Amid the pandemic, Guelph health-care providers have quietly worked on a drastic Ontario overhaul

March, 21, 2022 – ‘It’s getting them outside of their organizational silos and really focusing them around the patient.’

Just a few months before the start of the COVID-19 pandemic, the government of Ontario moved forward on a plan to transform how health care is delivered in the province.

Under the new mandate, Ontario would do away with Local Health Integration Networks (LHINs) and move to Ontario Health Teams (OHTs). Under the new model, the province said they want local health institutions more directly integrated with one another, to make navigating the health care system easier and more efficient. 

In November 2019, Guelph was one of the first community’s to be given the go-ahead to form an OHT. The team has now expanded to include Wellington County.

Although a formal governance structure hasn’t been established yet, it’s directed by a steering committee made up of health care leaders who have taken on OHT responsibilities. Emmi Perkins is the director of transformation for the Guelph-Wellington Ontario Health Team (GWOHT) and works full-time on the project. She says one of the main goals is better integration of services and communication among health care providers.

“So really, figuring out different and better ways to work and speak to one another as health care partners, with the intention of making patient experience outcomes better,” Perkins said.

In previous reporting, one of the key issues patients said they faced was the need to constantly re-explain their stories as they move through the health care system. Perkin’s said GWHT is trying to address this through digital and organizational changes, including encrypted communication tools that practitioners can use to share information from the plethora of software different institutions use to store software.

Ross Kirkconnell, director of the Guelph Family Health Team, said the issue also being addressed is through “Integrated Primary Care Teams.” For instance, when it comes to addiction counselling, Kirkconnell says they’re experimenting with having addiction counsellors act as part of primary practice teams. Meaning that a person could get help for addictions counselling at their family doctor. 

Pat Stuart, executive director of Hospice Wellington, offers another example of integrated care. Her organization has tried out a virtual nurse program that helped guide people new to palliative care through the system. “There are gaps,” Stuart said, adding that her organization gets routine calls from terminal people seeking guidance.

“They don’t know if they’re allowed nursing, or a PSW, and what happens a lot of the time is people become desperate and they call 911 and go to the hospital … I think if we can walk alongside them and guide them, that would help with some of the emergency department diversion,” Stuart said. “That’s a really important piece.”

Marianne Walker is the CEO of Guelph General Hospital and serves on the GWOHT steering committee.

“I’m very passionate about working together as partners, and (exploring) how we make it better for patients and families, so for them, it becomes seamless. They don’t need to wait for the next care provider …” she said.

Homecare, something LHINs were responsible for in the past, is one of the next facets that the team said they’re working on integrating. Integrating pharmacies is also on the list. 

There have been challenges. Perkins said the group is about nine months to a year behind schedule, thanks to having to shift focus to the pandemic, and Walker noted that it’s tough for staff to be doing the OHT work on top of everything else they’re dealing with. But each of the institution heads seemed hopeful that the new structure will benefit patients.

Each also noted that the pre-existing goodwill among Guelph health care providers has enabled the progress they’ve made so far.

While the system currently seems like more of a make-do situation, Perkins said there are systemic and structural changes in the works at the provincial level. 

Still, Kirkconnell said the shift is as much about culture as system. One of the main ideas the group focuses on is that each health organization is responsible for the health of the entire community — not just their individual patients. 

“It’s changing how people work together,” said Perkins. “It’s getting them outside of their organizational silos and really focusing them around the patient.”

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