Ontario HIV Outpatient Clinic Network

Terms of Reference

FINAL – March 12, 2010.

Introduction

The Ontario HIV Outpatient Clinic Network is a coalition of Ontario HIV outpatient clinics, represented at Network meetings by staff designated by their clinic. Clinic representatives can include Clinic Coordinators and Directors, and other designated clinic representatives, such as nursing staff, nutritionists, social workers and physicians. The Network formed out of a desire amongst Ontario’s HIV outpatient clinics to collaborate with one another in order to ensure high-quality and sustained outpatient clinic care for people with HIV in Ontario.

Background

For the past 15 years, the Ontario HIV Outpatient Clinic Network has met to network, share information and engage in knowledge-transfer and exchange activities. These activities have included a quarterly meeting, participation in workshops or educational sessions, coordination of advocacy efforts, and participation in an annual conference or Clinic Education Day. Up until Sept 2009, the Network has received financial and coordination support from the AIDS Bureau at the Ontario Ministry of Health and Long-Term Care.

In 2008/2009, the Ontario Ministry of Health and Long-Term Care underwent a transition as the ministry assumed its role as a steward within a regionalized health care system. As a result, the funding and ongoing coordination for the Network was transferred to the Ontario HIV Treatment Network (OHTN), a community-based HIV research organization with a strong capacity to support community networks and facilitate a range of knowledge-transfer and exchange activities. As part of this transition process, the Network re-examined and updated their Terms of Reference, adopted in April 1998.

When the Network was originally formed there was active participation in Network quarterly meetings from Clinic Directors, as well as Clinic Coordinators and other staff interested in participating in meetings and Network activities. However, by 2003/2004 Clinic Directors no longer felt it was necessary for them to meet quarterly. There were new opportunities for physicians to network with one another through work coordinated by the OHTN and it was felt by the Clinic Directors that these networking opportunities would be sufficient for their needs.

At the same time, Clinic Coordinators and other Clinic representatives to the Network felt strongly that there remained tremendous value to them and to their Clinics in continuing to meet quarterly. As such, Network meetings have continued with participation from Clinic Coordinators and other Clinic representatives interested in this important networking and capacity development opportunity.

Recently, some Clinic Directors have expressed the desire to meet either on an as needed basis, perhaps yearly, to network and discuss challenges of particular concern to Clinic Directors. These Terms of Reference have been updated with this expressed desire in mind, such that Clinic Directors will continue to be engaged in Network activities as desired and needed.

Overall Purpose

Ontario HIV Outpatient Clinics continue to play a pivotal role in HIV care in the province. HIV Outpatient Clinic and the Clinic Network remain vital as a group of health care providers:

  • uniquely positioned to identify emerging care and treatment issues and trends;
  • with specialized expertise in the multi-disciplinary management of HIV patient care that can be used effectively to anticipate and respond to clinical care challenges and opportunities.

The overall purpose of the Network is to support Clinic staff to best capitalize on these inherent strengths. These Terms of Reference are of value as an opportunity to articulate a shared vision of purpose toward the ultimate goal of supporting one another to effectively address the ongoing challenges of providing high quality, multi-disciplinary, client-centered and evidence-based clinical care to people with HIV in the province. The Network can best support this goal when it is organized, consistent, focused, forward thinking and relevant to the day-to-day needs of staff working in the Clinics.

Vision

All people in Ontario living with HIV have optimal HIV care.

Mission

We work to provide patient-centered care through specialized HIV outpatient clinics.

Goals and objectives

  1. Develop and maintain efficient ways for Ontario’s HIV outpatient clinics to collaborate through effective communication, shared information, networking and strategizing to improve the quality and accessibility of HIV outpatient care.

To this end, we will:

  1. Continue to hold meetings of designated clinic representatives. These meetings will be held on a quarterly basis in-person. If requested and available, video and/or audio teleconferencing will be accessed for members who are unable to attend in-person.
  2. Strike working groups as needed to address key issues and report back to the larger group.
  3. Facilitate communication among clinics and encourage ongoing discussion of concerns and issues with the assistance of electronic and other technologies.
  1. Support and encourage the delivery of optimal HIV outpatient care that is of high quality, equitable, accessible and holistic. All Network activities should be guided by our desire to provide patient-focused care that reflects best practices, is rooted in evidence, and is responsive to the local patient and community needs we each serve.

