From Innovation to Action, Collaboration is Key

Guest Blog: Elliot Fung

alaunusquoteA 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.

 

Reflections as Emergency Department Physician Lead

Guest Blog: Dr. Ian Digby

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Headshot1It has been a pleasure to work as Emergency Department Lead for the Waterloo Wellington LHIN since 2013. Over this period, Ontario health care has undergone tremendous transformation and local hospitals have worked through innumerable changes to improve patient care. I am inspired by the work of so many people to maintain excellent emergency services.

Since 2013, the number of local Emergency Department (ED) patient visits has increased faster than population growth, while patient complexity (as measured by numbers of ambulance patients, admitted patients and triage acuity scales) has increased markedly. Despite these challenges local EDs have maintained top provincial rank for several wait time metrics. Simply put, hospitals have responded to “front door” pressures with improved performance and patient wait times.

Credit for these improvements goes to the individual staff at each hospital, but also to the shared work of the Waterloo Wellington Local Health Integration Network Emergency Department Integrated Clinical Council. The “WWLHIN ED Council” was created in 2013 with an agenda to promote quality improvement and improve patient experience and wait times. We adopted best practices for asthma, stroke, trauma care and ambulance offload and quality improvement for patient experience and flow. Council members openly shared data and learned from one another’s challenges and successes.

In the fall of 2015, the WWLHIN ED Council tackled the annual “seasonal surge” through a series of multi-stakeholder meetings with hospitals, public health, primary care, and long-term care (seasonal surge is an annual period in which health care providers see an increased volume of patients as a result of cold and influenza season). Members developed novel methods to communicate and reduce patient backlogs. In 2016, these methods saw some success with improved wait times, but this current winter seasonal surge has been a challenge across our health system as a result of unprecedented volumes. Nevertheless I believe we are in a better place due to our collective preparation and planning.

As ED Lead, I attended monthly meetings to shape Provincial policy around issues like physician recruitment, ED funding, Ebola response and the newest challenge of potent narcotic street drugs. In turn, I worked to translate these ideas into practice at ED Council and individual hospitals so we could stay ahead of the curve in championing best practices. Waterloo Wellington is viewed as a leader due to our ability to activate new care models.

We are in the midst of great change in Ontario health care with new Patients First legislation and transformation at the LHIN. For the next while I will be stepping back from a regional role and focusing my work on my home community. It has been a great pleasure to work with so many skilled and committed people across the LHIN and I look forward to continuing to work together.

*The Waterloo Wellington LHIN would like to thank Dr. Digby for his invaluable leadership over the past four years. Over that time, we have made significant progress in reducing wait times for local residents. We are fortunate to continue benefiting from his leadership at Guelph General Hospital and at our ED Council.

Waterloo Wellington LHIN Brings Clinicians Together for Critical Conversations

Guest Blog: Primary Care Physician Lead – Dr. Sabrina Lim Reinders

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Conversations are the cornerstone of practice. Only through conversation can we, as practitioners, discover the issues, pains, challenges and obstacles that patients face in order to assist them.

However, throughout our practice we may wonder what conversations should we be having with patients? How can we develop better relationships to support the patient experience?

To help answer some of these questions and more, the Waterloo Wellington LHIN recently hosted its annual Critical Conversations event. Critical Conversations is designed to encourage physicians, nurse practitioners, hospitalists and other health care providers to discuss the challenges they face and to learn new approaches to care from specialists and other practitioners.

By bringing health system leaders together, the Waterloo Wellington LHIN is supporting providers, enabling us to learn from each other to problem solve and better understand the challenges our colleagues face. This year’s Critical Conversations revealed important insights, with breakout sessions focusing on three main areas: newcomer health, advanced care planning and orthopedics and diagnostic imaging with a focus on shoulders.

I’d like to especially thank our facilitators Dr. Rachael Halligan, family physician, Regional Primary Care Lead for the Waterloo Wellington Regional Cancer Program, and Co-lead for Palliative Care, Dr. Michael Stephenson, family physician at Sanctuary Refugee Health Centre, Dr. Matthew Snider, orthopedic surgeon, and Dr. Chris Geddes, orthopedic surgeon, for sharing their expertise and answering complex questions about how clinicians can improve access and quality of care for their patients.

