clair and South West LHIN Town Hall meeting in
Windsor. The morning session focused on repatriation, progress with implementation of life or limb policy implementation and review of the data to support compliance
6
and escalation of life or limb cases. The afternoon focused on data quality management to enable system improvement and integration and further enhancements to the
role of CritiCall regarding facilitation of transportation for critically ill patients.
Program Success Story
Initiative/Action
Status at March 31, 2016*
Planned Completion
Plan & Implement Provincial Life or Limb
Provincial Hospital Resource System
Critical Care Efficiencies & Improvement
Complete
Complete
Advanced Progress
2014-15
2015-16
2017-18
Diagnostic Imaging Program Highlights
Diagnostic Imaging was identified as a clinical services planning stream in October 2015. A project charter and the development of terms of reference for an oversight
committee have been developed. Scoping and identification of resources to support this work will be brought forward for planning to commence in fiscal 2016/17.
Program Success Story
Initiative/Action
Status at March 31, 2016*
Planned Completion
Diagnostic Imaging Coordinated Access
Early Progress**
2017-18
Emergency Services Program Highlights
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Implementation of South West LHIN Knowledge Transfer and ED Pay for Results program(s) focusing on improving access and spreading ED leading practices to high
volume emergency departments in the South West LHIN completed.
Created a ‘learning collaborative’ among participating ED Pay for Results and Knowledge Transfer improvement sites to promote accountability and sharing of leading
practice interventions. This will continue through 2016-17.
Key goal was to reduce wait times for admitted patients - Since 2012-13 (baseline), the South West LHIN has reduced admitted length of stay by almost 3 hours (90th
percentile) or 11%. Significant improvements in ‘admitted length of stay’ and specifically ‘time to inpatient bed’ for all 4 participating South West LHIN Knowledge
Transfer sites since 2012-13 baseline include: Stratford 20% improvement; Tillsonburg 24% improvement, Woodstock 68% improvement; and Strathroy 4%
improvement. All Pay for Results sites (LHSC, STEGH, GBHS and WGH) have targeted improvement action plans focusing on reducing admitted patient length of stay
and streamlining discharge processes. A targeted admission – discharge project was launched at LHSC in order to drive organizational improvements where needed
based on substantial wait times. All action plans were strategically tied to organizational strategy and required CEO endorsement.
Launched a Mental Health Access and Flow initiative, which focuses on improving access for patients with mental health conditions (on a Form 1) to a schedule 1
Mental Health Facility across the South West LHIN. Current work focuses on accessing data related to wait/referral times for Form 1 patients.
Working toward establishment of a South West LHIN Emergency Management Plan with LHIN and Ministry of Health Emergency Management Branch partners.
Program Success Story
Initiative/Action
Status at March 31, 2016*
Planned Completion
ES_ProgramSuccessS
tory.docx
Leverage Pay 4 Results Program
Spreading ED Best Practices
Improving ED Form 1 Mental Health Patients
Access to Schedule 1 Mental Health Facilities
Developed Emergency Management Plan
Advanced Progress
Complete
Complete
2016-17
2014-15
2015-16
Early Progress
2017-18
7
Health Links Program Highlights
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Four out of six proposed Health Links (Huron Perth, London/Middlesex, North Grey Bruce and South Grey Bruce) are actively supporting people with coordinated care
planning. Oxford and Elgin have completed their business plans.
The South West LHIN has been encouraging the widespread adoption of a coordinated care planning approach, as demonstrated by engagement with Hospice
Palliative Care, Behavioural Supports Ontario, Renal Care program, Acquired Brain Injury Corrections project, Long Term Care, and Hospital Discharge teams.
The South West Health Links Leadership Collaborative continues to meet monthly to bring together Health Link Leads and regional partners to provide leadership for
this work and has recently supported patient experience reports for the Aboriginal and Hospice Palliative Care populations.
