LOUD AND CLEAR Seniors and caregivers speak out S i d i k t about navigating Ontario’s healthcare system Presentation to Services for Seniors Extended Action Group Central West LHIN, April 11, 2012 Sine MacKinnon Sine MacKinnon Director, Communications and Community Engagement The Change Foundation
change the debate, change the practice, change the experience. & Today: Tales of healthcare transitions – and their place and purpose in our plan and their place and purpose in our plan • Preview findings/ messages from LOUD and CLEAR – to be released later this month • Shared understanding of what The Change Foundation is doing – and why – and how it relates to other efforts • The role of public engagement in implementing our plan – the planning and process of teasing out those tales of transitions tales of transitions • How we will continue the conversations with health system users– as conduit to patient-centred healthcare system users– as conduit to patient-centred healthcare H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T 2
2010/ 2011 Strategic Plan Hearing the stories, changing the story Engagement in today’s climate: danger and opportunity? Engagement in today s climate: danger and opportunity? •Deficits •Ontario’s Action Plan for Health Care •Demographics •New emphasis on primary and community p y y •Drummond d care – new integration levers? •Difficult decisions •Evidence for action on quality agenda •Devil in the details • Excellent Care for All requirements 3 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
change the debate, change the practice, change the experience. & Th Ch The Change Foundation 1-m inute prim er: F d ti i t i •Endowed by the Ontario Hospital Association in 1996 •Spent 10 years as a granting agency Spent 10 years as a granting agency focused on local system change •Reorganized in 2007 – Health policy R i d i 2007 H lth li think tank focused on issues of integration, quality improvement and patient experience. 4 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
change the debate, change the practice, change the experience. & Where we are now •Implementing strategic plan, Hearing the stories, changing the story •The Goal: ..to improve the experience of individuals and caregivers as they move in, out of, and across the healthcare system over time, as their health h l h i h i h l h changes. • The population of focus: Seniors with chronic health The population of focus: Seniors with chronic health conditions and their informal caregivers 5 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
change the debate, change the practice, change the experience. & On the PATH • Key components of our signature project • Seniors with chronic health conditions • One community partnership (across sectors) y p p ( ) • Care transitions • Patient co-design • Successful community coalition announced in May Successful community coalition announced in May 6 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
change the debate, change the practice, change the experience. & Aligning m ethods: all eyes on the prize Aligning m ethods: all eyes on the prize •Research h •Care redesign/ co-design: PATH g / g •Engagement 7 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
change the debate, change the practice, change the experience. & Engagem ent key part of plan Engagem ent key part of plan • Multiple components over time, integrated + iterative • Audience: healthcare’s stewards, stakeholders, users • Focus on users – missing piece of healthcare puzzle F i i i f h lth l • Probing the experiences of seniors with chronic health conditions, and caregivers, to understand where healthcare transition problems are what could healthcare transition problems are, what could improve them. Elem ents of engagem ent plan: • Regional engagem ent, round 1 (fall 20 11) Regional engagem ent, round 1 (fall 20 11) • Citizens engagem ent panel (20 12-20 15) • Regional consultations, round 2 (fall 20 14) • Sum m it (2015) Sum m it (2015) 8 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
change the debate, change the practice, change the experience. & Our Engagem ent Prem ise Our Engagem ent Prem ise • Lived realities and personal stories of people’s healthcare experiences are legitimate sources of info • Experiences = evidence. Does our system deliver on the promise of patient-centred healthcare? What do the experiences of seniors tell us about what adds value to our healthcare system, what needs fixing, and what's missing? h lth t h t d fi i d h t' i i ? • Health/ social care needs of seniors with chronic health conditions and caregivers often complex – many cross- g p y sector transitions, multiple providers and settings • If we can reorient services, practices, processes to address their transitions problems we can eliminate gaps dead their transitions problems, we can eliminate gaps, dead ends that inhibit improvements system-wide. 9 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
change the debate, change the practice, change the experience. & Our Process Our Process • Pilot-tested methodology/ tools with several groups • Blended methods and tools to meet objectives (and budget!): Blended methods and tools to meet objectives (and budget!): • face-to-face facilitated small group discussion across province • webinar • online Storybook li St b k • keypad voting on questions about transition experiences • informed discussion facilitated by Conversation Guide • evaluation incorporated at various points p p • Aligned our questions with other research • Took partnership approach • Took partnership approach 10 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
change the debate, change the practice, change the experience. & Fram ing the conversation- our sweet spot Fram ing the conversation our sweet spot 11 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
change the debate, change the practice, change the experience. & Discussion Topics Discussion Topics 1. Your experience in navigating the healthcare system: Transitions & Communication i i i i • W here did you experience challenges or problem s (e.g. any delays or disruptions, confusion, disconnects) along the w ay and w ho w as involved? y • In your experience, did your healthcare w orkers com m unica te a nd sha re im portant inform ation about your care? (w ith each other; w ith you/ your about your care? (w ith each other; w ith you/ your caregiver) • What big or little thing w ould have im p rov ed your experience? 12 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
change the debate, change the practice, change the experience. & Discussion Topics Discussion Topics 2. How your relationships with people affected your experience • In your experience, have your healthcare providers listened to y ou / y our ca regiv er to m ake sure that they understood your needs and w ishes? Did they know enough about you and your history to help? • Did and do you feel resp ected a nd p a rt of the d iscussion about decisions about your health? • Was the plan to treat and m anage your health conv enient for you and your caregiver? • Did you feel sup p orted a nd inform ed ? 13 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
2010/ 2011 Strategic Plan Hearing the stories, changing the story On the road • Ottawa (Pilot), Feb. 2011, 25 people ( Bruyère Continuing Care) • Dryden, Nov. 13/2011, 23 people ( Dryden FHT, Dryden Regional Health Centre, Patricia Gardens) • Timmins, Nov. 15/2011, 18 people ( Timmins Regional Hospital) ( g p ) • Peterborough, Nov. 28/2011, 16 people (Canterbury Gardens) • London, Nov. 30/2011, 13 people ( Council for London Seniors) for London Seniors) Toronto, Dec. 8 th , 21 people (Toronto • Community Housing, Regent Park CHC) • Total = 116 people p p 14 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
2010/ 2011 Strategic Plan Hearing the stories, changing the story Online Online 15 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
change the debate, change the practice, change the experience. & Sifting through the stories • Loud and Clear highlights key findings based on: – content analysis of the qualitative research from the in-person content analysis of the qualitative research from the in person engagements, the Share your Story website, and the webinar, as well as on tabulations from participants’ keypad voting on 10 closed-ended questions related to transitions in healthcare • It also includes details on the project methodology, participant profiles, and a useful section on process design learning • And of course it shares the voices and views of Ontario seniors and caregivers, to whom the report is dedicated. 16 H E A L T H C A R E D E S E R V E S O U R F I N E S T T H O U G H T
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