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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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Share your healthcare storyNovember 21, 2011
Share your healthcare story to inform our advice to decision-makers

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.


Provincial consultations begin with Ontario seniorsOctober 11, 2011
Provincial consultations with Ontario seniors/caregivers to get at what happens - or not - when moving across health services

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.


Barbara Balik talks at Hot Talks on HealthOctober 11, 2011
Catch Hot Talk on Health replay of IHI's Barbara Balik with sound advice for Ontario's new government

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.


Barbara Balik talks at Meeting of the MindsOctober 11, 2011
Meeting of the Minds 2011 Recap - How to ACE the Patient Experience?

Great slate of speakers who were individually very stimulating and together generated thoughtful conversation.
- participant -

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
Views by seniors/caregivers on what defines a good patient experience and a bad one:

  • Madeleine Dennis, Sudbury caregiver and former nurse (video).
  • Colin Lay, Ottawa patient advocate and caregiver (video).

Healthcare Leaders
International and cross-country examples of initiatives and ideas to advance meaningful and measurable patient-centred change:

UK

  • Lynne Maher, Director for Innovation and Design, NHS Institute for Innovation and Improvement on Experience Based Design and how's its changing organizational culture and helping the NHS's mandated financial sustainability goals (video and pdf).

Canada:

  • Lea Bryden, VP, Citizen Engagement & Accountability, Capital Health Halifax, Nova Scotia presented a provocative presentation on her organization's transformative public engagement strategy (video and pdf)
  • Stacey Daub, CEO, Toronto Central CCAC, on lessons from the innovative Virtual Ward program and the need to design community services around needs of families and patients (video).
  • Michael Evans, Director, Health Design Lab, Staff  Physician, St. Michael's Hospital on how social media is helping to better engage and care for patients (video).
  • Durhane Wong-Rieger, President & CEO, Institute for Optimizing Health Outcomes, emphasizes the importance of shifting our system to support patients to self-manage chronic disease  (video).
  • Ken Tremblay, President & CEO Peterborough Regional Health Centre talks about the shift started at PHRC towards patient-centred care (video).

Cathy Fooks talks to the CBC radioOctober 11, 2011
CEO Cathy Fooks talks to CBC radio about simplifying and supporting home care for Ontarians

There are so many things we can do, if we just sit down from a patient perspective to make small movements to redesign the way we organize this care.
- Change Foundation CEO, Cathy Fooks -

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:


social media toolkitPosted: September 23, 2011
Reminder: PATH submission deadline is October 14. If you're applying, get moving!

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, 2011Please 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.

Learn more about PATH.


social media toolkitPosted: August 22, 2011
Register for upcoming PATH webinar & bring your questions

The Change Foundation recently launched the Partners Advancing Transitions in Healthcare (PATH) project to engage and support a community coalition of providers, patients and informal caregivers to re-design problematic care transitions that they identify together. The first phase of the project, launched July 5, 2011, was a call for submission of letters of intent.  As noted in the July launch, The Change Foundation is offering a webinar for those who are planning to submit letters of intent (due Oct. 14, 2011). During the webinar, the Foundation staff will provide information on the key concepts of PATH and will open the floor for questions from participants. For your convenience, we are offering the webinar on two different dates and times:

Thursday, September 8, 2011, 11am to 12noon
Wednesday, September 14, 2011, 12noon to 1 pm

Please register for one of the webinar sessions by Friday, August 26, 2011 so we can plan for an adequate number of dial-in lines. The webinar package and login information will be e-mailed to you prior to the webinar. To register for one of the two webinar sessions please contact Genevieve Obarski at 416-205-1564 or via e-mail at: gobarski@changefoundation.com

 

boardPosted: July 14, 2011
June AGM brings board change-up: Foundation welcomes three new faces and bids adieu to two stalwarts

New members - Jim Elliot, Marcia Visser & Douglas Sinclair - will help us stay on PATH

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.


Integration of Care reporPosted: July 13, 2011
The ideal and the real in community care, as providers see it. Survey results released, with strategies to improve coordination of care

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?

In 2009-2010, The Change Foundation worked with the Community Provider Associations Committee (CPAC), an umbrella group of associations that includes most organizations providing home and community care in Ontario, to survey more than 2000 community care providers about those, and other, issues.

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.

The survey data were generally positive. Survey respondents clearly articulated that client-focused care, working well with other providers, prompt and complete information, effective communication with the client and with other providers, and timely assessment and care are highly valued. They view client involvement and client-focused care as integral to a well-coordinated system of care. Prompt information about care plans and changes to plans, having complete information from other providers, and good communication among providers were viewed as key to integration. However, analysis of the quantitative data indicates that there is a gap between community providers' ideals and their reality.

The majority of respondents would like to provide client-focused care. However, providers in the home care and community support sector are working within a broader healthcare delivery system that has evolved over time and undergone significant change. Based on what The Change Foundation has heard from individuals and their caregivers, it is a delivery system still not known for its client-focused orientation.

