Synergy winter 2012

aohc.org Transformative Information Management Strategy underway After extensive planning and preparation, a new information management strategy for Ontario’s Community Health Centres (CHCs) and Aboriginal Health Access Centres (AHACs) is now rolling out across the province. The multipronged plan is designed to improve the quality of care delivered to over 400,000 people served by these centres and Nurse Practitioner-led clinics through cost-effective health information management solutions.

Enabling the strategy is deployment of a state of the art electronic medical record (EMR) supplied by Nightingale Informatix Corporation. Each and every CHC and AHAC will use the Nightingale system, creating a myriad of new opportunities for research and quality improvement initiatives, as well as cost efficiencies.

The first in a province-wide roll out, Chigamik CHC staff The rolling out of the new EMR began in February at are ready for new Nightingale EMR. From left, executive Midland’s Chigamik Community Health Centre. Other “early director David Jeffery, physician Danial Schecter and adopters” in the two-year plan include Regent Park, Brock, health promotion coordinator Gabrielle Maurice.

South-East Grey and South Georgian Bay CHCs. Throughout the deployment process, AOHC is providing intensive suplarger and even more significant story. port, with efforts guided by the CHC- and AHAC-led Infor“The EMR deployment is the foundation of a strategy to mation Management Strategy Committee. It is one of the improve primary health care delivery. Once the foundation largest implementations of EMR using one common system is laid, we start building a whole new array of initiatives across Canada. and innovations,” he added. For The new EMR complements example, when EMR deployment an interprofessional approach New EMR system launched as is complete, CHCs and AHACs will by enabling use by a wide be able to share data on their colpart of province-wide initiative range of health providers inlective measurements for improvcluding pharmacists, mental ing health outcomes. This new health workers, chiropodists, social workers, dietitians, dia- “decision-support platform” will be invaluable to the rebetes educators, physiotherapists and health promoters. search community as well as boards and staff at CHCs and Initial feedback has been encouraging. “We were all im- AHACs as they press forward with quality improvement. pressed by the user interface of Nightingale On Demand,” Sector-wide data sharing can also serve as a powerful tool says Dr. Itamar Tamari, a family physician at Stonegate CHC for the province and the LHINs in making informed decisions and a member of the EMR evaluation committee. “This sys- on system-wide changes. tem will allow staff to get up and running quickly and effiAs a former CIO eHealth lead at the North Simcoe Musciently, while meeting the complex needs of interprofession- koka LHIN, Burns is excited about the many possibilities al teams.” ahead, stating: “This strategy is going to be transformative.

As the new EMR systems is launched in CHCs and AHACs And it’s also going to offer many lessons for harnessing across the province, AOHC’s Chief Information Officer (CIO) technology to improve primary health care throughout the Rodney Burns points out that this is just the beginning of a province.”

ONTARIO HEALTH ACTION PLAN

AOHC embraces the potential for primary care AOHC has strong praise for the province’s new Action Plan for Health Care, especially its commitment to make primary care a cornerstone of health system transformation.

In a news release issued immediately after the plan was released, the Association assured Minister of Health and Long-term Care Deb Matthews that its member centres are looking forward to playing a key role as the plan is rolled out across the province.

“Minister Matthews is right that system-wide change to primary care is the key to both better care and value for our health care dollars,” said AOHC Executive Director Adrianna Tetley.

“We’re looking forward to the challenge Minister Matthews has given us,” she added. “We hope other primary care providers and leaders feel the same. Now is the time for primary health care to live up to its full potential, focusing on keeping people well and not just treating them when they are sick. We also need to ensure that individuals and their families receive coordinated care as they navigate through different parts of the health care system.”

Tetley also noted that many of the measures listed in the action plan were also found in Don Drummond’s report of the Commission on the Reform of Ontario’s Public Services released February 15.

Measures of interest The Association was especially pleased with a number of specific measures the new health action plan lays out for primary care services:  Investing in community, bringing services closer to home;  Calling on primary care to help individuals and their families to navigate the system, particularly those with multiple complex conditions;  Expanding same day service and house calls;  Enabling non-physician health providers to use the full range of skills that they are trained and qualified to do;  And, integrating evidence-based best practices.

Partners in planning? AOHC and LHINs The Association is supportive of the government’s plan to integrate family health care into the LHINs and hopes to work in partnership with the LHINs to develop population needs-based plans to ensure the right care is provided by the right provider in the right place. “To implement her action plan, Minister Matthews can turn to Ontario’s Community Health Centres, Aboriginal Health Access Centres and WINTER 2012

AOHC’s new government relations lead, Jacquie Maund, with Minister of Health Deb Matthews at action plan announcement January 30. Photo: Howard Brown

Community-governed Family Health Teams which offer tried and tested solutions,” said Tetley.

Social determinants of health must be included While offering praise for new action plan’s general direction, AOHC is concerned about the lack of detail on how the province intends to tackle the social determinants of health which have such a profound influence on population health.

