Celebrating a year in the life of Central West CCAC

With another fiscal year already underway, it’s easy to gloss over the successes of the previous year as we turn our focus to the future. Nevertheless, it’s important to take the time to look back at our achievements to help us continue to grow as an organization. In June, we held our Annual General Meeting (AGM) to do just that.

We started the evening by releasing our 2015-16 Report to the Community, which speaks to the remarkable accomplishments we have achieved over the past year. Our online report highlights the daily experiences of our patients and their families, as well as our team who serves them, through our programs and services like Partnering for Change (P4C), Personal Computer Video Conferencing (PCVC) and the integrated Hospital to Home (H2H) program.

Our story is told in many ways, including the vast number of interactions we have with patients, families and health care partners. Here’s a snapshot of how we helped support the community:

  • 39,800 patients received Central West CCAC services
  • 234,680 in-home nursing visits completed
  • 1,239,310 hours of personal support services
  • 17,189 students benefitting from Partnering for Change program
  • 100% Primary Care Providers for adult patients aligned to Care Coordinators

At the event, we had the pleasure of meeting Angella Golding whose mother and sister received in-home services from Central West CCAC. Angella’s strength captivated the audience and reminded us why the work we do in the community is extremely important. She compared the Central West CCAC staff to family and credited her family’s care team with extending her mother’s life. I want to personally thank Angella for sharing her story with us.

It’s clear that we have an incredible team at Central West CCAC who do extraordinary things each and every day. We celebrated our many achievements and are ready to look to the future of health care in our community, which will see us continue to deliver the vital programs and services patients and families rely on.

When it comes to moving forward, David Robertson, Chair of the Board of Directors, said it best. “We will continue to encourage the fabulous people who work at Central West CCAC to deliver high-quality service, enhance patient engagement and support our culture of innovation.”

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Setting the course with our ABP and QIP

We’ve completed another fiscal year and with this end comes new beginnings. On April 1, we launched two new plans that will guide our success for the coming year: our Annual Business Plan (ABP) and Quality Improvement Plan (QIP).

We worked closely with our partners at Headwaters Health Care Centre (Headwaters) and William Osler Health System (Osler) to develop these plans with one shared goal in mind: improve care for patients and families across the Central West region. Here’s an overview of what each plan does and how they will benefit the communities we serve.

Annual Business Plan (ABP)

For 2016-17, all three organizations worked together to create our first-ever joint ABP. This year we’re using a set of five common pillars – People, Service Quality, Clinical Quality, Efficiency and Growth – to guide our work. The shared approach will help each organization achieve their individual strategic and clinical goals as well as make positive changes across our region.

While the ABP outlines where we will focus our energy in the coming year, it allows us to reflect on our achievements of the past 12 months. Here are a few of examples of the incredible work we’ve done at the Central West CCAC:

  • We’re part of a new regional Hospital to Home program where CCAC nurses provide support to patients as they return home after discharge

These achievements are just a snapshot of how Central West CCAC has improved the delivery of care in the community. By working together and sharing accountability with our hospital partners, we can continue to significantly enhance care for patients and clients in the Central West region.

Quality Improvement Plan (QIP)

We continued to work with our regional partners to create our second joint QIP. This tool harmonizes our efforts to improve the quality of care across local and provincial health care systems. Our progress targets are set and monitored by the Ministry of Health and Long-Term Care to make sure we are providing a high standard of care that matches provincial goals.

Amid a year of great change, everyone at Central West CCAC has worked incredibly hard to achieve some excellent results and position us as provincial leaders in the delivery of home and community care:

  • We exceeded our 30-day hospital readmission target
  • We achieved the lowest rate in Ontario for unplanned emergency department (ED) visits within 30 days of discharge from hospital
  • We are ranked first in the province for the number of patients receiving personal support visits within five days of being approved for CCAC services

I’m extremely proud of all that we have achieved over the past year – and you should be too! As we prepare for more change, which we know will continue, our ABP and QIP will ensure that the delivery of high-quality patient care will continue. I’m confident that there will be plenty more to celebrate in the months ahead.

