December 22, 2011

Dear Northerners:

Despite the decorations – garlands in the hallways, wreaths on the doors, and strings of lights wound around Christmas trees—in health care, December is a month like any other. Well, no, that’s not quite right. In fact it’s a harder month for many of our 186 health care providers here in the North East region. Patients and clients continue to need care, staff need time off to spend with family, and unfortunately flu season flourishes amid the handshakes and kisses.  

As the keepers and planners of the system, the pace of our meetings, funding allocations, and reports doesn’t slacken in December as we and our partners tie up loose ends before the New Year.

Amid the flurry of activity, it’s also an appropriate time  to reflect on what we’ve accomplished and what lies ahead for the next year – can it almost be 2012 already?

While it’s impossible to predict the future, we do have a sense of some of the ground rules. Hon. Health Minister Deb Matthews was very upfront, in a speech last month to the Ontario Hospital Association convention, about how health care spending will have to be curbed to a maximum increase of 1% a year.

“We live in a 1% world.  We created LHINs to bring decisions from Bay Street to Thunder Bay and to drive integration.  Our focus in the next months and years ahead will be improving home and community care,” she said.

At the same time, here in Northeastern Ontario we face some significant challenges: an older and aging population (17% over the age of 65); poor health behaviours with a higher proportion of smokers, drinkers, and those deemed obese; and higher rates of chronic diseases and cancer. And as you know, our population of 550,000 is dispersed across a huge geography with 60% living in four urban centres.  

So we will need to do better with the amount of funding that we are already receiving which for the North East tallies up to $1.3 Billion. Part of the solution lies in integrations -- on both administrative and clinical levels.  We need to merge the “back offices” of organizations so we can realize savings that can be put into frontline care.  When more than one organization is providing the same service within the community, how can integration help to maximize the service to the client?  Integrations aren’t always about saving money, more often in health care they are about improving services to people so that they can benefit from a stronger and more tightly knit health care system.

Part of the shift needed to strengthen our local system is to deliver more services in the community and outside of institutions.  We need to adopt better ways to care for our aging population because we know in another two decades more than 30% of us in the North will be in our senior years.  Seniors, like many of us, want to be cared for at home or in community before a hospital or long-term care home.

Here in Northeastern Ontario, we’ve already started to witness the shift.  Looking back on this past year alone….

  • Our Home First philosophy was rolled out across our LHIN. To date more than 510 seniors, who might have otherwise lingered in hospital waiting for a long term care bed, have been discharged home from hospital with 61% remaining in community more than 90 days. We’ve accomplished this by ramping up homecare services available to these frail elderly.
  • The numbers of Alternate Level of Care (ALC) patients, mainly the frail elderly who don’t require the 24-hour care provided by hospitals, was reduced by half at our four urban hospitals –going from a high of 26% the year before to 12% in November. This has freed up beds in hospital for acute patients who need them.
  • We also helped the North East Geriatric Services grow adding to its capacity so it could reach more seniors across the region, to help keep them healthy and living independently as long as possible at home.
  • The LHIN has been working on shifting Assisted Living from being building-bound to bringing it into the homes of high risk seniors who live in clusters near a provider. Assisted Living includes scheduled visits (like homecare) but also unscheduled visits where a client can call for assistance knowing that help is at most 15 minutes away. This year we brought Assisted Living to 69 more people.
  • We’ve opened five Joint Assessment Centres to cut down on the wait times for hip and knee surgeries and to provide more options for care.
  • I’m also proud to say that our region continues to embrace Telemedicine as a way to deliver care across our broad geography. Our LHIN is the highest user of the Ontario Telemedicine Network  amongst Ontario’s 14 LHINs!
  • We’ve started the ball rolling on the Algoma Anchor Agency for Mental Health and Addictions that will bring together 13 providers and some 100 services so clients only have to knock on one door to get the help they need.  The steering committee has selected a board and the board has begun work on incorporation, finding a CEO and developing a strong structure for this new organization.
  • Mental Health has definitely been a focus of ours with the creation of a Warm Heart line to serve the entire region and the approval of a plan to add more than 40 health care professionals to provide Behaviour Support for seniors with cognitive or physical impairments.
  • This year we focused on meeting with Northerners through 25 Community Engagements. About 700 people across the region told us what works and what doesn’t. You can read the Summary Report, which identifies 12 themes.
  • We hosted our first Chronic Disease and Prevention Forum to share best practices and bring together about 100 health care professionals.

In 2012 we will continue to work on improving access to care for Northerners.  And, we will do so with your input, your help and your partnership. It’s a big area, a big job but we’re all worth it and together we can build the best local health care system in Ontario!

Wishing all my fellow Northerners a Merry Christmas, a happy holiday and a healthy New year!