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We are an independent policy think tank, intent on changing the health-care debate, health-care practice and the health-care experience in Ontario.
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Two ways to get involved from the comfort of home This week, The Change Foundation began a series of six face-to-face consultations across the province to talk to seniors with chronic health conditions to better understand the quality of their experiences, transitioning from one kind of care to another. What can we do to improve these experiences and ensure that people don’t fall through the cracks? Seniors living with chronic illness and their family and friend caregivers are invited to tell us their story or join the conversation. Here’s how: 1) Share your Story through our online storybook questionnaire probing your/ or your family’s experiences moving through common healthcare transitions, such as going from your family doctor or specialist to labs/clinics, or moving from hospital to home with community care or on to long-term care. It will only take 15 minutes. Among the questions we'll ask: Are you clear what the next step in your care is, and when it will happen? If you’ve had a good experience, what made it so? 2) Register for one of our upcoming audio/online webinars, taking place on Saturday, December 10 from 9:30 to 11:30 pm and Thursday, December 15 from 6:30 – 8:30 pm. These two-hour "telephone town halls" will explore similar questions and feature facilitated, interactive discussions allowing for an easy mix of computer and/or telephone input. For more information: amacleod@changefoundation.com. The Change Foundation has just finished consultations in Dryden (Nov. 14th) and Timmins (Nov.16th), and next stops are in Peterborough (Nov.23rd), London (Nov. 30th), Toronto (Dec. 1) and Smith Falls (Dec. 5). We will report back in the New Year on what we heard from seniors and their informal caregivers across the province. These sessions are the first phase of a bigger public engagement plan, which wraps up with a Summit in 2015, to consolidate our recommendations to Ontario decision-makers. This collective public input will also inform the Foundation's cornerstone PATH project. Personal narratives can be powerful tools to ignite change. They make our system-level problems more real and their telling can help solve them. We welcome your input.
Next month, The Change Foundation will be in listening and learning mode, walking our strategic plan's talk by hearing directly from seniors/caregivers in six face-to-face forums and two online engagements. In the north, south, east and west, we'll be talking to seniors with chronic health conditions to get a better understanding of the quality of their experiences, and to probe what would have made transitioning from one kind of care to another, easier. For instance, how smooth is the hospital to home care move for seniors with chronic health conditions? What about accessing test results and other diagnostic supports during the back and forth of family doctor and specialist visits? The Foundation will also create a micro-site to directly capture patient and caregiver stories to augment what we hear on the regional roads. These sessions are the first phase of a bigger public engagement plan, which includes a Citizens Online Panel (2012-15), more regional consultations (summer-fall, 2014), and a wrap-up Summit in 2015 to consolidate our recommendations to Ontario policymakers. The plan was informed by earlier in-person and online engagements with Ontario seniors. This collective public input will inform the Foundation's PATH community care redesign project, the cornerstone of our 2010-13 strategic plan. We'll finalize the six locations for the engagement sessions shortly; right now you can visit our patient/caregiver portal to either weigh in yourself or learn from the wisdom of the crowds about how to improve the patient experience in Ontario.
Last June, at the start of Ontario's pre-election summer, The Change Foundation brought in The Institute of Healthcare Improvement's Barbara Balik to present our 3rd Hot Talk on Health in partnership with the School of Public Policy, U of T. Watch a video of her dynamic keynote, Making Sense of Patient Experience - Partnering with Patients and Families - Part 1 & Part 2 and read her presentation (pdf). The event drew a crowd of more than 150 curious minds, leading healthcare practitioners and policy thinkers to hear how partnering with patients and families is actually done. Balik shared her insight gathered from decades of practicing, leading, and advising on patient-centred change across many US health-care systems. Her talk focused on shifting from "doing to" patients to "doing for" patients -- and ideally, to respectfully working with patients and families as equal partners in decision making about their care. Balik's well-evaluated talk was followed by spirited and thoughtful reflections by a panel of august Ontarians: Susan Eng, VP, Advocacy, Canadian Association of Retired Persons (CARP), Danielle Martin, Chair, Canadian Doctors for Medicare, and Adalsteinn Brown, Chair, Public Health Policy, Dalla Lana School of Public Health U of T, and former ADM of Health. Hear their top ideas on how to move Ontario's system towards quality improvement goals mandated by Ontario's Excellent Care for All Act. Finally, hear a lively Q & A from the floor with a lead question from the Patients' Association of Canada. We also recommend the following paper by Balik.
