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Overcoming the Challenges of Integrating Care by Creating a Movement: Enabling broad system integration through shared vision, principles, priorities and distributed leadership.

Author:

Dave Pearson

Central West LHIN / Ontario Health, CA
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Abstract

In February of 2019 the Ontario Ministry of Health, responsible for administering the health care system and providing services to the province of Ontario, announced a series of broad legislative and structural changes that will transform the organization and delivery of care. Part of this transformation is focused on creating a new way of organizing and delivering care locally through the development of Ontario Health Teams (OHTs).

Positioned as a multiyear evolutionary change, OHTs will be comprised of health and care providers committed to working as one coordinated team. Ultimately functioning under a single funding and governance structure similar to Accountable Care Organizations/Systems. Teams have come together and self organized through a formal readiness and full application process that began in March 2019 with teams receiving formal approval in December 2019.

A culture of uncertainty exist in the health care system after years of pilots and other tests of structural change. Today the health system landscape has varying levels of maturity and trust amongst physicians, patients and providers throughout the province. As OHTs are being considered this has led to wide variance in the scope, size and quality of proposals across the province.

In contrast, the proposed Hills of Headwaters OHT partnership has responded to the development with positivity. Locally referred to as the Hills of Headwaters Collaborative, a distributed leadership forum has been established to formalize procedural trust. The Collaborative is comprised of physicians and patients as well as executive level leadership from a broad range of partners including acute care, mental health and addictions, housing, public health, social services, community supports, hospice and palliative care.

Supported by The Change Foundation, a provincial policy think-tank, the Collaborative partnership held a broad community symposium to establish local norms for change. Specifically they created a shared purpose, a set of guiding principles, as well as validating the shared priorities that would focus early efforts. This was critical to establishing transparency in process and ability for all to influence and lead.

With a foundation in place the Collaborative has committed to creating integrated care frameworks for palliative care, mental health and addictions and supporting patients with complex care needs in year one. All partners have committed to co-designing new models of care together with patients and physicians informed by provincial and international quality standards and best practices. The approach will focus on outcomes and scaled change in 30, 60 and 90 day planning cycles.

Already and ahead of OHT formal approval a palliative care work group, supported by the Collaborative, has defined a core team, bundles of care and committed to deploying staff to develop a shared interprofessional End-of-Life Core Team. This framework was developed based on best practices with local implementation and evaluation co-designed by patients, physicians and providers.

By focussing on shared purpose, principles and priorities the Hills of Headwaters Collaborative generated early successes towards a positive movement for change. By its very nature a movement is shared and distributed and Collaborative partners are all leading and growing the momentum.

 

How to Cite: Pearson D. Overcoming the Challenges of Integrating Care by Creating a Movement: Enabling broad system integration through shared vision, principles, priorities and distributed leadership.. International Journal of Integrated Care. 2021;21(S1):246. DOI: http://doi.org/10.5334/ijic.ICIC20183
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Published on 01 Sep 2021.

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