A Huge Thank You to Nurses

This week we have celebrated the incredible nurses working in our local health system. I was inspired by the diverse profiles of local RPNs, RNs, and NPs, working across the health system and how passionate they are about their patients. Most of them spoke about wanting to make a difference and the value they add supporting families through challenging times. I couldn’t agree more.

For me, I have been fortunate to have many great nurses care for me and my family over the years. I think of the care coordinator who helped make my mom’s final wishes a reality as well as those who cared for her in her home, the nurses at my family health team, and more. As a sports guy, I have had my fair share of injuries and as a dad, I’ve also spent a fair bit of time at the family doctor and in the ED worrying about my kids.

So on behalf of my family, and the thousands of families we serve across Waterloo Wellington – a heartfelt thank you for everything you do each and every day.

Bruce
@brucelauckner

Improving Hospice Palliative Care Across Waterloo Wellington

Guest Blog – Emmi Perkins, Director, Regional Hospice Palliative Care Program

As demographics shift and our population ages, hospice palliative care is becoming more and more important to local residents. Observing this shift, the Waterloo Wellington LHIN continues to improve access, supports and resources to make sure the right care is available when residents need it.

The first question you might ask is – what exactly is hospice palliative care?

Hospice palliative care aims to relieve suffering and improve the quality of living and dying.

Hospice palliative care strives to help patients and families:

• address physical, psychological, social, spiritual and practical issues, and their associated expectations, needs, hopes and fear.
• prepare for and manage self-determined life closure and the dying process
• Cope with loss and grief during the illness and bereavement.

Hospice palliative care is appropriate for any patient and/or family living with, or at risk of developing, a life-threatening illness due to any diagnosis, with any prognosis, regardless of age, and at any time they have unmet expectations and/or needs, and are prepared to accept care.

Over the last few years we have developed and implemented new strategies to improve the hospice palliative care patient experience. A great example of this is our successful Coordinated Bed Access Program.

The Coordinated Bed Access Program is a collaborative program, developed by hospice palliative care providers to communicate both demand for and availability of hospice palliative care beds throughout the region in a timely manner.  Depending on a patient’s needs, providers work together to match patients with available beds, which means patients are getting the care they need, faster.

Time is incredibly important in all aspects of a patient’s care, but especially in end-of-life care. It can mean the difference between honoring a patient’s preferred end-of-life care plan and having them pass away in a place that wouldn’t have been their first choice. Fortunately, 83% of local residents are able to pass away in their preferred place. But we still have more work to do to make this a reality for all residents.

Supporting residents to die in their preferred place is enabled through strong partnerships amongst hospice palliative care providers in each community.  These dedicated hospice palliative care teams are skilled and knowledgeable about palliative care and local resources and are therefore able to ensure the needs of patients with complex pain and symptom management issues are addressed in the setting of their choice.  Additionally,  these teams promote and support other providers in each community to identify patients who would benefit from a palliative approach to care and to deliver this comprehensive approach to addressing the needs of patients who are in their last year of life (and their caregivers).  A recent key enhancement to these teams is a standardized role for the hospice palliative care nurse practitioners to support primary care providers who are caring for patients with palliative care needs.

We are also undertaking planning activities to understand our current hospice palliative care resources and to plan for services that will be required in each sub-region to support equitable access to high quality hospice palliative care and in anticipation of greater future demand for hospice palliative care. Relative to other regions in Ontario, Waterloo Wellington is well resourced with respect to residential hospice and other end-of-life care beds.  In light of anticipated demographics shifts, we do need to better understand resources required to ensure high-quality care for patients whose preferred place of death is home.

But supporting care at end-of-life is only one component of hospice palliative care. As patients near end-of-life, we also need to develop supports to make the transition to hospice palliative care easier for patients and their families. One of the ways we will do this is to embed Advance Care Planning into all care settings.

It is difficult to know what to do when a loved one is diagnosed with a life-limiting illness. One of the best ways to prepare for this stage in life is to have a conversation about Advance Care Planning. Advance Care Planning is communicating your wishes, values and beliefs to your substitute decision maker (SDM) in the event you are incapable of making health care decisions for yourself. In order to assist and encourage patients to talk openly about their wishes we are supporting care providers and other community members to encourage individuals to identify their SDM and to have these conversations.

Overall, we have made many improvements to hospice palliative care in Waterloo Wellington. And as we continue to improve care, the patient experience will be our main focus. We want to create an equitable, accessible and experience focused health care system, and in order to achieve these goals we have to put the patient at the heart of everything we do, and this includes hospice palliative care.

From Innovation to Action, Collaboration is Key

Guest Blog: Elliot Fung

A few months ago on this blog, I challenged our health care ecosystem to go beyond innovating and truly disrupt how we approach solutions in health care to improve patient experience and outcomes.  The response was outstanding!

In late March, the Office of the Chief Health Innovation Strategist of Ontario announced that Alaunus (www.alaunus.com), a Waterloo based software company, was awarded $100,000 through the Health Technology Fund to pilot an innovative solution in the home care delivery model; improving patient care, choice, and reducing administrative costs.  As part of a Health Innovation Team that includes a brain injury service provider, Health Quality Ontario, Wilfrid Laurier University and the WWLHIN, we hope to see some exciting and innovative improvements for patients and their caregivers through this pilot.  Later this month, I am excited to join Alaunus at the Ontario Centres of Excellence Discover 2017 conference where I will be celebrating their success and meeting with more innovative health technology companies from across the province.

Another technology company in Waterloo, CloudDX was also awarded over $400,000 to pilot a way to better manage chronic obstructive pulmonary disease for patients living at home, with their Connected Health Monitoring Kit.  At the same time that CloudDX is working on this pilot, the WWLHIN is excited to be piloting their Connected Health Monitoring Kit with 40 of our most complex home care patients, to help better manage their care and avoid having these patients have to visit the emergency department unnecessarily.

The WWLHIN is exploring the potential for these innovative technology solutions, as well as the dozens more that are developing within our robust innovation ecosystem through partners such as Communitech, Innovation Guelph, St. Paul’s Greenhouse and the Accelerator Centre.

However, we recognize that it’s not all about technology.  Being innovative and finding solutions for all residents must involve partnerships with the community, non-traditional health care providers, patients and caregivers, municipalities and many more organizations to find ‘whole of community solutions’ to complex social issues.

Working together, the WWLHIN has partnered with health and social service providers (justice, education etc.) to impact community wellbeing through the Wellbeing Waterloo Region initiative. As a proud sponsor of Wellbeing Waterloo Region, we recognize that no one organization alone can address complex community issues such as reducing poverty, improving high school graduation rates or addressing addictions.  This initiative provides a structured approach to working collaboratively on these issues using shared resources and common measurement.  Together we will lead using a collective impact approach by identifying shared priorities and actions that will positively impact wellbeing.

Innovation can mean different things to different people, but most importantly, innovating to take actions that will improve the patient experience and outcomes will help to truly transform our system.

If you have innovative or disruptive ideas or want to talk about this post, please reach out at elliot.fung@lhins.on.ca or tweet me @elliotgfung and @ww_wlhin.

Elliot Fung is the Director of Innovation and Strategic Partnerships at the WWLHIN, is a passionate supporter of the local innovation ecosystem and after many months of trying, still cannot successfully flip a water bottle.