MasterClass–ImplementingIntegratedCareBy:Dr.WalterWodchis,AssociateProfessor,InstituteofHealthPolicy,ManagementandEvaluationattheUniversityofTorontoDr.RossBaker,Professor,InstituteofHealthPolicy,ManagementandEvaluation,UniversityofTorontoDr.FrancesMorton-Chang,PostdoctoralFellow,UniversityofTorontoMs.JodemeGoldhar,ChiefStrategyOfficer,StrategyandPlanning,CommunityCareAccessCentreDr.CarolynSteeleGray,Scientist,ResearchandInnovation,Lunenfeld-TanenbaumResearchInstitute,BridgepointCollaboratoryDr.KerryKuluski,Investigator,Lunenfeld-TanenbaumResearchInstitute,SinaiHealthSystemDr.JayShaw,PhysiotherapistandScientist,InstituteforHealthSystemSolutionsandVirtualCare,Women’sCollegeHospital’sDr.JennaEvans,StaffScientist,EnhancedProgramEvaluationUnit,CancerCareOntarioDr.AgnesGrudniewicz,AssistantProfessor,TelferSchoolofManagement,UniversityofOttawaDr.MylaineBreton,AssistantProfessor,UniversitédeSherbrookeDr.JeanLouisDenis,Professor,l’ÉNAP,DepartmentofAdministration,UniversitédeMontréalDr.YvesCouturier,Professor,SchoolofSocialWork,UniversitédeSherbrookeDr.DenisRoy,Professor,UniversitéLavalManyhealthcareproviders,organizations,andpolicy-makersarekeentoworktogetherwitholderadultswithcomplexhealthconditionstoimplementintegratedcareprogrammestomeetpatients’functionalandhealthcareneeds.Thismasterclassisofferedtothosewhoseektounderstandeffectiveapproachestoimplementintegratedcareprogrammes.PresentershavestudiedintegratedcareinternationallyandhavemostrecentlyconductedextensivecasestudiesoftheimplementationofintegratedcareinQuebec,OntarioandNewZealandaspartoftheimplementingIntegratedCareforOlderAdultswithComplexHealthneeds(ICOACH)program.Thismasterclasswillprovideaninteractivelearningopportunityforresearchers,policy-makers,organizations,providers,andpatientstoassesstheirownenvironmentsvis-à-viskeyfactorsthatwehavelearnedareessentialtoeffectiveimplementation,scaleandspreadofintegratedcareinitiatives.Integratedcareprogramscannotoperateinisolationandthedirectconsiderationofcontextincludingfundingandpolicy,organizationalvaluesandleadership,inter-organisationalandinter-sectoralrelationshipswillbediscussedwithsuggestionsforhowtomeasureandimplementthesemechanisms.Ourstudieshavealsoreinforcedtheimportanceofpatient-centredcareandhowthisisoperationalizedamongsuccessfulprogramsincludingbothpatientsandinformalcaregivers.Keyapproachestoimplementationofpolicies,organisationalandinter-organisationalstructuresandpracticesaswellasprovideractivitiesandengagementwillbeexamined.Howtheseactivitiesareimplementedvariouslyacrossdifferentprogramswillalsobepresented.Participantswillhavetheopportunitytolearnandusesomeofthekeytoolsemergingfromtheresearchinactiveandengagingsessions.Themasterclasswillincludespecificsessionsandactivitiesthatinclude:1.Policy,financingandregulatoryconsiderations;2.Organisationalassessmentandidentificationofstrengthsandgaps;3.Providerengagementstrategiesandvariedapproachestoorganizingteamsandmodelsofdeliverywithandacrossnon-traditionalsub-systems;and4.Approachestoinvolvingpatientsandcaregiversinthedevelopment,implementationandevaluationofintegratedcareprogrammes.Ineachsession,participantswilllearnofkeyfeaturesfrominternationalresearch;engageinself-assessmentandsmall-groupdiscussions;andengageinopendiscussionforums.Themasterclasswillberelevantandusefultopolicy-makers,organizationalleaders,providers,

individualsandorganisationsrepresentingpatientsandcaregiversaswellasresearchersseekingtounderstandevaluationconsiderationsforintegratedcare.ThroughouttheMasterClass,participantswilllearnfromeachotheraboutdifferentpolicyandorganisationalenvironmentsandvariedapproachestoimplementingintegratedcare.

MasterClassObjectives:

• Tosummarizetheinternationalcontextforintegratingcareforolderadults.• Tosummarizehowselectedinternationaljurisdictionshavepursuedpoliciestosupport

communityandprimarycareservicesingeneralandspecificallyintegratedcareforolderadults.• Tointroduceaframeworktounderstandkeyorganisationalfactorssuchasleadershipand

‘readiness’forimplementingintegratedcare.• Tounderstandhow“mechanisms”forintegratingcareplayakeyroleinthesuccessof

implementingmodelsofintegratedcare.• Tounderstandthecentralityofpatient-centerednessinhowwedesignanddeliverintegrated

modelsofcareandhowthishasbeenimplementedinvariouscontexts.

