South West Local Health Integration Network
SEPTEMBER 24, 2013
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September, 2013
Success Story: South West LHIN Initiative Helping
Ventilated Patients Live at Home with Supports
Chelsey Walters, 29, of London is like any young woman. She enjoys music, her daily Tim Horton’s coffee, and
hanging out with friends. The difference, though, is Chelsey requires long-term mechanical ventilation to help her
breathe.
Chelsey has been living with Congenital Fibre-Type Disproportion, a condition that affects the skeletal muscles, her
whole life. Six years ago she suffered respiratory failure that required her to enter the Intensive Care Unit (ICU) for
four months. After six months in Parkwood Hospital, she transitioned home. Two years ago she went into respiratory
failure again and wound up back in hospital. For more than a year, her family would visit her daily at Parkwood
Hospital and bring her home on weekends.
“It was a very stressful time,” says her mother, Susan. “She was very dependent on us being [at the hospital] every
day. On Sunday she was very hesitant to go back – she would be in tears.”
That changed in February 2011 when a space opened up in one of three assisted living units operated by
Participation House in London for people like Chelsey who require long-term ventilation. She now lives in a modern
semi-detached home where she can enjoy privacy, independence and an active social life. Her bedroom is even
painted her favourite shade of purple.
“We’re very happy she’s here,” says dad Rick. “She’s less dependent on us and she feels like the staff are like family
here.”
Long-term vented patients who are medically stable have been able to return to the community with support for many
years on a case-by-case basis, but the process gained more structure in 2009 when Dr. David Leasa and Clinical
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Nurse Specialist Cathy Mawdsley from London Health Sciences Centre (LHSC) submitted a proposal to the South
West LHIN. The goal is to improve the quality of life for people who would otherwise be forced to live inside hospital
walls. The long-term mechanical ventilation initiative is possible because of partnerships between LHSC,
Participation House, Parkwood Hospital, and the South West Community Care Access Centre.
A person may require long-term invasive or non-invasive ventilation for a variety of reasons such as trauma, a chronic
condition or weak breathing muscles. To date, up to 20 invasive treatment and 130 non-invasive treatment patients
have benefited from the long-term ventilation initiative. Otherwise, these individuals are supported in the ICU or at a
complex care facility. Vented patients can now have the option to return home, to an institutional setting (such as
Parkwood Hospital), or to a community setting, such as Participation House. Respiratory therapists train caregivers to
operate the specialized breathing equipment.
In addition to lacking the comforts of home, these facilities provide some of the most expensive care in the health
system. The cost to operate a level three ICU bed is $3,500 to $4,000 per day. Medically stable patients are able to
live in a Participation House unit for $300 per day. That cost includes supportive housing, transportation, day
programming and the support of a caregiver. Moving people back into the community also frees up ICU beds for other
patients who require this precious space.
“There are a lot of great initiatives across the South West LHIN, but this one truly is exciting,” says Jeff Low, Board
Chair, South West LHIN. “Not only does it dramatically improve the quality of life for people, it is the embodiment of
our goal: to help people live healthy, independently and safely at home.”
For Chelsey, there is nowhere she would rather be.
“A hospital isn’t a home,” says Chelsey.
ABOVE With Chelsey (L to R): Sheila Davies, PSW; Michelle Martin, DSW; Susan
Walters, mom; Rick Walters, dad; Dr. David Leasa, LHSC; Joanne Smith, Respiratory
Therapist; Carmell Tait, Chief Operating Officer, Participation House, Dragica Kresovic,
Coordinator, Participation House; Marianne Forget, Senior Coordinator, Participation
House
Advancing Health Links in the South West LHIN
Introduced in our June 2013 issue of the Exchange e-newsletter, Health Links is an evolutionary provincial initiative
that will foster necessary coordination and collaboration amongst health service providers to better serve those
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people most dependent on health services. 19 early adopter Health Links were identified throughout Ontario including
the Huron Perth Health Link (HPHL) in the South West LHIN.
