Government of Nunavut, Department of Health and Social Services - "Evaluation of Case Management Services for the Baffin Region of Nunavut"
HarbourFront Health Group is now building on its recent evaluation of specialist services and medical travel for Qikiqtaaluk, to perform a focused evaluation on case management services for clients receiving specialist care, both within the regional hospital in Baffin and in Ontario. This review incorporates detailed articulation of the organizations and processes within the network, benchmarking current practices and development of performance metrics for the system.
Government of Nunavut, Department of Health and Social Services - "Evaluation and Operational Review of Specialist Services, Telehealth and Medical Travel for the Baffin Region of Nunavut"
HarbourFront Health Group recently performed a summative evaluation and operational review of specialist services and medical travel for Qikiqtaaluk, geared to maximize efficiencies and minimize wait times for specialist care of the Baffin Region residents. To determine resource allocations, organizational structure, operating procedures, processes, and controls, this project involved analysis of workflow processes through the current manual system, as well as the documents involved with case management, specialist services and medical travel. Also, interviews of stakeholders and staff took place, all geared to provide an effective evaluation and recommendations to enhance the delivery of seamless, quality care.
Streamlining the current manual system will provide an effective framework for the future implementation of electronic health information management processes. This evaluation was aimed to ensure all participants are doing everything possible to guarantee optimal organizational structures exist and that processes for specialist services and medical transport are running most economically and efficiently to maximize desired results. Additionally, the role and utilization of Telehealth services for specialty care, and any barriers to optimizing its use including scheduling and human resource issues formed part of this review.
Health Canada/ Oneida Nation of the Thames
On request of this First Nations Peoples for development of culturally sensitive, primary care and health promotion services, conducted multistakeholder dialogue to develop a successful proposal to improve regional services. In collaboration with Health Canada, City of London, Band Council and representatives, and neighbouring tribal council and associations, developed and a framework for regional service integration ensuring a continuum of care for the South Western Ontario Region. This project has been included the federal Aboriginal Health Transition Fund, a major initiative for Native healthcare system development in Canada. Current planning for improved regional services for Native people is now underway under the guidance of Dr. Ashton. An evaluative framework was developed and a summative evaluation using quantitative and qualitative data collection and analysis by HFHG with the use of a Logic Model to inform future decisions and funding applications for this initiative.
MOHLTC/ WestEnd Family Care Clinic, Ottawa
In consultation with Ministry staff, developed 5 year Business and Operational Plans for this Family Health Team (FHT), resulting in early approvals for funding of nearly $10M. Resource and process models were created for effective healthcare delivery to treat a number of prevalent chronic diseases endemic to the patient population. Detailed facility space and equipment purchase planning was conducted to ensure efficient expansion of facility services and personnel over a five year period. Accolades received by Ministry of Health and client for timeliness, accuracy and conciseness of Plans. Integrated Electronic Medical Records system architecture designed with IT consultant and costing developed with timelines in business plan. Linkage with hospital database/ lab/ radiology IT drafted. Salary and benefits packages developed for all non-contract staff of FHT. A comprehensive evaluation plan for this project was developed by HFHG to guide implementation over five years.
Oshawa Health Center
Retained to provide experienced health care strategic guidance and leadership, HFHG definitively assisted this organization in fulfilling its ambitious vision to become a leading edge care centre for the region with multidisciplinary care expertise to be disseminated on a national basis.
Current operating costs, balance sheet and cash flow reports were thoroughly analyzed for the transition into a facility four-fold the size of the previous centre. Detailed financial plans were constructed with elaboration of current and future management and characteristics of debt/asset accumulation with corresponding operating costs and cash flows. Financial resource objectives were implemented to ensure long term sustainability of the centre with a recruiting strategy for private health care services as well as practitioners to form a core group for the facility's delivery of health care to the community.
Administrative and support staff protocols were formed and documented to optimize human resource utility and satisfaction with standardized training programs. Such documents were crucial in the equitable settlement of employee and union issues with administrative staff. To develop shared vision and collaboration in a rapidly expanding professional and administrative staff, tenets of the "Learning Organization" (Senge, MIT, 1990) were adapted to multidisciplinary care giving rise to the "Learning Model of Integrated Care" (Ashton, Duffie, Aiken, 2007). Expert advice was obtained and a plan for summative evaluation was developed in collaboration with health service researchers at Queen's University.
The Oshawa Health Centre successfully grew to a collaborative group of 35 health professionals and staff members from 12 two years previous, and provides comprehensive, high quality primary care services to the Durham community.
The "Learning Model of Integrated Care" has received national attention with a presentation at the 2007 National Health Leadership Conference, a feature article in the September 2007 Medical Post entitled "Programs that Work", and has been cited by the Health Quality Council. In addition, a detailed, peer reviewed article has been submitted for publication in the 2008 summer issue of Healthcare Policy.