To this end, we will:

  1. Strive to support each clinic in establishing standards of HIV care in order to foster consistent care that is evidence based.
  2. Identify activities that HIV outpatient clinics can pursue collectively and collaboratively that will improve the quality and accessibility of HIV outpatient care.
  3. Reduce unnecessary duplication of effort among HIV outpatient clinics.
  4. Develop indicators that can be used to guide and evaluate the care provided through HIV outpatient clinics.
  5. Establish and promote standards of care, which take into account the need for local flexibility.
  6. Develop relevant educational and training opportunities for clinic staff that reflect ongoing advances in HIV research and practice.
  7. Work collaboratively to improve access to clinical trials and other HIV research in all parts of Ontario, consistent with prioritizing patient care and ensuring patient confidentiality.
  8. Encourage specialty clinics (e.g. Mt.Sinai Clinic for HIV-related Concerns, a psychiatric and mental health clinic) to act as a resource to other clinics
  1. Demonstrate leadership to identify and address issues that affect the health and well being of people who need HIV outpatient care.

To this end, we will:

  1. Identify and addressemerging treatment issues.
  2. Identify and advocate around the needs of emerging populations at risk of and/or living with HIV.
  3. Identify and addressgaps in outpatient care, services or service coordination, as well as other concerns that may affect the quality and accessibility of HIV outpatient care in Ontario.
  4. Identify and address HIV treatment and outpatient care research questions as well as collaborative mechanisms that outpatient clinics and others involved in HIV research can use to answer them.
  1. Work effectively with other organizations that have an impact on HIV outpatient care.

To this end, we will:

  1. Provide expert advice to key partners in the service of HIV outpatient clinic care, including the AIDS Bureau, Ontario HIV Treatment Network, community-based AIDS organizations, Local Health Integration Networks and other partners working towards optimal HIV care in our local communities.
  2. Through our link with the OHTN, make recommendations towards ensuring research relevance in support of optimal HIV outpatient care.
  3. Remain open to and evaluate recommendations arriving through these collaborations with key partners, and act upon them as deemed appropriate.
  4. Remain current with respect to government policies as they pertain to health care delivery. These can include government programs (e.g. Trillium Drug Plan) and systems or structures (e.g. Local Health Integration Networks).
  1. Advocate for policies and resources that support high quality HIV outpatient clinic care.

To this end, we will:

  1. Work collectively to identify gaps in policy and resources that are impacting on our ability to provide optimal HIV outpatient clinical care.
  2. Strive to support each clinic, as desired, in establishing tools to track, the complexity, depth and volume of care provided in the clinics.
  3. Develop and implement an advocacy strategy to ensure HIV outpatient clinic budgets are secure and that HIV outpatient clinics have full access to the professional supports needed to provide optimal, multi-disciplinary HIV patient care.
  1. Ensure ongoing, high-quality, relevant and timely knowledge-transfer and exchange activities are available to all staff working in HIV outpatient clinics.

To this end, we will:

  1. Participate, with the support of the OHTN, in the development of an annual Clinic Education Day, a one-day conference for HIV outpatient clinic staff.
  2. Identify relevant topics and speakers for ongoing knowledge-transfer and exchange activities to take place on the evening prior to quarterly meetings and/or during quarterly meetings and broader community.
  3. Advise on agenda items for quarterly meetings.
  4. Respond to communications between quarterly meetings, as needed, to support ongoing information exchange and collaboration between clinics.
  5. Provide advice on relevant clinical care topics and speakers for other knowledge-transfer and exchange activities coordinated by the OHTN and other HIV partners, as needed and/or requested.
  6. Include on our meeting agenda standing items to keep us abreast of what is happening with other key partners in HIV care. We may change our standing items as needed. Currently, standing items include:
  • Ontario HIV Treatment Network,
  • Canadian Association of Nurses in AIDS Care (CANAC/ACIIS)
  • Ontario Advisory Committee on HIV/AIDS and AIDS Bureau, and
  • HCV Task Force.