The key question on the table during our 2011 Meeting of the Minds was what role do access, communications, and engagement (ACE) play in teasing out a better experience for people interacting with the healthcare system? In response, the previous night's Hot Talker, IHI's Barbara Balik, delivered another substantive keynote, Getting in Gear: What Drives an Exceptional patient and family experience, this time focused on key drivers of change. See agenda. Hear audio of Balik's June 21st talk: Part 1 & Part 2. Finally, hear a lively Q & A including Toronto CCAC CEO Stacey Daub's inquiry on what patient-centred care means in a community vs. hospital setting. The assembly gathered more than fifty keen minds including patients, providers, healthcare leaders and change-makers of all kinds from across Canada, the US, and the UK. To lead and ground the discussion, Foundation CEO Cathy Fooks framed the day's discussion by differentiating patient-centred care, patient engagement and patient experience, underscored by a new video, What's your patient experience story and how do we change it? For other videos and presentations from Meeting of the Minds 2011, see below: Patients
Healthcare Leaders UK
Canada:
On October 2, The Change Foundation's CEO Cathy Fooks shared with CBC radio listeners her own challenging healthcare experience coordinating home-care services for her elderly parents, both of whom are now deceased. Her more than 20 years of experience working in health policy were tapped by CBC Metro Morning radio reporter, Mary Wiens, as part of the Indignity of Aging series. Cathy's personal story illuminated common coordination and communication challenges faced by many Ontarians accessing home and community services and underscored Wiens' characterization of the current state of home care as "impenetrable." Drawing on the Foundation's work, Cathy also emphasized the underlying need to better integrate home care with primary care and other parts of the healthcare continuum to build a real system for patients and their families to improve both care and experience. Host Matt Galloway rightly noted that if the head of a healthcare think tank can't figure out our system, then what hope is there for the rest of us? The Indignity of Aging series explores ways to improve home and community care for Ontario patients, caregivers and providers. Hear Cathy's Metro Morning interview (click on Part 5). To learn more on the topic, read the following Change Foundation analysis based on primary research:
As you may know, on June 21, 2011, The Change Foundation launched a unique signature project called Partners Advancing Transitions in Healthcare (PATH): A first with Ontario patients. The Foundation is currently accepting submissions from Ontario communities interested in taking part in this innovative, ground-breaking project to improve patient experience. If you plan to submit a Letter of Intent package, just a quick reminder that the deadline is fast approaching. Send the application package - LOI Submission Template, Partnership Profile form and three letters of support to Genevieve Obarski, gobarski@changefoundation.com, 416-205-1564, no later than 2 PM on Friday, October 14, 2011. Please note the main contact for these submissions has changed (previously Hasmik Beglaryan). Read these Q&As and LOI Guidelines to help you complete those documents and see key dates ahead in the process. The aim of PATH is to engage and support a community coalition of providers and patients and their family and friend caregivers to redesign care delivery to address problems that they identify together. The Change Foundation will select one community and will provide resources to that community to build and support the provider-patient partnership, engage patients and caregivers in co-design, provide process design and improvement expertise, and to manage the project overall.
