Since 2016, CorHealth Ontario (CorHealth) has been working closely with the Ministry of Health (MOH), and with leadership in cardiac, stroke and vascular care in Ontario, to establish more transparent, effective and proactive planning practices, with the aim of supporting timely and equitable access to the latest, leading, safe and effective cardiac technologies for Ontarians.
CorHealth Ontario took part in the Canadian Cardiovascular Congress in Montreal, Quebec, and at the Canadian Stroke Congress in Ottawa, Ontario. Highlights and presentations from the Congresses are available.
The Endovascular Thrombectomy (EVT) Steering Committee will be expanding its role and purpose to include guidance and direction for the Ontario Telestroke Program.
CorHealth Ontario, together with clinical experts and system partners, is beginning to develop a Lower-Limb Preservation (LLP) Strategy to address Ontario’s lower-limb amputation rate and wide regional rate variations.
The AVI Model of Care Change Management Forum, which is comprised of representation from all 11 surgical advanced cardiac hospitals in Ontario, CorHealth Ontario, and the Ministry of Health, has met three times since September 2019. Forum discussions to date have reinforced a shared goal to ensure that all persons with aortic stenosis receive evidence-based care, including timely and equitable access to AVI treatments – either surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI).
Draft Coronary Artery Bypass Grafting (CABG) bundle recommendations (patient cohort, care pathway and performance indicators) based on the Trillium Health Partners Pilot, and draft Stroke bundle recommendations (patient cohort, care pathway and performance indicators), have been submitted to the Ministry of Health.
CorHealth Ontario’s (CorHealth) Measurement and Reporting Initiative is employing a comprehensive approach to achieving alignment across cardiac, stroke, and vascular reporting products and engagement strategies, while laying the foundation for monitoring critical indicators across the care streams to support system improvements.
Health care in Ontario is moving towards greater integration between acute and post-acute care settings. CorHealth Ontario (CorHealth), along with our key Stroke and Coronary Artery Bypass Graft (CABG) stakeholders, has been working to advise the Ministry of Health and Long-Term Care (MOHLTC) on Stroke & CABG surgery integrated care.
As the province continues to take steps to transform Ontario’s health care system, the formation of the Ontario Health agency progresses. Susan Fitzpatrick, interim CEO of Ontario Health, is setting up a number of working groups to establish the agency with a clear focus on the continuity of patient care throughout the transition process.
For the second year in a row, CorHealth Ontario took part in the Heart and Stroke Foundation’s Big Bike initiative to support critical cardiac disease and stroke research.
It is with mixed emotions that we share Laurie Bourne, Senior Director of Health System Policy, Planning & Performance, will be joining Michael Garron Hospital (MGH) as the Director of Quality, Operational Excellence & Innovation.
In 2018/19, the Ministry of Health and Long-Term Care (MOHLTC), along with CorHealth Ontario (CorHealth) began to explore the possibility of implementing an alternative, population-based reimbursement model for patients with Aortic Stenosis (AS). Through preliminary consultation with experts, and review of evidence, CorHealth identified that there was an opportunity to change from the current method of volume-based funding of Surgical Aortic Valve Replacement (SAVR) and Transcatheter Aortic Valve Implantation (TAVI), to a new Aortic Valve Implantation (AVI) reimbursement model.
In March 2019, CorHealth Ontario (CorHealth) requested that all hospital vascular programs complete a standardized self-assessment, the Ontario Vascular Program Core Service Criteria Evaluation Tool.
CorHealth Ontario’s (CorHealth) engagement with vascular stakeholders identified a need for the development of support tools for emergency department (ED) clinicians to appropriately manage patients with vascular emergencies.
Data and information are at the core of what we do – whether they are used to drive evidence-informed practice, inform planning and resource allocation, or to measure and report on quality and outcomes.
For the past 2 years, CorHealth Ontario (CorHealth) has been working collaboratively with various stakeholders to support maturation of the provincial EVT system.
In the March 2019 edition of the CorHealth Quarterly, I wrote about the health system transformation that was announced by the Ministry of Health and Long-Term Care (MOHLTC) in February 2019. Since the release of that newsletter, the MOHLTC has taken steps to transform Ontario’s health care system to be centred around patients, their families, and their caregivers. The following highlights key activities from the last few months supporting the transformation.
This year’s stroke report card marks the ninth edition of the provincial and Local Health Integration Network (LHIN) report cards and progress reports, capturing data from the 2017/18 fiscal year. These reports are created annually to provide an evaluation of stroke care and service in the LHINs and across Ontario, aligned to national recommended performance measures set out in the Canadian Stroke Best Practice Recommendations.
