Partnering for a Healthy Community 2018 Awards

Recognizing Quality and Innovation in the Halton LHIN Tuesday, June 5, 2018 Welcome Partnering for a Healthy Community

Colleagues, health system partners and friends,

Welcome to our third annual awards event: Partnering for a Healthy Community. We are pleased you could join us tonight for an evening of celebration and collaboration recognizing quality and innovation in the Mississauga Halton Local Health Integration Network (LHIN).

This evening emanated from a desire to recognize and showcase the transformative work being done in our LHIN and to thank all of you for your dedication and commitment to putting patients first. It is also an opportunity to share results across the health care system, which has become a proven methodology for increasing quality care for patients leading to stronger outcomes and a better health care experience.

We are so proud to be working with such a passionate team. With strong leadership demonstrated by our health service providers and service provider organizations, we are supporting smart decisions that strengthen our health care system. Through these partnerships, we are developing innovative, collaborative solutions to improve access to health care and enhance the experience of patients and clients.

So this evening, we encourage you all to familiarize yourselves with the exciting work underway in the Mississauga Halton LHIN. Meet new people. Share ideas. Discuss opportunities. And of course, let’s celebrate together your achievements!

Mary Davies, Acting Chair Bill MacLeod, CEO Mississauga Halton LHIN Mississauga Halton LHIN

2 Agenda 5:00 pm Registration / Showcase Preview 5:15 pm Welcome Remarks Bill MacLeod, CEO, Mississauga Halton LHIN Mary Davies, Acting Chair, Mississauga Halton LHIN 5:20 pm Keynote Address Christopher Hayes, MD, MSc, MEd Chief Medical Information Officer | St. Joseph’s Healthcare Hamilton Thank you by Dr. Amir Ginsberg 5:40 pm Food Stations / Showcase Preview 6:10 pm Let’s chat about quality 6:30 pm Awards Presentation Host Jutta Schafler Argao Menu Passed Appetizers A selection of hot and cold hors d’oeuvres Pasta Station Your Choice of Fusilli Pasta with Tomato Basil Sauce or Bow Tie Pasta with Pesto Sauce Stir Fry Station Your choice of Beef, Chicken or Pork served with Asian Vegetables on Chow Mein Noodles with a Garlic Ginger Soya Sauce Cheese & Fruit Station Canadian & International Cheeses Served with Assorted Crackers, Baguette, Grapes, Seasonal Fruits & Berries Beverage Station Freshly Brewed Regular Coffee, Decaffeinated Coffee, Tea & an assortment of fruit and vegetable infused water Music will be provided by an award winning trio Jeff Salem on Percussion, Carson Freeman on Saxophone and Rob Tardik on Guitar 3 Special Thanks

Committee Chair Angela Jacobs, Director, Quality and Risk, Mississauga Halton LHIN Members Carleen Carroll, Director Communications and Engagement, Mississauga Halton LHIN Lisa Gammage, Director, Quality, Systems and Accreditation, Nucleus Independent Living Sandie Seaman, Manager, Quality and Risk, Mississauga Halton LHIN Don Stewart, Administrative Assistant, Quality and People, Mississauga Halton LHIN Andrea Szakolcai, Communications Lead, Mississauga Halton LHIN Melissa Szilagyi, Communications and Engagement Specialist, Mississauga Halton LHIN Geraldine Cabral, Event Manager, Shake It Up Events Áine Magennis, Event Manager, Shake It Up Events Evaluation Committee Lisa Gammage, Director, Quality, Systems and Accreditation, Nucleus Independent Living Dr. Amir Ginzburg, Mississauga Halton LHIN Clinical Quality Lead and Chair, Regional Quality Table Joanne Hawkins, Director, Quality Improvement, Acclaim Health Angela Jacobs, Director, Quality and Risk, Mississauga Halton LHIN Farah Khan, Natasha Milijasevic, Director, Quality and Patient Safety, Trillium Health Partners Sandie Seaman, Manager, Quality and Risk, Mississauga Halton LHIN Radhika Subramanyan, Chief Executive Officer, Canadian Mental Health Association – Halton Region Branch James Yuan, Quality Improvement Consultant, Mississauga Halton LHIN

We welcome new members to join our planning committee. If you are interested in joining our committee for 2019, please contact Angela Jacobs [email protected] for more details. 4 Our 2018 Initiatives

We are pleased to present the 2018 Partnering for a Healthy Community Initiatives showcasing the collaborative work underway amongst health service providers across our LHIN.