A multi-cohort Learning Collaborative approach is successfully being implemented and leveraged to support effective knowledge translation for teams working to
implement the coordinated care planning process
Program Success Story
HL_PatientStory_20
15.docx
Initiative/Action
Status at March 31, 2016*
Planned Completion
Health Links Partnering for Quality
Home First Philosophy
Cluster Care & Virtual Ward Care Models
Supporting people at risk of being part of those
with the Greatest Unmet Needs
Supporting people with the Greatest Unmet
Health Care Needs
Advanced Progress
Advanced Progress
Advanced Progress
Early Progress
2017-18
Beyond 2017-18
2016- 17
2016-17
Early Progress**
2017-18
Hospice Palliative Care Program Highlights
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Refreshed Shared Leadership Model, the South West Hospice Palliative Care (HPC) Network was established to oversee the work of HPC planning
Network is comprised of Leadership Committee and 5 local HPC Collaboratives made up of cross-sector multidisciplinary members (Grey Bruce, Huron Perth, London
Middlesex, Elgin and Oxford). The Network is working towards the vision of an integrated HPC program throughout the LHIN.
A quality improvement approach was adopted to influence improvements in HPC. Accomplishments to date: current state process map and future state client journey
map, establishment of the driver diagram identifying primary and secondary drivers and change ideas that will help meet the big dot or aim, adoption of the Quality
Improvement Enabling Framework and the System Design Framework realms, Call to Action Summit event held, and Experience Based Design interviews conducted
with patients and families requiring hospice palliative care support.
All 5 sub-LHIN area HPC Collaboratives are actively working on multiple change ideas using a Plan-Do-Study-Act (PDSA) Quality Improvement approach each directed
at contributing to our ability to achieve our defined future state
Developed a Data and Performance Working Group to evaluate the effectiveness of the change ideas and have created a regional HPC dashboard to monitor ongoing
performance of the system
Established a Communications and Community Engagement Strategy including the use of the thehealthline.ca to educate and communicate HPC palliative care
resources; use of the South West Hospice Palliative Care Network website to update individuals and providers on the work being done and to provide a forum for
ongoing education.
Regional HPC Capacity Planning report and recommendations to enhance capacity have been developed and released.
Program Success Story
Initiative/Action
Status at March 31, 2016*
8
Planned Completion
Integrated Hospice Palliative Care System
Early Progress
2017-18
successstory_hpc201
5.docx
Long-Term Care Home (LTCH) Redevelopment Program Highlights
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Successful closure of Bonnie Brae in Tavistock and transference of bed licenses to new Earl’s Court in London. Earl’s Court opened in August, 2014. Significant efforts
by South West CCAC placement staff and surrounding LTC Homes to ensure client choices were met prior to closure.
Collaborative effort by Kensington Village, CCAC, Dale Brain Injury and South West LHIN staff to submit request to MOHLTC to designate 14 bed specialized unit for
people with Acquired Brain Injuries. Awaiting approval from the MOHLTC
Ministry and LHIN half day engagement with all 79 LTCHs in January, 2015 to communicate LHIN and Ministry redevelopment goals
LHIN held individual meetings with each of the 47 LTCH s that need to redevelop to understand plans and work to ensure adequate access to LTCH beds across the
LHIN based on a beds per 1000 analysis. Further engagement continues with LTCHs in areas where improvements to access need to be made.
Program Success Story
Initiative/Action
Status at March 31, 2016*
Planned Completion
Long-Term Care Home Redevelopment
Early progress
2024-25
Mental Health & Addictions Program Highlights
•
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•
•
•
•
Evaluation of a pilot has begun related to the creation of a multidisciplinary team from Grey Bruce Health Services and Canadian Mental Health Association Grey Bruce
to provide intensive case management services for those 16 years of age and older with assessments, primary care referrals, medical monitoring, social services,
referral and support with psychiatry, and support for families.
March 2015 marked the 1 year anniversary of the amalgamation of WOTCH Community Mental Health Services, Search Community Mental Health Services and
Canadian Mental Health Association (CMHA) London-Middlesex into CMHA Middlesex. Since launching in 2014, CMHA Middlesex has seen a 17% increase in the
number of individuals they support, and a 12% increase in referrals. This demonstrates the amalgamation has improved access for individuals in our community seeking
mental health supports. Programs have been relocated to make the Huron Street Site a first point of access for individuals seeking services, including rapid intervention
supports from Information & Support, Intake and Transitional Case Management. Feedback from individuals they support has demonstrated that these changes have
had little to no impact on their service experience.