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Working with our partners to take patients from Hospital to Home

Sometimes when patients return home from the hospital, they need a little bit of extra support. In December, the Central West CCAC began working with our partners at Headwaters Health Care Centre (Headwaters) and William Osler Health System (Osler) – as well as the Ontario Telemedicine Network (OTN) and the Central West Local Health Integrated Network (LHIN) – to meet this need by launching a program called Hospital to Home (H2H).

H2H is an innovative new way we are working together to improve clinical handoffs and information sharing when patients leave hospital and re-enter the community. This means that patients continue to receive short-term nursing care from the same team, made up of H2H nurses hired by the Central West CCAC, after they return home. The program currently supports patients with cellulitis and urinary tract infections (UTI) but will later expand to help those with more complex needs.

Last month, H2H launched at Brampton Civic Hospital after originally launching at Etobicoke General Hospital in December and then at Headwaters in January. This full complement of H2H sites ensures that patients can receive coordinated care from the same team whether in hospital or at home.

The goal of H2H is to help prevent unnecessary hospital admissions, shorten the length of stay for admitted patients, provide greater continuity of care and ultimately, enhance the patient experience for those we serve.

H2H is an excellent example of how different organizations from across the continuum of care can work together to improve access to services that truly benefit patients. Since its launch, more than 135 patients have been enrolled in the program and dedicated H2H nurses have completed over 750 nursing visits in the community.

The project team gathered feedback from staff and patients at each phase of the rollout to help shape the program even further. So far, feedback to date has been overwhelmingly positive. Here’s what some H2H patients had to say:

  • I received outstanding care!”
  • My experience was fantastic. Each Nurse was extremely knowledgeable and they arrived in the timeframe as promised.”
  • “I really appreciate this program. You took the time to talk with my wife and comfort her when I did not know what to say to make her feel better.”
  • “You hired the best nurses for the job. They have all been wonderful!

These incredible comments are proof positive that the H2H is one more way the Central West CCAC, with our hospital partners, is providing outstanding care to every person, every day.

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Making a difference to children by ‘Partnering for Change’

It is truly rewarding to see the positive impact the Partnering for Change (P4C) initiative is making, thanks to an innovative partnership among Central West CCAC, Hamilton Niagara Haldimand Brant CCAC and education partners in the Central West and Hamilton Niagara Haldimand Brant (HNHB) regions. Through P4C, we are bringing Occupational Therapists right into the classroom to work alongside teachers to identify and support children with developmental needs.

It is also gratifying when such great work is recognized. This week, Central West CCAC was featured in a story on CTV News Toronto, showcasing how P4C is helping so many children.

Traditionally, children who are referred for occupational therapy (OT) may have to wait years for services that are ultimately ineffective because the assistance comes too late and is not provided in the right place – at home or in school. And access to existing school health support services varies greatly across Ontario. With the help of the P4C model, we are able to provide OT support more effectively and screen thousands of children for special needs sooner than under the current referral system.

Through the support of CanChild Centre for Childhood Disability Research at McMaster University – as well as the Peel District, Halton District, Hamilton Wentworth Catholic District, Dufferin-Peel Catholic District and Upper Grand District school boards – P4C is making a difference in the lives of children, parents and teachers alike.

Early intervention and capacity building programs like P4C provide tremendous benefit to the community. In the last two years, P4C has supported more than 17,000 children in over 700 classrooms and eliminated wait lists for service – at no additional cost – in the Central West and the HNHB Local Health Integration Networks (LHIN).

Michelle Kristof is one of the thousands of parents, whose children, Bobby and Claudia, receive support through the program. She spoke with CTV Toronto about how P4C has provided her children with timely care – support that otherwise would have taken another two years.

Hearing first-hand from parents like Michelle about their positive experiences with the program further validates that the P4C model is working. P4C has already been adopted in more than 60 schools and others are expressing interest.

Of course, all of this has been made possible because of the outstanding people we work with. Thank you to the P4C team for the incredible work in leading this initiative and the entire CCAC team for your commitment to continue delivering on our vision – Outstanding Care – every person, every day!

To watch the CTV Toronto news story, please click here.