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Dr. Sabrina Lim Reinders welcomes attendees

Insights gained from the newcomer health breakout session included the need for a regional program to leverage the skills of experienced practitioners while building and increasing capacity. There is also a need to focus on relationship development with newcomers. Only by building trust with families and individuals are patients more willing to share their health histories, which will ultimately lead to more positive health outcomes.

Following newcomer health, the palliative care breakout session revealed the importance of initiating advanced care planning conversations with at risk or older patients, or at critical junctures, like surgeries. In addition, digital health solutions will likely be needed in order to share crucial end-of-life information with other health care professionals during care transitions.

The last breakout session focused on orthopedics and diagnostic imaging. Overall, there is a need for family practices to work with orthopedic surgeons to provide streamlined access to fracture clinics without having to go to emerge. Also, it is important to help manage patient expectations around what treatment will entail.

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Palliative Care breakout session

Through Critical Conversations 2017, many themes emerged as key areas for improvement. These insights will be used by the Waterloo Wellington LHIN to assist providers and increase efficiencies. By sharing insights and speaking with colleagues, we are working together to develop a more equitable and patient-focused health care system.

 

Sabrina Lim Reinders, Primary Care Physician Lead, WWLHIN

Why I don’t want you to Innovate: the paradox of innovation

Guest Blog: Director, Innovation and Strategic Partnerships – Elliot Fung

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The word ‘innovation’ means different things to different people. Most organizations and leaders say that they want to be more innovative, or lead innovation, however to truly innovate means you have to be willing to think differently, produce and deliver in ways you aren’t likely equipped to do, take risks, bend the rules, and leap frog the status quo.

In truth, most organizations, governments, businesses and leaders are pretty much the opposite; they are successful in their industry because they set the rules, follow the rules, and deliver on incremental improvements that seem innovative, but are in reality only steps ahead of what they currently deliver on today. To be an innovator, especially in health care, ‘steps ahead’ isn’t good enough for patients – you must be willing to take risk, create a totally new paradigm, and most importantly leap frog the status quo. As a patient, I don’t want just better care for my grandmother, I want the best care possible.

So, I don’t want you to innovate. Yes, we need innovation to provide sustainable solutions to our vast health care challenges, like reducing emergency department wait times or providing effective mental health care; we need innovation to help find ways to spend our precious health care dollars in more efficient ways; we need innovation to continually drive improvements in health for all residents to ensure equity, regardless if you live in the suburbs or on the street. I don’t want you to innovate, I want you to disrupt.

The transportation industry, much like health care, is complicated, very old, impacts everyone, and most notably, entrenched. For almost 100 years the taxi industry has operated around the world in a conveniently standardized way, customers had a basic expectation of service, accepted marginal experiences but almost always paid the full fare. Uber absolutely disrupted the transportation industry by introducing ride sharing – and gave riders the ability to rate the drivers, but importantly, gave drivers the ability to rate the passengers. This not only encourages better customer service, but improves the customer experience for everyone, at an average cost of 30% cheaper than a traditional taxi.   Now, Uber is often referred to as a gold-standard of disruptive innovation and is worth an estimated 40 billion dollars. It’s time to Uberize health care.

In our work as brokers, connectors and catalysts; connecting health innovators to the health system to test, pilot and adopt innovative technology and processes, and catalyzing opportunities to provide better care for patients, better patient experiences, and support and grow our innovation ecosystem in Waterloo Wellington, the WWLHIN recognizes that it takes leaders coming together from all sectors to drive these changes. Real innovation, disruptive innovation, in solving our biggest health and social issues will be realized through the deepest collaboration across health, technology, community, social services and government, when those sectors come together to not only lead together, but truly put patients first.

So I don’t want you to simply innovate, I want you to disrupt.

