CEO REPORT TO THE BOARD

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April 2015

The following is a compilation of the major activities/events undertaken during this

period in support of Mississauga Halton LHIN’s strategic directions;

Accessible and Sustainable Health Care

Improve access to services to improve consumer flow, quality and safety

Support consumers, families and health care professionals to navigate the health care

system

Improve sustainability of the health care system

Family Health Care When You Need It

Improve access to family health care

Increase linkages between family health care and other health care providers to improve

communication, coordination and integration across the continuum of care

Enhanced Community Capacity

Enable people to stay in their homes longer

Provide integrated services that bring care closer to home

Optimal Health – Mental and Physical

Increase healthy habits and prevention of disease

Build partnerships for healthy communities

High Quality Person - Centred Care

Support and foster a quality culture across the continuum of care

Value people’s experiences to support system improvement

Apply a health equity lens for the delivery of health care services

CONTENTS: MINISTRY OF HEALTH AND LONG-TERM CARE UPDATE 3 ANNUAL BUSINESS PLAN PRIORITIES 2015/16 5 Highlights 6 Accessible and Sustainable Health Care 7 Family Health Care When You Need It 12 Enhanced Community Capacity 14 Optimal Health – Mental and Physical 19 High Quality, Person-Centred Care 21 ACCOUNTABILITY 23 Ministry-LHIN Accountability Agreement 23 COMMUNITY ENGAGEMENT 26 COMMUNICATIONS 27

MOHLTC Updates Annual Business Plan

Priorities Accountability Community Engagement Communications

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April 2015

MINISTRY OF HEALTH AND LONG-TERM CARE UPDATES

Long Term Care Redevelopment

On October 28, 2014 the Associate Minister of Long Term Care and

Wellness announced the Ministry of Health and Long-Term Care (the

ministry) is engaging the Long-Term Care (LTC) sector to deliver on

a number of components that will enable the success of the Enhanced

Long-Term Care Home Renewal Strategy.

Across the province there are approximately 30,000 beds, located in

over 300 homes that have been identified for redevelopment. For the

Mississauga Halton LHIN this equates to a total of 10 homes and

1,336 beds.

The ministry is committed to working with stakeholder in the LTC

sector throughout this process and has actively engaged and sought

advice from the Stakeholder Advisory Committee.

As a part of the process the ministry has sent out an “Enhanced

Strategy Survey” to all eligible LTC home licensees/approved

operators for municipal homes. This survey was issued in order to

gauge redevelopment interest and project readiness within the sector.

Respondents have been asked to complete the survey by May 1, 2015.

The ministry will be scheduling meetings with each LHIN to review

the homes that responded to discuss specific issues/plans identified in

the surveys.

On April 20, 2015 the Mississauga Halton LHIN met with ministry

representatives to have an in-person educational session by the

ministry to provide an overview of the renewal strategy. Priorities

and updates of the Mississauga Halton LHIN were shared with the

ministry. The topics covered by the ministry included:

1) Overview and current status of Enhanced Long-Term Care

Home Renewal Strategy including:

• Updates to the Construction Funding Subsidy (CFS) Policy

• Design Standards (including the review process for

variance requests)

2) Licencing 101

Budget Update

The Provincial Budget has now been tabled in the legislature and it

aligns with the previous information and directions that had been

communicated to the Board. The growth in the Health component of

the Budget will still be less than the combined effects of inflation,

population growth and aging. Specific funding allocations will be

available within the next 3 to 4 weeks as the Ministry begins the roll-

out process. We have already been informed of our Health Links

allocation and can begin our own work on delineating the 2015-16 use

of those funds.



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April 2015

Home and Community Care Report

The Report of the Expert Panel has been released for public comment

and feedback and has been generally very well received. The

Ministry anticipates that they will be in a position to shortly release

their response to the Report. Discussion of the implications for the

LHIN will form part of future Board discussions as the Chair of the

panel, Gail Donner, will be the guest speaker at the Board Retreat in

June.

Capacity Planning Report

The Joint Seniors Capacity Planning process with Central West LHIN

is now complete. We have prepared a summary version of the report

that presents the high level findings as well as some of the Policy

implications for the changes in emphasis and direction that are

recommended. The report and methodology has been presented to all

of the other LHINs and received very positive feedback. We have

entered into discussions with the Ministry of Health on some of the

province-wide implications for the methodology.

Pan LHIN activities

The 14 LHINs have been actively pursuing a joint strategic agenda for

common priorities. These have been identified and have now been

cross referenced with the guidance provided by the Assistant Deputy

Minister on Ministry priorities for the upcoming IHSP process. The

concept of common priorities is that the LHINs will conduct some

collective work in these priority areas and then share that as better

practice across all LHINs. We believe this will accelerate the process

of improving Health Services across the province. The list of Pan

LHIN Priorities and CEO Leads is as follows:

PanLHIN Priorities CEO Leads

1. Mental Health Louise Paquette / Bruce Lauckner

2. Health Links Paul Huras / Laura Kokocinski

3a. Home & Community Care Laura Kokocinski / Gary Switzer

3b. Long Term Care Deb Hammons / Donna Cripps /

Bruce Lauckner

4. End of Life/Palliative Care Bill MacLeod / Gary Switzer

5. Patient Experience Kim Baker / Gary Switzer /

Michael Barrett / Jill Tettmann

6. Population Health Scott McLeod / Camille Orridge

7. Innovative & Sustainable

Service Delivery

Bill MacLeod / Chantale LeClerc



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April 2015

PROGRESS ON ANNUAL BUSINESS PLAN PRIORITIES 2015/16

ACCESSIBLE AND SUSTAINABLE HEALTH CARE FAMILY HEALTH CARE WHEN YOU NEED IT ENHANCED COMMUNITY CAPACITY OPTIMAL HEALTH – MENTAL AND PHYSICAL HIGH QUALITY PERSON-CENTRED CARE



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April 2015

REPORT HIGHLIGHTS

Ministry commits to working with LHINs and engaging

stakeholders for a successful in the new Long-Term Care renewal

strategy implementation.