Thursday, September 8, 2011, 11am to 12noon
Change, as they say is constant, and while the Foundation is all about progressive change in healthcare, when it comes to our Board, change-up is both invigorating and bittersweet. As of our June 9th Annual General Meeting, new talent on board to help steer our strategic PATH ahead: Jim Elliott, Marcia Visser, and Douglas Sinclair. Jim Elliott is a retired senior healthcare administrator and consultant who brings vast financial acumen to his new role as treasurer. Jim takes over this role from Neil Stuart who continues on the board. Marcia Visser brings more than 20 years of diverse experience from the Canadian and U.S healthcare sectors to our board. She has been a member of OHA's Region 3 Regional Executive Committee since 2008, and was elected to the OHA Board in 2009. Our third new face, MD Douglas Sinclair, adds valued frontline, executive clinical expertise from the field as the current Executive VP and Chief Medical Officer of St. Michael's. Douglas spent the last two decades in Halifax in a number of progressive leadership and academic healthcare roles. We say adieu and offer heartfelt thanks to outgoing chair, Scott Dudgeon and former chair, Gail Donner; these dedicated stalwarts have provided much advice, expertise and heart over the last six years during a challenging and exciting time for the Foundation. They were both instrumental in helping to hone and shape our vision. Two board members will take on new roles: longstanding member Sheila Jarvis, President and CEO of Holland Bloorview Kids Rehabilitation Hospital, becomes our new chair. And, Susan Pigott, Vice President, Communications and Community Engagement at the Centre for Addiction and Mental Health (CAMH), is now chair-elect. See our current 12-member board roster, from now until our 2012 AGM. We look forward to collaborating with old and new alike on the exciting work ahead.
Understanding the perspectives and experience of community-based providers is an important input to understanding and improving the experience of individuals and their caregivers. What does integrated care mean to the range of providers who deliver home care and support services in the community? What do they think are the most important elements of integrated care, and how do their experiences stack up against them? We captured frontline views from care coordinators, regulated health professionals (registered nurses, nurse practitioners, advanced practice nurses, registered practical nurses, physio and occupational therapists, speech language pathologists, dietitians, social workers, respiratory therapists, and pharmacists) and personal support workers. The work, encapsulated in a new report released today, Integration of Care: The Perspectives of Home and Community Providers, complements the Foundation's earlier work (June 2008) probing patient/caregiver perspectives on navigating the system.
Interested in improving the healthcare journey in your community? The Change Foundation seeking a coalition of providers, patients and caregivers as it launches unique project to improve seniors' healthcare experience The overarching goal of The Change Foundation's Strategic Plan is to improve the individual and informal caregiver's experience as they move in, out of, and across Ontario's healthcare system over time, as their health changes. To help reach that goal, the Foundation promised "to scout for, incubate and create innovative quality improvement solutions to address key problematic transitions in healthcare delivery identified by those who use the services and those who care for them." Over the next four years, The Change Foundation is channelling its resources into making that real. In The Storyboard, we explain that we have narrowed our patient focus to seniors with chronic health conditions and their family and friend caregivers. And now, we begin our search for a coalition of providers, patients and caregivers in one community/region in Ontario committed to working differently -- to co-designing improvements that span the continuum of care, to making improvements that stick and can spread across the province. To that end, we are launching a unique signature project called Partners Advancing Transitions in Healthcare (PATH): A first with Ontario patients. The Project and The Purpose The aim of PATH is to engage and support a community coalition of providers and patients and their family and friend caregivers to redesign care delivery to address problems that they identify together. Read these LOI Guidelines for more information. "We think this work is bold and groundbreaking and has great potential to cement and incite change," said The Change Foundation CEO Cathy Fooks. "Together with our partners in the community, we will try to prove in the field that you can successfully co-design - with health-system users and providers - services, processes, journeys, and systems in Ontario that will be sustainable across the continuum of care." The Pitch The Change Foundation will select one community and will provide resources to that community to build and support the provider-patient partnership, engage patients and caregivers in co-design, provide process design and improvement expertise, and to manage the project overall. Through involvement of a broad partnership reflecting the continuum of care, PATH will focus on seniors with chronic health conditions and on improving their whole healthcare experience as they transition between and among healthcare settings. The Process This innovative multi-year investment will use a competitive process to select a community willing to work with patients and caregivers to look at all aspects of its service delivery, and to make changes where needed. It will be a two-staged selection process beginning with this letter of intent phase over the summer and early fall followed by an invitational Request for Proposal process in the late fall/early winter. We invite organizations to come together to assemble a coalition of community partners and to submit an LOI to be considered for selection as the PATH partnership to co-design care transitions. We encourage you to contact us for more information or with any questions you might have. Please email: hbeglaryan@changefoundation.com or gobarski@changefoundation.com. Next on the PATH After reading the LOI Guidelines, you will need to fill out the Submission Template and the Partner Profile. Read these Q&As to help you complete those documents. The Mini-Movie Preview If you want to grasp what The Change Foundation and the PATH project are all about, watch Who is the Change Foundation? It will take less than two minutes.