In 2018/19 a key priority was to begin implementing our Information and Digital Strategy by defining our core data needs, reducing data collection burden on hospitals, and improving the value of our reporting. To support this, we engaged three Task Groups to make clear recommendations on how to enhance the value of our reporting across cardiac surgery, stroke and vascular.
From 2017-2019, CorHealth Ontario partnered with Health Quality Ontario and three Early Adopter Teams to begin the Integrating Heart Failure Care Initiative, a model that integrates heart failure care delivery with quality standards for a localized population of persons suffering from heart failure.
During the December 2018 issue of CorHealth Quarterly, we were excited to share the kickoff of our Leadership Councils, which are part of CorHealth’s Advisory and Task Group Structure. Since last year, the Leadership Councils have met two times, where they provided advice and guidance on multiple CorHealth initiatives and projects.
In May, CorHealth Ontario met with Dr. Rueben Devlin to discuss the importance of community-based rehabilitation services. The objective of the meeting was to reinforce community rehabilitation services as an area where additional access will relieve pressures causing hallway health care.
The Echocardiography Quality Improvement (EQI) Program recently achieved a major milestone, having completed the on-site reviews for all sites that registered prior to November 1, 2017.
Key Learnings from the Integrating Heart Failure Care Initiative (IHFCI) to Improve Patient Care in Ontario
TORONTO, ON, May 6, 2019 -- From 2017-2019, CorHealth Ontario partnered with Health Quality Ontario and three (3) Early Adopter Teams, to begin the Integrating Heart Failure Care Initiative (IHFCI), a model that integrates heart failure care delivery with quality standards for a localized population of persons suffering from heart failure.
CorHealth Ontario has translated the experiences gained from the Integrated Heart Failure Care Initiative into resources that begin to integrate care more broadly – an approach that can be expanded beyond cardiac disease into other chronic illnesses and population health management overall.
CorHealth Ontario has always had a focus on evidence-informed practice being delivered consistently across the province; integrating care delivery where possible; and, supporting the best cardiac, stroke, and vascular care for all Ontarians. This approach is consistent with the Ministry of Health and Long-term Care’s vision for Ontario Health.
CorHealth Ontario’s inaugural 2017-22 Strategic Plan made a commitment to ensuring that patients and families would be partners and key advisors in helping shape cardiac, stroke and vascular care services in Ontario. As patients & families have been involved in several CorHealth initiatives to date, CorHealth is excited to introduce a more formal Patient & Family Engagement Strategy for the organization.
A key priority in 2018/19 was to further define how CorHealth Ontario’s baseline data and reporting needs across the cardiac, stroke and vascular clinical domains, and to make recommendations on how CorHealth Ontario can reduce its data burden on hospitals. Three Measurement and Reporting Task Groups were formed across the cardiac surgery, stroke and vascular clinical domains, and Dr. Adalsteinn (Steini) Brown , Dean of the Dalla Lana School of Public Health, was formally engaged to provide leadership and advice throughout the process.
On October 24, 2018, CorHealth Ontario produced the first-ever provincial report on Endovascular Thrombectomy (EVT) performance in Canada. On March 29, 2019, the Q1/Q2 biannual report for FY 2018/19 will be released, followed by an anticipated release of the annual report in September 2019.
Managing and supporting patients with heart failure (HF) along the care continuum and across transitions in care, requires a coordinated approach that connects teams of providers to provide ‘wrap around’ care to patients. To help improve care for patients living with HF and their caregivers in Ontario, CorHealth Ontario, in partnership with Health Quality Ontario (HQO), is championing and continues to support the Integrating Heart Failure Care Initiative (IHFCI).
In 2016, CorHealth Ontario worked with hospitals to provide Level 1, 2, or 3 designations to acute care vascular programs across the province using the ‘Ontario Current State Assessment and Proposed Program Framework: Acute Care Vascular Services’ as the guide. Since then, CorHealth has continued to focus on opportunities to advance vascular care through driving evidence-informed practice; and, informing planning, access, and resource allocation.
In the Ministry Realignment announcement made on October 18, 2018, by our Deputy Minister, Helen Angus, we noted that our former Assistant Deputy Minister, Lynn Guerriero, was reassigned to OHIP (formerly Negotiations and Accountability Management) and also as the Executive Lead of the Ministry of Health and Long-Term Care (MOHLTC) Agency Review.
We are pleased to announce that on October 24, 2018, CorHealth Ontario launched the 2017/18 baseline performance results for Endovascular Thrombectomy on a dashboard hosted by Integrated Decision Support. This EVT performance measurement initiative is the first of its kind in Canada, and we are thrilled that Ontario is leading the nation.
