Transcript Document

New Expectations, New Possibilities:
Creating an Integrated Health System
June 5th, 2007
Overview
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alignment
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change
integration
accountability
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alignment
leadership for
change
integration
accountability
vision
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alignment
leadership for
change
integration
accountability
What we Have Done
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Extensive community engagement across the region
Establishment of planning partnerships
Detailed feedback and data collection to validate directions
Integrated Health Service Plan
IHSP work plan
New investments and projects launched
LHIN Board and organizational developmental start-up
April 1 transition to LHINs
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LHINs New Expectations Health Service Providers
• Align their strategic and service planning within the overall LHIN
framework, with specific reference to the priorities identified in the
2006-2010 Integrated Health Service Plan
• Participate in LHIN planning exercises and provide the input and
necessary information for the development of LHIN plans
• Identify integration opportunities and demonstrate continuous
improvement in service integration, coordination and quality
• Implement the directions for integration laid out in the accountability
agreements with LHINs
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5 main areas where the public can expect change:
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5.
Increased integration and improved service coordination
Increased local decision-making about funding and allocation
Greater emphasis on local health system planning
Increased community engagement
Enhanced Accountability
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Alignment to the
Integrated Health
Service Plan
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accountability
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$1.35M for
Geriatric
Emergency
Management
$.9M for
Musculoskeletal
Assessment
Centre
$1.5M for ICU in
Rouge Valley
Ajax-Pickering
$.6M to increase
home care &
community
supports
Central East LHIN
New Investments
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Criteria for Integration Innovations and Proposals
1.
2.
3.
4.
5.
Was it vetted by LHIN Planning Partners?
Is it aligned with the IHSP?
Is it evidence-based and can it be measured & monitored?
Who shares accountability for its accomplishment?
How will it be resourced?
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Our Commitment to
Leading Change Through Engagement
• We will promote and reward a culture of cooperation and mutual
interests (negotiation) rather than the failed approaches of command
and control (provocation).
• Engagement will happen at all levels from governance to front lines
to community residents
Because….
• Engagement unlocks and leverages system planning expertise to
create real solutions
• Provides a means for emerging trends to be identified
• Involvement stimulates ownership and responsibility for results!
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Central East LHIN Planning Partnerships
LHIN Strategic
Networks
Alternative Levels of Care
Emergency Department Wait Times
LHIN Tactical
LHIN Community
Mental health and addictions / Seamless Care for Seniors / Chronic Disease Prevention and
Management
Task Groups
9 Planning and Engagement Collaboratives
Rehabilitation Services / E-Health
Primary Care Working Group
Collaboratives
Local residents, seniors, family members,
physicians, nurses, pharmacists, physiotherapists, administrators,
and other health professionals are working together!
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Governance for System Change
• The Central East LHIN Board has identified the engagement of local
health care governance as a top priority.
• “Board to Board” engagement will focus on bringing together
governance leaders within health service providers and the LHIN to
for information sharing and strategic planning
• It is expected that health service providers will engage each other in
the efforts to meet local need
• A governance steering committee will be established in the Fall of
2007 that will examine ways to equitably and effectively engage local
governance
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“Integration” as defined through Legislation
2(1) “integration” includes
(a) to co-ordinate services and interactions between different persons and
entities;
(b) to partner with another person or entity in providing services or in
operating
(c) to transfer, merge or amalgamate services, operations, persons or
entities
(d) to start or cease providing services
(e) to cease to operate or to dissolve or wind up the operations of a person
or entity.
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In simple language…
• Health system experienced as a coordinated system: People will
get the right treatment at the right time by the right provider
• Seamless flow of information that supports patient care
• A system that begins with primary care providers with an equal focus
on prevention and health maintenance
• Create timely access to quality services by aligning people,
processes and resources
• Elimination of wasteful and time consuming duplication
• Involvement of patients, residents, family and informal caregivers
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Making Integration Happen
• Requires coordinated efforts of the LHIN and health service providers.