For example, more than a quarter of respondents (28%) were not informed in a timely manner when a client to whom they were providing care was moved from home to hospital or to another care facility. Almost half of care coordinators and regulated health professionals (48%) did not know if there was a single person in charge of communicating all necessary information to the facility. When the client returned home from the facility, almost one-third of respondents (31%) did not receive information about the discharge care plan promptly-36% of care coordinators, 27% of regulated health professionals, and 18% of PSWs.

Four predominant themes emerged from our analysis of the survey responses: human resources strategy development; operational design improvements; information exchange and communication improvements; and improved linkages with primary care. The Foundation offers targeted recommendations for each area. For those interested in detailed data and/or data specific to the various provider groups, four technical reports are available. There are three provider technical reports, and a fourth comparative summary report analyzing the responses of all provider groups.


social media toolkitPosted: July 7, 2011
Call for Submissions: The Foundation launches PATH -- Partners Advancing Transitions in Healthcare (PATH): A first with Ontario patients

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.



social media toolkitPosted: June 27, 2011
Using social media to improve the quality of patient experience

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:

  • Compared to other sectors, healthcare has been a slow adopter of social media tools for quality improvement (despite the fact that health is one of the hottest online topics.)
  • Questions about ethics, patient privacy, data control, measurement, and return-on-investment are major stumbling blocks, but experimentation and experience are showing that healthcare organizations can use these new tools conscientiously and with positive purpose to improve care and respond more quickly to patient concerns and suggestions.
  • Things are changing fast: In the past year alone, the number of social media accounts (Facebook, Twitter and the like) by Canadian healthcare organizations has quadrupled

Practical takeaways for healthcare organizations:

  • Plan to integrate social media strategically. Try it out in a prudent and phased approach - across divisions, units, programs - wherever it can help the organization meet its goals.
  • Target your online "listening" strategies to understand and engage with different audiences.
  • Move from a "numbers model" (e.g. counts of web hits) to a "relevance model" in measuring online engagement, using a variety of free or paid tools that can inform you about trends in online conversations about issues important to your organization.
  • Use social media tools for collaboration among your staff, to foster discussion and innovation about ways to improve the organization's service delivery.

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:
"We applaud The Change Foundation and The Innovation Cell for encouraging healthcare organizations to think about the ways in which social media can improve engagement and drive quality improvement. This is an area of great interest to CAMH and our participation in this project helped us learn much more about existing tools and methodologies for tracking and making sense of the information being conveyed. We now have a clearer idea of how to proceed to play an appropriate role in the dialogue."

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:

  • Melanie Barwick, Scientific Director KT, Child Health Evaluative Sciences Research Institute, Hospital for Sick Children and Ginger Council Member

  • Pat Campbell, CEO, ECHO: Improving Women's Health in Ontario

  • Cathy Fooks, CEO, The Change Foundation

  • Rob Fraser, Graduate Nursing Student, University of Toronto & Founder, Nursing Ideas

  • Manuel Gitterman, Director of Operations, Policy, Education & Health Promotion, Centre for Addiction & Mental Health (CAMH)

  • Neil Seeman, CEO, Health Strategy Innovation Cell

  • Tom Sommerville, Business Technology Specialist at Ontario Ministry of Health and Long-Term Care


Meeting of the Minds Posted: May 25, 2011
How do we ACE the Patient Experience? Focus of 2011 Meeting of the Minds

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:

  • Getting in Gear: What drives exceptional patient and family experience? A keynote address focused on cross continuum, system issues by Barbara Balik, senior faculty, Institute of Healthcare Improvement, followed by facilitated discussion. Barbara also headlines our Hot Talks on Health the night before.
  • International and cross-country examples of how to engage patients in designing and redesigning care from the likes of UK's Lynne Maher (NHS Institute for Innovation and Improvement.
  • A session on Social Media - how it's changing everything and what it can mean for health care - with leading experts Dr. Michael Evans and Innovation Cell's Neil Seeman, who will also join CAMH VP Susan Pigott in sharing lessons from an Ontario experiment.
  • A session designed by seniors and caregivers about their take(s) on what makes the difference between a good experience and a bad one.
  • Word on the street and the health-care beat, a video to ignite input on how to improve the patient experience.

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.


Barbara BalikPosted: May 18, 2011
The wait list is now open for June 20 Hot Talks on Health with IHI's Barbara Balik - Making Sense of Patient Experience - Partnering with Patients and Families

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.


The Storyboard - Implementing The Change Foundation Strategic PlanPosted: May 2, 2011
The Storyboard reveals next steps in Foundation's narrative

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:

  • The Foundation's work is guided by a conceptual framework for understanding the elements required for good patient/caregiver experiences. That includes the "what" - clear, consistent information; coordinated, connected, comprehensive care - and the "how" - shared engagement in care; respectful, empathetic, considerate; and timely and convenient.
  • The Foundation has chosen seniors with chronic health conditions as its population of focus; this group was selected because of the potential for our work to have the greatest impact, make a value-added contribution, and spread solutions.