OTN continues to provide clinical leadership and guidance by supporting the LHINs in developing and expanding their Telemedicine programs. To this end, OTN is
hosting a Telemedicine Nurse (TMN) Forum in Southwestern Ontario in February or March 2016 (TBD) with goals to:
• build awareness across Southwestern Ontario around successful TMN programs and
• improve skills in the area of successful telemedicine program development and expansion.
Phoenix and Choices for Change undertook a back office integration initiative in September 2014. Phoenix youth workers became employees of Choices for Change so
the youth workers now have wage parity. Phoenix purchases the services of one youth worker from Choices for Change. Because of the partnership, the program is
now able to run 5 days a week from 11 am to 3 pm. There has been a remarkable increase in the number of youth accessing the programming, from 3 or 4 youth per
day in March 2012, to 33 youth per day in the spring of 2015. The refreshed Community Capacity continues to guide work in priority areas such as supportive housing,
coordinated access, peer support, quality and performance.
1,000 MH&A Supportive Housing Units: a three-year provincial strategy to increase access to supportive housing for those with mental health and addictions to ensure
more people are stably housed and supported, people with mental illness and addiction issues are empowered to manage in the community, improve patient health
(compliance with testing, treatment, recovery, detection of illnesses), reduce chronic homelessness by providing sustainable housing options.
Building off of the refreshed community capacity report recommendations, Addiction Services Thames Valley (ADSTV) has been designated as the lead agency in
coordinating mental health services in the South area (Oxford, Elgin and London-Middlesex). A “Coordinated Access Model” has well-defined and advertised system
access points (phone, website, agency walk-ins); consolidated intake functions; shared electronic client records; coordinated waitlist management; support for
9
•
•
•
•
individuals on waitlists; and referrals to the appropriate resources. Common screening tools are now used to ensure people receive the same level of care. Providers
are also using a shared calendar for timely access to appointments, and partners are now working to get a single access number for people to call for support. Through
this work, mental health and addiction services are more integrated allowing care to be more accessible to those who need it
Peer Support: 2014/15 creation of a Peer Support Strategy that has led to ongoing work with the following goals to ensure sustainability of CSIs:
• Strengthen SWAN structure, with involvement of MH&A community partners to become the regional support for strategic oversight of peer support
• South West LHIN to facilitate integration & collaboration discussions between CSIs and MH&A organizations to implement formal linkages
• Implement identified promising practices
Work has begun to better understand the capacity, function and utilization of all community-based crisis response services to determine if further standardization is
required in terms of staffing, hours of service, service delivery model and outcomes
The Huron Perth Addiction and Mental Health Alliance makes it easier to access services in Huron and Perth counties by having one number to call for mental health
and addictions support (1-888-829-7484). Involved organizations include: Alexandra Marine & General Hospital, Choices for Change, Canadian Mental Health
Association, Huron Perth Healthcare Alliance, Phoenix Survivors Perth County
IDEAs Project: Optimizing Transitions of Care for Mental Health and Addictions Patients in Grey Bruce (Hospital to Community). The aim of the project is to reduce 30
day readmissions at Grey Bruce Health Services for acute and SMI patients. This will be achieved through early discharge planning, collaborative care planning with
community partners, and ensuring patients being discharged understand their recovery plan prior to discharge from hospital.
Program Success Story
successstory_MHA20
15.docx
Quality and Value Program Highlights
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Initiative/Action
Status at March 31, 2016*
Planned Completion
Shared Care Models
MH&A Case Management Services
Enhanced MH&A Crisis Services
WOTCH-SEARCH-CMHA Merger Improvements
Grey-Bruce Telemedicine Expansion
MH&A Coordinated Access Care Model
Anti-Stigma Promotion & Support
Care Partner Maximization of Patient Information
Methadone Maintenance Treatment
MH&A Telemedicine
Define Standardized Outcome Measures
Support of RMHC to Community Settings
Back Office Integration Opportunities
MH&A Community Capacity Recommendations
Early Progress
Complete
Advanced Progress**
Complete
Advanced Progress
Advanced Progress
Complete
Advanced Progress**
Complete
Advanced Progress
Complete
Complete
Early Progress**
Advanced Progress
2017-18
2014-15
2016-17
2014-15
2016-17
2016-17
2015-16
2017-18
2014-15
2016-17
2015-16
2014-15
2018-19
2016-17
The Quality Advisory Group is implementing a Quality and Performance Improvement (QPI) work plan that is focused on building a culture of continuous quality
improvement in the South West.
