In early 2023, paediatric services in Timmins and District were at significant risk. With only two practicing local paediatricians, wait times were escalating and critical paediatric care gaps increasing.

Through collaboration between more than a dozen service providers and engagement with many care practitioners, along with the help of two recently graduated nurse practitioners (NPs) with pediatric backgrounds, a new model of care was developed to better serve people in Cochrane and Temiskaming Districts. A key partner in this model is the Inspire Centre (formerly known as Cochrane Temiskaming Children's Treatment Centre) providing funding for staff and a community-based location for the Paediatric Clinic.

“This paediatric program is unique to the province," said Joan Ludwig, Vice President of Clinical & Chief Nursing Executive with Timmins and District Hospital (TADH). “Child and family centered, it focuses on a seamless delivery of services for families. TADH appreciates the substantial support and collaboration of the Inspire Centre in helping to transform paediatric care."

Since implementing the new model of care, referral wait times have significantly decreased. Prior to its start, paediatric referral wait-times averaged 18 months to two years. Now wait times are four months or less.

This new model is community based, with easier to access referrals, virtual care for families living within its large catchment area and empowered by a children's health coalition to ensure co-funding of supports and clear pathways. The Timmins Pediatric Clinic services the same area that TADH covers — about the size of Atlantic Canada stretching up to James Bay with 11 referral hospitals. It also employs NPs as linchpins in the care team, ensuring patients and their families are connected to community and province-wide resources.

“We are thrilled to be part of a transformative partnership that co-creates and  reimagines how paediatric care is delivered in Northern Ontario. Integrated care is more than a model — it's a promise," said Marie Rouleau, Executive Director of the Inspire Centre. “At Inspire Centre, our Paediatric Program partnership is a bold step toward advancing care that is timely, compassionate, built around families' realities, and truly integrated."

Paula Crotteau, Director of Clinical Services at the centre, added that staff have been integral in implementing change:“ I'm immensely proud of our team of clinicians and the role they've had in this partnership. Their unwavering dedication and expertise, along with the Timmins Pediatric Group team, have helped to streamline referrals and cut wait times, ensuring families receive prompt, comprehensive care for their children when it matters most."

NPs Jennifer Sharp and Chantal Dell'Erede, employed by TADH, are primarily based out of the Inspire Centre, which is easily accessible, with free parking and offers a child-focused environment.

Paediatricians Dr. Willem Verbeek and Dr. Kim Genier work closely with their NP team members at the centre. With other paediatric health professionals onsite, such as physiotherapists, occupational therapists and speech language therapists, the location facilitates referrals to many other community and health provider supports.

Both Dell'Erede and Sharp, who worked as RNs at the hospital while studying to be NPs, began working in aPediatric Program after receiving their NP designation in the fall of 2023. “I'm still pinching myself about how well this has worked out," said Sharp.

The NPs provide a variety of paediatric consults, seeing, on average, eight to 10 patients at day at the Inspire Centre. Besides working closely with the paediatricians, they also consult with specialists across the province. Patients, with and without primary care providers, can access their services.

“For parents who live across the Cochrane and Temiskaming districts, in many cases, follow-up can be done over the phone often in collaboration with the patient's primary care provider," said Sharp, who has focused on children with behavioural and mental health disorders.

When working in hospital, NP Dell'Erede assesses and treats newborns, which enables  paediatricians on call to focus on caring for neonates admitted to the NICU, the paediatrics department, or to offer consults to the emergency department and provide rapid assessment to patients in the district.

“I also manage patients in the paediatric Asthma Clinic at TADH once a week and consult on a broad range of paediatric medical concerns at the Inspire Centre, collaborating with families and specialists to support optimal child health and development," she said.

Paediatric Clinics are held by the local or locum paediatricians in hospital for more urgent consults. Children seen in emergency department, or who need urgent consult as requested by their family provider, are triaged appropriately and seen in a timely manner

“The Timmins Pediatric Clinic provides more equitable care to patients in Timmins and across Cochrane and Temiskaming," said Ludwig. “It reflects a caring community collaborating together around the needs of children and their families."

Timmins and District Hospital (TADH) is a medium-sized hospital offering a wide range of services and district-wide teaching, and training opportunities. TADH operates 225 beds and is a referral hospital for eleven hospitals across Northern Ontario, receiving patient transfers at nearly three times that of other medium-sized hospitals in the province.​