Primary Health Care Conference 2013
CHCs & AHACs are Comprehensive Five areas of Primary Health Care services under one roof Health Promotion
is the MOHW needed:
Unique to CHCs & AHACs Demonstrates shared principles and characteristics of the work we do Captures consistent domains and attributes in how we do the work Supports the Second Stage of Medicare Reminds us that community is central to all we do Identifies our work as part of the larger struggle for equity and social justice 3
Model of Health and Wellbeing Compass for program delivery Common understanding Across the sector, Among Staff Between Staff and Boards Tool for communicating what CHCs and AHACs are to others
ď ś The
CHC Model of Care captures consistent principles that underlie the work of Ontario CHCs. The model has been refreshed with CHCs and AHACs to create a shared set of values and practices.
Everyone participates, individually and collectively, in decisions about their health and wellbeing. Individuals and communities receive health care that meets their needs, in a timely fashion and from the most appropriate providers, and experience the best possible results. Health care and other service providers work in respectful, collaborative relationships with individuals, families, and communities and each other. The quality of care is optimized through continuous innovation and learning to improve the experience and outcomes of those accessing care, and the efficient use of resources.
Key characteristics of PeopleCentred Health Care: For individuals, patients and their families: Access to clear, concise and intelligible health information and education that increase health literacy; Equitable access to health systems, effective treatments, and psycho-social support; Personal skills which allow control over health and engagement with health care systems: communication, mutual collaboration and respect, goal setting, decision making, and problem solving, self-care; and Supported involvement in health care decision-making, including health policy. World Health Organization 10
Health Equity and Social Justice Reduction in social inequality improves Health outcomes. Social inequality is reduced when all people become aware that inequality impacts health outcomes for all. Equity and dignity and integrity of the person is manifest in access to nutritious food, safe and secure housing, clean water, adequate and appropriate clothing, dignified and justly-remunerated employment. Health care appropriate to all ages and stages of life, and mechanisms of fulsome engagement and participation in civic, social and political processes.
Socially produced (and therefore modifiable)
Unfair and unjust
From the Health Equity Charter Adopted by the Sector in 2012: ď ˝
We understand health equity to be an approach that includes policies and interventions that address discrimination and oppression with a goal of eradicating social inequality and disadvantage for the purpose of reducing differences in health outcomes.
Community Vitality and Belonging Safe and caring communities improve health outcomes. Shared values and shared vision strengthen belonging. All members of the community have opportunities to participate in decision making about their communities. Public, private sectors and community organizations work together to strengthen inclusive, caring and connected communities. 14
Performing Primary Care System
Provides better coordinated, client/patient-centred and seamless levels of care Is integrated with the rest of the health system Ensures system navigation and care coordination for those they serve All members of inter-professional teams work to full scope of practice Ensures timely access by providing extended hours, implementing advanced access and providing 24/7 coverage wherever possible Engages with the community to ensures programs and services meet their needs Evidence based practice Continuous focus on quality improvement
All Ontarians facing barriers to health have access to quality primary health care within a coordinated system of care Community Health Centres: • Improve access by understanding and addressing systemic barriers • Serve clients who face challenges in finding appropriate care within the main stream healthcare system • Provide care within an anti-oppression framework
Anti-oppressive and Culturally Safe Services are provided: • In anti-racist, anti-oppressive environments safe for people; • Where there is no assault, challenge or denial of their identity; • Promoting values of living and working together with truth, respect, honesty, humility, wisdom, love and bravery; • Enabling various cultural and linguistic backgrounds to control or influence health and wellbeing 19
Provide Coordinated Services “Every door leads to service” Partnerships across sectors and with the community CHCs average 28 partnerships Unifying goals & resources across organizations Benefits: Improved overall quality of care More timely, seamless care and appropriate referrals, so people don’t fall through the cracks A more efficient and cost-effective healthcare system. 20
Integrated Key Considerations: CHCs are the entry point to the health care system for many clients Different ways to integrate Working with partners is an essential criterion for accreditation Solving problems by developing common goals and pooling resources, while maintaining autonomy Local Health Integration Networks (LHINs) expect integration 21
Inter-Professional Working together: Decreases competition & duplication Recognizes the skills and expertise of others For clients: increases the chances that their needs will be met by the right provider at the right time For providers: supports their personal and professional needs For the system: creates new and sustainable solutions 22
CHC /AHAC services and programs are: Responsive to local community initiatives and needs Build on community leadership, knowledge, and life experiences of community members and partners to contribute to the health of their community. Increase the capacity of communities to improve community and individual health outcomes
Community-Governed “We are the communities we serve.” CHCs are non-profit with boards of directors, that are made up of people who know the community best offer a way for community members to participate in and take ownership of their CHC ensure the CHC is accountable and transparent to its community
Local boards drive programming that is responsive to local needs
Community-Governed â€œThe most significant value added of community governance in health appears to be related to its ability to achieve better health outcomes for both individuals and communities by increasing empowerment and social capital.â€? Patzer, K. Review of the Trends and Benefits of Community Engagement and Local Community Governance in Health Care
Levels of Community Engagement
Ladder of Participation, Bruns (2003) 26
CHCs are inclusive of the Social Determinants of Health Avoidable health inequalities arise because of the circumstances in which people grow, live, work, and age, and the systems put in place to deal with illness. The conditions in which people live and die are, in turn, shaped by political, social, and economic forces. The WHOâ€™s Commission on the Social Determinants of Health (2008) Page 9.
Population and Needs-Based ď ś CHCs and AHACs are continuously adapting and refining their ability to reach and to serve people and communities. ď ś CHCs and AHACs plan services and programs based on population health needs and develop best practices for serving those needs. 29
Accountable and Efficient CHCs and AHACs are: high performing efficient Primary Health Care (PHC) organizations that are accountable to their funders and the local communities served. Strive to provide fair, equitable compensation and benefits for their staff. Capture and measure their work are essential parts of delivering Primary Health Care. Invested in developing and implementing meaningful indicators based on our MOHWB that allows for: reporting to all funders about services and programs delivered as well as the outcomes that follow. 30
ď ś Take
10 minutes to discuss the attribute that youâ€™ve been assigned and come up with 3 ways that your CHCs/AHACs address the attribute