Elliot Fung
@elliotgfung

#WeRally2021 for the Health and Wellbeing of Our Community

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When I introduce myself, I always start with three things. I am a dad. I coach soccer. And I’m the CEO of the Waterloo Wellington health system.

Sports has been an integral part of who I am my entire life. It teaches essential core values – dedication, perseverance, teamwork – and a whole lot about sweat equity.

It also has a value much greater in terms of health. When you hear about sports and health, an obvious connection is made between the benefits of physical activity and disease prevention. We all learned a long time ago from Hal Johnson and Joanne McLeod the importance of being active to keep fit and have fun!

A lesser known benefit is the connection between sports and one’s sense of community, also an important social determinant of health. Building a strong social network is key to one’s health – having people you can rely on to support you. Feeling connected and involved is also crucial for one’s mental health. There isn’t anything I wouldn’t do to support the kids I coach and mentor – something I learned from those who coached and mentored me through the years.

For me, sports has been a way to connect to my community and give back (outside of my day job) and I can’t think of a better way to build a sense of community though sports than by rallying together to host the 2021 Canada Summer Games.

This year, Kitchener, Waterloo, Cambridge, and the Region of Waterloo have come together to bid on the Games – competing against other communities like Niagara, Sudbury, and Ottawa.

The games bring with them investment in local sports infrastructure, more than $100 million in estimated economic activity for the host community, the opportunity to inspire and motivate our youth to get and stay active, and another way to bring Waterloo Region and the surrounding communities together.

A key criteria for winning the bid? Community Support. How do they measure community support? By the numbers. Let’s show the Bid Committee #whywaterlooregion. They arrive in town on February 28th to see what we’ve got to offer.

Join me in supporting the bid here. It takes only a minute to add your name. Then tell us why you rally and post your pic tagging @CanadaGames with #WeRally2021.

Bruce
@brucelauckner

Health Technology Innovation

Guest Blog: Director, Innovation and Strategic Partnerships – Elliot Fung

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Go North Canada, The Innovation City, The Start-Up City; these are all monikers that are being used more and more to define a thriving local innovation and technology culture right here in our own community.

We boast world-class universities and colleges that are all developing ground breaking research that is helping to re-shape health and bio-medical fields. We have first-rate front-line care providers who deliver exceptional care to patients every day, and entrepreneurs and innovators who have earned reputations for creating cutting edge technologies and ideas.

But, how do we capture the work from multiple industries to harness ideas, passion, valuable perspectives and solutions and get them working for our patients?

That question became a mission, and then a passion that saw the launch of the WWLHIN’s first ever Health Collision Day, in partnership with Communitech. More than 40 health care providers and researchers joined over 20 local health technology companies to “collide” with the intent to improve patient experiences and health outcomes through innovative solutions and new technologies.

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Elliot Fung with Ben Fluter and Andrew Ringer from Alaunus, a Waterloo based start-up

High tech start-ups pitched ideas and solutions to health care leaders from all sectors; hospitals, primary care providers, home care, long-term care and community health partners.

We heard from companies that have designed equipment that will improve patient care and outcomes. Others have developed tech solutions and algorithms that help with care provision, improve wait time management and provide remote care to patients who don’t live close to the care they need, or have trouble getting there. These were all companies started and growing right here in our LHIN, and we know there are many, many more.

The health system is eager to partner with our thriving local innovation and technology culture to broker relationships and partnerships, break down barriers to innovation, and together solve challenges that impact the experiences of our patients, our residents. To truly change our health care system, here and provincially, we have to find new ways of doing things, build non-traditional partnerships, and make our exceptional health and technology industries collide to help to build on improvements that have already been realized.

Health Innovation isn’t just cool and trendy, it is absolutely imperative.

We live in one of the most innovative communities, not only in Canada but the world. Together, we have an incredible opportunity to build the solutions that will address community problems, create a sustainable, patient-centred health system and empower patients and families like never before.

Elliot Fung
@elliotgfung

A Thank You to Family Doctors

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In my last blog, I shared my experience as a patient in our local health system. When I realized I needed medical care, the first place I turned to for help was my family doctor.

