North West Local Health Integration Network

Annual Community Engagement Plan

2012-2013

April, 2012

Table of Contents

1.0 Executive Summary

2.0 Introduction

2.1 North West Local Health Integration Network (LHIN)

2.2 Community Engagement in the North West LHIN

3.0 Where We Are Going - Planning for Community Engagement in 2012-2013

3.1 Advancing the Strategic Directions

3.2 Advancing the Integrated Health Services Plan

3.2.1 Priority Stakeholder Groups in 2012/13

3.3 Engagement at the Governance Level

3.4 Engaging our Shared Stakeholders—Working with Our Local Health Service Providers

3.5 Evaluation and Reporting

3.6 A Voice Outside of the North West LHIN

4.0 How to Get Involved and/or Stay Informed

Appendix 1: Principles of Engagement

Appendix 2: Stakeholder Analysis Template

Appendix 3: Evaluation Form Templates

1.0 Executive Summary

Community engagement is an integral component to fulfilling the mandate of the North West Local Health Integration Network (LHIN)—to plan, integrate and fund local health services. Engaging our stakeholders, including the public, health service providers, community leaders and others (for full list seetheCommunity Engagement Strategy), enables the LHIN to better understand local data and experiences and therefore set priorities and make decisions based oninformationprovided by those who best know their community.

The objectives for community engagement are:

  1. To provide community stakeholders with balanced and objective information.
  2. To obtain information on what is working well and can be improved upon, what service gaps exist, and what opportunities for service coordination and integration exist.
  3. To ensure that stakeholders have a forum to voice concerns and that stakeholder concerns and ideas are considered in decision-making and priority-setting activities.
  4. To build and maintain partnerships within and across sectors and communities.

The importance of community engagement is demonstrated through the requirement for engagement outlined in the Local Health System Integration Act (2006) and locally through the North West LHIN Board of Directors’ Strategic Directions, Leading Health System Transformation in our Communities. Community engagement informs all planning, priority-setting and decision-making.

Given the North West LHIN’s large geography (47% of Ontario’s landmass) and small population (approximately 235,000 people; 2% of Ontario’s population), engagement can be a challenge. Overcoming the challenges posed by a geographically dispersed and diverse population strong partnerships and innovative use of technology to support two-way communication and involvement of individuals and communities across the LHIN.

In 2012-2013, the North West LHIN will continue to engageits communities and advancelocal planning and decision-making, in a number of key areas that support the LHIN’s strategic directions, including integration along the continuum of care, chronic disease prevention and management, access to primary care, Aboriginal health, and mental health and addictions services. Improvements in evaluation and reporting of engagement and planning activities will continue to be strengthened.

2.0 Introduction

2.1 North West Local Health Integration Network (LHIN)

The North West LHIN covers approximately 47% of Ontario’s landmass (from west of White River to the Manitoba border and from the United States border to Hudson Bay) and is home to 2% of the population (approximately 235,000 individuals).The North West LHINis comprised of numerous small towns and First Nation communities spread throughout rural and remote areas. The geographic location of these towns and communities creates challenges in planning, delivering and accessing health services. Many First Nation communities in Northwestern Ontario are not accessible by road year- round. People living in the region are exposed to hazardous weather and road conditions and delays when travelling long distances to receive health care. Broader engagement of individuals throughout the LHIN remains a priority of the board and staff of the LHIN.

In fulfilling its mandate to plan, fund and integrate local health care services, the North West LHIN places high priority on community engagement with diverse groups of stakeholders to inform local planning and decision-making.

2.2 Community Engagement in the North West LHIN

The North West LHIN worked with its other provincial LHIN partners and the Ministry of Health and Long-Term Care to establish the LHIN Community Engagement Guidelines and Toolkit (February, 2011). Within these Guidelines, community engagement is defined as:

“…the methods by which LHINs and Health Service Providers (HSPs) interact, share and gather information from and with their stakeholders.

The purpose of community engagement is to inform, educate, consult, involve, and empower stakeholders in both health care or health service planning and decision-making processes to improve the health care system.

Community engagement activities can be ongoing or project specific, outbound or inbound.”

Community engagement is a priority of all LHINs in Ontario. As outlined through the Local Health System Integration Act (2006), each LHIN is required to “engage the community of diverse persons and entities involved with the local health system about that system on an ongoing basis, including about the integrated health service plan and while setting priorities.”

At the North West LHIN, community engagement is also highly valued, as indicated by its inclusion as a ‘critical success factor’ in the Board of Directors’ Strategic Directions (2010). This is outlined under ‘A spirit of engagement and collaboration’, with the following goals[1]:

  • Diversity is embraced and respected.
  • Engagement is fundamental to health system transformation.

­The North West LHIN is a leader in engagement strategies.

  • Effective communication by the North West LHIN is essential.
  • Collaboration is valued.

­The North West LHIN recognizes system partners who collaborate, innovate and integrate.

­Partnerships exist based on trust, transparency, and system benefits.

This Annual Community EngagementPlan outlines activities for 2012-2013 and outlines how individuals, organizations and communities can becomeinvolved and stay informed.

