The Change Foundation (the Foundation) is an independent health policy think-tank that works to inform positive change in Ontario’s health care system. With a firm commitment to engaging the voices of patients, family caregivers and health and community care providers, the Foundation explores contemporary health care issues through different projects and partnerships to evolve our health care system in Ontario and beyond. The Change Foundation was created in 1995 through an endowment from the Ontario Hospital Association and is dedicated to enhancing patient and caregiver experiences and Ontario’s quality of health care.


The Change Foundation’s Vision:

To be a key influencer and advisor in Ontario’s health care system to ensure providers, patients and caregivers have an equal voice in informing positive change.

The Change Foundation’s Mission:

Dedicated to evolving Ontario’s health care system by enhancing patient and caregiver experiences and exploring contemporary health care issues. TCF works on projects and partners with organizations that have the same goal of informing positive change in the province’s health care system.

The Change Foundation aims to:

Make patients, family caregivers, and health providers equal partners in finding ways to improve care and experience in Ontario’s health care system.

Generate robust and independent research and policy analysis of health care issues related to improving care and experience of patients and caregivers as they navigate the health care system.

Lead informed discussion and strategic engagement with the stewards, stakeholders and users of the health care system.

20 Years of Change, 1995-2015

The Change Foundation (TCF) was founded by the Ontario Hospital Association (OHA) to “promote, support and improve health and the delivery of health care” in Ontario. TCF’s initial business model was formed based on The King’s Fund in the UK, with three streams: applied research and analysis, development projects and education initiatives.
In 1995, TCF provided grant funding for the second phase of the Ontario Case Costing Initiative, which was established in 1992 by the OHA and the Ministry of Health and Long-Term Care (MOHLTC) to improve decision support by collecting and analyzing case costing data and to develop hospital funding methodologies. TCF involvement continued until 2005, when the OHA took it over as one of their core programs.
Management of Emergency Stroke Care
TCF funded a program, led by the Heart and Stroke Foundation, to develop and implement the promotion of effective management of stroke emergencies in London, Hamilton and Kingston. The program’s success was a significant factor in the creation and launch of Ontario’s Stroke Strategy.
Kingston General Hospital (KGH) developed the Waiting List Management System (WLMS) software, through funding from TCF. This software application for recording elective surgery wait lists, led by Dr. W.J.S. Marshall and John Lott, later became a commercialized product, now owned by Novari Health.
In 1998, TCF began operating study tours for health care executives as an opportunity to learn from and share expertise with other leading health care jurisdictions. Three regular tours were set up to the UK, Sweden and Norway, and Australia and New Zealand. In total, there were 13 tours, and 158 participants, primarily from Ontario before the program ended in 2007.
Ongene was created as an online resource centre, led by Phillip Wyatt and funded by TCF, to provide clinicians with information on the availability of genetic services in Ontario, in an efficient, effective, and economic way. Ongene was used as the prototype for the national genetic testing website. Due to its success, in 2004 MOHLTC provided ongoing operational funding.
The MOHLTC joined TCF as a co-funder for our grant program. In partnership with the MOHLTC Nursing Secretariat, new grants for nursing research were set up.
In response to the gap in the system exposed by the SARS crisis, TCF funded the creation and evaluation of an online interdisciplinary course to increase knowledge of infection prevention and control. Led by Robert Duke and done in partnership with MOHLTC, the course was endorsed by Infection Prevention Agency of Canada and used broadly at Centennial College.
Led by Dr. Linda Rabeneck, TCF funded a change initiative meant to build non-physician colorectal cancer screening capacity in Ontario. The project led to significant changes to Ontario’s health policy surrounding colorectal cancer screening and the launch of ColonCancerCheck, Canada’s first province-wide colorectal cancer screening program.
Led by Dr. Robert Reid, an Integrated Health Systems model for hospital- based smoking cessation programs was developed using the Ottawa Model for Smoking Cessation, which is still used today. The project was funded by TCF, with matching funding from the former Ministry of Health Promotion.
TCF redefined our organization as Ontario’s Health Care Think Tank, intent on making a meaningful and unique contribution to the system, by focusing on areas where we could make the biggest difference.
TCF launched The Meeting of the Minds, a facilitated forum for select health care leaders to have frank and substantive discussion on top of mind health care and system issues. Since 2008, we have held four sessions, and attracted the who’s who of Ontario health care.
TCF’s inaugural health integration report Who is the Puzzle Maker? showed that the patient experience and perspective were absent from the literature on the health system and integration. This report defined our focus: health system integration and improving the patient experience, by partnering with patients and caregivers as experts.
Dr. John Hirdes’ research on services that frail, elderly patients with heart failure use in their homes, funded by TCF, was the foundation for the Cardiac Care Network (CCN) of Ontario’s 2014 Strategy for Community Management of Heart Failure.
The Centre for Healthcare Quality Improvement (CHQI) became part of TCF on July 1, 2008 from the MOHLTC. It provided training, coaching and support for quality improvement in Ontario’s health care organizations through the Flo Collaboratives, the use of the Triple Aim Framework and the introduction of the Leadership for Performance Excellence program. CHQI became part of Health Quality Ontario (HQO), when its mandate was expanded in 2011.
TCF launched our speaker series Hot Talks on Health, to supplement our Meeting of the Minds, and offer a wider audience an opportunity to learn and engage on timely and targeted health care issues. Five events have been held, and our Hot Talks materials have been downloaded over 11,800 times.
TCF commissioned Dr. John Hirdes, to examine data on Ontario seniors with chronic conditions, many of whom contribute to the Alternate Level of Care (ALC) challenge in Ontario. Based on his research, TCF published our Because This is a Rainy Day report, outlining how this population uses homecare services, what their health care needs are as they move from hospital to home or community care, and the implications for their caregivers.
The Northumberland PATH project was created in 2011 as the first system-wide patient, caregiver and provider co-design venture of its kind in Ontario. It brought together over 160 patients and caregivers, 12 organizations and 190 health care professionals. The project has shown that patient and caregiver engagement can become a community norm, and by putting patients at the heart of quality improvement, you can make impactful changes on health care usage rates, patient experience ratings and communication between patients and providers.
A panel of 31 Ontario patients and caregivers, PANORAMA was created as a forum to exchange views, experiences and provide advice to help TCF improve the health care experience in Ontario. The panel was reflective of a growing proportion of people living with chronic health conditions or providing care for someone who is, who came together – physically and virtually – for two years as advisors to TCF.
Working in partnership with Ontario communities and LHINs, TCF offered 12 regional workshops on patient engagement between 2013 and 2015. The workshops were developed to build capacity within Health Links for meaningful patient engagement, and were designed to meet the specific needs of each local community.
The Change Foundation celebrates our 20th Anniversary at our Capstone Summit on March 9 and 10, 2015.
In honour of our 20th anniversary, 20 Faces of Change Awards are presented to 20 people, groups and organizations that are leaders in engaging with patients to make positive change in the health care system.
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