The HPHL, led by the North Perth Family Health Team, now has its business plan in place. The plan identifies gaps
and opportunities in the delivery of health services that will guide implementation. The plan is comprised of three
major projects: (1) Access to Care and Transportation Support, (2) Coordinated Care Plans, Pathways and Health
Information and (3) Shared Information for Providers and Patients. Information technology will be a key enabler for
Huron Perth Health Link to support the sharing of information. For more details click here.
The South West LHIN, in partnership with the Ontario Medical Association (OMA), has been hosting regional
physician engagement sessions to provide physicians and other allied health professionals with a clear understanding
of the Health Links initiative and to obtain feedback on how they envision their role in Health Links. Sessions in Huron
-Perth, London-Middlesex and Grey Bruce took place this past spring, and two more sessions are scheduled in Elgin
and Oxford in October and November 2013.
The sessions are open to all health professionals in the South West LHIN. A complimentary networking dinner will be
provided at 6:00 pm, and CME credits will be available to physicians who attend the event. The session will provide
an overview of Health Links, and will feature a panel discussion with local health professionals in the Elgin and Oxford
regions.
“As we come closer to fully actualizing Health Links in the South West LHIN, it is important to understand the
perspective of physicians and other health professionals as they will be playing a significant role in the implementation
of this initiative,” says Dr. Rob Annis, Family Physician, North Perth Family Health Team and Primary Care Lead,
South West LHIN. “Through the engagement of health professionals, the South West LHIN will obtain useful insight
on successfully advancing this important initiative.”
For more information on the fall South West LHIN/OMA physician engagement sessions please click here.
Health Links work towards achieving both Strategic Direction #1 ‘Improve Access to Family Health Care’ and
Strategic Direction #2 ‘Improve Coordination and Transitions of Care for those Most Dependent on Health
Services’ as outlined in the South West LHIN's Integrated Health Service Plan.
Click here to learn more about Health Links in the South West LHIN.
Three Local Physicians Join South West LHIN Team
As the South West LHIN works to implement our current Integrated Health Service Plan (IHSP) 2013-2016, three area
physicians will be helping us achieve our goal of improving access to primary care.
We are pleased to welcome Dr. Gordon Schacter, Dr. Scott McKay and Dr. Jonathan Thomas as our new Primary
Care Co-Leads. They will join Dr. Rob Annis who has been our Primary Care Lead since January 2012.
These physicians will work one day per week to improve the overall quality and access to primary care services and
to advance health system integration. Each co-lead will work in their geographic area to implement the Health Links
initiative, as well as support physician engagement. They will also be looked to for their leadership and input on LHINwide initiatives such as access to care, behavioural support services, chronic disease prevention and management,
mental health and addictions, seniors and adults with complex needs, clinical services planning and eHealth.
“The recent hire of three more Primary Care Leads, all working one day per week, will help coordinate the primary
care voice, and transform the South West LHIN's three-year plan into a reality,” says Dr. Rob Annis. “This is a bold
and forward-thinking move by our LHIN, and one I am confident will produce great results.”
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Dr. Gordon Schacter has worked as a family physician for the past 18 years and has
strong linkages with primary care providers and agencies throughout the London and
surrounding area. He is co-Chair of the South West Primary Care Network and was the
Primary Care Lead for the South West Diabetes Regional Coordination Centre.
Dr. Scott McKay is a comprehensive family practice physician and Assistant Medical
Director at the Byron Family Medical Centre in London and the attending physician at the
Dearness Long-Term Care Home. He also serves as a Community Advisory Council
member at LHSC and Site Chief, Department of Family Medicine at Victoria Hospital.
Dr. Jonathan Thomas is a family physician working in a rural setting on the Bruce
Peninsula with the Peninsula Family Health Team. In addition, he is the attending
physician at the Golden Dawn Senior Citizen Home and works with the South West
Primary Care Network and as a family and Emergency physician at Grey Bruce Health
Services.