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Season’s Greetings from Central West CCAC!

I can’t believe we’re at the end of another amazing year at Central West CCAC! Over the past 12 months, we’ve made incredible strides toward transforming health care in our region.

This was all made possible by the inspiration and support from our patients and families, our dedicated staff and our health care partners from across the region.

The next year promises to hold a lot of changes for our organization. However, what will not change is the safe, quality care that we deliver each and every day to thousands of patients in our community. And I look forward to continuing our journey together.

You are the heart of this organization. Thank you for making 2015 one of our most remarkable years yet!

This will be my final blog of the year. I wish you a very happy holiday season and I’ll see you again in the New Year!

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A Caregiver’s Guide to the Holiday Season

While the holiday season is a magical time of year, many of us feel stress during this extra busy time – from finding that perfect gift to making your home a winter wonderland to caring for loved ones. It’s easy to feel overwhelmed by our seasonal “to-do” lists and when caring for a friend or family member is added to the mix that stressful feeling is amplified.

This is one of the reasons the Central West CCAC is here. Our dedicated team of Central West CCAC care coordinators will be out in the community during the holiday season, alongside our service provider partners, to deliver care to patients and their families. I have no doubt that they will continue to do a tremendous job of providing high-quality health care during this busy time.

But what about the caregivers who also work tirelessly throughout the year? There are a number of self-serve resources available to caregivers and families that can help you balance it all this holiday season:

  • Download our Caregiver Support Guide to help you create caregiving strategies during the holidays and throughout the year
  • Find support in your community through the Central West Healthline, which provides up-to-date information about over 1,000 heath care services and resources in our region
  • Follow us on Twitter for caregiver tips on how to make the most of the holiday season
  • Know your health care options so you and your family can receive the right care, in the right place this holiday season

Most importantly, take time to enjoy the season by asking for help from family and friends. By sharing the caregiving responsibilities you are able to participate in the special holiday moments and know that you’re appreciated for all you do. This also allows you to take a break to rest and recharge. It will go a long way in helping to keep you well and prevent you from burning out, because if you’re not well it becomes even more challenging to take care of others.

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Transforming the patient experience one ‘neighbourhood’ at a time

Whenever we move into a new season, I can’t help but think about how life refuses to stand still. From cooler temperatures to the vibrant colour, change is all around us. I think it would be safe to say that we’ve had a transformative year at CCAC as we’ve elevated our partnership with Headwaters Health Care Centre and William Osler Health System and redefined how we work with our community partners.

All of this has brought us to the launch of our aptly-named Transformation project. We’ve changed everything – from the physical boundaries of our catchment areas to our relationships with primary care providers.

In short, Transformation will improve the patient experience. CCAC teams will work more closely with our system and community partners, as well as with each other, to make sure patients continue to receive the community-based health care supports they need.

The first step was creating four distinct ‘neighbourhoods’ that are closely aligned with Health Links boundaries in the Central West region. Each neighbourhood consists of teams that are responsible for coordinating care for patients who have primary care providers in their particular area, which include Dufferin, Bolton-Caledon, Brampton-Bramalea, and North Etobicoke-Malton-West Woodbridge.


Next, we set out to change our working relationships with primary care providers in the community. Care Coordinators will work more closely with these providers than ever before to ensure that patients and families receive the community home care services they need. Here’s how we’re going to improve the patient experience through Transformation:

  • Care Coordinators will meet with primary care providers on a regular basis to discuss their patient’s health care needs and how the CCAC can help provide support in the community. This will help create a more seamless experience for patients and families.
  • Primary care providers will be able to tap into the knowledge, skills and experience of the CCAC team get a better understanding of what community health care services and resources are available and how they can access them in order to benefit patients.
  • Care Coordinators will spend even more face-to-face time with patients to provide better support and develop stronger relationships that will really help them understand the individual care needs or each person.
  • By having one point of contact, there will be fewer transitions between Care Coordinators when a patient’s condition changes, so they can feel more stable and confident in their care.

We know that patients want – and deserve – more seamless care across the health care system. The Transformation project is an important step in making this a reality.

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