Over the course of the plan, the Foundation will:

  • gather and analyze baseline data about patient/caregiver experience navigating across the continuum of care; using both qualitative and quantitative methods, the Foundation will probe perspectives from the stewards, stakeholders and users of the health-care system;
  • sponsor a competitive process to select a community coalition to work with us and seniors/informal caregivers on a care delivery redesign investment in Ontario;
  • launch and complete a care delivery redesign project, and implement engagement initiatives including provincial patient / caregiver advisory panel;
  • collect follow-up data from our community-level engagement and co-design participants - i.e., seniors and caregivers, and community-level providers - to assess if their experience and understanding has improved during the course of the care delivery redesign initiative;
  • collect follow-up information from policy and decision makers and from seniors and caregivers through regional consultations to see if their experience and understanding has shifted;
  • develop engagement, communications and knowledge transfer strategies to assist with the spread of care delivery redesign project learning to other communities. This will include an inclusive stakeholder summit following the completion of the care delivery rede­sign work to expand and refine the learning, support the uptake of learning, and develop and spread policy reform recommendations.

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).


Barbara BalikPosted: May 1, 2011
Registration full and wait list now open for June 20 Hot Talks on Health with IHI's Barbara Balik - Making Sense of Patient Experience - Partnering with Patients and Families

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.

Audience Q & A to follow, with lead-off inquiry from the Patients' Association of Canada. Bring your burning questions to add to this dynamic, timely discussion.

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.


chart packsPosted: April 13, 2011
The Change Foundation offers fresh fact sheets and chart packs to go

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
-William Allen White-

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: 

  • Fact 1: the percentage of ALC patients with moderate care needs waiting for long-term Care varied by as much as 20% across Ontario's LHINs.  What accounts for this?
  • Fact 2: caregivers of palliative home-care clients report most distress after 18-35 hours of weekly care, suggesting when support is critical.  How do we proactively target support to informal caregivers and sustain their invaluable contribution?
  • Fact 3: seniors with CHF are heavy users of medications, but only 29% are on the right drug regimen. Why? Is a fragmented system to blame? Ensuring the right medication use will help to stabilize health and decrease emergency department use.

Learn more:

Fresh fact sheets

33 powerpoint-ready charts & highlights

Understanding Ontario's ALC patients: need for realignment of services revealed

  • Comparison of priority levels for access to community support services between ALC patients waiting for LTC and home-care clients (65+), Ontario 2007-2008 
  • Clinical characteristics of ALC patients (65+) waiting for LTC vs. home-care clients (65+), Ontario 2007-2008

Ontario home-care clients with Congestive Heart Failure and their use of health-care services

  • Recommended medication use by home-care clients with CHF (65+), Ontario 2004-2007
  • Top seven comorbidities of home-care clients with CHF (65+), Ontario 2004-2007

What do we know about families and friends taking care of Ontario's palliative home-care clients?

  • Profile of informal caregivers of palliative home-care clients, Ontario 2006-2008
  • Risk of distress among informal caregivers of palliative home-care clients, Ontario 2006-2008

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) 


informal care for seniorsPosted: April 4, 2011
CHQI to move to Health Quality Ontario; Patients and providers well-served by CHQI's quality-focused work
: The Change Foundation

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
Ontario Health Quality Council


Barbara BalikPosted: March 22, 2011
Save June 20 for next Hot Talks on Health with IHI's Barbara Balik on Making Sense of Patient Experience - Partnering with Patients and Families

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).

Mark your calendars for Monday, June 20 (4-7 pm) to catch this dynamic doer and thinker at the Faculty Club, U of T or read the agenda or read her biography.  More details to come next month.


Baroness Barbara YoungPosted: March 22, 2011
Video playback of Hot Talk featuring UK Baroness Barbara Young, now on offer

If you missed our last Hot Talk (October 28), get a front-row seat at Rt. Hon. Baroness of Old Scone, Barbara Young's Health and Social Reform in a Cold Climate by video playback. This noted UK health leader incisively deconstructs the potential impact of radical NHS restructuring just started and still underway on quality and patient care. Also view a panel discussion from-the-day on implications and learning for Ontario, featuring: Ross Baker, Carolyn Baker, and Ben Chan, (agenda). And, get the latest on the UK's fast changing health-care landscape, by visiting the Commission on Leadership and Management in the NHS.

Learn more about this past Hot Talk


informal care for seniorsPosted: February 8, 2011
Is good care at home for seniors with chronic health conditions possible? At what cost? To whom?
New data released.

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 conditionsthe 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?

  • We need to better align home-care services to seniors' needs;
  • We need to realign resources from acute to community care (if we're ever going to address the needs of ALC patients)
  • We need to use home care more strategically to provide seniors and their informal caregivers with care and support tailored to their needs as well as to help solve health system and sustainability problems.

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