Providing coordinated care for patients with complex
conditions comes with valuable lessons, many of which can be applied to improve
care for people with mental illness and addictions. That was the main theme of
this year’s Health Quality Ontario Leadership Summit that took place late last
A unifying feature of the day-long meeting was the emphasis
on patient-centred care and learning from the lived experiences of patients who
spoke in different panel discussions.
In the morning, Tammy Stadt, who described having to manage
six chronic conditions and work with 23 different types of health care
providers, discussed how she had used self-care management plans to avoid
emergency room visits. While Stadt said her personal experience as a community
health worker gave her the skills to become her own advocate, those who help
coordinate patient care could help other patients to do the same.
“Empower your patients to be an active partner in their
health,” she said.
On the closing panel, Steve Keczem, whose eldest son has
schizophrenia and who provides support services for other parents, spoke of the
importance of health care providers listening to their patients. Both he and
Stadt also talked of the importance of peer support.
“Until you understand what the patient wants, you are not
going to be able to achieve the clinical outcomes that you want,” said Lyn
Linton, Executive Director, Gateway Community Health Centre, who was on the
same panel as Stadt.
The meeting, which featured in-person and virtual participants,
could be divided into two components: The first providing an update on the
provincial program to provide more integrated care to patients with multiple
medical conditions or complex needs with an emphasis on what has changed and
the impact of implementing those changes. Given the prevalence of mental
illness and addictions among patients with complex needs, the second part of
the day focused on innovations to better integrate mental health and addictions
Lee Fairclough, Vice President, Quality Improvement, Health
Quality Ontario noted that since the Health Links program was initiated in
2012, there have been 70,060 patients identified and provided care through the
new approach of care coordination. The involvement of 536 health care organizations
in the province to be part of that care highlights the complexity of care
required, with several of these organizations extending into other sectors than
health – such as housing.
Lee Fairclough sharing remarks at the Leadership Summit.
One key indicator of the evolving success of the program,
Fairclough said, was almost three-quarters of patients recently reporting that
they have timely access to primary care. Dr. Walter Wodchis, an adjunct
scientist at the Institute for Clinical Evaluative Sciences, provided a more
detailed assessment from available data on how well the program was working. He
noted that patients enrolled in the program had fewer acute admissions to
hospital than before they were enrolled.
Following remarks from Helen Angus, Deputy Minister for
Health and Long-Term care, sessions focused more specifically on mental health
and addictions with it being noted that the new government has made a strong
commitment to improve mental health.
One panel discussed how partnerships and collaborations
between health care providers and community organizations, such as the police,
could lead to better care in mental health. Two Ontario Provincial Police
officials discussed how their changed approach to addressing situations
involving someone with a mental illness has led to better resolutions.
Among the programs discussed were Health Quality Ontario’s
quality standards major depression schizophrenia developed for patients with
mental health conditions such as Dr. Phil Klassen, VP Medical Affairs, Ontario
Shores Centre for Mental Health Sciences, discussed how his centre had used
these standards to improve patient care. Assessment since the standards were
implemented at the end of 2016 to February 2018 have shown significant
improvement in several of the indicators selected in both patient populations,
The final panel of the day brought together the various
themes discussed and took a forward-looking approach to how innovations in
mental health care could provide more integrated and better care.
On that panel, Dr. Paul Kurdyak, Director, Health Outcomes
and Performance Evaluation, Institute for Mental Health Policy Research,
stressed the importance of acting on new data and evidence as they became
available to better understand how care is currently delivered and can be
Dr. Paul Preston, Clinical Quality Lead, North East LHIN,
provided a perspective from Northern Ontario with other panelists acknowledging
his perspective that there was a need to recalibrate and distribute services in
Kimberly Moran, CEO, Children’s Mental Health Ontario,
reflected the need to extend current thinking to include child and youth mental
health, and consider a systems approach to designing how services across care
settings get together.