Point of Care IntegrationDriving Transformation

BRIDGES Conference 2014

Thursday March 27th, 2014

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OUTSTANDING CARE – EVERY PERSON, EVERY DAY

A Debate About Reform and Which Road is Best…

Structural Reform? Layered On?

Point of Care – Functional Integration

Steadfast Despite Political Context

Point of Care Integration

ONE CLIENT: ONE TEAM

A Perspective On Lessons Learned From A Regional Partner

Flip Our Thinking

Ground The Approach

Delivering integrated care requires integrated action within 3 key domains…

At home, in the community When necessary,

the transition

Acute, CCC or Rehab

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Multiple Integration Initiatives

Aim: One client, One team

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Point of Care Integration

Virtual Ward

Kids with Medical Complexity

Point of Care Integration

ICCP Older Adults

Palliative Care

Point of Care Integration and Alignment with BRIDGES

Integrated Home Based Primary Care(IHBPC)

IMPACT Plus

Integrated Community Care Team (ICCT)

Stop, Take Stock and Reflect

Principals to Guide Integration

Deliberately being openDeliberately responding differently

“I meet with my ICCP care coordinator every two weeks or so… She speaks with

my doctor. This is the first time the doctor ever came to my home.” – Client

“The Coordinator works with other professionals to collect information, so I just have one person to contact. It saves

me time.” – Primary Care Physician

“The cross-sector care we now provide is improving the patient experience - as witnessed by shorter lengths of

stay and improved patient satisfaction scores within these patient groups.” – Acute Care Partner

Incremental Build

Maturity Reached Over Time

How can we work together

differently?

What do I need to do differently?

How can we understand and experience different perspectives?

How can we all work together on what is most important to the client/family?

Walk a Mile or Two…

Opposing NotionsTensions Integrated Solutions

Need For Scientific Evidence And Outcomes With Quality Improvement Frameworks For Complex And Disruptive Change

Processes

Balance

Demonstrating Value Less Talk And More Delivery

Do not wait for complex solutions

There is no script…

LeadThrough Ambiguity

Relationship Will Determine Success

Trust Will Determine Success

Safe

Shared Accountability

Greater Emphasis on EMOTIONAL INTELLIGENCE

Leadership Leaderful

Lift Up, Look out…

…and Honour the Past

Jodeme GoldharLead, Health System Integration for Complex Populations and Primary Care

Thank You