​Photo: North York Toronto Health Partners Backbone Team

By: Sylvia Hagopian MEd, on behalf of NYTHP

When the COVID-19 crisis hit and pushed aside many standing health care agenda items, the newly formed "Backbone" of the North York Toronto Health Partners (NYTHP) knew their top priorities weren't going to change. Those priorities were the immediate needs of at-risk populations such as isolated seniors, low-income individuals and families and patients with urgent addiction and mental health concerns.

The NYTHP adopted its shared purpose, called "Compassionate North York," developed its collective impact model, and created  a unique way to work together during the COVID-19 crisis through its core partners, alliance partners, Primary Care Association, and Patient and Caregiver Health Council core.  It also created the Backbone team, an integral feature of the NYTHP. The Backbone is composed of professionals from eight member organizations from across the continuum who work as one virtual team to align and support the planning and implementation of all aspects of NYTHP work.  

"The Backbone of NYTHP functions like an anchor table, where the needs of patients and the community are brought forward from across our complex network," says Ivy Wong, the Backbone's lead and Senior Lead, Strategic Initiatives North York General Hospital. "Everyone's needs are important and valid, and it's our shared responsibility to respond to those priorities. This is how we were able to learn and understand the immediate needs resulting from COVID-19, and mobilize quickly to fill those gaps."

A model of collaboration

This model of collaboration is based on the Collective Impact Framework — a way of working together towards a common goal where accountability is shared across sectors. It was through the breadth and reach of NYTHP's partnerships and alliances that the Backbone was able to ignite the strength of community and enable the NYTHP to meet the needs of the most vulnerable people during COVID-19. 

Judy Katz, a volunteer from Patient and Caregiver Health Council, has been involved with the NYTHP since the beginning, before NYTHP was designated as one of the province's first Ontario Health Teams. She explains that many different committees work on initiatives such as vaccine strategy, equity and inclusion, and privacy, and that a member of the Backbone team sits on each committee to coordinate and ensure there is no overlap.

"What's amazing is that a patient or family advisor also sits on each of these committees," Judy shares. "Their input is valued from the time initiatives are being designed right through to its launch."

Reducing barriers to meet needs

As a result of COVID-19, mobile testing and vaccinations emerged as an urgent priority. Dr. Rebecca Stoller, Co-chair of the NYTHP Primary Care Council, explains how doctors, staff, community members and volunteers worked side-by-side to bring these services to long-term care facilities, shelters for women, refugees and newcomers, and residential support homes directly.

"We really rely on our partnerships and on each other to make this work," says Dr. Stoller. "And because we have built close relationships with community organizations, we can be responsive and go back if needed. It's been really wonderful to come full-circle in our COVID-19 response for at-risk community members and now be able to also provide them with a vaccine."

She adds that community leaders stepped up to support the primary care group's response and provided communication support, such as language translation and mobilizing neighbours to get tested.

Rapid Action Addiction Medicine

Another service that NYTHP prioritized early was the Rapid Access Addiction Medicine (RAAM) Clinic. RAAM clinics are drop-in clinics that do not require an appointment. They offer fast access to quality care including brief counselling, case management support, primary care and connections to other community services. 

"We didn't shut down when COVID happened," says Penny Marrett, CEO of Addiction Services of York Region, a core partner of NYTHP. "All the partners kept meeting regularly and were focussed on what was happening and what the needs were and how we can provide support."

Penny says that the Backbone was instrumental in ensuring that the RAAM clinic and other services continued to be offered and were adjusting to emerging needs of patients and families.

"We were all pivoting to provide services virtually, and ensuring we were aligned with Ontario's privacy laws," she says. "Most community agencies were able to achieve this without having legal, privacy and ethics counsel on staff. Our weekly meetings allowed for timely knowledge sharing and didn't require each of us to reinvent the wheel."

Helping seniors stay connected

Diane Enhorning, an active volunteer and past chair of the Community Share Food Bank, was grateful that Better Living – a core NYTHP partner – and NYTHP were there to help the food bank respond to the increasing demand for food from seniors, many of whom were isolated at home and unable to drop in.

"It was amazing that they were reaching out and offering the food bank support with deliveries, PPE and personal care items that were now so much harder to come by," says Diane.

By the end of December 2020, NYTHP core partnership, along with the instrumental support of the Backbone, alliance members and community volunteers, were able to provide over 90,000 swabs; train 2,000 staff on infection prevention and control; reach over 400 family doctors and 60 congregate sites, including LTC homes; launch 28 new initiatives; and deliver 3 hotlines to respond to immediate community needs. All of this was accomplished with one shared purpose — Compassionate North York.  

Wendy Wu, Co-chair Patient and Caregiver Health Council, said the co-operation has ensured no one is working in isolation.

"We are learning from each other," says Wendy, "and also from other health teams, being creative, solving problems and adapting as we go forward. This co-operation is a breath of fresh air in our shared purpose of developing seamless and integrated services that are genuinely patient centred."