• LHIN Planning Partnerships are a resource to the LHIN and its
health service providers
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Example: Supporting Health Service Provider Planning
Health Service
Provider (s)
LHIN Collaborative
Task Group/Networks
• Local health service provider (s) identify to the LHIN
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Integration opportunity
New program / services
Local barriers for improved performance
• Health service provider(s) engage LHIN planning partners for
expert advice and information in support of meeting local needs,
advancing new ideas, or in the preparation of business plans
• May also involved governance to governance engagement
Governance Advisory
Bodies (TBD)
Central East LHIN
Health Service
Provider (s)
• Health service provider(s) submit business plans or ideas (with
demonstrated engagement of LHIN planning partners) to the
LHIN for further consideration.
• LHIN may implement through service accountability agreements
(SAA) with service providers or integration decisions.
Denotes potential referral back to LHIN
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Opportunities for Integration & Integration Decisions
• Facilitated or Negotiated Integration Decisions
• Required Integration Decisions
• Stopping Voluntary Integration
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Example: Facilitated or Negotiated Integration Decisions
under 25(2)(a)
Ministry-LHIN Accountability Agreement
Use of Planning Partnerships
Board-to-Board Engagement
Presupposes prior negotiation with Ministry of Health
and/or engagement of health service providers, other
entities and LHIN planning partners.
LHIN facilitates or
negotiates integration
involving HSP(s)
LHIN issues integration decision
Health Service Provider(s)
implement
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Example: Required Integration Decisions
25 (2)(b) A local health integration network shall issue an integration
decision when the network requires a health service provider to
proceed with an integration under s. 26;
• Such instances may be a result of government action or policy, or
public interest requiring expedited outcomes
• In all other instances, use of such authority signals a
shortcoming by the LHIN in meeting its standards of
collaborative planning
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Required Integration Decisions under 25(2)(b)
Anyone may make
submissions regarding
proposed decision, including
LHIN requires integration by funded
HSPs
LHIN issues proposed integration decision
Task Group/Networks
Within 30 Days
LHIN Collaborative
Health Service Provider
LHIN considers any submissions; may change
or confirm original integration decision
No timeframe
specified
LHIN issues final integration decision
Health Service Provider
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Example: Integration Decisions that Stop Voluntary
Integrations
25 (2)(c) A local health integration network shall issue an integration
decision when the network orders a health service provider not to
proceed with an integration under s. 27;
• Use of such authority by the LHIN signals a shortcoming by the
health service provider(s) in providing early awareness of the
issues and/or health service providers lack of participation in
LHIN collaborative planning.
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Example: Integration Decisions that Stop Voluntary
Integrations
HSP gives notice to LHIN that it
wishes to integrated funded services
Within 60 Days
LHIN does not issue a proposed
decision stopping integration
LHIN considers HSP notice
Integration may proceed
Within 30 days, anyone may make
submissions regarding proposed
decision, including
Task Group/Networks
LHIN issues proposed decision
stopping integration
LHIN Considers any submissions;
may change or confirm proposed
integration decision
LHIN Collaborative
Health Service Provider
Within 30 Days
LHIN does not issue a final
decision stopping integration
LHIN issues a final decision
stopping integration
Integration may proceed
Integration may NOT proceed
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A Focus on Accountability
• People have the right to expect accountability from their governments
– To that end, Central East LHIN has entered into an accountability
agreement with MoHLTC That sets out the mutual understandings and
performance obligations of both parties in the period from April 1, 2007 to
March 31, 2010
• The public also have the right to expect that their health service
providers will be accountable for the quality of services they provide
– To that end, part of CE LHIN mandate is to negotiate Service
Accountability Agreements (SAAs) with health service providers
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The Purpose of the
Planning to Action Symposium
June 6-7, 2006
• Network and celebrate champions for change: Networks,
Collaboratives and Task Groups
• Create capacity of system to plan, coordinate and innovate across
organizations
• Align planning partnerships to specific tasks outlined in the Integrated
Health Service Plan
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N = Network!
• Identifying and implementing change is our collective
responsibility
• Your LHIN is committed to removing the barriers that keep
all of us from working and achieving together
• New challenges and opportunities for health system
governance
Confidence Abounds!
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Thank You!
integration
accountability