The Partnering for a Healthy Community Awards are aligned with the three key priorities of the Mississauga Halton LHIN’s 2016-2019 Integrated Health Service Plan (IHSP) – Access, Capacity and Quality. Each priority has goals and strategies that serve as a road map to keep us focused and move us forward.

This year, we received 5 applications which include the work of 17 health care organizations reflecting partnerships that are improving the health care system for patients, clients, families and residents.

Through strong partnerships and high quality initiatives that ensure better access to the right care for those who need it most, we are truly partnering for a healthy community. Let’s celebrate these successes.

5 CHRIS HAYES Chief Medical Information Officer

Chris Hayes is an internationally recognized thought leader in quality improvement and patient safety. Chris has previously served as the Medical Officer for the Canadian Patient Safety Institute and was the 2013-14 Canadian Harkness / IHI Fellow in Health Care Policy and Practice. Chris was the Medical Director of Quality and Performance at St. Michael’s Hospital in for a decade and more recently has undertaken the role of Chris Hayes, MD, MSc, MEd Chief Medical Information Officer at St. Joseph’s Chief Medical Information Officer St. Joseph’s Healthcare Hamilton Healthcare in Hamilton. In addition to working as a specialist in intensive care medicine, Chris holds academic appointments at the Department of Medicine and Institute for Health Policy at the University of Toronto and is Lead Faculty at the Canadian Foundation for Healthcare Improvement.

6 Access • Bring care closer to home • Integrate and partner to improve access and services through coordinated efforts • Make it simpler to navigate the health care system and reduce barriers to access

7 One-Link-System Access Model for Addiction and Mental Health Services The Mississauga Halton LHIN’s one-Link enables equitable access and coordinated care to make it possible for people to receive the right addiction and mental health care, at the right time and in the right place.

Since implementation in the fall of 2014, one-Link has processed over 41,000 referrals for individuals 16 years of age and over, seeking support for mental health and addiction concerns. Through the application of standardized processes developed through Continuous Quality Improvement at all levels of the model, one-Link has established its operations in ensuring that screening and referral coordination is completed with standardized processes, daily attention to wait times, and minimizing work flow that does not add value to clients or families who are referred for services. Ongoing collaboration with the 10 Mississauga Halton funded Addiction and Mental Health Service providers, with oversight from a Steering Committee, ensures that the vision of one-Link is operationalized each and every day.

Participating Organizations:

Halton Region Branch Filiale de la région de Halton

8 Reducing Emergency Department Transfers from Silverthorn Nursing Home Transfers from Long-Term Care centres to the Emergency Department carry significant risk, especially in elderly and frail populations. Patients are at risk of delirium, hospital-acquired infections, falls, and loss of muscle mass among other problems. Often times, patients can be treated at the Long-Term Care centre, or be seen semi-urgently in the clinic setting and do not always require transfer to the Emergency Department. Consequently, Silverthorn co-created a novel tool with all relevant stakeholders at Silverthorn Nursing Home to help reduce the number of Emergency Department transfers. The pilot project involved using telemedicine technology to have General Internists evaluate patients who were felt to be clinically deteriorating at Silverthorn. The vision of this initiative was to allow residents at Silverthorn to remain in the comfort of their own home and be treated there, provided it was safe. These individuals could be seen in a clinic setting at a later date to follow up with symptoms. The project’s aim was to avoid complications associated with Emergency Department transfer and potential admission to hospital thereafter as well as addressing the financial burden of transferring a patient to hospital. This initiative has major impacts in terms of avoidance of complications, cost savings (> $10,000), and quality of life, as most residents prefer staying at the home. Silverthorn has demonstrated proof of concept of this tool and are in the process of spreading to various other Long-Term Care centres that would benefit from improved access to speciality care.