The Change Foundation & The Health Strategy Innovation Cell release Guide, e-Toolkit, & 1st dynamic directory of healthcare social media users in Canada to help organizations improve patient experience CAMH and Providence Healthcare testing grounds for unique project The Change Foundation, in partnership with the Health Strategy Innovation Cell at Massey College, has released a suite of timely, interactive resources for healthcare organizations to help them better understand social media - its potential and limitations -- and prompt them to use these tools to capture and improve the patient experience. The products are the result of a two-year collaboration that included work with Ontario field partners, The Centre for Mental Health and Addiction (CAMH) and Providence Healthcare. The Foundation funded the project and worked closely with the Innovation Cell from beginning to end with an expert advisory council of social media and healthcare experts. "We learned that healthcare organizations in Canada are not yet taking advantage of social media for quality improvement purposes," said The Change Foundation CEO Cathy Fooks."This project was an opportunity for us to explore whether social media could help organizations get information from a broad spectrum of patients, and begin to engage with them with an eye to designing care and services that improve their experiences." Innovation Cell CEO Neil Seeman said: "Many patients are already online - and the next generations of patients and caregivers will conduct more and more of their daily activities through social media. We are confident that, by joining them there, you can open new doors to patient engagement, particularly by listening to how patients define what quality means in their own healthcare experience." Resources released today: Using Social Media to Improve Healthcare Quality: A Guide to Current Practice and Future Promise Part 1, Introduction and Key Issues in the Current Landscape, includes scans of the fast-changing social media environment. For the social media novice and initiated alike, the guide reports on how healthcare organizations are using social media, probes the link to quality improvement, features leading practices, opportunities and limitations, and addresses head on issues such as privacy, data control, ethics, and return on investment. Part 2, Exploring Two Case Examples and Imagining the Future, offers practical learning from 10-month explorations with the project's field partners: the Centre for Addiction and Mental Health (CAMH), Canada's largest mental health and addictions teaching and care delivery institution; and Providence Healthcare, a Toronto-area teaching hospital specializing in rehabilitation and geriatric care. Before the project, both organizations were just testing the social media waters. Afterwards, both reported a much greater understanding of the implications and opportunities presented by social media and increased capacity to make well-informed and strategic decisions about its uptake. Both organizations moved quickly to reflect and build on what they gleaned. e-Toolkit & Canada's first open and user-editable directory, hosted by The Innovation Cell The e-Toolkit holds all the content from the guide and will host real-time updates on what's trending in discussions in the field. It includes Canada's first open and user-editable directory of healthcare organizations using social media. The resource, which integrates social media tools, will allow healthcare organizations in Canada and abroad to collaborate with like-minded organizations to share 2.0 learning. Rob Fraser, RN, a member of the project's advisory council, says social media tools can bridge gaps: "The benefit of directly listening to patients and involving a diversity of voices is the opportunity for insight into the lived experience of the people that we're providing service to. It's very difficult for someone to sit in a boardroom and decide how best to deliver care and services to a population." Key learning on context & use:
Practical takeaways for healthcare organizations:
Susan Pigott, the VP of Communications and Community Engagement from CAMH, said her organization has used what they've learned to advance and enrich their plans for uptake: See video views from partners and participants reflecting on key project learning and the promise and potential of social media to improve patients' healthcare experience. Interviews include:
Building on last year's session, Redesigning Health Services with Patients Top of Mind, this year's invitational Meeting of the Minds zeroes in on how to make "patient experience" a priority in a meaningful and measureable way. What role do access, communications, and engagement (ACE) play in teasing out a better experience for people interacting with the health-care system? The June 21st program includes:
We plan to share and spread learning from and beyond the fine minds participating in the exchange. Watch for presentations, proceedings, video podcasts and top ten takeaways and much more following the event.