3.0 Where We Are Going - Planning for Community Engagement in 2012-2013

Community engagement is a ‘critical success factor’ in local health service planning and decision-making. The North West LHIN will continue to engage broad stakeholder groupson the evolving role of the LHIN, LHIN priorities, and health system planning and transformation initiatives. Stakeholder groups will include the general public, health service providers and others. Specific strategies for engagement include: presentations, participation at information fairs, communication via newsletters and newspaper articles, and open houses.

Community engagement activities will take place at boththe governance (board) and operational (staff) levels. All community engagement activities will support the implementation of the LHIN’s Strategic Directions.

3.1 Advancing the Strategic Directions

The Strategic Directions of the North West LHIN will be advanced through engagement with various stakeholder groups on specific topics aligned with the Integrated Health ServicesPlan. Specific to community engagement, the Strategic Directions include the following goals:

Diversity is embraced and respected.

  • Meetings will be held with health service providers over the next year to discuss the North West LHIN Diversity Framework, the care experience indicator and expectations of health services providers as outlined in their service accountability agreements. Training on cultural awareness and competency will be offered to health service providers.

Engagement is fundamental to health system transformation.

  • Community engagement planning is included in all LHIN project charters toensure that stakeholders are informed and engaged in planning processes. Input from these sessions will support decision making and priority setting as it relates to funding allocations.
  • In 2012/13 the North West LHIN will undertake extensive community engagement activity related to the Health Services Blueprint, a 10-year plan for health system reform in Northwestern Ontario. Engagement activities will includelarge number of stakeholder groups and will focus on specific plans and timelines for implementation of recommendations from the report. Resource material will be made available on the LHIN’s website under “Health Services Blueprint”.

The North West LHIN is a leader in engagement strategies.

  • The LHIN has signed a memorandum of understanding with McMaster University to support a PhD dissertation on the effectiveness of community engagement, including a case study on the North West LHIN. This research began in 2011/12 and will be continued through 2012/13.Findings from this research will be used to develop a framework for informing decision-making based on engagement activities.
  • The North West LHIN is participating in a national community of practice who will work together to advance evaluation activities and uptake of best practices across the country. Included in this work is the development of a national framework for evaluation and collaboration with Accreditation Canada to modify requirements for accreditation (in 2011/12 the focus was on the long-term care sector).
  • The North West LHIN will partner with other organizations (including research, health service providers and networks) to increase capacity for conducting community engagement across the LHIN and increase the use of best practices.

The LHIN will continue to participate in regional, provincial and national discussions and activities related to community engagement, building internal capacity and ability to share and implement best practices locally.

Effective communication by the North West LHIN is essential.

The North West LHIN has a communication strategy. Information-sharing is supported through broad and focused email and mailing distributions, a website and a LHIN newsletter, LHINkages.For 2012/13, an integrated community engagement and communications plan will be developed.

Collaboration is valued.

  • The North West LHIN recognizes system partners who collaborate, innovate and integrate.
  • Partnerships exist based on trust, transparency, and system benefits.

The North West LHIN will continue to recognize the successes of system partners through various communication channels. A more formal recognition is being looked at for 2012-2013, with the possibility of a showcase of local successes of collaboration, innovation and integration.

Existing partnerships will be maintained and strengthened, while new partnerships will be pursued, including a focus on those organizations and sectors outside of the LHIN-funded health service providers, such as public health, Emergency Medical Services(EMS), primary care, other Ministries and Health Canada. Examples of current partnerships include: North East LHIN and Northern Ontario School of Medicine; Centre for Rural and Northern Health Research; McMaster University; and numerous partnerships with local health service providers.

3.2 Advancing the Integrated Health Services Plan

The Integrated Health Services Plan (IHSP) identifies the priorities and action plans for the North West LHIN for 2010-2013. Community engagement is a critical element of each action plan and thus is a focus of all priority-related work plans. As a part of each work plan, a stakeholder analysis[2] will be completed and a community engagement plan developed. Some highlights of community engagement activities planned for 2012-2013 (in alignment with the LHIN’s Annual Business Plan) include:

  • Emergency Department (ED) Wait Times & Alternate Level of Care (ALC): The North West LHIN will engage key stakeholders about the ED/ALC Strategy to advance the recommendations of the Regional Emergency Department Study(2009); Dr. Walker’s report recommendations related to ED/ALC; Ross Baker’s report on avoidable hospital admissionsand initiatives to support implementation of the Home First philosophy. The North West LHIN will engage its stakeholders to monitor progress with integration ofinitiatives like the Flo Collaborative, ED Pay for Results, Home First philosophy and to raise awareness about Ministry directions, LHIN activities and related indicators.

­Stakeholders[3]:Other LHINs, MOHLTC, MPPs, Committees and Advisory teams, Home FirstSteering Committee, health service providers, ED, Primary and Critical Care LHIN Leads, physicians, and general public.

  • Methods[4]: Forums, meetings, roundtable discussions, advisory committees, and steering committee.
  • Primary Care:Propose changes to wording: Engagement of primary care practitioners is essential to facilitate system transformation. Interaction with primary care will assist in identifying new models of care delivery that can be implemented at the community level and support safe and effective transition from hospital to home for individuals at high risk of readmission to hospital. Identification of strategies to reduce emergency department visits; admission to hospital and alternate level of care is an expected outcome of engagement with primary care practitioners.