“We’d like to see more details on how the province intends to deliver better care to communities which have traditionally had difficulty accessing primary care services and whose living circumstances leave them vulnerable to poor health. These are the very same people who very often end up in hospital emergency departments,” said Tetley. “And it’s also not clear how this new action plan is aligned with the province’s poverty reduction strategy. We need to make sure the benefits of primary health care transformation are not limited to healthier and wealthier populations.”

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PRIMARY HEALTH CARE CONFERENCE

June 7-8 Toronto airport Doubletree by Hilton Don’t miss this action-oriented conference spotlighting transformative new ideas and innovations Speakers include:  Steven Lewis, one of Canada’s leading primary health care experts  Representatives from Alaska’s Southcentral Foundation – home of the world-renowned Nuka model of care  Cathy Fooks, CEO and President of the Change Foundation Who should come? Anyone with an interest in how Ontario’s primary health care system can be improved, including: primary health care providers; administrators and board members of primary health care organizations; representatives of LHINs and of provincial and federal governments responsible for primary health care Online registration now open! Member discounts available.

www.aohc.org/conference

To its membership: 

Associate member St. Francis Memorial Hospital with the Rainbow Valley CHC satellite

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Donna Shanley of eHealth Ontario who is on loan to AOHC until March 31 to help the EMR project go forward

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Christine Randle, Data Management Coordinator at East End Community Health Centre, who is seconded for two years to work with her peers across the province as EMR Transition Coordinator

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Emerging group member Innisfil Community Health Committee

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A special welcome to AOHC’s first Nurse Practition A boost for the EMR team in Bruno Loones, Deployment Coorer-led clinics!: Huronia, Health Zone, The French dinator and Randy Houston and Abdullah Khan, Data MigraRiver and Anishnawbe Mushkiki tion Analysts

To its board of directors: 

New Central Constituency director Sarah Hobbs, executive director of Planned Parenthood Toronto CHC; and

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New South West Constituency director Carole Cleave, past board chair of the North Lambton CHC.

And to its staff: 

Chief Information Officer Rodney Burns to oversee all of AOHC’s Information Management Strategy

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Jacquie Maund, a former policy advisor inside the provincial government and long-time anti-poverty activist who has come on board as our new Policy and Government Relations Lead

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Louise Slobodian, our new communications coordinator who brings extensive experience developing online communications in the non-profit world

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Melissa Heng, IMS communication lead who will be handling the multi-faceted communications involved in AOHC’s information management strategy

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Equity in health care: WHO pilot project Hamilton Urban Core Community Health Centre is one of seven organizations in Canada to participate in a project initiated by the World Health Organization (WHO) to pilot-test Standards for Equity in Healthcare for Migrants and Other Vulnerable Groups. Seven countries have confirmed their participation in the WHO initiative, including Canada – the only country outside Europe.

Building on previous instruments, the Standards for Equity in Healthcare include

measurable indicators for each of five domains: equity in policy, equitable access and utilization, equitable quality of care, community involvement and promoting equity. The pilot sites, including Hamilton Urban Core, will be evaluating the standards. The final project will take place between February and April 2012.

“We are very excited about this project,” says Denise Brooks, executive director at Hamilton Urban Core. “The project is clearly connected to the client population we serve

and aligned with the centre’s commitment to health equity. It is also consistent with the equity priorities at the Ministry of Health and Long-Term Care and the Local Health Integration Networks.”

The pilot sites will be able to use this process to help identify gaps in service, barriers, and risks to clients and the organization.

Members in action!

Thursday afternoons, 3-4, on Twitter

UPCOMING CHATS  What is health promotion? Expanding awareness and understanding  Role of CHCs in supporting healthy development for girls  Putting the mouth back in the body -- oral health within primary health care  Balancing quantity/quality in primary health care  Improving electronic health records in primary health care  Improving quality of life and care for seniors (World Health Day)  Moving from "patient-centred" to "people-centred" care.

CHCchat.com Reporting in as a success, A Big Picture Summit: How Boards Succeed in a Changing Health Environment, held in November, brought together 45 board members from 22 centres.

The goal was to support the board members of member centres in even more effective strategic thinking.

Presentations included strategic planning; community engagement, strategic communications and quality oversight.

Donner recognition Congratulations to AOHC member Community and Primary Health Care (CPHC) of Lanark, Leeds and Grenville and its Community Family Health Team. For the fourth time in seven years, CPHC has been awarded Excellence in the Delivery of Services for Seniors by the Donner Canadian Foundation Awards. And this year, there was icing on that cake as they also received the prestigious Peter F. Drucker Award for demonstrating a record of excellence and innovation in its delivery and management of services.

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Presentations available through: capacitybuilding@aohc.org  More learning events: www.aohc.org/upcomingevents

CPHC executive director Ruth Kitson with Lieutenant Governor David Onley WINTER 2012

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Member spotlight

Midwives and LAMP birth new partnership Five weeks pregnant. That’s how soon you have to book a midwife in Ontario, the demand is so high. That’s early! Lots of women don’t even know they’re pregnant yet at five weeks. So midwives tend to be booked by women who have planned their pregnancy and know how to navigate the system well.