Participating Organizations:

9 Quality • Ensure the needs and voice of the patient and their family shape how services are delivered • Coordinate and integrate care with the person at the heart of the health care system • Foster a culture of health and community wellness

10 Centre for Innovation in Peer Support

The Centre for Innovation in Peer Support (the Centre) is embedded in Support & Housing-Halton. The Centre, now recognized as a Promising Practice, supports the implementation of intentional peer support in organizations including 11 Mississauga Halton Local Health Integration Network-funded & accredited health service providers. Peer support is rooted in hope through an empowering and empathetic relationship between people who have a similar life experience or circumstance in common. Peer workers engage in special training and skill development to enhance their ability to support individuals. Over 40 peer workers are employed in organizations aligned with the Mississauga Halton Local Health Integration Network, including hospital psychiatric inpatient units, addictions residential treatments, supportive housing, central access, employment support programs, community mental health and addiction providers, and self- help education/ support groups. In order to support the authentic roll-out of peer work, the Centre focuses their work on training, implementation, evaluation and research, capacity building, knowledge brokerage, and quality improvement. Some of their work includes: training all peer workers, peer supervisors and teams; facilitating communities of practice for peers and their supervisors, and the creation of a validated tool to measure the integrity, quality and impact of peer support and ongoing involvement at system initiatives (regionally, provincially and internationally). The Centre is pioneering this area of intentional peer support positions and infrastructure into healthcare for improved person-directed experiences and outcomes. Most importantly, the Centre works to have lived experience/patient and family/caregiver’s experiences embraced as expertise and evidence towards evolving our healthcare system. Participating Organizations:

Halton Region Branch Filiale de la région de Halton 11 Capacity • Quantify capacity needs and expand supports to care providers • Enhance program capacity to support the right care in the right place • Recognize and address the impact social determinants play in building a sustainable, person-centred health care system

12 Capacity 99 In October 2017, the Government of announced that Trillium Health Partners (THP) would receive funding for 99 dedicated beds as part of a provincial plan to make 2,000 additional beds available in the immediate term to address capacity challenges faced by the highest need hospitals across the province. THP, in partnership with the Mississauga Halton Local Health Integration Network established the Capacity 99 Project team to support the implementation of this initiative. The team worked together to identify opportunities, establish new partnerships, and operationalize the dedicated 99 beds for immediate, short-term transitional care in the community for Alternative Level of Care and long-term vented patients. In two months, the project team established partnerships with: Halton Healthcare for thirty-five beds in the 2N Regional Unit at the Milton District Hospital site; West Park Healthcare Centre for five beds, Bridges to Care partners via the Mississauga Halton LHIN Home and Community Care for twenty-four additional beds in the community; UHN Toronto Rehab for five beds. Additionally, THP operationalized thirty additional internal contingency surge spaces.

A parallel work stream, consisting of representation from THP and the Mississauga Halton LHIN Home and Community Care, was set up to clinically review patients for transfer. Upon full review, each patient was segmented based on their required needs, then prioritized by the identified space opportunities through Capacity 99 funding.

As a result of this work, a total of 99 THP Alternative Level of Care patients were transitioned to a more appropriate care setting and the percentage of Alternative Level of Care Long-Term Care patients decreased from 40% to 25% (74 to 30) by the end of March 2018. These transitional care settings offered THP the opportunity to offset capacity challenges by providing access to an equivalent of 8.5 acute care beds and 1 ICU bed during the winter period, as well as promoting timely access to acute-care for those requiring hospital- based services. Participating Organizations:

13 No Wrong Door The No Wrong Door Initiative is supported by all Addictions and Mental Health Service providers across the Mississauga Halton LHIN and championed by a team that is comprised of 13 individuals from 10 funded agencies including hospitals and one-Link (Mississauga Halton LHIN’s Central Access Model).

Four agencies across two LHINs embarked on the Improving & Driving Excellence Across Sectors (IDEAS) Advanced Learning Program through the University of Toronto’s Faculty of Medicine. The purpose of this applied learning was to test some of the change ideas presented in the No Wrong Door Best Transfer Protocols that were created through collaboration amongst all participating agencies. For the purpose of testing the change ideas, the Peer Program at the Canadian Mental Health Association-Halton Region Branch was selected with the aim to reduce the “did not attend” rate by 30% from baseline, by March 31, 2018.

The vision of the No Wrong Door initiative is to improve client experience and transitions by focusing on continuity of care across the system.

The outcome of this applied learning which led to a reduction in the “Did not attend” rate leads to more efficient and effective patient-centred care, as the efforts were to ensure that client’s changing needs and preferences were accommodated in scheduling appointments.