The Primary Care Co-Leads will work towards achieving both Strategic Direction #1 ‘Improve Access to Family
Health Care’ and Strategic Direction #2 ‘Improve Coordination and Transitions of Care for those Most Dependent on
Health Services’ as outlined in the South West LHIN's Integrated Health Service Plan.
South West LHIN Board Approves Bed Realignment
Process
In order to ensure equitable access to services across the South West LHIN, the Board of Directors approved the
start of a rigorous process to move some complex continuing care beds (CCC) and rehabilitation (rehab) beds to
different sites in the LHIN at its meeting on June 26.
A detailed analysis of bed usage and distribution drove the recommendation for these changes and is part of the
overall Access to Care strategy. Access to Care, in addition to the CCC/Rehab bed realignment is also making
investments in assisted living, supportive housing, adult day programs and the Home First program.
The changes to CCC/rehab beds with the other parts of the Access to Care strategy will ensure that a better mix of
health care services exist in communities across the LHIN area.
At the end of the process, the location of the beds will better match the population and need for these services.
Analysis found that 37% of the patients in CCC beds were waiting for care somewhere else, such as a long-term care
home and did not need the specialized care provided in that type of bed.
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Currently the distribution of beds per 1000 people age 65+ is:
• Elgin County: 3.30
• Oxford County: 3.17
• Grey and Bruce Counties: 0
• London and Middlesex County: 1.26
• Huron and Perth Counties: 3.15
The approved bed realignment will result in the implementation of the following changes over the coming 18 months:
• Increasing 10 CCC beds at Grey Bruce Health Services, Owen Sound site
• Increasing 2 rehab beds at St. Thomas Elgin General Hospital
• Decreasing 15 CCC beds at St. Thomas Elgin General Hospital
• Decreasing 6 CCC beds at Tillsonburg District Memorial Hospital
• Decreasing 9 CCC beds at Alexandra Hospital, Ingersoll
• Implementing consistent criteria for access to these beds
• Implementing centralized access through the South West Community Care Access Centre (CCAC)
South West LHIN staff will work with health service providers to initiate a facilitated integration process. Provider
boards will consider these changes at their board meetings in the fall of 2013 and, after that process, the changes can
be implemented in 2014.
CCC/Rehab bed realignment works towards achieving Strategic Direction #4 ‘Increase the Value of our Health
Care System for the People We Serve’ as outlined in the South West LHIN's Integrated Health Service Plan.
The Province Continues to Make Strides in Improving
Access to Physiotherapy Services in Ontario
As highlighted in our June 2013 Exchange e-newsletter, the Ontario government is implementing improvements to
physiotherapy and exercise and falls prevention classes across the province. Under the new model an additional
200,000 seniors and other eligible patients will have improved access to high quality physiotherapy and to exercise
and falls prevention classes.
The changes are intended to ensure that seniors, eligible community patients and long-term care home residents get
the services they need to help them stay healthy, physically active and independent. In addition, the government is
expanding access to physiotherapy by making it available in more places across Ontario.
The ministry, Community Care Access Centres and the LHINs have been working closely together so that services
are provided for those who need them and that there are minimal service disruptions. The priority of the government
is to ensure that seniors, eligible community patients and long-term care home residents get the services they need to
help them stay healthy, physically active and independent. There are five streams of work underway:
1. Exercise and Falls Prevention classes for seniors are in place in retirement homes and other community
locations throughout the South West LHIN. Visit the southwesthealthline.ca for a list of Exercise and Falls
Prevention classes. Click here to learn more about the Exercise and Falls Prevention Initiative in the South
West LHIN.
2. One-on-one physiotherapy for long-term care home residents with assessed need and group exercise classes
are in place in long-term care homes and the funding now flows directly to the long-term care homes.