Mississauga Halton LHIN endorsed Trillium Health Partners

(THP) combined Stage 1 Proposal and Stage 2 Functional

Program of the proposed Courtyard Project.

To inform the development of integrated community hubs,

Mississauga Halton LHIN will create neighbourhood profiles to

help identify regions that may be underserviced and have barriers

to accessing health and social services.

Addiction and Mental Health Adult Services Central Intake

initiative one-Link, moves ahead with plan-do-study-act (PDSA)

cycles at THP and Halton Healthcare Services including internal

testing of new common referral forms, tools and processes.

The Honourable MPP Kevin Flynn, Minister of Labour kicks off

Every Door is the Right Door, a Mississauga Halton LHIN event

dedicated to Customer Service Training in healthcare with a focus

on the eight (8) No Wrong Door Principles.

The second annual Primary Care Clinic day was held on March

27, 2015 with over 160 delegates registering for the event.

The Mississauga Halton LHIN hosted its second annual Health

Equity Symposium on Monday March 23, 2015 at the Centre for

Health and Safety Innovation.

MPP Flynn announces $2 million in mental health and addictions

funding for Mississauga Halton LHIN

UPCOMING EVENTS

Event

Date

Milton District Hospital Groundbreaking May 25, 2015

Governance to Governance Session

June 8, 2015

CGCG Meeting

June 8, 2015

Community Quarterly Sector Meeting

June 18, 2015

Board Retreat

June 19/20, 2015

Pan Am Games

July 10-26, 2015

Parapan Am Games

August 7-15, 2015



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ACCESSIBLE AND SUSTAINABLE HEALTH CARE

Life or Limb & Repatriation Policy Evaluation

The provincial life or limb policy is a “no refusal” policy for patients

with life or limb threatening conditions with the guiding principles of

the policy being triggered when a patient is life or limb threatened and

therapeutic options exist, which are needed within four (4) hours.

The Provincial reports are populated into the Mississauga Halton

LHIN Performance Scorecard System to inform, trend and monitor

performance. The system performance includes:

Follow-up letters for defined cases within two (2) business days

Weekly Life or Limb Reports

Hospital Performance

System Response Reports

Monthly Life or Limb Summary Reports.

The Mississauga Halton LHIN has collaboratively engaged in ongoing

communication, meetings and evaluations with the hospitals since the

inception of the policy in January 2014. The Mississauga Halton

LHIN’s performance is aligned to the provincial targets and is

trending well.

Mississauga Halton Life or Limb System Indicators April 2014 – March 2015

( Halton Healthcare Services and Trillium Health Partners)

System Indicators Year to Date (YTD)

Number of Requests for Consult 560

Number of Cases Referred 460

Number of Cases Confirmed as Life or

Limb

250

Percentage of Patients Arrived at

Designated Site Within the 4 Hour

Timeline

96.5

Mississauga Halton Repatriation June 2014 - February 2015

System Indicators Total Cases (YTD)

Repatriation – Sending 140

Repatriation – Receiving 72



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April 2015

Emergency Preparedness and Management

In preparation for the Toronto 2015 Pan Am/Parapan Am Games

2015, the Mississauga Halton LHIN actively participated with the

Ministry of Health, Regions, Hospitals and LHINs in a three day

“Celebratory Spirit Exercise” from April 14 – 16, that tested our

emergency preparedness. Over 40 hospitals along with 3 Community

Care Access Centres (CCACs), Public Health Units, LHINs,

paramedic services, and other organizations participated in mock

scenarios such as tornados, train derailment, outbreak, and heat, where

a newly implemented emergency management communication tool

(EMCT) was tested. As the Mississauga Halton LHIN further

prepares for the Games beginning July 10, 2015 and the beginning of

athlete arrival in June, emergency preparedness for all HSPs is a top

priority.

Regional Access and Flow

The Mississauga Halton LHIN is responsible for planning,

coordinating and allocating resources to hospitals and community to

ensure patients receive the right care based on their needs in the right

setting, and to heighten patient flow and transition through the

continuum of care across the region. To help facilitate patient flow

and transition, the newly revised Regional Access and Flow

Committee has included in the proposed terms of reference, a patient

first philosophy of care with a focus on seamless transitions within

and throughout the health care continuum. This will be achieved by

implementing a responsive, flexible, system-wide approach that

fosters a culture of regional collaboration, transparent communication,

system integration and accountability.

Connecting GTA (cGTA)

cGTA is a regional solution that supports the delivery of provincial

electronic health records by linking and integrating electronic patient

information from across the care continuum and making it available at

the point-of-care to improve the patient and clinician experience.

There are currently 16 data contributing sites across multiple LHINs

that are part of the early adopter phase of the project. The second

phase will expand to other data contributing sites and Health Service

Providers who will gain view only access to the cGTA data. Trillium

Health Partners (THP) is part of the early adopter phase and Halton

Healthcare Services (HHS) will be a data contributing site within the

expansion phase. Additionally within the expansion phase, four of

our HSPs will gain view only access. Kick off meetings took place in

Q4 2014/15 with our participating organizations. Planning activity is

underway and will continue into the fall of 2015.

Resource Matching and Referrals (RM&R) Clusters

Resource Matching and Referral Business Transformation Initiative

(RM&R BTI) program provides a way to streamline the complex

patient referral environment across Ontario.

Within the Mississauga Halton LHIN, our participating organizations:

THP, HHS and the Mississauga Halton CCAC have successfully

implemented the Provincial Referral Standards (PRS) for all defined

pathways. Work continues at a Provincial level into fiscal 2015/16 to

ensure all pathways have completed their implementation work across

all targeted organizations.


