Agenda

According to the most recent data from CIHI, 1 in 11 patients have their hospital stays extended until home care services are ready. This translates into 400 bed nights – every day.  

Manitoba has the lowest incidence of hospital stays while waiting for home care. Their successful initiatives have freed up more hospital beds for acute care while providing timely transitions to home care.  

Key Session Takeaways Include:  

• What were the key success factors to ensure home care services are readily available 
• What would they do differently in hindsight  
• How Manitoba is preparing for future trends and their impact on the health care system 

An open dialogue fireside chat with Carly Ellis, Director of EnterpriseHealth and Sandra Ketchen, CEO of Spectrum Health to discuss lessons learned and the predictions of home and community care across Canada.

The Overlook, a new ground-breaking harm reduction, peer supported housing project in Halifax will house 65 individuals who struggle with active and problematic drug and/or alcohol use; as well, many have chronic health conditions, a lengthy experience with homelessness, and/or are actively engaged in sex work.

The Overlook staff are trauma informed, understand addiction, and endeavour to ensure each individual is able to live there with more dignity as they try to recover and turn their lives around.

Key Session Takeaways Include: 

• How is staffing managed to ensure adequate and timely support for a multitude of services

• How are systems and programs rolled out, and how have they been viewed by residents

• How were partnerships established, how are they maintained, and how are they funded

• What lessons learned are they seeing on the ground

Unattached patients have an over reliance on emergency room use, particularly those with chronic diseases. With more and more patients seeking care, and without a family physician, we are seeing more and more stress on hospital emergency services.  

To mitigate these stressors, and improve the health of their local community, Gateway Community Health Centre developed a successful strategy to provide more services, especially those struggling with Chronic Disease Management issues.  

Key Session Takeaways Include: 

• Practical strategies for creating a system that can capture unattached patients in your community 
• The importance of partnering with OHTs to develop a community wide approach and processes to capture the most critical patients for success  
• How the program led to an 86% drop in EM usage post entry into the program 
• The road ahead, and how they are adapting on the ground 

All healthcare organizations are committed to EDI, though they are not always effective in executing those practices.  

Delivering care that is sensitive to EDI is essential, but difficult in practice. In this session we look at how you and your team can deliver effective care to their diverse communities while remaining humble and open to feedback.    

Key Session Takeaways Include: 

• Negotiating and meeting the changing language around EDI  
• How to communicate with patients and the public where health equity is a serious issue 
• How to demonstrate to the community you are progressing 
• How smaller organizations can adapt  

The Mobile Withdrawal Management Services, or MWMS, is a mobile detox and stabilization clinic for individuals who reside in Winnipeg, East St. Paul and West St. Paul. The program focus is currently on individuals 18 years and older who are voluntarily looking for supports to withdraw from any substance while remaining in the community. This program is unique to Manitoba and was started in September 2019 as a result of  the VIRGO report which identified significant gaps in both clinical and mental health resources for those struggling with addiction.  

Running 365 days a year and staffed by health and social support workers, psychiatric nurses, a program coordinator/addiction counsellor and a physician, it offers resources that include peer support, cultural support, groups and trauma counselling. Access to harm reduction supplies such as Naloxone kits (and teaching), safe injection kits and condoms are always available. Klinic has established partnerships with AFM, Peer Connections MB, The 24 hour Klinic Crisis Line, RAAM and the University of Manitoba Addiction Fellowship program to name a few.   

Key Session Takeaways Include: 

• How is the program structured, and how are the services delivered 
• How the program will evolve and grow based on our internal learnings and ongoing feedback provided directly by the clients we support.  
• What are some of the secrets to the program’s success and how are barriers removed to ensure more equitable service delivery 
• What advice they have for other communities looking to embark on similar programs 

As far as social determinants of health, housing is number one. Housing formerly unhoused individuals, or improving the living conditions of those in poverty, will lead to healthier communities. Building a housing continuum of care that suits the needs of your community is vital to ensure you can provide the right support, to the right persons, at the right time. 

Key Session Takeaways Include: 

• Which options are seeing success, and what expected and unexpected challenges have we faced 
• How has a healthcare strategy impacted healthcare needs and support 
• What are the key factors you need to be aware of when developing an integrated health care and housing strategy  

The Saskatoon Community Clinic (SCC) is a primary health care service provider that operates under a co-operative model to deliver care focused on healthy lifestyles, disease prevention, patient education, and diagnosis and treatment. 

Key Session Takeaways Include: 

• Learn how SCC’s group programming is helping our clients develop skills to take care of their own health  
• How they are improving their overall wellbeing  
• How they are reducing their sense of social isolation 

This session will explore several different ways Indigenous and non-Indigenous Organizations have partnered in Niagara to begin deconolozing supports in several areas of children’s services.

Key Session Takeaways Include:

• Identify methods to strengthen partnership when trying to find solutions with multiple stakeholders
• Describe the knowledge translation process used to create a bridge between system issue and the solution(s) to address it
• Explore strategies to support a sustainable care system within interorganizational care environment

Retention of ​care providers is a persistent area of concern for home and community managers. ​Nurses and personal support workers are fundamental to delivery of services, and being aware of their job satisfaction, or dissatisfaction, can enable staffing managers to preemptively avoid losing vital staff.  

Surveying staff from a representative community, researchers were able to determine certain predictors in retention, and ​learn from staff strategies and suggestions to proactively address their concerns.  

Key Session Takeaways Include: 

• What were the findings and the major lessons learned 
• What were the major predictors to leave ​and how do they differ among types of care providers 
• ​What keeps staff in homecare and what are their suggestions to help retention 
• How staffing managers can respond to retain key staff 

Healthcare continues to become more complex, and home and community care organizations are seeing this play out daily. To provide better care, it is becoming more important to have the tools necessary to provide the most effective standards of care.

Improving patient care requires better integration between primary and home care. And while we are seeing this trend play out, there is much more to do, with better integration from technology leading to improved patient experience at home.

Key Session Takeaways Include:

• How primary care practitioners would benefit from home care provider remote patient monitoring systems to improve patient health outcomes, decision support and strengthen interdisciplinary team-based care
• Why seamless integration is important for home care patients with complex health needs or treatment-based episodes of care
• What principles are critical to build integrated digital solutions between home care and primary care

Delays in paramedic offloads has been a challenge across most jurisdictions in Canada. In order to reduce the delays, and free up paramedic resources to go back to the community, l’Hôpital Montfort and the Ottawa Paramedics Services created a pilot program to improve patient care and flow within the emergency department.

This was achieved by deploying 4 Primary Care Paramedics in Montfort’s Emergency Department, providing 12-hour coverage during specific times, seven days a week.

Patients’ care can now be transferred from the transporting paramedic crew to the paramedic trained in the Emergency Department and working with clear medical directives. This allows the paramedic crew to return to the community so they can be available for the next call

Key Takeaways and Insights Include:

• How the partnership was developed, structured, and executed
• What is the new scope of practice for the integrated paramedics in the ED
• What were the outcomes, and what were the lessons learned