Current evergreen contracts and market share restrictions do not allow for integrated care delivery and perpetuate fragmented care. Our patients describe a desire to have all services provided by a single team of providers so as to limit confusion and re-assessments. And our providers tell us that they need a common mechanism for communication and shared care planning. Achievement of these features would be optimized under new a contractual model whereby we can optimize the primary in-home care that is delivered by the Integrated Primary Care Team (without being restricted by the need to maintain current market share volumes) and where a single provider delivers all secondary in-home care so as to minimize re-assessment and streamline care coordination and delivery.
The Guelph and Area OHT planning table understands the need to evolve the home and community care model of care delivery over time in such a way as to not negatively disrupt care to patients. H&CC resources are, by virtue of how they function and what they are accountable for, supported by functional program teams in contracts, finance, decision support and IT (e.g. CHRIS is still the provincial tool of choice). The timing of required policy and legislative changes and the approach supported in managing labour relations issues (including collective agreements), will influence how quickly and to what degree roles can transition and evolve.
Clarity on the provincial work underway to modernize home and community care will be of benefit to the design work that will be required in year one. This includes the need for better understanding of which current functions of the LHIN home and community care will be centralized, regionalized or added to the accountabilities of OHTs. As these functions currently sit within one agency, they may need to be uncoupled, and again, solid change management and partnership with both the Ministry and the Waterloo Wellington LHIN to achieve an effective transition will be enablers of success.
The provision of home and community care by the LHIN based teams is anchored in a strong working relationship with program teams in contract management, finance, procurement, decision support and IT. The Guelph and Area OHT will work with the Waterloo Wellington LHIN and the Ministry to understand how these functional areas will be able to continue to support home care activity in the future.