Priorities Accountability

Community Engagement

Communications

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April 2015

Governance to Governance Collaborations

Governance to Governance (G2G) session held on March 31, 2015

focused Personal Health Information Protection Act (PHIPA)

education and the Board’s role in privacy and data security. The

speaker was Robin Gould-Soil, Director Privacy and Access, and

Chief Privacy Officer, University Health Network who has expertise

in both the private sector as well as with the Office of the Privacy

Commissioner of Canada. She reviewed the PHIPA, provided her

perspective on what the new Privacy Commissioner of Ontario (Brian

Beamish) is focused on, and presented on the current privacy

landscape and the Board’s role in privacy and date security. The

session was well attended and the HSPs appreciated the opportunity to

ask their specific organizational questions throughout the session.

Feedback from this session was excellent as shown by some examples

of comments from the survey:

“The speaker was very knowledgeable and did a great job at

addressing concerns from the audience. It was a great way to

share relevant information.”

“Will serve as a good reference in future governance

discussion.”

“Although my knowledge on the subject matter is very high,

it's helpful to have a third party reiterate what I have been

requesting of my staff.”

“Important topic which could cause a great risk to our

organization if not handled properly”

“Gained a more comprehensive understanding of what is

required and current trends and process required in the

training of staff and recognizing our obligations for

compliance.”

The Community Governance Consultation Group (CGCG) is a LHIN

sponsored group consisting of 12 Board Chairs and Board Members

from our Community HSPs and three Mississauga Halton LHIN

Board members. The group met on March 31, 2015 and provided

very positive feedback on the Privacy and Data Security G2G session

and identified a future consultation to be held on June 8, 2015 on the

Integrated Health Service Plan (IHSP).

Capital Planning and Development

Trillium Health Partners

The Mississauga Halton LHIN provided a letter to the Ministry of

Health and Long-Term Care on January 15, 2015 endorsing the

combined Stage 1 Proposal and Stage 2 Functional Program of the

proposed Courtyard Project.

Community Capital

The Mississauga Halton LHIN has been working at identifying high

needs neighbourhoods using social risk indicators. The creation of

neighbourhood profiles will help to identify neighbourhoods that may

be underserviced, and may have barriers to accessing health and social

services. Profiles for neighbourhoods across the Mississauga Halton

LHIN will be used to inform the development of integrated

community hubs. Early visioning for this model includes a preferred

mix of health, social and recreational services designed to meet the



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needs of the local community. Broader stakeholder input into the

development of neighbourhood profiles will include local community

agencies to validate identified neighbourhoods and the potential

service needs.

Telemedicine

A small working group has been struck to develop strategic priorities

and a revised work plan for 2015-2016. The Group will also look

closely at the purpose and role of the committee members. With this,

new opportunities and technology will also be considered in addition

to the current telemedicine activities within our region.

Health System Funding Reform

In the context of mobilizing effort to implement Health System

Funding Reform (HSFR), a multi-year implementation provincial

funding policy, a regional group of HSPs convenes at the HSFR Local

Partnership Committee to discuss local impacts, implications and risks

associated with the implementation, and related mitigation strategies

for Quality Based Procedures (QBPs). The Committee is developing

its 2015/16 workplan and will incorporate feedback from the annual

evaluation of Committee objectives. Local efforts will include

ongoing performance evaluation of quality based procedures and

opportunities for regional collaboration; volume planning and

management and implementing a data quality framework.

Regional Hospice Palliative Care

The Regional Hospice Palliative Care Steering Committee (RHPCSC)

is considering a “Lead” vs “Host” model. Plans for issuing a “request

for interest proposal” to implement the model were delayed at the

request of the Mississauga Halton LHIN pending further information

from the newly formed Provincial Palliative Care Network (PPCD)

initiative. In the interim, the RHPCSC is working to complete a

palliative care inventory in the Mississauga Halton LHIN.

The Mississauga Halton LHIN invested in the Learning Essential

Approaches in Palliative Care (LEAP) with four courses presented in

late 2014-2015. There are now nine trained facilitators in place

delivering a consistent course. Ninety-three individuals completed the

LEAP course (including 35 MDs, 45 RNs). Mississauga Halton

LHIN is now working with Dr. Bob Sauls on a business case to

continue the investment in this important training.

Acclaim Health, Heart House Hospice and Dorothy Ley Hospice’s

business case for a regional Spiritual and Bereavement Service

Delivery Program was LHIN approved and funded. Full

implementation of the program will continue to progress through

2015/16.

The LHIN attended the annual Hospice Palliative Care Ontario

(HPCO) conference on April 19 - 21, followed by an all-day meeting

on April 22 with the Provincial End-of-Life Care Network and LHIN

Leads for Palliative Care.



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April 2015

Addictions and Mental Health

one-Link

The development and implementation of the Addictions and Mental

Health system access model one-Link continues. Throughout the

winter the new referral form and screening tools began internal testing

cycles at both THP and HHS. The new service resolution protocols

for case collaboration were being trialed and refined. Lean

methodology specialists mapped current intake processes at all ten

addictions and mental HSPs in preparation for upcoming wait list

management integration planning. Peer Support positions were

developed and hired to provide planning support during the

implementation phase and wait list management support. These

continual cycles of testing and refinement throughout the development

and implementation phase ensure that the system will have the

capacity and capabilities to manage the demand when the service is

launched.

“Every Door is the Right Door” Service System

Peel Addiction Assessment and Referral Centre (PAARC) was

identified as the lead agency to implement system wide (Mississauga

Halton LHIN) adoption of the No Wrong Door principles among the

participating Addictions and Mental Health agencies. This is a

philosophy of care based on eight (8) core principles, namely:

creating a welcoming culture; common practices and standards for

establishing client needs; collaboration and information sharing;

informed consent; shared educational opportunities; informing the

community about wait times, clearly stating eligibility criteria; and

timely service resolution. A charter was created to demonstrate a

commitment to adopting these principles and was signed by all ten

Mississauga Halton LHIN funded organizations. It was also signed by

two non-Mississauga Halton LHIN funded agencies. A celebration

and training event for Addictions and Mental Health organizations

was hosted on March 20 that included some opening and closing

remarks from key individuals from the community and the LHIN, as

well as a keynote from The Honourable MPP Kevin Flynn, Minister

of Labour. A half day dedicated to Customer Service Training in

healthcare was presented with a focus on the eight No Wrong Door

Principles. The participating agencies were acknowledged with a

presentation of a Mississauga Halton LHIN certificate of achievement

for their commitment to this philosophy of care.

