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Champlain LHIN Inpatient Mental Health & Addictions Capacity Plan

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Champlain LHIN Inpatient Mental Health & Addictions Capacity Plan Champlain LHIN Inpatient Mental Health & Addictions Capacity Plan Current State Report 21 August 2017 CHAMPLAIN LHIN INPATIENT MENTAL HEALTH & ADDICTIONS CAPACITY PLAN CURRENT STATE REPORT TABLE OF CONTENTS ACKNOWLEDGEMENTS ....................................................................................................4 EXECUTIVE SUMMARY.....................................................................................................6 1. CONTEXT ............................................................................................................. 15 1.1 Project Overview .......................................................................................................... 15 1.2 Project Scope................................................................................................................ 15 1.3 Project Approach & Methodology ............................................................................... 16 1.4 Key Definitions ............................................................................................................. 18 1.5 Data Limitations ........................................................................................................... 19 2. CURRENT STATE ASSESSMENT .............................................................................. 21 2.1 Description of the Champlain LHIN .............................................................................. 21 2.2 Inpatient MH&A Capacity ............................................................................................ 22 2.3 Related MH&A Programs and Services ........................................................................ 31 2.4 Leadership, Governance, and Culture .......................................................................... 32 2.5 Regional Need for Service ............................................................................................ 35 2.5.1 Prevalence of Mental Health .......................................................................... 35 2.5.2 Projected Future Need .................................................................................... 36 2.6 Service Delivery ............................................................................................................ 37 2.6.1 Service Volumes .............................................................................................. 38 2.6.2 Patient Profile ................................................................................................. 40 2.6.3 Reason for Admission...................................................................................... 48 2.6.4 Occupancy Rates ............................................................................................. 54 2.6.5 Service and Operations ................................................................................... 58 2.6.6 Use of Technology ........................................................................................... 60 2.7 Patient Flow ................................................................................................................. 62 2.7.1 Entry and Admission ....................................................................................... 62 2.7.2 Patient Flow .................................................................................................... 72 2.7.3 Discharge ......................................................................................................... 74 2.7.4 Conditions Best Managed Elsewhere.............................................................. 77 2.7.5 Community Capacity Impact ........................................................................... 81 2.8 Access and Equity ......................................................................................................... 82 2.8.1 How equitable is access to inpatient MH&A Services? ................................... 83 2.9 Quality .......................................................................................................................... 85 2.9.1 Readmission Rate ............................................................................................ 85 2.9.2 Incidents and Restraints .................................................................................. 91 Prepared by OPTIMUS | SBR © 2017 All rights reserved P a g e | 2 CHAMPLAIN LHIN INPATIENT MENTAL HEALTH & ADDICTIONS CAPACITY PLAN CURRENT STATE REPORT 2.9.3 Patient Outcomes ........................................................................................... 92 2.10 Efficiency ...................................................................................................................... 94 2.10.1 Service Costs ................................................................................................... 94 2.10.2 Service Efficiency ............................................................................................. 98 2.11 Health Human Resources Utilization ......................................................................... 100 2.11.1 HHR Capacity and Resource Mix ................................................................... 100 2.11.2 Scope of Practice ........................................................................................... 104 3. JURISDICTIONAL SCAN AND BEST PRACTICE SUMMARY ...................................... 105 4. APPENDIX .......................................................................................................... 116 4.1 LHIN Demographic Profile .......................................................................................... 116 4.2 Champlain Inpatient Mental Health and Addiction Programs and Services .............. 119 4.3 Patient Acuity Measures ............................................................................................ 130 4.4 Admission Diagnosis ................................................................................................... 135 4.5 ALC Destination Waiting for by Hospital, Last FY ....................................................... 140 Prepared by OPTIMUS | SBR © 2017 All rights reserved P a g e | 3 CHAMPLAIN LHIN INPATIENT MENTAL HEALTH & ADDICTIONS CAPACITY PLAN CURRENT STATE REPORT Acknowledgements This report has been prepared on behalf of the Champlain Inpatient MH&A Service Capacity Plan Steering Committee. The committee is acknowledged for its dedication and thoughtful direction of the process. The Steering Committee members are listed below. Steering Committee Membership: George Weber, The Royal Ottawa Health Care Group, Co-Chair Bernard Leduc, Hôpital Montfort, Co-Chair Raj Bhatla, Chair Champlain Inter-Hospital Committee Barbara Casey, Children's Hospital of Eastern Ontario Jacinthe Desaulniers, Réseau des services de santé en français de l’Est de l’Ontario Jeanette Despatie, Cornwall Community Hospital, Interim CEO Brockville General Hospital Heather Garnett, The Ottawa Hospital Kathy Gillis, Chair Department of Psychiatry Marc LeBoutillier, Hawkesbury & District General Hospital Alex Munter, Children's Hospital of Eastern Ontario Pierre Noel, Pembroke Regional Hospital Tom Schonberg, Queensway Carleton Hospital Frank Vassallo, Kemptville District Hospital Kevin Barclay, Champlain LHIN, Senior Health System Integration Specialist The OPTIMUS | SBR Project Team: Terri Lohnes Andrea Spencer Rachel Steger David Lynch Glenna Raymond Janice Dusek Jacquie Dale Guy Théroux Nathan Duyck Lindsay Martin The following individuals, organizations, and groups are acknowledged for their participation in the stakeholder consultation process. People with lived experience Psychiatric Survivors of Ottawa Parents' Lifelines of Eastern Ontario Prepared by OPTIMUS | SBR © 2017 All rights reserved P a g e | 4 CHAMPLAIN LHIN INPATIENT MENTAL HEALTH & ADDICTIONS CAPACITY PLAN CURRENT STATE REPORT Ottawa Police Ottawa Paramedic Service Indigenous Health Circle Forum Champlain Inter-Hospital Committee ACTT/FACTT-DD Champlain Crisis Teams Champlain Primary Care Working Group Addiction and Mental Health Network Champlain Member hospitals of the Champlain Association of Small Hospitals CMHA Ottawa and other Community MH&A Providers Montfort Renaissance Salus Ottawa THRIVE The contributions from the participating organization’s administrative, clinical, and decision support teams at each hospital and the Champlain LHIN are also appreciated, in particular to: Andrew Bonner, The Ottawa Hospital Mitsi Cardinal, The Royal Ottawa Health Care Group Sonia Dicaire, Hôpital Montfort Barb Fisher, Children's Hospital of Eastern Ontario Robyn Griff, The Royal Ottawa Health Care Group David Hesidence, The Royal Ottawa Health Care Group Henna Hussain, The Royal Ottawa Health Care Group Heather Mallon, The Royal Ottawa Health Care Group El Mostafa Bouattane, Hôpital Montfort Coralee Purdy, Queensway Carleton Hospital Brian Schnarch, Champlain LHIN Gamil Shahein, Pembroke Regional Hospital Rhiannon St. Pierre, Cornwall Community Hospital Ellen Whittingham, Queensway Carleton Hospital Prepared by OPTIMUS | SBR © 2017 All rights reserved P a g e | 5 CHAMPLAIN LHIN INPATIENT MENTAL HEALTH & ADDICTIONS CAPACITY PLAN CURRENT STATE REPORT Executive Summary Context In response to the objectives outlined in the Champlain LHIN’s Integrated Health Services Plan 2016-19, and in recognition of the need to continue to improve access to inpatient mental health and addiction services, the Champlain LHIN convened a Steering Committee to develop
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