Key elements of the QPI work plan include the spread of experience based design approach, developing a coordinated approach to quality improvement plans (QIPs)
and quality based procedures (QBPs) and embedding quality improvement tools and resources within the South West LHIN Project Management Office (PMO).
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Internal Quality Improvement Plan analysis process was established and integrated into strategic review. Internal QIP review identified key themes, top performers and
successful interventions / change idea. The outcome of this analysis will inform partners of opportunities to collaborate and have a shared focus within QIPs for the
following submission year.
Through our Health System Funding Reform Local Partnership committee, we have designed and completed an assessment to understand readiness and stage of
implementation of all organizations implementing QBPs in each LHIN across the province. This information has been shared with the Quality Advisory Group in order to
develop a coordinated improvement strategy. QBP summary information for COPD and Hip and Knees has been developed and shared with appropriate steering
committees and the local partnership committee.
Internal Quality Improvement capacity building has been integrated into the South West LHIN Organizational Development Plan. The IDEAS program continues to be
leveraged to support and build a culture of quality improvement. An IDEAS road map has been developed to identify initiatives for the program based on their alignment
to the IHSP and address performance gaps. The South West LHIN has sponsored seven projects to participate in the IDEAS advanced program. There have been
approximately 12 internal LHIN staff that have participated in the two-day IDEAS program and five organizational Leads that have participated in the nine-day advanced
program.
The South West LHIN’s Quality Improvement approach and specific quality improvement initiatives, have been recognized through awards and invited presentations at
provincial and international conferences. The South West LHIN has played a role in knowledge translation, ensuring the spread of current successful quality
improvement changes and processes to other organizations and other LHINs.
In collaboration with Partner for Quality and Health Links Learning Collaborative, EBD training has been offered to a variety of sectors and linked to Health Link and
Hospice Palliative Care implementation. In addition, a Community Support Services sector- wide Experience Based Design survey has been developed and shared with
all organizations.
A Pan LHIN / HQO partnership agreement has been established and will identify opportunities for LHINs and HQO to partner together to support quality improvement
across the province.
In partnership with HQO, the South West Clinical Quality Table is being developed. A South West LHIN Clinical Quality Lead has been hired to lead and chair the
South West Clinical Quality Table with links to a provincial quality table.
Program Success Story
QualityValue_Succe
ssStory_Building Cap
Initiative/Action
Status at March 31, 2016*
Planned Completion
Partnering for Quality Implementation
Quality & Patient Improvement Capacity
Quality & Performance Strategies
Advanced Progress
Advanced Progress
Advanced Progress
2016-17
2017-18
2017-18
Safety Program Highlights
Wound Care
 The South West Regional Wound Care Program (SWRWCP) has developed a sound governance structure that will strengthen relationships with all stakeholders
 SWRWCP has engaged stakeholders to develop a measurement plan that includes performance indicators, program evaluation and sharing / reporting of baseline
metrics. As of 2015/16 Q3, the SWRWCP is submitting a quarterly metrics report to the LHIN.
 By the end of 2014/15 Q3, 100% of the Wound Care Champions were signed up to HealthChat with access to wound care resources and tools, and 100% cross sector
partnership agreements were signed and the governance model is in place with active record management
 Significant community engagement has occurred over the past year, including process mapping and sustainability planning with partners. In addition, specific
engagement meetings have occurred with the LTCH council and LTCH FOG and FLAG groups to discuss and demonstrate the value of the SWRWCP.
Falls Prevention
11
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The new South West Falls Prevention and Intervention Stewardship Committee has been well established and supported by 5 planning hubs in each sub-LHIN area
with an identified geographic hub lead to support implementation and engagement of key stakeholders
Asset and process maps have been completed for each geographic hub to support the development of implementation plans including priority setting and
recommendations for training and education of frontline health care providers is complete.
