1. Point of Care Integration Driving Transformation BRIDGES Conference 2014 Thursday March 27th, 2014 1 OUTSTANDING CARE – EVERY PERSON, EVERY DAY

2. A Debate About Reform and Which Road is Best… Structural Reform? Layered On? Point of Care – Functional Integration Steadfast Despite Political Context

3. Point of Care Integration

4. O NE C LIENT : O NE T EAM A Perspective On Lessons Learned From A Regional Partner

5. Flip Our Thinking Ground The Approach

6. Delivering integrated care requires integrated action within 3 key domains… At home, in the community When necessary, the transition Acute, CCC or Rehab 1 1 2 2 3 3

7. Multiple Integration Initiatives Aim: One client, One team 7

8. Point of Care Integration Virtual Ward Kids with Medical Complexity

9. Point of Care Integration ICCP Older Adults Palliative Care

10. Point of Care Integration and Alignment with BRIDGES Integrated Home Based Primary Care (IHBPC) IMPACT Plus Integrated Community Care Team (ICCT)

11. Stop, Take Stock and Reflect Principals to Guide Integration

12. Deliberately being open Deliberately responding differently

13. “I meet with my ICCP care coordinator every two weeks or so… She speaks with my doctor. This is the first time the doctor ever came to my home.” – Client “The Coordinator works with other professionals to collect information, so I just have one person to contact. It saves me time.” – Primary Care Physician “The cross-sector care we now provide is improving the patient experience - as witnessed by shorter lengths of stay and improved patient satisfaction scores within these patient groups.” – Acute Care Partner

14. Incremental Build Maturity Reached Over Time

15. How can we work together differently? What do I need to do differently? How can we understand and experience different perspectives? How can we all work together on what is most important to the client/family? Walk a Mile or Two…

16. Opposing Notions Tensions Integrated Solutions

17. Need For Scientific Evidence And Outcomes With Quality Improvement Frameworks For Complex And Disruptive Change Processes Balance

18. Demonstrating Value Less Talk And More Delivery

19. Do not wait for complex solutions

20. There is no script… Lead Through Ambiguity

21. Relationship Will Determine Success Trust Will Determine Success Safe Shared Accountability

22. Greater Emphasis on EMOTIONAL INTELLIGENCE Leadership Leaderful

23. Lift Up, Look out… …and Honour the Past

24. Jodeme Goldhar Lead, Health System Integration for Complex Populations and Primary Care Thank You