Administrative Support & Coordination

The Ontario HIV Treatment Network will provide ongoing administrative support and coordination to the Network and its activities. The OHTN will be responsible to:

  • Coordinate the meeting agenda with the Network co-chairs and circulate it in advance of quarterly meetings;
  • Ensure meeting minutes are recorded and disseminated in a timely fashion;
  • Provide meeting coordination support through timely notice of meetings and other meeting communication;
  • Support the coordination of relevant speakers and presentations scheduled for meetings; and
  • Work with the Co-Chairs to ensure action items arising through meetings are carried out in a timely fashion.

Clinic Network representatives will respond to electronic and other communication in a timely fashion, as needed. Clinic Network representatives will take on action items and other tasks as needed and appropriate.

Co-Chairs

The Network will have co-chairs, nominated and selected by the members. Co-Chairs will serve for a two-year term, beginning on alternate years. Co-Chairs will be responsible for setting the agenda for meetings, keeping meetings on time and on focus, and following up on any action items outlined in meetings. Co-Chair designation will be reviewed at the end of a two-year term. Co-Chairs can serve more than one term.

Meetings

The Network will meet on a quarterly basis. Meetings will take place in-person at the Ontario HIV Treatment Network, unless otherwise notified in advance.

One or more of the quarterly meetings may also be conducted via audio or video technologies, if this is the desire of the Network.

Clinic Directors will be encouraged to participate in one of the quarterly meetings, annually, unless it is otherwise determined that such participation is not desired. The OHTN will contact the Clinic Directors once each year to assess the level of interest for an in-person meeting and will work with the Directors to identify relevant agenda items for such a meeting.

Meetings of task-focused working groups will be coordinated by the OHTN, and will occur as needed. Under normal circumstances these meetings will be held via video or audio teleconference.

Between meetings, the Network will rely on audio, video or electronic communications to conduct its business.

Quarterly meetings will be chaired by one of the co-chairs.

Representation and Accountability

Network members attend Network meetings as representatives of their clinic and, in part, their hospital or community agency within which they are housed.

Representatives who serve on other policy and research bodies in Ontario as representatives of HIV clinics are accountable to the Network for communicating Network member concerns. Where feasible, Network representatives should discuss issues with the Network in advance of representation of those issues at other bodies. In all instances, Network representatives should communicate about the issues and perspectives arising through their ongoing participation on other policy and research bodies to the Network members in a timely fashion. Other policy and research bodies include the OHTN, the Ontario Advisory Committee on HIV/AIDS, and other work groups coordinated by the AIDS Bureau or other levels of government.

Membership

Membership shall consist of a Clinic Coordinator or other clinic representative (as determined by the local clinic) from each of the HIV outpatient clinics in Ontario. At the time of the production of these terms of reference, these included:

Guelph:The Masai Centre, HIV Clinic

Hamilton:SIS Clinic, Hamilton Health Sciences

Kingston:Clinical Immunology Clinic

London:Infectious Diseases Care Program, St. Joseph’s Health Care London

Oshawa:Positive Care Clinic, Lakeridge Health Oshawa

Ottawa:Infectious Diseases, Module G, OttawaHospital

OASIS,

Division of Infectious Diseases, Children’s Hospital of EasternOntario

Sudbury:The HAVEN Program, SudburyRegionalHospital

Thunder Bay:Clinical Care Program, AIDS Thunder Bay

Toronto:Health Centre at 410, St. Michael’s Hospital

Clinic for HIV-related Concerns, Mount SinaiHospital

Positive Care Clinic, St. Michael’s Hospital

Medical Outpatient Clinic, Sunnybrook Health Sciences Centre

Hospital for Sick Children

Immunodeficiency Clinic, Toronto GeneralHospital

TorontoEastGeneralHospital

Windsor:HIV Care Program, WindsorRegionalHospital

Persons can be invited to become members of the network.

When members are unable to attend a meeting they will assign an alternative representative, who will have all the rights and privileges of the member for whom they are attending.

The AIDS Bureau, Ontario Ministry of Health and Long-Term Care will participate on the Network as an ex-officio member.

Date of Review

The terms of reference shall be reviewed every 5 years. The next review will be in 2015.

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