­Stakeholders:Primary Care Physician Lead, physicians, nurses, nurse practitioners, allied health professionals, Ontario College of Family Physicians, Ontario Medical Association, local Medical Societies, Family Health Teams, Community Health Centres, Aboriginal Health Access Centres, nursing stations, Nurse-Led Practitioner Clinics, Health Professionals Advisory Committee (HPAC), Northern Ontario School of Medicine, North West Community Care Access Centre.

­Methods: Survey, key informant interviews, roundtable discussions, group meetings, advisory team (HPAC).

  • Specialty Care & Diagnostic Services: Provincially announced expansions and changes to the Wait Time Strategy will be supported. Additionally, the LHIN will engage hospitals and other stakeholders on: a) new models of care delivery; b) care pathway development for hip, knee and stroke patients; c) regional surgical service delivery model; d) performance improvement processes for MRI and CT testing, e) opportunities to improve access to speciality services in the appropriate setting, and f) evaluate opportunities to improve access to surgical and diagnostic imaging services (e.g. Regional Joint Assessment Centre).

­Stakeholders:Surgeons, hospitals, primary care providers and patients.

­Methods: Key informant interviews, roundtable discussionswith stakeholders; meetings; surveys.

  • Chronic Disease Prevention & Management:To engage stakeholders in discussions of enhanced system integration and new service delivery models, identification of champions of change and buildcapacity for self-management, improved health literacy, and increased care in the community.

­Stakeholders: Health service providers serving people with chronic diseases, Health Quality Ontario and North West CCAC as the lead for self-management.

­Methods:Meetings with stakeholders and participation in planning initiatives.

  • Long-Term Care Services:Information from the Local Area Plan, in addition to extensive consultation, will support planning for futureenhancements to community support services across the LHIN with a focus on supportive housing, assisted living services and home care. .In addition to this work, a Regional Behavioural Support Service Delivery Model will be implemented to care for those individuals with responsive behaviours in alignment with the provincial BSO Strategy.

­Stakeholders: Clients, health service providers, physicians and referral agencies.

­Methods: Focusgroups including clients/caregivers, physicians and service providers and key informant interviews.

  • Mental Health & Addictions Services:By working with system partners, repeat, unplanned emergency department visits due to mental health and substance abuse conditions will be reduced. With the scheduled closure of the Lakehead Psychiatric Hospital, transition planning for clients from the existing site to an alternate setting will be facilitated.. Steps will be taken to implement therecommendations contained in the MOHLTC’s 10 year strategy for mental health and addictions with a specific focus on child and youth.Access to speciality services such as the Schedule one inpatient mental health beds will improve through development of an integrated approach as one regional program with consistent care pathways and practices.In addition engagement efforts will include development of a fully integrated model of care for mental health and addictions services that is externally validated by health service providers and clients.

­Stakeholders: Hospital CEOs, clinical vice presidents, community mental health and addictions program directors and staff, program managers, psychiatrists, primary care, housing providers and municipal andenforcement sectors.

­Methods: Focused planning and implementation sessions, roundtable discussion and meetings.

  • Aboriginal Health Services:The Aboriginal community will be engaged tofoster and build relationshipswith health services providers and the North West LHIN. Engagement will support the needs of the Aboriginal communities by encouraging greater input into health planning and improvement initiatives. The goal is to increaseaccess to health care services through collaborationand coordination of care delivery; discuss opportunities for integration of care along the continuum(between the federal/provincial and First Nation communities)and to ensure care is culturally appropriate to better meet the needs of population.

­Stakeholders: Aboriginal health service providers within each Treaty area, urban and Métis population (including health directors, CEOs, managers, health policy analysts).

­Methods: Advisory committee andcommunitymeetings.

  • French Language Health Services:The North West LHIN will promote awareness and sensitivity to French language service issues with the health service providers through the monitoring of the implementation of the French Language Services Plan. The North West LHIN will also work closely with the Réseau du mieux-être francophone du Nord de l’Ontario (French Language Health Planning Entity) to ensure that the needs of the Francophone community are integrated in LHIN planning activities.

­Stakeholders: Réseau du mieux-être francophone du Nord de l’Ontario (Entity), Association des francophones du Nord-Ouest de l’Ontario (AFNOO) and its group members, Francophone community and health service providers.

­Methods: Focus groups, round table discussions and regular meetings.

  • Health Human Resources: The North West LHIN will foster relationships between the health service providers and will engage the providers on the development of a 10 year HHR Strategy.Support for HealthForceOntario initiatives including the regional locum program, interprofessional care delivery models and other programs will continue. Links with academic institutions will be strengthened.

­Stakeholders: HealthForceOntario (various departments), local Community Partnership Program coordinator, local hospitals and physicians, Health Professionals Advisory Committee (HPAC), Lakehead University, Northern Ontario School of Medicine, Confederation College, local health service providers, Ontario Telemedicine Network, and KO Telemedicine.