My family doctor was the one who connected me with the right care and walked alongside me during my journey. Having someone who knows me, who knows my family, and who always had my best interests first was critical to my health and recovery.

I can’t thank my doctor and his team enough and I know many, many, many others feel the same way. This week is Family Doctor Week – an annual opportunity to thank these heroes who work tirelessly to care for us from pre-birth to end-of-life.

Over the past few months, my colleagues and I have been fortunate to spend time shadowing a number of family doctors and their teams to see first-hand the work they do. Doctors like Anil Maheshwari at Grandview Medical Centre,the team at Langs Community Health Centre, and more. I am always looking for opportunities to shadow more primary care practitioners on the front-line so please invite us. You can reach us on twitter at @WW_LHIN and me personally on Twitter @brucelauckner or by email bruce.lauckner@lhins.on.ca

While this is a week to celebrate doctors, we know just as important are the nurses, nurse practitioners, and other members of the inter-professional health team who work alongside them. We also know that not everyone has access to this type of team-based primary care – we are working on ways to build equitable comprehensive primary care for all residents and we need the help of primary care and the rest of the health system to make this happen.

On behalf of the almost 800,000 residents in Waterloo Wellington – thank you to our local doctors. With you – our vision of better health for our residents is made possible.

Share your thanks on Twitter by using #lovemyfamilydoc.

Improving the Patient Experience: A Patient Perspective

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Working in health care there’s a funny phenomenon that occurs – we are so focused on helping others and improving care that we tend to compartmentalize people into targetable streams. We have one strategy for patients. One for caregivers. One for people working in health care. We often forget that they are all the same people. We are all patients.

This was never truer than earlier this year when I found myself in my doctor’s office after others found me slurring my words and not making sense. I have spent many years working to improve the patient experience without giving much thought to myself as a patient. Of course when I was caring for a loved one or listening to the stories of others, I was always struck by the need to do better to improve their experience. However, I think it speaks to the nature of those who work in health that we never say we are going to improve the experience for ourselves – even though we are also users of the health care system.

Sitting in my doctor’s office, I was vulnerable in a way I had never been before. I didn’t know what was wrong – only that I needed help. I felt fortunate to have great access to primary care – and I thought about how we need to continue to work hard to make sure everyone has this kind of access to their doctor or nurse practitioner.

On my way to the hospital, I was scared – much like I’m sure everyone is when they don’t know what’s wrong but the look on the doctor and nurse’s face the says it’s serious. Even though I took great comfort in knowing that the quality of care in our local hospitals is second to none – nothing eases the stress of the unknown. Nothing that is, except the incredible people working in our local health care system.

From triage to testing to admission I was overwhelmed with their confident compassion. “Don’t worry, we’re going to take care of you.” The simplest words meant so much to me and to my family at a very difficult time. The health care I received was of the highest quality but it was the way I was cared for that made the experience so much more. As I moved into rehab, all I could think was that the wonderful staff in hospital, primary care and rehab go above and beyond – Every. Single. Day. Regardless of what might be going on in their lives that day – stresses at home, a sick child or parent – patients were the highest priority in the moment.

My recovery was slow but steady and I am incredibly grateful for all the support I received across our health system. I am also grateful that I received care within an area of our health system where great focus has been placed on improving the patient experience through best practice and integration. I know that this is not the experience of everyone – but I also know we have what it takes to change that.

I am glad to be back and excited to share my experience as a patient as a means of continuing our work to improve the patient experience for all residents in Waterloo Wellington. Former hospital CEO Bonnie Adamson spoke recently at the National Forum on Patient Experience about how her perspective changed when she retired from her role to become a full-time caregiver. She said she wished she could go back and re-do her time as a CEO all over again. She said she thought she “got it” but she really didn’t until she had journeyed through the health system with a loved one.