Above: Graeme Goebelle (Chair, Mississauga

Halton LHIN)



Left to right: MPP Kevin Flynn (Oakville), Betty-Lou

Kristy, Graeme Goebelle (Chair, Mississauga Halton

LHIN)

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FAMILY HEALTH CARE WHEN YOU NEED IT

Electronic Medical Record (EMR) Implementation

OntarioMD manages the program, which is funded by eHealth

Ontario, and provides assistance to physicians in the adoption and

implementation of funding eligible EMR offerings.

The Mississauga Halton LHIN EMR adoption rate as of March 31,

2015 is 86%. This is 4% higher than the Provincial average. As

Trillium Health Partners gets closer to implementing Hospital Report

Manager (HRM), there should be an increase in adoption of EMRs

since HRM will enable physician EMRs to automatically receive

hospital discharge reports for their patients.

Hospital Record Manager (HRM) Implementation

OntarioMD's HRM enables physicians using EMRs to receive direct

electronic hospital reports into their patient's medical record within 30

minutes of transcription.

HHS has been live with HRM for approximately one year. Initial

delays in testing HRM have led to the decision for THP to hold off

until the fall of 2015 to resume implementation.

Primary Care Integration Strategy

The Primary Care Integration strategy, designed to improve access to

primary care and increase linkages between Primary Care and other

health care providers, is working towards initiatives that will build

awareness of health care system resources and capacity within the

Primary Care sector.

Primary Care Advisors Primary Care Advisors have launched their role and have started

meeting with Primary Care Physicians across the LHIN. Their initial

foci include: introducing their role; promoting the eConsult initiative,

Falls Prevention & Exercise programs, and CCAC’s Advanced

Palliative Care program along with an upcoming Oncology Day.

Primary Care Clinic Day The second annual Primary Care Clinic day was held on March 27,

2015 with over 160 delegates registering for the event. Over the

course of the day, Primary Care Providers learned about: clinical

topics including palliative care, geriatrics and caring for complex

patients; practice related topics such as billing codes and new regional

initiatives such as eConsult, and the eCompendium. The Primary

Care Network held their official launch at the event where keynote

speaker Dave Howlett spoke about breaking down silos and using

networks to enhance patient care. The delegates networked with

colleagues from their subLHIN geographies over lunch through

discussions facilitated by their Primary Care Network core member

and corresponding Primary Care Advisor. Within the exhibit hall,

Primary Care Providers were able to connect with 45 HSPs and

agencies to learn about the services and resources available within our

LHIN. The day was a great success with delegates commenting that

sessions offered practical relevant information that could be applied to



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their practices and the presence of community providers provided a

valuable opportunity to become aware of resources they can access.



Left to right: Primary Care Advisors: Shellie Diplock, Lindsay Fedchyshyn, Maged Guirguis,

Kristen Raiskums, Dave Howlett (Keynote Speaker at Primary Care Day 2015), Jennifer Tran

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April 2015

ENHANCED COMMUNITY CAPACITY

Seniors’ Strategy

The Seniors’ Strategy Steering Committee met in March to receive an

overview of the results of the Collaborative Community Capacity

Study. Continued review of the results, along with region reports and

provincial reports will be used to help determine the priorities for

2015 - 2016 planning for care for seniors in our communities.

The Senior Friendly Hospital Working Group will be implementing

the new Delirium Indicator as per their HSAAs for each hospital

respectively. The Working Group will continue to meet to further the

Senior Friendly Hospital Initiative, considering the Functional Decline

Indicator next.

The Specialized Geriatric Services program provided a summary from

a regional planning day, held on October 28, 2014. The summary

included:

Next steps from Year 1 (2015/16)

Principles of services design

Defined goals and improvement activities.

Advancement of Community Practice

Respite

The Caregiver Respite Program continues to target caregivers whose

loved ones have high needs/high acuity. Referrals to the program are

made to the Central Registry with one number to call. Respite

Advisors are in place and accessible through Central Registry. They

provide assistance with choice and navigation to the five (5) respite

services available. Some recent accomplishments include:

Development of processes for the newly appointed respite

advisors

Central Registry website is live, allowing for electronic

referrals and a central private information repository

Implementation of monthly minimum usage of eligible respite

hours, and reallocation of funding to support higher needs

clients (80% of funding going to highest needs)

Transformed two recovery beds at OSCR to short stay respite

beds (first clients were in early April, 2015)

Expanded on-site adult day services bathing program in select

sites

Implemented LHIN monthly data collection

Defined the criteria for emergency respite services.

Respite Program In-Home Respite Services Research Study

Completion of the University of Waterloo research study on the

Respite Program In-Home Respite Services concluded March 2015.

While the contribution of informal caregivers has been recognized as

a crucial factor in health system sustainability, limited attention has

been paid to how best to support caregivers. The objective of the

research collaborative between the University of Waterloo and the

Mississauga Halton LHIN was to evaluate the Caregiver Respite In-

Home Respite Services in order to identify if the right individuals



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were targeted for the service (high need/high acuity individuals and

their caregivers), if the service provided a positive impact that could

be measured, and if there was a return on investment from the service.

