Theme description: While Health Links are focused on high users of health services, all Ontarians stand to benefit – as patients and citizens – from greater collaboration among healthcare providers, other agencies, community stakeholders and governments. Presentations in this stream will focus on building collaborative relationships and working with community partners towards providing the right care, at the right time, in the right place. This includes improving the patient’s experience during their journey through the health care system, and identifying and addressing gaps in the quality of care and service delivery for individuals with complex chronic illnesses and other needs that compromise health. A4 – CVFHT Lung League – Our journey to decreasing ER visits by 50% This team presentation will describe both internal and external process improvement and outcomes through a variety of measurements and patient/stakeholder case studies including process improvements made to CDM, prevention and business case. B4-A – PATH – Partners Advancing Transitions In Healthcare PATH – “Partners Advancing Transitions in Healthcare” is a community-based partnership between patients, caregivers and providers working together to understand people’s experiences at key transitions between healthcare settings and services. The PATH Partners will work together in teams, using experience based co-design, to re-design transition processes and measure the impact of the improved processes. B4-B – Strategies to address the social determinants of health and health equity in clinical practice The presentation will begin with a brief overview of the impact of the social determinants of health on overall population health followed by an overview of the study design and methodology. C4 – “Mind the Gap” – Addressing Phlebotomy in Rural Ontario: A Case Study in Partnership, Community Engagement and Grass Roots Initiative-Taking During this presentation, first hand experiences of mobilizing local community stakeholders, advocating with the Ministry of Health, collaborating with partner health service providers, and engaging the private sector will be shared. D4 – Adopting a Network Approach – promoting skills and preventing duplication in multi-provider areas via networks that work (presentation to follow) Participants will see concrete examples of a network approach to successful stakeholder partnerships and its impact on access to care as well as benefits for providers. Successes, challenges and lessons learned will be shared, as will specific information on best practices in smoking cessation and falls prevention program delivery. E4 – Integrated Hospice Palliative Care: Bringing Family Physicians Back into the Team Recognizing the critical role played by Family Physicians in caring for patients at the end-of-life, local stakeholders collaborated to re-integrate primary care in the provision of HPC care in Guelph. This integrated approach being implemented in Guelph respects patients’ end-of-life care wishes while supporting families into bereavement all while maintaining the trusted patient – family physician relationship. F4 – Innovative Partnerships to improve patient care and address social determinants of health This presentation discussed two key points: to help reduce ER visits and support complex patients; and to support patients with social determinants of health barriers.
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