Critical Success Factors For Protecting Patient Care During Health Care Integration

Ontario Hospital Association
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Wednesday, September 8, 2004

Review of Rural and Northern Framework Provides Lessons for Local Health Integration Networks

TORONTO – Just before an expected announcement of the Ontario government's Local Health Integration Networks, a multi-stakeholder review of the government's 1997 Rural and Northern Framework confirms that health care integration will only be a success if it is open and collaborative, fact and results-based and supported with an investment in time and additional financial resources.

"This important review provides critical lessons for protecting patient care during health care integration," said OHA President and CEO Hilary Short. "As the government prepares to announce details of proposed Local Health Integration Networks, these recommendations could not be more timely."

To improve access to quality health care for people in rural and northern communities, voluntary trustees, hospital professionals and countless community volunteers have worked tirelessly on promoting and implementing Rural and Northern Networks over the past seven years. The OHA and the Ministry of Health and Long-Term Care conducted the formal review in collaboration with District Health Councils and Community Care Access Centres. Critical success factors for successful health care integration identified by representatives include:

An acknowledgement by government and stakeholders that the successful implementation of networks is a long- term undertaking that requires a considerable investment of time and resources;
Mandating collaboration alone is insufficient to produce results and ensure success;
The process to determine networks should be flexible and evolve over time;
Established outcomes for networks, supported by clear targets and indicators;
To ensure adequate access to services, 'core health services' for rural and Northern communities must be defined and adequately funded;
Common core services should reflect factors such as community needs, geography, health status, economics and other determinants of health; and
Robust information technology networks are required to improve both the quality and efficiency of the delivery of health care services.

"Everyone shares the goal of a more integrated health care system," added Short. "But based on experience in rural & northern Ontario we strongly encourage the government to incorporate these critical success factors into planning for province-wide Local Health Integration Networks."

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Backgrounder
Access to quality health care for residents of rural, remote and northern communities in Ontario is a critical issue. In general, rural populations experience a heightened burden of illness and less access to health care services than their urban counterparts. The overall mortality rate of Northern Ontarians is higher than the Ontario average and the impact of a number of diseases, such as cardiovascular disease and injuries/poisonings, is significantly greater.
In 1997, the Government of Ontario released the Rural and Northern Health Care Framework, which presented a vision, principles and planning directions for a fully integrated and coordinated rural health system.
Aimed at enhancing access to health care for residents of rural, remote and northern communities, the Framework promotes a cooperative and collaborative approach to service delivery in health care. It recommended that health integration initiatives build upon the partnerships already established in rural and northern communities and capitalize on the potential for sharing resources to optimize health options for patients.

The Ontario Hospital Association (OHA) and Ministry of Health and Long-Term Care (MOHLTC), in conjunction with District Health Councils (DHCs) and Community Care Access Centres (CCACs), have undertaken a joint review of the implementation of the 1997 Framework.

The final report of this review is entitled Review of the Implementation of the Rural and Northern Health Care Framework and explores ways of strengthening existing health networks and building upon the work completed in the Framework document.

Comprised of representatives from the OHA, the Ministry, District Health Councils and CCACs, a Working Group reviewed the Framework document and addressed six key issues:

Network configuration and membership;
Roles and responsibilities of the Ministry, hospitals, District Health Councils and others;
Network goals and outcomes;
Incentives;
Funding; and
Evaluation and monitoring.

In its deliberations, the Working Group identified critical success factors required for efficient and effective networks. These success factors include:

An acknowledgement by all stakeholders that the successful implementation of networks is a long- term undertaking that requires a considerable investment of time and resources;
Mandating collaboration alone is insufficient to produce results and ensure success;
The process to determine hospital network members should be flexible and evolve over time;
Outcomes be established for networks, supported by clear targets and indicators;
To ensure adequate access to services, 'core health services' for rural and northern communities must be defined;
Common core services should reflect factors such as community needs, geography, health status, economics and other determinants of health; and
Robust information technology networks are required to improve both the quality and efficiency of the delivery of health care services.

The Ontario Hospital Association remains committed to working collaboratively with all key stakeholders on the implementation of the recommendations contained within their Review.

For further information:
Stefan Baranski, OHA Public Affairs
416-205-1305