Initial analysis indicates that the Caregiver Respite In-Home Respite

Service has been potentially delaying LTC admission, resulting in an

annual saving to the system of an estimated $1.1 million dollars over

the two years of the program. Further, the analysis suggested that

some of the quality of life indicators experienced by the caregiver

predict care recipient admission to LTC. Results of the study are also

being used to inform interRAI’s ongoing refinement of the interRAI

Caregiver Survey.

The study also included the development of a new caregiver respite

assessment survey which will be trialed internationally.

In summary, the research study demonstrated that the Caregiver

Respite In-Home Respite Service:

Is using appropriate eligibility criteria;

Has been focusing on caregivers with high respite needs (the

targeted group); and

Has a positive impact on caregivers. This is a successful

service that has been enabling the community dwelling frail

elderly to age in place.

The outcome of the research and the return on investment report will

be provided to the Mississauga Halton LHIN in June 2015.

Exercise and Falls Prevention

The Exercise and Falls Prevention Collaborative just completed a very

successful first year, where they began to map out a recommended

Exercise and Falls Prevention Strategy for the Mississauga Halton

LHIN.

The Collaborative developed a vision statement that will be used to

guide the work plans of the collaborative. The focus for fiscal year

2015/16 is the development of a client process map that highlights the

client’s journey through the continuum of care as it relates to Exercise

and Falls Prevention. The consensus amongst the collaborative

members is that an individual's health status as well as the home

environment has an influence the risk of having a fall, which is a

major threat to the health and quality of life of older adults. There

were a number of recommendations made by the collaborative

members that will be included in the development of our regional

Exercise and Falls Prevention Strategy.

Education and Development

The Education and Development Collaborative was developed in

response to the needs identified through the community engagement

sessions and informed through a diverse, multi-participant think tank,

and brainstorming sessions that identified the needs of the community.

The target population is the Mississauga Halton LHIN HSPs and

informal caregivers/family with a focus to strengthen the capacity of

direct care providers (informal and formal caregivers) through

education and focused training to transfer new knowledge and best

practice skills.



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Leadership, education, resource library, and wvaluation were four

areas acknowledged as the foundation for the work/action plan that

aligns with the collaborative’s shared purpose: We will standardize the

methodology for the development and dissemination of evidenced

informed leading practice, aligned with continuous quality

improvement initiatives that advance the skills and

knowledge of HSPs, and informal caregivers/family within the

Mississauga Halton LHIN community.

Regional Learning Centre Update

The Mississauga Halton Regional Learning Centre has been created

for the community as an innovative educational resource to help

educate, train and support HSP staff and management as well as

caregivers in the Mississauga Halton LHIN.

Educational services and sessions began in June 2014. The total

number of educational sessions and participants both on-site and off-

site locations completed by the Community Educators in the first year

of operations at Regional Learning Centre exceeded the expectations

of the Mississauga Halton LHIN with results demonstrated in the

following table:

Continence

Continence Care Collaborative

The purpose of the Continence Care Collaborative will be to improve

the health, wellness and quality of life for Mississauga Halton

residents by improving access to assessment and treatment of

incontinence including urinary incontinence, fecal incontinence and

constipation. The inaugural meeting will be on April 30, 2015.

Mississauga Halton Regional Learning Centre Educational Sessions

June 2014 – March 2015

Session Number

Total number of educational sessions held on-site 99

Total number of educational sessions held off-site 7

Total Sessions 106

Participants Number

Total number of participants for on-site educational sessions 1,022

Total number of participants for off-site educational sessions 168

Total Participants 1,190



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Medication Management

Medication Management Interaction Levels Ranking Scale

(MMILRS) has been developed to determine the degree of

Medication Management (Interaction) in the Community Service

Sector programs for the purpose of developing policies and education

programs for better management of medication for clients on service.

Currently the HSPs are self-identifying their level, by program, using

the new ranking scale. The Collaborative is developing a medication

management framework and will be making recommendations to the

Regional Learning Centre to develop training based on client

interaction levels.

Behaviours

Fiscal year 2014/15 was a very busy year for the Behaviours

Collaborative. The membership consists of representation from every

sector of the Mississauga Halton LHIN and has varying levels of staff,

from front line to senior management, each bringing their own

valuable perspective to the table. With a vision to see “every

individual impacted by a responsive behaviour, has access to

coordinated, quality care and services”, the collaborative focused on

three specific areas:

Knowledge exchange and capacity building

System coordination

Service delivery

The achievements during this year included:

Revising the LTC and Adult Day Program (ADP) clinical

pathway documents

Formalizing the escalation process for complex behaviours

Creating an algorithm for various transfer points

Creation of a glossary of terms related to responsive

behaviours for consistent understanding across the various

sectors and HSPs.

The collaborative is now ready to start their work-plan for 2015/16

which will include:

Analyze and test the revised pathways and algorithms in the

appropriate settings

Creation of a guide book to accompany the revised pathways Development of a process map that will ensure system

navigation and coordination of client movement through the

continuum of care in the context of responsive behaviours

ensuring that we include the lived experience

Test and pilot the newly created algorithms for hospital to

LTC and LTC to hospital.



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April 2015

Services for People with Development Disability

The Mississauga Halton LHIN, working in collaboration with partners

from Ministry of Community and Social Services (MCSS) and

Ministry of Child and Youth Services (MCYS) funded services, has

worked towards developing more comprehensive health services for

people with developmental disabilities. Establishing a cross ministry

working group with the Central West MCYS MCSS regional office as

well as the Halton Developmental Services Planning table the LHIN

has begun work in the following areas for 2015/16:

Analyze the number of individuals with a developmental

disability in LTC, and assess the need for specialized

education and support in the LTC sector

Pilot a standardized transitional plan for individuals with a

developmental disability to move from community settings to

LTC

Analyze Emergency Department (ED) use patterns of people

with developmental disabilities to develop possible diversion

strategies.

Improved Services for People with Complex Care Needs

The Mississauga Halton LHIN in partnership with its HSPs is working

to provide improved services for people with complex care needs.