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3. In-home physiotherapy for seniors and other eligible patients who cannot access these services outside their
home because of their condition will now be managed through the South West CCAC. Assessments by the
CCAC are in progress for people who were receiving in-home physiotherapy from a Designated Physiotherapy
Clinic provider. For questions related to new physiotherapy services or how to access services contact
[email protected] or 1-800-811-5146 ext. 5461.
4. Community physiotherapy clinic services across Ontario for seniors and other eligible patients will be
expanded. Applications are currently under review for additional physiotherapy clinic locations in the South
West LHIN.
5. Physiotherapy services will be integrated into primary health care settings including Family Health Teams,
Nurse-Practitioner Led Clinics, Aboriginal Health Access Centres (if applicable in SW LHIN) and Community
Health Centres. Eligible primary health care settings will be determined through a Call for Applications
process.
“It is a priority to work with our partners to ensure the continuity and expansion of physiotherapy services for residents
in the South West LHIN,” says Michael Barrett, Chief Executive Officer, South West LHIN. “In implementing this more
accountable approach, we intend to place patients/clients/residents at the centre of their care. We want to ensure that
these changes will ultimately benefit Ontario residents and create aa system that is both sustainable and effective at
providing the best possible care.”
For other information on physiotherapy changes in the South West LHIN click here
Priorities for Investment Planning in the South West LHIN
The South West Local Health Integration Network (LHIN) is working to finalize a list of recommended Priorities for
Investment initiatives for the Board of Directors to consider for approval at its September Board Meeting.
Each year, the South West LHIN executes a Priorities for Investment Plan to invest the discretionary funding
allocations received from the Ministry of Health and Long-Term Care. In the past, that plan invested in base and onetime funding opportunities aimed at improving the local health system.
This year, the LHIN is using the Priorities for Investment process to manage and coordinate the allocation of several
sources of funds with the ultimate goal to ensure maximum impact and coordination of services and resources. The
following funding sources are part of the South West LHIN’s plan:
• Community Sector Base Funding Increase (approximately $15.7M)
• LHIN Urgent Priorities Fund (approximately $4.5M one-time funding)
• Small and Rural Hospital Transformation Fund (approximately $5.4M one-time funding)
• Small Hospital Base Funding Increase (approximately $1.2M)
The Integrated Health Service Plan 2013-2016’s (IHSP) strategic directions will be the guide for all investment
recommendations.
Some of these investments will continue existing work, such as Home First, but the majority will be directed to
enhanced or new services and programs.
New investments will consider the following factors:
• South West LHIN 2013-2014 Annual Business Plan objectives and deliverables must be given priority status
and advanced. For example:
◦ Increase timely access to family health care
◦ Divert avoidable ER visits to the appropriate care setting
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• New or enhanced services must demonstrate measurable impact and value for money by directly impacting
one or more of the South West LHIN’s performance metrics For example:
◦ A reduction in emergency room visits and hospital readmissions
The South West LHIN is conducting two information sessions for all sectors about the 2013-2014 investments on
September 17th and 18th and will continue to provide updates as the process unfolds.
Health System Funding Reform - Local Partnership
Committee
As mentioned in the June, 2013 e-Exchange Newsletter, the South West LHIN has established a new Local
Partnership Committee to manage the implementation and change as a result of Health System Funding Reform
(HSFR) in the South West LHIN.
To help foster a change management environment, Local Partnership Committees have been established in all 14
LHINs across Ontario in order to help support the successful implementation of HSFR. The Local Partnership
Committee will act in an advisory capacity facilitating clinical, financial and decision support advice to and from the
LHINs and the Ministry of Health and Long-Term Care. The Local Partnership Committee has senior representation
from LHINs, hospitals and CCACs and is connected and aligned to existing local structures in order to coordinate with
other ongoing activities within the South West LHIN. The Local Partnership Committees across Ontario and in the
South West have members with the following areas of expertise:
• Clinical and program leadership
• Financial leadership
• Clinical health informatics and decision support
• Quality and performance improvement
The Local Partnership will promote open dialogue, encourage constructive thinking, debate and remain solutions
focused. The South West LHIN Local Partnership Committee will help guide HSFR implementation and change,
advise on the LHIN’s clinical services planning initiatives.
