Ontario Health Team in Mississauga Co-Design Session Outputs September 12, 2019
Our approach We took a user-centred design approach to develop our Mississauga OHT care model 1. Developed patient personas based on our Year 1 priority populations: • People who would benefit from a palliative approach to care • People with minor acute gastrointestinal (GI) / genitourinary (GU) issues 2. Created maps of the patient journey to identify pain points / challenges to improve upon in the future patient experience 3. Mapped the patient journeys onto a service blueprint to identify the various health care service touchpoints that needed improvement 4. Held a co-design session on Tuesday, August 27 th with many diverse stakeholders, including patients and family / caregivers, primary care, acute care, home care, and community partners, to: • Validate our understanding of the current-state patient experience and service challenges • Generate “Big Ideas” for improvement in the future OHT care model, according to the OHT guiding principles • Discuss how these ideas could be implemented and measured in the new OHT model by describing a “Road to Success” 5. Incorporated elements of the co-designed “Big Ideas” and “Road to Success” into our OHT care model described in the Full Application
Our co-design session 2 75 12 Diverse stakeholders, including areas of focus participants big 8 patient and for year 1 ideas family reps Our OHT year 1 populations are… 49 people focused on palliative care Group included patients and family We came up with… People with palliative care needs 26 people focused on acute GI/GU / caregivers, primary care, home 8 big ideas for palliative care People with acute GI/GU issues care, acute care, community 4 big ideas for acute GI/GU partners, and others We asked, “How do you want to be engaged after October 9?” (n=34) Engagement level Channel 50% 80% 40% 60% 30% 40% 20% 20% 10% 0% 0% Teleconference Email In-Person Town Road Show Inform Involve Consult Collaborate /Webinar Hall
Reflections on Ontario Health Team development so far Selections from feedback provided I love… I wish… I wonder… The opportunity to be The human-centred design What the future entails For more of these meetings; To remain involved and a involved approach, starting with pain More engagement events like part of the work; to continue points / journeys of this to help design the OHT to provide feedback How things will progress participants but considering Group activity / discussions; post-October all users Team work For more knowledge on how It was happening at a slower How can we be involved? OHT is formed pace; We all had more time Creative solutions to Working in small groups with available to work on things problems variety of stakeholders If it will turn out great – hope so Have the meetings during the (different perspectives) day We were further ahead The concept; The idea of If we will be able to create creating a system that is one big electronic platform easier for patients, families to Use of OHT resources to More $ to support big ideas That all of these disciplines for information improve patient education understand and be that will improve care were invited to collaborate / connected to the right care discuss / learn about / co- How the Ministry will work for them design this exciting change We could integrate electronic though the funding systems easier, and have methodology to actually less privacy hurdles for enable all this Sharing network, talking Interactions and virtual care about the future collaboration, lots of great Why was this not done ideas earlier? Clarification on 24 / 7 care for Collaborative workshop, big solo practitioners New ways to think about picture system thinking About focusing more on things; many people on board opportunity with partners preventative care Rehab were involved in palliative care journey How palliative patients feel Openness in collaboration The vast information being about palliative care shared, collaborative Inclusion of community approach in relationship and How we can better manage Idea of a digital system for all providers of lab and imaging trust building at a population level to access services
How to stay connected with the M-OHT Thank you again for your ongoing support in the development of the Mississauga OHT! If you have any questions, please contact info@moht.ca. For updates and events, you can also check out our website at www.moht.ca The next info session will be held the week of September 23rd. Please stay tuned for details!
Outputs from the co-design session Our big ideas + Road to success
PALLIATIVE CARE: TABLE 1: OHT-Coordinators TABLE 2: “ Start Early and Do It Right” TABLE 3: Quarterback with Clinical Skills TABLE 4: Multi-Lingual and Multi-Channel Navigation and Resource Directory TABLE 5: Palliative Care Hubs TABLE 6: The “Always Experience” – Automated Trigger for Early ID TABLE 7: Secure Information Access in Real-Time (Blockchain) TABLE 8: Palliative Access and Rapid Response Team ACUTE GI/GU: TABLE 1: Advance Practice in Diagnostic Imaging TABLE 2: One-Stop-Shop for Suite of Digital Services TABLE 3: Rapid Access Diagnostic Center TABLE 4: Advancing to a Digital Health Care Future
PEOPLE WITH PALLIATIVE CARE NEEDS TABLE FACILITATOR: Bonnie Scott PROVOCATIVE THOUGHT STARTER TABLE 1: OHT-Coordinators How can we leverage people at the right time and place to provide much-needed palliative care in times of crisis? (e.g., family / caregivers, WHAT IS THE CHALLENGE? mobile nurse teams, paramedics) How might we… allow patients to access one number (care team) who knows them and can trigger the right care (for planned and unplanned care)? WHAT IS YOUR BIG IDEA FOR WHAT IS THE DESIRED IMPACT? WHAT ACTIVITIES COULD YOU DO WHO NEEDS TO BE INVOLVED? THE FUTURE? TO GET THERE? • Patients are educated about alternatives to ED / hospital care • Embed care coordination into the Year 1: primary care team – this enhanced role • Patients feel more confident that they Year 1 • Palliative Care Physicians is the OHT-C (Ontario Health Team are ‘on the right path’ • Identify early champions • Primary Care Physicians (starting Coordinator) • Reduces physician concerns of not with initial primary care groups) • Create OHT coordinator function having enough time for care • OHT-C • Step 0: Teach patients who to call in • Set up governance and coordination with patients and building times of crisis (one number / website) accountability structures • Community Paramedics trust – OHT-C is the trusted point-of- • Establish clear goals and metrics • Home Care contact for navigation and coordination • Step 1: Patient contacts OHT-C via • Community Care phone / video / text (someone is on call • Hospice any time of day / night). OHT-C is part RISKS / BARRIERS? of a care team, knows the patient (has • Hospital • Currently, care coordination function followed the patient throughout their Year 2 journey), and has access to patient’s not standardized into primary practice; Year 2: • Evaluation of Year 1 performance large change management activity health record and implementation of changes • Organized Health Teams • Limitations exist for paramedics to • Step 2: OHT-C has a clinical provide palliative care in the home background and triages patient to (e.g., medication administration) appropriate resources, such as primary care, specialist, ED (triaging may be DRIVERS / ENABLERS? Year 3: Year 3 supported by AI); no referrals • CarePoint’s primary care model embeds • Expand to solo PCPs care coordination into the team • Rapid response can be provided by • AI technologies? • “Paramedics providing palliative care” paramedics, who can be leveraged to program (NS/AB) currently being scaled provide palliative care in the home and spread in pockets across ON and Canada (incl. by OPCN)
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