Work underway for 2015/16 includes:

Analyze Emergency Department (ED) use patterns of people

living in supported housing, and with acquired brain injuries,

to develop possible diversion strategies

Establishing a Memorandum of Understanding between the

HSPs to create assisted living environments for individuals

with acquired brain injuries and other complex care needs

Enhancement of assisted living services in the community

allowing individuals with complex care needs to age in place

Formalizing Memorandum of Understanding between

Children’s Treatment Centre and Trillium Health Partners to

provide a swallowing clinic for children with complex care

needs, thus eliminating the need for families to travel out of

the Mississauga Halton LHIN for services.



19 | P a g e

April 2015

OPTIMAL HEALTH – MENTAL AND PHYSICAL

Myhealth365

Myhealth365 is an integrative and innovative strategy with the focus

on both patient and provider. The strategy will closely follow

Ontario’s Patients First Action Plan for Health Care with a strong

focus on access, connection and information.

Myhealth365 builds on the previous successes of the Mississauga

Halton LHIN’s holiday surge work, namely, the valuable partnerships

across the region. However, in this iteration, it utilizes technology,

such as smartphone apps to make the process of finding care when

you need it user-friendly, cost-effective and quality controlled. The

strategy is also moving from a holiday centric strategy, to a year-long

strategy. In this way, we are reinforcing to residents of Mississauga

Halton their health is important every day of the year.

Most notably, two new aspects of the strategy are the implementation

of patient and provider profiles. With the patient profiles, residents

will now be able to save all their key information (e.g. local

pharmacy, physician’s hours) at their fingertips. Providers will be

able to create a login and update their information as changes occur,

therein, keeping clinic information up-to-date and accurate. This will

address any potential surge periods throughout the year as providers

will be able to update any clinic changes and it will be updated in real-

time. They will also be able to send messages to their patients, for

example, flu-shots or medication refills. Through this strategy

providers and residents alike will be able to be more proactive and

preventative than ever before.

To address the social determinants of health, patients will be able to

search for providers that are in their language of choice, where

parking is accessible and even where there are public transportation

options – removing those frequent barriers to care. The initiative is

currently going through its branding process and will have an official

launch this summer.

Chronic Disease Prevention and Management (CDPM)

The Chronic Disease Prevention and Management (CDPM) Regional

Advisory Working Group met in February after a successful

completion of the Mississauga Halton integrated model of chronic

disease prevention and management. The group has decided to do a

refresh, most specifically, looking at its governance model, terms of

reference, membership and its strategic plan for the 2015-2016 year.

The strategic plan will be aligned closely with the panLHIN strategic

directions for chronic disease prevention and management.

Key priority areas that have been identified in the Integrated Health

Service Plan (IHSP) 2013-2016 will be completed in the CDPM

strategic plan. Membership for the refreshed CDPM group will

include disease-specific sectors as well as the inclusion of community,

public health, persons with lived experience and self-management

with ad-hoc membership (e.g. primary care) as needed.



20 | P a g e

April 2015

Diabetes Central Intake

In November 17, 2014 the new eReferral system went live enabling

eReferrals between the Central Intake Program and the Diabetes

Education Programs. This is providing efficiencies in the internal

referral process between the Central Intake Program and the Diabetes

Education Programs and improved tracking mechanisms for referrals.

The eReferral system continues through the development phase and

launch to primary care is anticipated in Q2 2015/16. There were more

than 6000 Diabetes Education Program referrals processed through

Central Intake in 2014/15 and this represented a 212% increase in

number of referrals processed for the Diabetes Education Programs

versus 2013/14. An article highlighting the new e-referral system

being utilized in Mississauga Halton was published in Canadian

Healthcare Technology in March 2015.

http://www.canhealth.com/2015/03/ereferrals-used-to-manage-

diabetes-education/

Foot Care

The Mississauga Halton High Risk Diabetes Foot Care Program was

launched on May 20, 2014 by HHS with three community locations

(two in Oakville and one in Mississauga). This preventative foot care

program was established to support individuals in Mississauga Halton

with diabetes who are at high risk for complications and otherwise do

not have access to preventative foot care support. The program is

staffed by Chiropodists and Registered Practical Nurses with foot care

expertise. Eight accessible community locations were established in

2014/15. During the first year of the implementation, foot care

services were provided to 415 individuals. This number is expected to

increase with the addition of new sites in 2015/16. Referrals to the

program are only accepted from a Mississauga Halton LHIN Diabetes

Education Program and are processed through the HHS’ Central

Intake Program.

Foot care self-management Peer Education Program (PEP) workshops

will be established in collaboration with the diabetes education

programs. PEP is a standardized program created by the Canadian

Association for Wound Care to promote foot care self-management

skills and prevent foot ulcers. These self-management workshops will

support the High Risk Diabetes Foot Care Program. A standardized

screening tool and eligibility criteria for the High Risk Foot Care

Program has been established and extensive training has been

conducted with all diabetes education programs on the referral process

and implementing the 60 second foot assessment as a screening tool

for eligible clients.



http://www.canhealth.com/2015/03/ereferrals-used-to-manage-diabetes-education/

http://www.canhealth.com/2015/03/ereferrals-used-to-manage-diabetes-education/

21 | P a g e

April 2015

HIGH QUALITY PERSON-CENTRED CARE

Health Equity

A key focus for the Mississauga Halton LHIN System Planning

Advisory on Health Equity was on data collection initiatives aimed at

collecting socio-demographic data to apply an equity lens to better

understand health outcomes as well as inform program development

and organizational outreach to marginalized groups. To aid in the

development of understanding health inequities, a work group was

established to review the tri-hospital "We Ask Because, We Care"

report. Key questions were identified to shape a survey on the types

of socio-demographic data currently being collected by HSPs and

community partners in Mississauga and Halton. The findings will be

utilized to design a foundational framework which will help inform

the development and implementation of a standardized data collection

tool and focused implementation sites.

