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A New Approach to Community Care Integration for Children and Youth with Multiple Needs

A New Approach to Community Care Integration for Children and Youth with Multiple Needs. Children’s Treatment Network of Simcoe York, Sandy Thurston, Director, Evaluation and Planning Healthtech Inc., Catherine Renwick, Senior Consultant 2007 Home Care Summit

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A New Approach to Community Care Integration for Children and Youth with Multiple Needs

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  1. A New Approach to Community Care Integration for Children and Youth with Multiple Needs Children’s Treatment Network of Simcoe York, Sandy Thurston, Director, Evaluation and Planning Healthtech Inc., Catherine Renwick, Senior Consultant 2007 Home Care Summit Embracing the Future: Stimulating Expertise

  2. Agenda Children’s Treatment Network • Origins • Vision to Reality Electronic Client Record • Components • Challenges • Research / Evaluation • Anticipated Outcomes • Next Steps

  3. CTN Origins • 20 Children’s Treatment Centres in Ontario • Service gap existed in York Region and Simcoe County • Population 1.32 million • Area 6,600 km2 • A broad range of stakeholders collaboratively developed an implementation plan for a children’s integrated rehabilitation service system for Simcoe York • Funding and model approved in December 2004 • CTN – new entity to enhance local services and enable integrated care

  4. CTN Origins Families told us that: • They had to tell their story MANY times • They had to travel long distances to access services • They were responsible for maintaining the records of care • carried boxes of assessments, reports, records

  5. Local Team Agency Community School Initial Plan for Assessment & Service Team Assessment Summary Single Plan of Care Service Wait List Service Coordination and Delivery Wait List High level ID of service needs Service Wait List Service Service Navigation SPOC reassessment or Service Plan complete or Discharge Access & Info Post Secondary School / Work / Community

  6. Specialized Resources Tertiary Providers PlanningCoalitions Access R 10 MULTI Local Teams MULTI: Sector Organization Partner Discipline R Specialized Resources Electronic Client Record Partner & Data Sharing Agreements CTN

  7. CTN’s ECR and MUCH MORE

  8. And 40 other partner agencies ECR Specialty Services OT SLP Specialty Services Record Rehab Agency Record Hospital Record Social Service Tertiary Care Provider Child Community Agency Record singleplanofcare.com Tertiary Care Record Inclusive Recreation PT PT Agency Record Recreation Agency Record

  9. singleplanofcare.comComponents • ‘Open’ and accessible to all Child and Family team members • Templates for: • Assessments • Single Plan of Care development • Referral notes • Progress notes • Workload tracking • Wait lists • Accommodates the inclusion of documents in searchable format • Consent and security framework provides access and restriction by user, client and time period

  10. Goal Goal Goal Goal Activity Activity Activity Activity Activity Single Plan of Care – Goals and Activities SPOC Coordinated plan developed by team and family Activity

  11. singleplanofcare.comFacilitates Integrated Working Team members can: • Easily share client information • View other team members’ assessments and documentation • Develop a truly customized and multidisciplinary single plan of care based on goals determined by the child, family and the team Network can: • Manage waiting times • Maximize capacity where the need is greatest

  12. singleplanofcare.com - Anticipated Outcomes System Improvements Child & Family Benefits • Consistency of practice • Partner collaboration • Resource utilization • Range of services delivered • Capacity management Family focused care Coordinated care Effective care Timely care Reduced travel time No file boxes!

  13. singleplanofcare.comResearch/Evaluation Research project in conjunction with Dr. Gina Browne, McMaster University, an evaluation of outcomes for: • Child and Family • Network Effectiveness • Economics “The Comparative Effect and Expense of More and Less Integration of Services that Provide Treatment and Rehabilitation for Children with Multiple Disabilities: A Randomized Controlled Trial”

  14. singleplanofcare.comChallenges • Collaboration • Working together builds trust between partners • Supported by governance, accountability • Privacy • Privacy Impact Assessment has been reviewed by Information and Privacy Commission of Ontario • Review results are being incorporated into Information Management and Data Sharing Agreements and Policies • Further exploration of role as both Health Information Custodian (HIC) and Health Information Network Provider • Connectivity • Broad range of information systems • SSHA installation progressing • Web access in remote locations • Education and Training • Change management to new integrated service model • Software training – managing volume and timing • Concurrent evolution of network and software development

  15. CTN’s singleplanofcare.com Next Steps Integration and Adoption Education and Training Interfaces Reporting MIS / workload Planning and Decision Support Practice Wait list Assessment and referral tools Continuing software refinement based on user feedback

  16. Children’s Treatment Network Contact: www.ctn-simcoeyork.ca 1-877-719-4795

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