I have the great fortune of utilizing this perspective now as we lead a high-quality, integrated health system for local residents – in partnership with all of the incredible heroes working in our health system. Collectively, we have one role – to improve the patient experience. From pre-birth to palliative care and everything in between. It’s an important one – for patients, for caregivers, for health professionals, for everyone. We are all patients, after all.

Bruce
@brucelauckner

 

Job Shadow – Waterloo Wellington Aphasia Program

Guest Blog: Chief Strategy Officer  – Toni Lemon 

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One of the most inspiring opportunities we have at the LHIN is getting out and seeing the benefits of the work underway to improve local health care through the eyes of the patient. It is really a privilege to meet with front-line staff to see first-hand what they do and to be able to personally share in the experiences of residents.

This summer, I joined Antonella, a speech language pathologist (SLP), and Jenny, a communications disorders assistant (CDA), at one of the Waterloo Wellington Aphasia Program sessions. Aphasia is a disorder that affects language and communication. It is caused by damage to the brain, most usually from stroke. Some people with aphasia have difficulty with speaking, listening, hearing and/or writing. The group offers a place where residents with aphasia can develop their communication skills with the help of people like Antonella and Jenny.

Patient Centred Care from Providers and Residents

I was immediately struck by the feeling of camaraderie and support in the room. The participants and staff have created a safe space to talk about struggles, practice new skills, and support one another. When a member struggled in telling their story, they were met with patience and sometimes encouraged with strategies to help. Successes and milestones were celebrated and everyone had patience, empathy and an eagerness to learn from one another.

Stroke care in Waterloo Wellington has been changing through integration and collaboration. Providers across the system are working together to ensure that all residents are able to access high-quality stroke care and rehabilitation – no matter where they had their stroke. Patients are going home healthier and with better ability sooner. This work is why Waterloo Wellington was identified by the Ontario Stroke Network as a provincial leader in stroke care.

The Aphasia Program in particular supports people after they leave the hospital. Communication is so vital to the human experience and life participation. Programs like these can bring back quality of life and limit isolation.

Thank you to Antonella and Jenny from the Waterloo Wellington Aphasia Program for sharing your passion and work with me. Thank you also to the group members for sharing your experiences, challenges and resilience with me. You are an inspiration.

Toni

For more information on the Waterloo Wellington Aphasia Program click here.

 

Story Circle and Job Shadow – Langs Community Health Centre, Cambridge

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This week is Community Health and Wellbeing Week – as an organization focused on improving the health and well-being of local residents it’s an important one for us to celebrate along with our four Waterloo-Wellington Community Health Centres

As part of this week’s celebration, I had the opportunity to visit Langs Community Health Centre in Cambridge to participate in a story circle.

We sat there somewhat nervously – a group of patients, board members and a colleague of mine. We were asked to share what Langs meant to us. To actively listen and connect with one another through our stories. Some came with notes, some more comfortable sharing than others. The circle was expertly facilitated by a Langs Board Member who has a gift for storytelling and putting others at ease.

Once we started, the feeling in the room shifted and we became like old friends reminiscing, rather than strangers meeting for the first time. I was struck by the bravery and authenticity of the participants and even more struck by their stories. We had all come from different places, had all faced different challenges, and yet all shared connections with the heroes in local health care and how they had impacted our lives.

This is the power of storytelling. It doesn’t matter who you are, where you come from, or what you do – we are all patients and we all have a story. My goal as the CEO of the Waterloo Wellington Local Health Integration Network is to make more of our health stories positive ones. It’s a goal that is shared by many of the health professionals working in our community and was clearly demonstrated by the staff at Langs during my visit.

Following the story circle, one of the participants invited me to join him for his doctor’s appointment. There, I witnessed first-hand the positive difference that comprehensive primary care makes. The doctor took the time to discuss not only his patient’s medical concerns, but the other factors in his life that influence health (things like income and social supports). This is so important to improving overall health and for this patient, this holistic approach has rebuilt his trust in health care.

Thank you to Langs for inviting me to participate – it’s a real reminder of why I do what I do – and thank you for everything you do to improve the health and well-being of our local community.

@brucelauckner