The proposed Southlake Community OHT is a partnership of a number of healthcare organizations who share both a rich history of collaboration and an exciting vision for the future of healthcare in our communities. We have worked closely together over the years to provide high-quality services to the patients, families and communities who rely on us for care.
Our vision is a local healthcare system that:
- Provides coordinated care for patients, reduces wait times, and leads to better health outcomes at the population level
- Takes the guess work out of navigating the healthcare system for patients, families and caregivers
- Improves access to secure digital health tools, including online health records and virtual care options
- Reduces clinician burnout (a healthcare system that also cares for the people who care for patients)
- Improves efficiency and lays the foundation for sustainability into the future
Patients will be part of an OHT based on where they access primary care. The population who would eventually be part of the proposed Southlake Community OHT already receive most of their care from our local partner organizations. Most live in the following municipalities:
- Bradford West Gwillimbury
- East Gwillimbury
Our priority patient populations
As part of the OHT application process, the Ministry of Health required teams to identify patient populations that they would focus on in Year 1. While all patients will continue to receive care, these are specific populations with unique needs that we believe we can have the biggest positive impact. The healthcare organizations making up the OHT would focus first on improving care for these patients.
Based on a review of data from the partner organizations and with significant input from clinical leaders, front-line teams and patients themselves, we have identified two Year 1 priority populations:
- Older adults with complex healthcare needs
- Adults with mental health and addictions challenges
These are patient populations for which our organizations have historically worked together to provide integrated care.
The Ministry of Health’s OHT application process
We submitted a Self-Assessment in mid-May, the first step of the Ministry’s OHT application process. Over 150 Self-Assessments were received from across Ontario.
Our team was one of 31 who have been invited to move to the next stage and submit a Full Application, which is due in early October.
Over the last 5 months, our organizations have been working together to design what a future local integrated healthcare system can look like for our communities, based on the input from patients, families, caregivers and clinicians. These efforts are building on our years of collaboration to improve the health of our communities.
Case study of improved care – Southlake@home
In March 2019, Southlake, Bayshore, CHATS and SE Health launched Southlake@home, the first initiative of its kind in Ontario. Southlake@home was designed to improve care for older adults with complex medical and social needs who are transitioning home after an admission to Southlake. These patients require significant support to stay well at home.
Prior to Southlake@home, these types of patients waited an average of 14 days at Southlake for their homecare and community support services to be coordinated. This unnecessary extended stay in hospital put them at increased risk for hospital-acquired infections. When they eventually went home, often they would come back to the Emergency Department soon after. In addition, during those 14 days that bed at Southlake was not able to be used for another patient in need, which led to longer wait times in our Emergency Department.
Over the last six months, Southlake@home has proven that by working directly together, healthcare organizations can have a massive positive impact on health outcomes, how patients experience care, and clinician satisfaction, all at a significantly reduced cost to the system.