The Mississauga Halton LHIN hosted its second annual Health Equity

Symposium on Monday March 23, 2015 at the Centre for Health and

Safety Innovation. The focus of the symposium was to provide a

better understanding of the why, how and what is behind collecting

socio-demographic client data. This was accomplished via key

presentations, engaging activities, and insightful discussion. The

symposium keynote speaker was Dr. Kwame McKenzie, an

international expert from the Wellesley Institute and the Centre for

Addiction and Mental Health, who provided great insight into the

importance of data collection.



Above: Health Equity symposium keynote speaker: Dr. Kwame McKenzie

Above: Graeme Goebelle, Chair, Mississauga Halton LHIN

22 | P a g e

April 2015

French Language Services (FLS)

Across the province, Francophones organizations agreed on two

questions to better identify Francophones: 1) What is your mother

tongue? 2) If your mother tongue is neither French nor English, in

which official language of Canada are you comfortable to receive

services?

In order to have a better understanding of how health services

providers in the Mississauga Halton LHIN identify Francophones,

these questions were included in the data collection survey developed

in partnership with the Health Equity Advisory Committee.

FLS Identified and non -Identified organizations in Mississauga

Halton were asked to fill the annual FLS report on how they are

addressing the needs of the Francophone community. The results will

help to understand the French language capacity and the gaps within

the Mississauga Halton LHIN.



23 | P a g e

April 2015

ACCOUNTABILITY

Ministry-LHIN Accountability Agreement (MLAA)

The 2015/16 M-LAA has 22 indicators across four (4) Ministry

priority areas aligned with the Patients First Action Plan for Health

Care as follows:

Home and community care

System integration and access

Health and wellness of Ontarians including mental health; and

Sustainability and quality.

Three indicator categories for inclusion in the MLAA include

performance, monitoring and developmental level indicators.

Timelines and determining the target-setting approach are in progress.

Mississauga Halton LHIN Performance Scorecard System

(PScS)

The Mississauga Halton LHIN PScS is a customized software

application that the LHIN introduced in early 2014. The tool allows

us to more effectively manage performance information and have the

results available on-demand to internal staff to support system

development and decision making. The tool has now been rolled out

to hospital and CCAC, Decision Support staff, and will increasingly

be used by HSP program staff (e.g. ED Leaders, Wait Times

Committee, etc.).

While the tool is primarily used to capture hospital data at this point,

the intention is to add more indicators from other sectors (e.g. CCAC,

Community, LTC) as the data becomes available in order to develop a

more complete system perspective.



24 | P a g e

April 2015



25 | P a g e

April 2015

Service Accountability Agreements (SAA)

Long-Term Care Home Service Accountability Agreement

(L-SAA)

All long-term care homes in the Mississauga Halton LHIN have

received their amended L-SAA. The LHIN continues to work with

the homes to ensure the homes understand the Performance Standard

changes, so as to have the SAA executed by way of signature. As of

April 16, 2015 there were 50 percent signed SAAs with the remaining

awaiting board meetings for signatures.

Multi-Sector Sector Accountability Agreement (M-SAA) The Local Health System Integration Act, 2006 (LHSIA) necessitates

that the LHIN have a SAA in place with each HSP they fund. The

Mississauga Halton LHIN and community based HSPs have entered

into M-SAAs for a three-year period effective April 1, 2014 to March

31, 2017. The planning for the 2014/15 Community Accountability

Planning Submissions (CAPS) and the M-SAA Schedules was

reviewed and updated to incorporate the financial, service

information, and performance expectations for fiscal 2015/16 and

2016/17. This process is defined as the 2015/16 CAPS and M-SAA

Schedule Refresh. We continue to work in collaboration with the

HSPs in the Mississauga Halton LHIN towards the completion

process of the M-SAA Refresh for 2015-16.

Hospital Sector Accountability Agreement (H-SAA)

Both Halton Healthcare Services and Trillium Health Partners have

executed their 2015/16 H-SAA. Both hospital corporations submitted

balanced budgets. The LHIN will continue to work with both

corporations to finalize and update performance targets. The 2015/16

H-SAA included local performance conditions as follows:

Health Equity;

French Language Services; and

Senior Friendly Hospitals.



26 | P a g e

April 2015

COMMUNITY ENGAGEMENT

Community Engagement (Patient/Family Committee

Participation)

A Community Engagement Framework has been developed and is

being implemented internally with Mississauga Halton LHIN. A large

community engagement effort will ensue during the months of May

and June to contribute to the development of the Mississauga Halton

LHIN’s Integrated Health Service Plan (IHSP) 2016-2019. Patients

First will be a priority approach to these engagement efforts. Putting

“patients first” means engaging with people within our individual

LHINs so that we fully understand their needs and we can respond

with investments and initiatives to strengthen the local health care

system so that it is more coordinated and a patient can get the right

care from the right providers.



27 | P a g e

April 2015

COMMUNICATIONS

Media Relations Several news releases and media stories referenced Mississauga

Halton LHIN from February to April 2015.

News Releases

March 18, 2015 (Oakville) - Investing in Community Mental Health

And Addictions Services In Mississauga Halton LHIN - Ontario

Connecting People With the Care They Need Closer to Home

News Coverage – Mississauga Halton LHIN

Flynn announces $2 million in mental health and addictions

funding for Mississauga Halton LHIN - Oakville Beaver –

March 20, 2015

Those dealing with mental health and addiction will see $2 million

invested in services designed to help them, Oakville MPP and

Ontario Labour Minister Kevin Flynn announced Wednesday.

Publications

The Governance Centre of Excellence (GCE) presented their tenth

issue of Boards, its quarterly official publication and source for

articles, news, announcements and information from the field of

health care and not-for-profit governance.

The February 2015 issue contains an interview with Mississauga

Halton LHIN Vice Chair Ronald Haines (pages 12-13). In

addition, the GCE welcomed our newest board members - Mary

Davies, Patrick Hop Hing, Kimbalin Kelly and Gulzar Ladhani.