Sorry, this event is full, but if you're still interested in attending, don't despair, just add your name to our wait list and we'll let you know if a spot opens up. And if you don't get in, catch a video of Balik's Talk on our site after the event. Presented by The Change Foundation in partnership with U of T's School of Public Policy & Governance. Learn more about the event, see agenda.
Focus on seniors with chronic health conditions & quest for community coalition to redesign health-care delivery with/for patients The Foundation today releases The Storyboard - Implementing The Change Foundation Strategic Plan, Hearing the Stories, Changing the Story. You'll recall that our strategic goal is to improve the experience of individuals and informal caregivers as they move in, out of, and across the health-care system over time. With The Storyboard, we're announcing how, and with whom, we'll work to try to achieve that. If you're tracking our story, here's the latest from The Storyboard:
Over the course of the plan, the Foundation will:
Said The Change Foundation CEO Cathy Fooks: "We think this work is bold and groundbreaking and has great potential for change. Together with our partners in the community, we will try to prove in the field that you can successfully co-design - with health-system users and providers - services, processes, journeys, and systems in Ontario that will be sustainable across the continuum of care." Added Chair Scott Dudgeon: "A high-performing health system understands, measures and responds to the patient experience. And that - we believe - should be front and centre in any health-care reform - not just symbolically, but substantively." Stay tuned for ongoing updates on our ambitious quest. We will be announcing more details about our initiative at our upcoming Meeting of the Minds June 21st. Read The Storyboard (pdf, 460KB) and Strategic Plan (pdf, 1MB).
Ontario panel to reflect & recommend ingredients - and actions - to improve patient/caregiver experience, pre and post election As Ontario aims to advance patient-centred care through such channels as the Excellent Care for All Act, the Institute for Healthcare Improvement's Barbara Balik will share her expertise working with American patients and families to improve their health-care experience, and will talk about how that partnership can contribute to better designed systems for effective cross-continuum care. In addition to being a senior member of IHI faculty and a former hospital CEO, Barbara also heads Common Fire, an independent consulting and teaching practice that works in partnership with health-care leaders to improve quality and safety. Balik has authored much on the topic, including: Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care (IHI, 2011) and 10 years After To Err is Human: Are We Listening to Patients and Families Yet? (National Patient Safety Foundation, 2010). And for those keeping their eyes on the provincial election front, and their minds on what health-care changes may result from its results, we offer a panel of smart, spirited speakers: Susan Eng, VP, Advocacy, Canadian Association of Retired Persons (CARP), Danielle Martin, Chair, Canadian Doctors for Medicare, and Adalsteinn Brown, Chair, Public Health Policy, Dalla Lana School of Public Health U of T, and former ADM of Health. They will reflect on our Hot Talk and recommend what ingredients - and actions - are required in Ontario to improve the health-care experience of patients, in particular seniors, and their informal caregivers. See event agenda. The event takes place on June 20, 4:00 - 7:00 pm at the Faculty Club, University of Toronto. See map. Update: this event is now full. You can sign up on the waiting list.
New resources paint deeper data-profile of Ontario seniors with chronic health conditions, ALC patients, home-care use & tipping points for caregivers The facts fairly and honestly presented; truth will take care of itself The Change Foundation today releases new fact sheets and power-point friendly chart packs -with over 30 graphs- based on recent data on home-care use in Ontario mined by Prof. John Hirdes and his University of Waterloo research team. The resources accompany and draw out aspects of our paper Because this is the rainy day: a discussion paper on home care and informal caregiving for seniors with chronic health conditions (February 2011). The ready-to-insert resources paint a clearer profile of Ontario seniors living with chronic disease, and those moving from hospital to home, and/or community care, pinpointing key challenges they experience. The fact sheets reveal the care and support needs of seniors living with the fourth most common chronic disease, Congestive Heart Failure (CHF), the critical stress points for caregivers of palliative home-care clients, and the composition and service needs of Ontario's ALC population, pegged at 16% in 2010. The following data nuggets emerge to help connect dots and/or raise flags for policy makers:
Learn more:
33 powerpoint-ready charts & highlights Understanding Ontario's ALC patients: need for realignment of services revealed
Ontario home-care clients with Congestive Heart Failure and their use of health-care services
What do we know about families and friends taking care of Ontario's palliative home-care clients?