Organization
Name
Title
Alexandra Hospital
Lisa Gardner
Director of Patient Services/Chief Nursing
Executive
Alexandra Hospital and Tillsonburg District
Memorial Hospital
Frank Deutsch
CFO, Shared Director of Finance and
Corporate Services
Alexandra Marine & General Hospital
Karen Davis
CEO
Grey Bruce Health Services
Martin Mazza
VP Corporate and Diagnostic Services, CFO
Grey Bruce Health Services
Julia Scott
VP Clinical Services & CNE
Hanover & District Hospital
Marnie Ferguson
VP Finance and Operations
Huron Perth Healthcare Alliance
Iris Malig, Co-Chair
Director, Decision Support and Financial
Planning
Listowel Wingham Hosptials Alliance
Karl Ellis
President and CEO
London Health Scienes Centre
Murray Glendining
Executive VP Corporate Services & Clinical
Support
London Health Scienes Centre
Silvie Crawford
VP Patient Centred Care
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London Health Scienes Centre
Deepak Sharma
Director, Decision Support
Middlesex Hospital Alliance
Paul Long
CFO
Middlesex Hospital Alliance
Nancy Maltby
COO
South Bruce Grey Health Centre
Kate Kincaid
CNO
South Huron Hospital Association
Darlene Borland
CFO
South West CCAC
Hillary Halliday
Senior Director of Corporate Services
St. Joseph's Health Care, London
Roy Butler
VP Quality and Clinical Support
St. Joseph's Health Care, London
Lori Higgs
VP Corporate Services and CFO
St. Joseph's Health Care, London
Elaine Gibson
VP Complex, Specialty Aging & Rehab Care
St. Thomas-Elgin General Hospital
Nancy Whitmore
VP and Chief of Staff
St. Thomas-Elgin General Hospital
Tonya Sheldon
Acting CFO
Woodstock General Hospital Trust
Dee Perera
VP Finance / CFO
South West LHIN
Mark Brintnell, Co-
Senior Director, Performance and
Chair
Accountability
Click here to learn more about health system funding reform in the South West LHIN.
Refreshing the South West LHIN
In keeping with our transformation mandate, the South West LHIN has updated our organizational structure in order to
better leverage the skills and experience of LHIN staff in delivering on the Integrated Health Service Plan 2013-2016
(IHSP) priorities.
This update aligns our staff to functional responsibilities like system design, integration, performance, finance,
communications and engagement and ‘system-focused’ portfolios being Acute, Primary Care/Chronic Disease
Prevention and Management, Mental Health & Addictions, Seniors and Adults with Complex Needs and Special
Populations. This emphasis on the ‘system-focused’ portfolios is intended to help advance achievement of goals and
outcomes in these areas.
We have renamed our functional teams for better alignment. The Planning, Integration and Community Engagement
team is now the System Design and Integration team, led by Kelly Gillis, Senior Director. The Performance, Contract
and Accountability team is now the Performance and Accountability team, led by Mark Brintnell, Senior Director.
Community engagement accountability has shifted to the Communications team, led by Mary Ellen Khan, Director.
This realignment may mean a shift in your South West LHIN contact. An updated contact list will be provided soon.
The updated organizational structure positions the South West LHIN to most effectively fulfill our mandate, collaborate
with health service providers and partners, and to better serve the people in the South West.
Another change that we have made is a refresh to our website to improve usability and to better align content with the
new IHSP 2013-2016. Thank you to those of you that provided feedback. We have done our best to incorporate as
many improvements to content, navigation and functionality as possible. You can see the changes at
www.southwestlhin.on.ca. While you are there open or update your ‘MyPage’ account. MyPage allows you to select
topics areas that you would like to be alerted about when content is updated. We will continue to improve and update
our website to make it as valuable as possible for visitors. If you have feedback, or difficulty finding content please
email [email protected]
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