Falls Prevention and Intervention program resources have been adapted for implementation and potential early adopters have been identified
o 100% of the geographic areas are implementing low risk initiatives, are in the process of adapting or implementing moderate and high risk initiatives
A formal communications plan has been developed and is currently being operationalized. Strategic planning related to sustainability completed by the Stewardship
Committee with engagement of the local planning hubs.
Program Success Story
Initiative/Action
Status at March 31, 2016*
Planned Completion
Advanced Progress
Advanced Progress
2016-17
2016-17
Successstory_falls201
5.docx
Regional Wound Care Program Plan
Falls Prevention Strategy
Infection Prevention Strategy - 2014-15 decision
to monitor through SAAs and QIPs
Technology to Connect and Communicate Program Highlights
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All Hospital Information Systems in the South West LHIN are now populating the provincial Ontario Laboratory Information System.
End users deployed for the regional clinical viewer, ClinicalConnect, has increased from 679 in April 2015 to 11,000 in October 2015. All hospitals in the South
West LHIN now have eNotification with the South West CCAC.
The proof-of-concept eConsultation project has successfully completed Phase 1. Continuation of Phase 2 will end in Dec 2016 leading to a provincial rollout
Telehomecare was launched for COPD and CHF patients.
Deployment of Hospital Report Manager has begun in the South West LHIN with 69 primary care physicians live as of September 2015.
Electronic Care Coordination Tool (CCT) is being piloted by the Huron Perth and London Middlesex Health Links.
Integrated Assessment Record (IAR) deployed across several CSS, LTC and MH&A health service providers.
Regional Integrated Decision Support (RIDS) solution is successfully implemented by all hospitals in the South West LHIN
Majority of RM&R standardized pathways have been implemented with additional work in the Acute to CCC/Rehab and Acute CCAC pathways to be completed by
March 31st, 2016.
Program Success Story
cSWO_Update1115
FINAL.pdf
Initiative/Action
Status at March 31, 2016*
Planned Completion
Ontario Lab Information System
Diagnostic Imaging Repository
Resource Matching and Referrals Solution
eReferral/eNotification/eDischarge
CSWO-SPIRE
CSWO-Clinical Connect
Regional Integrated Decision Support
Integrated Assessment Record
CSWO-Hospital Report Manager
Complete
Complete
Advanced Progress
Complete
Complete
Advanced Progress
Complete
Complete
Early Progress
2014-15
2013-14
2016-17
2014-15
2014-15
2016-17
2013-14
2014-15
2017-18
12
eConsultation Planning & Expansion
Health Links Care Coordination Tool
Telehomecare
Surgical Waitlist Management
Transportation Best Practices Program Highlights
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Early Progress
Early Progress
Advanced Progress
Early Progress
2016-17
Beyond 2017-18
Beyond 2016-17
Beyond 2017-18
A working group of LHIN funded transportation providers supported by LHIN staff worked to develop guiding and implementation principles to guide the delivery of
transportation as a key enabler to accessing Adult Day Programs (ADP)
ADP-related transportation providers and the LHIN developed solutions for each community where transportation was a barrier
Integration through funding supported the reallocation of base funding to enable a standard ADP transportation fee for access to day programs including accessible and
non-accessible transport. Standardized $10/round trip ADP transportation fee fully implemented.
As part of the 2014/15 Priorities for Investment we enhanced accessible and non-accessible transportation in the City of St. Thomas, a program previously supported by
United Way. The service is now provided by VON Middlesex-Elgin.
Program Success Story
Initiative/Action
Status at March 31, 2016*
Planned Completion
Optimize Transportation Best Practices
Early progress
Beyond 2017-18
successstory_transp2
015.docx
* Status Definitions:
Complete – Initiative complete as of March 31st, 2016 or sooner
Early Progress – 50% or less complete as of March 31st, 2016
Advanced Progress – 51% or more complete as of March 31st, 2016
** Recalibration – The progress of the initiative changed from last year due to a new stream of work being added to the initiative and/or two initiatives were consolidated which
impacted the overall progress of the initiative.
13