(Photo and bios pages 15-16)

To download Boards - February 2015 click here.

Engagements

Website

The Mississauga Halton LHIN website continues to be a primary

vehicle for both communication and engagement with our

stakeholders. Translation of website content into French is complete

and accessed by clicking on the Français tab on the page.



http://www.mhlhin.on.ca/newsandevents/newsreleases/PressReleases/MentalHealthAnnouncement-March182015.aspx

http://www.mhlhin.on.ca/newsandevents/newsreleases/PressReleases/MentalHealthAnnouncement-March182015.aspx

http://www.mississauga.com/news-story/5517312-flynn-announces-2-million-in-mental-health-and-addictions-funding-for-mississauga-halton-lhin/

http://www.mississauga.com/news-story/5517312-flynn-announces-2-million-in-mental-health-and-addictions-funding-for-mississauga-halton-lhin/

http://www.thegce.ca/Pages/default.aspx#1

http://www.thegce.ca/THOUGHTLEADERSHIP/Boards/Documents/Boards%20February%202015%20Issue%2010.pdf

28 | P a g e

April 2015

Reports

Bringing Care Home

Modernizing home and community care is a

priority for the Minister of Health, and a key

element of the 2015 Patients First: Action Plan

for Health Care. In response to the growing

challenge to provide increasingly more

complex care over a longer period of time to

individuals in their homes, the Minister of Health and Long-Term

Care appointed the Expert Group on Home and Community Care with

a mandate to provide input on strategies to address these issues. In

mid- March 2015, the Expert Group on Home & Community Care

released its report.

The report identified 16 recommendations in a few specific areas:

That the planning and delivery be reflective of truly Client-

and Family Centred Care.

Support for Family Caregivers. Caregivers urgently need

respite along with access to information about available

services and how to access them.

Clearly defined, publicly funded “basket of services”.

Capacity Planning - Ensuring that Ontario’s health system

has the capacity and resources to deliver the core “basket of

services” and;

At the strategic level, primary care should be better aligned

with other sectors (primary care providers, hospitals and other

members of the home and community circle of care) and more

accountable for client and system outcomes.

The Expert Group indicated that they had found many pockets of

excellence in home and community care in Ontario through their work

but in many cases the programs were implemented on such a small

scale that they cannot contribute in a meaningful way to system-wide

culture shift needed to ensure the system is both high performing and

client-and family- centred.

Their recommendations are intended to provide a starting point for

beginning the culture change needed to create a truly client and

family-centered home and community care sector. To read the report

and recommendations please click on the following link:

http://health.gov.on.ca/en/public/programs/ccac/docs/hcc_report.pdf

Experiencing Integrated Care: Ontarians’ views of health care

coordination and communication

Health Quality Ontario released a report on

patient experiences of care coordination and

communication. The Experiencing Integrated

Care: Ontarians’ views of health care

coordination and communication report

reveals that Ontario ranks among the best in

Canada and internationally when it comes to certain measures of

coordination of care and communication between older patients and

their health care providers. The report also uncovers where Ontario

could improve.


Priorities Measurement and

Performance Notable Sector

Engagement Communications


http://www.hqontario.ca/Portals/0/documents/pr/report-experiencing-integrated-care-1504-en.pdf





29 | P a g e

April 2015

The report uses data from the Commonwealth Fund International

Health Policy Survey of Older Adults to compare Ontario’s

performance with the rest of Canada and 10 other countries.

For more findings and to download a copy of Experiencing Integrated

Care visit www.hqontario.ca

Mississauga Halton LHIN Annual Report 2013/14

The Mississauga Halton LHIN 2013/14 Annual

Report, Building Capacity Through Innovation:

Shaping the Future and a Better Health Care System

was tabled in the legislator on April 9, 2015. The

report has now been posted on our website. To read

or download a copy of the report, please click on the following link:

http://www.mhlhin.on.ca/~/media/sites/mh/Primary%20Navigation/A

ccountability/AnnualReports/MississaugaHalton_LHIN_AR_2013-

2014_English_Final.pdf?la=en

Press Conferences

Mental Health Funding Announcement

Support and Housing Halton (S&HH) hosted Oakville MPP Kevin

Flynn as he announced a $2 million investment in local mental health

and addiction for high priority services initiatives. The MPP was

joined by Graeme Goebelle (Mississauga Halton LHIN Chair) and

John Smith (CEO S&HH), along with representatives from all ten

local mental health and addiction agencies.

Left to right: MPP Kevin Flynn (Oakville), John Smith (Executive Director, Support & Housing

Halton), Graeme Goebelle (Chair, Mississauga Halton LHIN).



http://emailcc.com/collect/click.aspx?u=/G1GTPto3VWK+H6Z90rCBj+bZJrwCl1g&rh=ff001ea3ecc8a7efb5d00858494787721d098120

http://www.mhlhin.on.ca/~/media/sites/mh/Primary%20Navigation/Accountability/AnnualReports/MississaugaHalton_LHIN_AR_2013-2014_English_Final.pdf?la=en



http://www.mhlhin.on.ca/~/media/sites/mh/Primary Navigation/Accountability/AnnualReports/MississaugaHalton_LHIN_AR_2013-2014_English_Final.pdf?la=en

30 | P a g e

April 2015

Notable Mentions

Awards of Recognition

Congratulations to Dr. Bob Sauls, Mississauga

Halton LHIN RHPCSC Chair (2012-14), who was

recognized by HPCO for his contribution to

advance community palliative care. The Dr. S. Lawrence Librach

Award for Palliative Medicine in the Community is given to a

physician who demonstrates excellence and leadership in palliative

care and advances palliative care in their communities through

mentorship of family physicians.



Dr. Bob Sauls (center) receives The Dr. S. Lawrence Librach Award for Palliative Medicine in the Community.

http://www.hpco.ca/

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