This Change Foundation-funded research also informs the article A profile of older community-dwelling home care clients with heart failure in Ontario (March 2011)
As part of the implementation of the Excellent Care for All Act, the Ontario government is amalgamating its health quality programs effective April 1, 2011, bringing them into the Ontario Health Quality Council, which will have an expanded mandate and a new name: Health Quality Ontario. One of the organizations joining the umbrella organization is the Centre for Healthcare Quality Improvement (CHQI), which The Change Foundation created in July of 2008 to augment the Foundation's policy work. Operating arms-length from government and focusing on issues of provincial strategic priority, CHQI worked on many fronts to build capacity and capability for improving how health care is designed and delivered in Ontario. Whether working with hospitals to improve patient flow, supporting QI efforts in Local Health Integration Networks and Community Care Access Centres, or coaching health-care leaders to develop quality as a core business strategy, CHQI has laid a solid foundation from which the province can build. "Working with intent, Paula Blackstien-Hirsch and her team have achieved results and earned the respect of the health-care community. We know that staff from CHQI will continue to apply the same passion to helping Ontario health-care organizations embed improved quality and safety into every process and decision point," said Change Foundation CEO Cathy Fooks. "We are enormously proud of the work our colleagues have undertaken while at the Foundation and we look forward to continued collaboration with Health Quality Ontario," she added. "I feel tremendously privileged to have led CHQI at The Change Foundation," said CHQI Executive Director Paula Blackstien-Hirsch. "From the outset, our philosophy has been to build capability for improvement through action-based learning, and I believe that approach has proven its value, from the front-lines of care to the board rooms, across the many Ontario organizations with whom we've worked." "The Change Foundation applauds the province's more pronounced focus on quality. Bringing CHQI's proven strength in working on the ground with providers, health-care leaders and patients and behind the scenes with policy makers can only help bring about and embed changes that will improve people's interactions and connections with the health-care system," said Change Foundation Chair Scott Dudgeon. Over the next three years, The Change Foundation will focus on improving the quality of peoples' health-care experience as they move in, out of, and across the health-care system over time. The Change Foundation is an independent policy think tank, intent on changing the health-care debate, health-care practice and the health-care experience in Ontario. A charitable Foundation established in 1996 and funded through an endowment, The Change Foundation leads and leverages research, policy analysis, quality improvement and strategic engagement to enable a more integrated health-care system in Ontario designed with individuals and caregivers top of mind. Learn more: Centre for Healthcare Quality Improvement
As Ontario shifts towards patient-centred care through the Excellent Care for All Act, IHI's Barbara Balik comes to share timely expertise in achieving excellent patient and family experience and redesigning systems for effective cross-continuum care. Barbara (RN, Ed.D) also heads Common Fire, an independent consulting and teaching practice that works in partnership with healthcare leaders to improve quality and safety. This June 20th Hot Talk, Making Sense of Patient Experience - Partnering with Patients and Families is presented by The Change Foundation, in partnership with the School of Public Policy, University of Toronto. Balik has authored much on the topic, including: Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care (IHI, 2011) and 10 years After To Err is Human: Are We Listening to Patients and Families Yet? (National Patient Safety Foundation, 2010).
Learn more about this past Hot Talk
The Change Foundation answers those questions - and asks others - in a discussion paper released today. Called Because this is the rainy day: a discussion paper on home care and informal caregiving for seniors with chronic health conditions, the paper draws heavily (but not wholly) from recent data on home-care use in Ontario mined by Prof. John Hirdes and his University of Waterloo research team. It examines Ontario seniors with chronic health conditions to help us understand how they use home-care services, what their health-care needs are as they move from hospital to home and/or community care, and what the implications are for their families and friends who care for them. For the first time, we have a clearer - and surprising - picture of the coping patterns of informal caregivers of palliative home-care clients in Ontario - findings that tell us when their family and friends need help the most. The paper also wraps in work that shows the economic value of home care, based on a project co-partnered by The Change Foundation. What are some of the take-away messages from this work?
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