onil bhattacharyya, md, phd frigon blau chair in family medicine research
DESCRIPTION
Overview. Onil Bhattacharyya, MD, PhD Frigon Blau Chair in Family Medicine Research Women ’ s College Hospital University of Toronto. Acknowledgements. Executive Committee Dr. Vicky Stergiopoulos Dr. Gary Naglie Dr. Onil Bhattacharyya. Dr. Wendy Levinson Dr. Lynn Wilson - PowerPoint PPT PresentationTRANSCRIPT
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Onil Bhattacharyya, MD, PhDFrigon Blau Chair in Family Medicine Research
Women’s College HospitalUniversity of Toronto
Overview
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Acknowledgements– Dr. Wendy Levinson– Dr. Lynn Wilson– Dr. Fiona Webster– Dr. Kaveh Shojania
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Key Partners:Ontario Ministry of Health and Long-Term Care – Health Quality Branch
Executive Committee– Dr. Vicky Stergiopoulos– Dr. Gary Naglie– Dr. Onil Bhattacharyya
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Schedule
8:15 Overview of BRIDGES Onil Bhattacharyya 9:00 Keynote Ed Wagner 10:00 Integrated Home-based Primary Care Tia Pham10:20 BREAK 10:40 Coordinated Access to Care from Hospital ED Vicky11:00 BRIDGES meta-analysis Dr. Fiona Webster 11:30 Lunch and Poster viewing12:30 Leveraging Lessons Learned Jodeme Goldhar 1:00 Closing Remarks Dr. Wendy Levinson
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What is the most important problem in health care?
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What is the most difficult problem in health care?
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What is the solution?
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Objective• Create a platform for development of new
models of integrated care for complex patients.
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Family Medicine
Medicine Psychiatry
Across Disciplines Across the Continuum
Community Services
Primary Care
Hospital
Incubating Models of Integrated Care
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Bridging Different Worlds
Health Service
Providers
Pragmatic Decision-Making
Data-Driven Decision-Making
Academics
HSR Clinical Sciences
Basic Sciences
Rigorous QI Methodology
Shared Space for Innovation
High Quality Health Services
Research
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The BRIDGES Process
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• 61 proposals, 9 funded• From Barrie to South Lake
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Reviewed on• Scientific rigour• System relevance
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• Study design, data coordination and analysis• Qualitative evaluation• Economic evaluation
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Hypothesis Testing Framework
PROBLEM MODEL OBJECTIVE OUTCOME
VALUE HYPOTHESIS
To Patients
To Providers
GROWTH HYPOTHESIS Patient and Provider
Recruitment Strategy
POTENTIAL PROBLEMS
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• Work with HQO and CAHO• Many potential partners• No firm results yet
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Project
Collaborative
System
Collective Impact
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Project Population Model
IMPACT Plus Complex patients Multidisciplinary team consultation
IHBPC Homebound elder Multidisciplinary homecare team
Innovate AFib Atrial Fibrillation Nurse coordinator
PIC COPD COPD Nurse-led self-management
CATCH-ED Frequent ED users in Mental Health
Transitional case management
SCOPE GPs with high user patients
Phone consultation + coordination
H-SOAP Addictions Rapid consultation + care
RAPT Mental Health Rapid consultation
ICCT GPs w/ complex older patients
Shared or assumed care
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The BRIDGES Collaborative
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BRIDGES in Brief
• 9 projects• 28 lead investigators• 23 Institutions• 2,300+ patients• 30 providers + their patients
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Communication between
institutions
Joint care delivery
Joint management across institutions
SCOPE IHBPCPIC COPD
TEAMCATCH ED
ICCT
Integration Across the Continuum
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Building BRIDGES
• Continuous testing and improvement• Co-leadership w/ psychiatry• Characterizing key elements of QI• Building trust and sharing
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Impacts
• Tested model for incubating pilot projects– Adapted for provincial pilot initiative
• Strong collaboration b/w departments and CCAC
• All models sustained after funding• Synergy w/ Health Links
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Key Deliverables
• Increase likelihood of project success in terms of effectiveness and learning
• Assess impact of overall initiative and potential of models
• Project results by 2015
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What have we learned?
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It’s Hard
• Recruitment• Targeting• Making the intervention work• Management across institution• Outreach to primary care
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It’s Easy to get it Wrong
Be ready to change• Zoom in/out• User segment pivot• User need pivot• Business architecture pivot• Channel pivot
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It’s Worth It
• Patients appreciate the comprehensiveness• Providers appreciate being connected• Managers appreciate connection to other
institutions• Policymakers like the coherence
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There’s Much More to Do
• No magic bullets• No clear answers yet• More people are in the game• Growing potential for cumulative learning
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Thanks!