2015 North West LHIN Leadership Award Recipient – City of Thunder Bay Integrated District Network (IDN) Health Link Steering Committee
In 2012, the Ministry of Health and Long-Term Care introduced Health Links, a program designed to bring health care providers together to improve access to care, transitions between care settings, and the patient’s care experience. Health Links were designed to serve people who need the health system the most, who in many cases have multiple, complex conditions or are from a vulnerable population.
The City of Thunder Bay Integrated District Network (IDN) Health Link is one of five Health Links that will eventually be established in the North West LHIN. When the City of Thunder Bay IDN Health Link was first announced, health service providers from different sectors were invited to join a Steering Committee to oversee the process from development to implementation. The result was a collection of partners from different sectors such as primary care, emergency services, mental health and addictions, long-term care, and housing, who may not have had the opportunity to work together to significantly advance health system transformation without the Health Link.
To proceed, the Steering Committee collaborated to develop a business case complete with an action plan for implementation. As part of the Steering Committee’s approach, clients determine the goals that will make the greatest difference in their health. A Coordinated Care Plan is developed based on these goals and adhered to by all providers at every turn, ensuring that clients continue to drive their own care.
In addition, the Steering Committee determined that the best way to treat complex patients was to consider the whole person, addressing the social determinants of health rather than focusing on a specific illness or condition. As a result, a Health Coach position was created to help clients navigate the health care system, support them as they implement their Coordinated Care Plans, or to address related issues affecting their health.
From a statistical perspective, the City of Thunder Bay IDN Health Link has achieved significant results. Since its inception in 2014, over 300 emergency department visits have been avoided due to the Enhanced Care Team Clinic, over 500 interactions between Health Link clients and their Health Coaches have taken place, and nearly 200 rides have been provided for Health Link clients to get to medical appointments, which in turn reduces avoidable ambulance trips.
But while this data is impressive, the clients’ firsthand experiences with the program are a testament to the Steering Committee’s success. In their own words, they described the Health Link as a “priceless,” “wonderful” program that allows them to feel more “supported,” “confident,” and “heard.”
Ministry of Health and Long-Term Care – Health Links Explained video (click here)
2015 North West LHIN Leadership Award Runner-Up – Arlene Thomson, Director, Cardiovascular and Stroke Program, Thunder Bay Regional Health Sciences Centre
As the Director of the Cardiovascular and Stroke Program at Thunder Bay Regional Health Sciences Centre (TBRHSC), Arlene Thomson’s journey to bring a comprehensive cardiovascular program to Northwestern Ontario began over two decades ago.
She was the founding manager of the Cardiac Catheterization Lab at the Port Arthur General Hospital in 1988 and later helped to establish the angioplasty program at TBRHSC in 2007. Strongly believing that the medical expertise and capacity existed to support more advanced cardiac services in the Northwest, she collaborated with cardiologists and community partners to draft what would be the first of several proposals to the Ministry of Health and Long-Term Care for a cardiac surgical program, without success.
Undeterred, she forged ahead to expand the existing cardiac services at TBRHSC as volumes continued to grow. A second cath lab was constructed in 2011, and she worked with a multidisciplinary team to improve the quality and effectiveness of the care provided within and outside of her program. For example, the interdepartmental collaborations initiated by Arlene significantly reduced discharge delays for patients requiring a pacemaker.
However, as she continued to closely monitor health outcomes, demographics, and health system changes she found the need for a comprehensive cardiovascular program was still clearly evident. Arlene nurtured a partnership with between TBRHSC and the University Health Network, which ultimately led to the development and approval of a fourth proposal for the first Comprehensive Cardiovascular Surgical program in Northwestern Ontario.
The proposal includes plans to recruit cardiac and vascular surgeons to the team. In the meantime, partners at the University Health Network will accept and treat patients from the Northwest until renovations are complete and the program is fully functional at TBRHSC. It is anticipated that when the program is off the ground in the upcoming years, hundreds of Northwestern Ontarians will have to access cardiac and vascular services closer to home.
Improving Cardiovascular Services for Patients in Northwestern Ontario – TBRHSC News Release