CorHealth Ontario’s corporate 2017-22 Strategy recognizes the need to focus on quality and performance across the continuum of cardiac, stroke and vascular care. The Strategy also recognizes that CorHealth Ontario should help primary care practitioners through active partnerships with organizations who have the expertise and mandate in this sector.
CorHealth Ontario would like to congratulate the 20 cardiac programs for their efforts in improving timely ST-Elevation Myocardial Infarction (STEMI) access in Ontario. Since CorHealth launched the Quality Performance Measurement & Monitoring Cycle in 2017, we have seen an improvement in timely access to STEMI care in the province.
Check out some of the available CorHealth Ontario resources and presentation highlights that have been shared throughout Ontario and beyond during these past few months. Please visit the Resources for Planners & Providers section of our website to view any of the referenced material.
CorHealth Ontario, in collaboration with our many colleagues in the system across the province, has been working on a redesign of our Advisory and Task Group Structure that reflects our expanded mandate.
In collaboration with experts across the province, CorHealth Ontario is pleased to have produced the Chronic Heart Failure: General Information and Practical Tips for Healthcare Providers pocket guide that is aligned with the 2017 National Heart Failure Guidelines. These national guidelines recommend the need for an integrated systems approach to organizing care and helping improve outcomes for patients with heart failure.
This issue includes performance and reporting updates regarding CorHealth Ontario's Information and Digital Strategy, Adult Percutaneous Coronary Intervention Outcomes and Cardiac Surgery Outcomes Reports, Quality and Performance Measurement and Monitoring and the 2016/17 Stroke Report Cards.
The Interdisciplinary Heart Team model was developed by CorHealth Ontario to provide a complementary and balanced approach to patient care through shared and integrated decision making by various medical care stakeholders from various specialties.
CorHealth Ontario hosted a webinar on June 20, 2018, on evidence and potential implications of the 6-24 hour Endovascular Thrombectomy Treatment Window for acute ischemic stroke as well as CorHealth Ontario, Heart & Stroke and the Canadian Institute for Health Information came together on a joint effort on a new project called CIHI Special Project 440.
This is an exciting time in our organization’s evolution! Created by the 2016 merger of the Cardiac Care Network of Ontario and the Ontario Stroke Network, CorHealth Ontario’s new mandate spans cardiac, stroke and vascular care in the province. By building on the tremendous work of our legacy organizations, CorHealth Ontario is uniquely positioned to lead the way in enhancing cardiac, stroke and vascular care.
CorHealth Ontario is an organization formed by the merger of the Cardiac Care Network and the Ontario Stroke Network. In June 2017, we became CorHealth Ontario, with an expanded mandate spanning cardiac, stroke and vascular care in the province. Last year, CorHealth Ontario launched its inaugural Strategic Plan, which marked an essential step towards the unification of our organization and the creation of a cohesive path to improved care in Ontario.
As we look ahead, we know that CorHealth Ontario’s data needs have an impact on our healthcare planner and provider colleagues in the province. Today, we have the opportunity to collect relevant data in a more efficient and forward-thinking way, leverage data that already exists, and optimize the use of the collected data to support policy, planning and quality improvement.
CorHealth Ontario is proud to mark Stroke Month! While we work diligently year-round to improve the quality of stroke care throughout the province, June brings us the opportunity to reflect on the strides we’ve made together, and the work that still lies ahead.
Time is of the essence when a patient is experiencing a vascular emergency. We believe that Ontarians who are at risk of losing a limb, or worse, their life, should get the right care quickly and closest to home. To get there, this summer, CorHealth Ontario is proud to partner with CritiCall Ontario to improve the referral pathways for emergency vascular patients.
CorHealth Ontario’s foundations are built on the impactful and lasting work of our legacy organizations. It is with great responsibility that we plan how to best build on their important work.
Optimal regional structures can be extremely effective in advancing evidence-based care, sharing best practice and innovation, targeting quality improvements and improving patient outcomes. In the fall, CorHealth Ontario launched the Regional Review Initiative, which seeks to understand today’s regional structures and resources supporting cardiac, vascular and stroke services in the province.
Rehabilitation can improve health outcomes and quality of life, and reduce costs by shortening hospital stays. Last summer, CorHealth Ontario began its work to create a Rehabilitation Call-to-Action to the Ministry of Health and Long-Term care that identifies the gaps and issues in rehabilitation care in our three clinical domains, cardiac, vascular and stroke.
We are proud to share with you two new Implantable Cardioverter-Defibrillators (ICDs) deactivation resources for healthcare professionals!