Participating Organizations:

Halton Region Branch Filiale de la région de Halton

14 Special thanks to all of our Showcase Partners and Participating Organizations

15 Mississauga Halton LHIN Funded Health Service Providers Community Support Services (CSS) • Acclaim Health • MICBA-Forum Italia • Alzheimer Society of Peel Community Services • The Arthritis Society • Milton Meals on Wheels • The Canadian Hearing Society • Nucleus Independent Living • Canadian Red Cross - • Oakville Kiwanis Meals Peel Branch on Wheels • City of Mississauga - Next Step • Oakville Senior to Active Living Program Citizens Residence • CNIB – Halton/Peel • Peel Cheshire Homes Inc. • The Corporation of the • Mind Forward Brain Town of Injury Services • Dixie Bloor Neighborhood • Peel Senior Link Drop-In Centre • Regional Municipality of Halton • Dorothy Ley Hospice Inc. - Supportive Housing • Halton Healthcare - Supportive • S.E.N.A.C.A. Seniors Housing Day Program • Heart House Hospice Inc. • Seniors Life Enhancement Centres • India Rainbow Community Services of Peel • Trillium Health Partners - CSS • Ivan Franko Home • Victorian Order of Nurses - Peel Branch • Joyce Scott Non-Profit Homes Inc. • Wawel Villa Incorporated • Links2Care • Wesburn Manor - City of Toronto • March of Dimes Canada - Peel • Yee Hong Centre for Geriatric Care Community Health Centre • LAMP Hospitals • Trillium Health Partners • Halton Healthcare

16 Long-Term Care Homes • Allendale - The Regional • Mississauga Long-Term Municipality of Halton Care Facility • Bennett Health Care Centre • Northridge Long-Term • Cawthra Gardens Long-Term Care Facility Care Community • Post Inn Village - The Regional • Chartwell Waterford Long-Term Municipality of Halton Care Residence • Sheridan Villa - Regional • Chartwell Wenleigh Long-Term Municipality of Peel Care Residence • Sienna Senior Living - • Chartwell Westbury Long-Term Camilla Care Community Care Residence • Sienna Senior Living - • Cooksville Care Centre Streetsville Care Community • Dom Lipa Nursing Home • Sienna Senior Living - (Slovenian Linden Foundation) Silverthorn Care Community • Eatonville Care Centre • Tyndall Seniors Village Inc. • Erin Mills Lodge Nursing Home - • Villa Forum Long-Term (Devonshire Erin Mills) Care Residence • Extendicare - Halton Hills • Village of Erin Meadows - Oakwood Retirement • Extendicare - Mississauga • Wesburn Manor - City of Toronto • Labdara Lithuanian Nursing Home • West Oak Village • McCall Centre Long-Term Care - • Wyndham Manor Trillium Health Partners • Yee Hong Centre for Geriatric Care Mental Health and Addiction • Canadian Mental Health • Summit Housing & Association Halton Outreach Programs Region Branch • Support & Housing - Halton • Halton Alcohol, Drug & • Supported Training and Gambling Assessment Rehabilitation in Diverse Prevention and Treatment Environments (STRIDE) (ADAPT) • The Peel Addiction Assessment • Halton Healthcare - and Referral Centre (PAARC) Community Mental Health • Trillium Health Partners - • Hope Place Centres Community Mental Health • North Halton Mental Health Clinic - The Regional Municipality of Halton

17 Welcome to Mississauga Halton LHIN

The Mississauga Halton LHIN brings together local providers to develop innovative, collaborative solutions to improve access to health care and enhance the experience of patients and clients.

Through the stewardship of approximately $1.6 billion of public funds allocated to our health service providers and home and community care, the Mississauga Halton LHIN has laid foundations for the future, finding better ways to provide services to the 1.2 million people in our communities.

Through our provincial mandate, we have been entrusted to plan, fund, integrate and deliver health care across our region, partnering with our many diverse health service providers, including:

18 Showcase Passport Name: ______

Email: ______We encourage you to visit all 5 showcase displays to collaborate, learn and share. All participants who get their passport stamped at five showcase displays can enter their passport to be drawn for a lovely ‘health-themed’ gift basket this evening!

Capacity 99 STAMP

No Wrong Door STAMP

one-Link-System Access Model for Addiction and STAMP Mental Health Services

Reducing ED transfers from Silverthorn Nursing STAMP Home to Hospital

Centre for Innovation STAMP in Peer Support

19 Mississauga Halton Local Health Integration Network 700 Dorval Drive, Suite 500 Oakville, ON L6K 3V3 Phone 905.337.7131 Toll-free 1.866.371.5446 www.mississaugahaltonlhin.on.ca