2018 Minister’s Medal Application Template

Individual Champion Category

Theme: Innovating Integration – adopting innovative models to promote
and deepen integrated health systems through local areas of care

The individual champion stream of the Minister’s Medal honours individuals who have demonstrated excellence in innovation, enhancing integration,leadership, and engagement with patients, families, and caregivers.

Individuals can self-nominate or be nominated by organizational leadership, peers, or a patient or caregiver. If you are nominating someone, it is recommended that you contact the individual to gather information that could support their nomination,

Please note the word limits for each section.

Completed applications should be emailed to the Local Health Integration Network (LHIN) by 5:00pm onAugust 24, 2018.

For more information, please visit the Minister’s Medal webpage at

Name of individual champion nominee:

Nominee’s Title:

Affiliated Organization(s):

Nominee’s Phone:

Nominee’s Email:

Nominator’s name (if applicable):

Nominator’s Email (if applicable):

Name of LHIN: (Please identify only one LHIN):

Notice of release of information

By submitting this application, the nominator is affirming that the applicant is consenting to the use of information provided in the application for promotional purposes,such as being featured in the Ministry of Health and Long-Term Care (the ‘ministry’) publications and other materials. The ministry will take all measures necessary to ensure advance notice is provided to the applicant of any intended public use of the information.Please do not include any identifiable patient information in this application.

APPLICATION CRITERIA

Note: The following information is intended to be a guideline to highlight the attributes and experience upon which the nominee will be assessed.

1)Innovation (250 words): 30 Points

Describe how the individual has used innovative approaches, working practices and/or technologies within their organization or local area of care to deepen integration, enhance health outcomes, and improve the patient and provider experiences. Highlight how the individual has challenged the status quo with new solutions and applied new ways of thinking to positively transform health outcomes within their community. These solutions may be new systems, technologies, partnerships, programs or policies that improve access to care, value, health outcomes and overall health care needs of Ontarians.

2) Collaboration and enhancing integration (250 words): 30 Points

Describe how the individual has supported enhancing integration efforts in their local areas of care to improve patient experiences and outcomes and/or ensure a more seamless patient experience. This can include supporting initiatives that aim to improve access and navigation within their community, and engaging in partnerships with other community members and local providers. Highlight how the individual has demonstrated a clear commitment to community engagement and quality improvement through collaborative partnerships to build system responsiveness to patients’ needs, values, and preferences.

3) Leadership (250 words): 20 Points

Leadership is the cornerstone for the success of new and innovative initiatives. Describe how the individual’s leadership ability has contributed to the results of the work they oversee. A successful candidate will have demonstrated critical thinking, challenged the status quo, motivated others to drive quality, supported innovation, and championed change.

4) Dedication (250 words): 20Points

Change is not always easy and requires working together to overcome challenges. Describe the obstacles that the individual has faced in their work, and how the individual has tackled these obstacles. In what ways has their dedication helped to achieve effective results despite these challenges?

How to submit this application:
Please submit this application by 5:00pmon August 24, 2018to your local LHIN office. Only one application should be submitted for each nominee.
Contact th any questions related to completing this application.
Thank you!

2018 Minister’s MedalIndividualChampion Category