But midwives Tory Tudor and Barb Heathcote had another vision. They wanted to be available to women who didn’t typically use midwives, at least in Canada. So they opened a new practice with a commitment to 75 per cent spots for women in vulnerable positions. And they opened their practice in a new kind of partnership, right within the walls of the East Mississauga satellite of LAMP Community Health Centre.

A year later, they have attracted three other midwives to join them and grown enough they hope to expand into the vacant unit next door in the same plaza – but the partnership with LAMP continues.

The new practice was approved by the Ministry of Health and Long-Term Care and Minister Deb Matthews has visited the site.

“As the grandmother of a beautiful baby delivered by midwives, I've seen first-hand the incredible care midwifery offers mothers and babies in Ontario,” said Matthews.

“The clinic at LAMP is no exception, and I know this partnership will not only enhance midwifery care in the community, it will also ensure new families have easy access to the health supports they need before, during, and after pregnancy.”

While many CHCs work with midwives, it’s the commitment to the same individuals and families, in partnership and proximity, that makes this new model unique. Formal and informal consultation between midwives and CHC care team and outreach workers is common.

From the LAMP end, it’s a natural fit and they expect their clients will overlap more and more over time says Bill Worrell, LAMP’s director of healthy communities.

Adds nurse-practitioner Rosanne Hickey, “The ‘win’ for us is that the family comes back to the CHC for care.” Midwives connected to the centre provide a natural entrée to the whole centre, for the whole famWINTER 2012

ily. The “continuity of care at the CHC with all the resources and support a CHC can provide,” makes a big difference for vulnerable families, she adds.

That was the draw for the midwives too.

With backgrounds in public health and social work, Tudor and Heathcote not only wanted to reach out to vulnerable women, Healthcote says they wanted to connect them to the other services they need. “We had originally thought we would bring in other services,” she says, “until we realized that is already there at the CHC – social workers, for example – serving the same people, already in place.”

The new practice was a risk for the midwives who don’t get paid for spots that aren’t filled. They’re gratified other mid-

wives have joined them in caring for women who face barriers to access, specifically refugee women or those in or having survived abusive relationships.

Heathcote explains that most of those served are the new immigrants that keep Mississauga growing – women from India, Pakistan, China and refugees from Africa.

Most don’t have OHIP coverage; they are in the waiting period or in process for applying for permanent resident status. But with an enlarged practice, the vision is growing too. “Now that we have more midwives, we plan on reaching out to teenagers and women’s shelters.” says Heathcote. “The flexibility we can offer, such as home visits, is especially helpful when there other children at home.”

‘They made it easy’ Laure and her family arrived as refugees from the Congo last March – and Nathaniel was born October 19 with the help of midwives from LAMP CHC, where she receives her medical care. “They made it easy and I miss them,” she says of the women who guided her through pregnancy and hospital birth in Canada – she also has 11-year-old twins and a 20-year-old daughter. “Lots of the time they were coming” she says of home visits, so she didn’t have to take the two buses to the health centre. And they took her calls, which was reassuring too. Best, though, was having women she already knew with her at the birth, and not strangers.

The care team: Midwife Barb Heathcote, Laure and Nathaniel, and LAMP CHC nurse -practioner Rosanne Hickey ASSOCIATION OF ONTARIO HEALTH CENTRES

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Openings! Three new CHCs make their debut Bridges Community Health Centre marked the grand opening of its permanent Port Colborne-Wainfleet site on November 9 – a temporary site had been open since 2009.

Board president Russ Wilson reported that "It's been a long, hard road, but success comes to those who wait." He noted that the Port Colborne site has registered more than 1,400 clients and intake has "dramatically increased" since the new facility opened. Consolidating all of its programs and services under one roof will make a "huge and positive difference in the lives of our clients," said executive director Taralea McLean.

Ribbon cutting, from left: Russ Wilson, president of Bridges CHC’s Board of Directors; executive director of Bridges CHC Taralea McLean; Port Colborne mayor Vance Badawey; Bridges CHC client Cathy Wight; mayor of the Township of Wainfleet April Jeffs; and Bill Millar, member of the board of the Hamilton Niagara Haldimand Brant LHIN.

With a new facility, name and logo, Langs CHC has a lot to celebrate! Their new 58,000 sq. ft. facility in Cambridge was officially opened on December 5. Vice-chair Gary Desborough reports that most of Langs’ current programs are now under one roof and that over 20 agencies will be onsite in 2012 which means increased access to essential services in the community. Features of the building includes a living wall, gymnasium, walking track and six group rooms of various sizes.

Belleville Quinte West CHC celebrated the opening of its Quinte West facility on January 26 with ribbon cutting, MPPs and the mayor, among other dignitaries. With just over 15,200 square feet, the centre houses physicians, nurse practitioners, nurses, dietitians, health promoters and an administrative team … “everything the community could possibly need under one roof,” says a local paper. With a waiting list of 800, executive director Marsha Stephen expects to serve up to 10,000 clients when the centre is fully staffed.

BQWCHC promotes healthy movement with walking poles through sessions along Belleville and Quinte West’s waterfront and parks. During a grand opening tour, health promoter Bianca Sclippa Barrett gave a demo to MPP Todd Smith.

WINTER 2012

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