PresenterBiographies

Dr.WalterWodchis,AssociateProfessor,InstituteofHealthPolicy,ManagementandEvaluationattheUniversityofToronto

Dr.WalterWodchisisAssociateProfessorattheInstituteofHealthPolicy,ManagementandEvaluationattheUniversityofToronto.HeisalsoaResearchScientistattheTorontoRehabilitationInstituteandanAdjunctScientistattheInstituteforClinicalEvaluativeSciences.Heisco-leadforiCOACH(implementingIntegratedCareforOlderAdultswithComplexHealthNeeds).Hehaspreviouslyleadcasestudiesofintegratedcarein7countries.Theseprogramshavedevelopedfoundationalknowledgeonthe

characteristicsofintegratedcareprogramsbutalsoontheconditionsforimplementingintegratedcare.Dr.WodchisisthePrincipalInvestigatorfortheHealthSystemPerformanceResearchNetworkfocusedonevaluatinghealthsystemperformanceandinterventionsthatimproveintegrationofcareforcomplexpopulationsacrossmultiplehealthcaresectors.Dr.Wodchis’researchinterestsincludehealtheconomicsandfinancing,healthcarepolicyevaluation,andlong-termcare.Pastsignificantpublicationsincludequalityoflifemeasurementforolderpopulations,incentivesandgovernmentpaymentforphysiciansandlong-termcareincludingpayforperformance,andtherelationshipbetweenqualityandcost.

Dr.RossBaker,Professor,InstituteofHealthPolicy,ManagementandEvaluation,UniversityofToronto

G. RossBakerisaprofessorintheIHPMEattheUofTandProgramLeadfortheMSc.PrograminQualityImprovementandPatientSafety.Dr.Bakerhascarriedseveralmajorstudiesofpatientsafetyeventsinacutecare,homecareandpediatrichospitalcare.Recentresearchhasfocusedonexaminingtheimplementationchallengesandsuccessesforpatientsafetyinterventions.RosshasalsoledtheiCoachOntarioteam’sorganizational

analysis,focusingonidentifyingandmeasuringfactorsunderlyingthedevelopmentofsuccessfulcommunitybasedprimarycareorganizations.

Ms.JodemeGoldhar,ChiefStrategyOfficer,StrategyandPlanning,CCAC

Jodemehasheldclinicalandstrategicleadershippositionsinhealthcareforovertwentyyears.ShejoinedtheTorontoCentralCCAC'sleadershipteamin2010astheLeadforHealthSystemIntegrationforComplexPopulationsandPrimaryCare.JodemeservedastheChiefStrategyOfficeratTorontoCentralCCACuntil2017.ShenowservesastheExecutiveLeadforStrategy,InnovationandGlobalPartnershipsattheChangeFoundation.Jodemehaspositivelyimpactedthecaredelivery,experienceand

outcomesforsomeofthemostcomplexneedpopulationswholiveathomeandintheircommunities.Theimpactofherinvolvementindrivingintegrationhasinformednewmodelsofcare,influencedpolicyandissoughttoinformcaredeliveryinothercountries.SheisadeptatleadingcomplexchangeincomplexadaptivesystemsandsharesherthoughtleadershipacrossNorthAmericaandbeyond.Withafocusonleadingintegratedcare,theTorontoCentralCCAChasbeenrecognizedbytheMinisterofHealthandLongTermCarewiththe2013Minister'sMedalHonourRollforExcellenceinHealthQualityandSafetyforIntegratedCareforOlderAdults,andthe2014Minister'sMedalfortheIntegratedPalliativeCareprogramandtheCanadianHomeCareAssociationasthe2014NationalHighImpactPractice.JodemehasbeenrecognizedbyPatientCommandoasoneoftheTenCanadianWomanTransformingHealthCare.SheisPresident,InstituteforHealthPolicy,ManagementandEvaluation(IHPME),SocietyofGraduatesandAdjunctLecturerattheUniversityofToronto,aswellasPrincipalandCoPrincipalInvestigatorforanumberofresearchprojectsfocusedonintegratedcareinpartnershipwiththeLiKaShingKnowledgeInstitute,YorkUniversity,BRIDGESandtheUniversityofToronto.JodemeholdsMastersDegreesinbothSocialWorkandHealthScienceinHealthPolicy,ManagementandEvaluationandisagraduateoftheAdvancedHealthLeadershipProgramfromtheRotmanSchoolofManagement.

Dr.DenisRoy,Professor,UniversitéLaval

Dr.DenisA.RoyholdsacommunitymedicinespecialtyandisaHarknessFellowoftheCommonwealthFundinHealthPolicy.SinceMay2015,heservesasVice-President,ScienceandClinicalGovernanceatInstitutnationald’excellenceensantéetservicessociaux.HeisalsoActingPresidentoftheCanadianAssociationofHealthServicesandPolicyResearch(CAHSPR/ACRSPS).From2009to2015,asVice-President,ScientificAffairs,hehasbeenresponsibleoftheInstitutNationaldeSantéPubliqueduQuébeccomprehensivescientificprogramonthedeterminantsofpopulationhealth.Dr.RoyhasalsobeenpresidentoftheBoardofl'Initiativesurle

PartagedesConnaissancesetleDéveloppementdesCompétences,aprovince-widecapacitybuildingconsortiumaimedathealthsystemimprovement.Heistheproudco-authorofareferencebookonhealthnetworks’managementandgovernance.Previously,Dr.Royhasoccupiedthreeotherexecutiveleadershippositionsatl’AgencedelaSantéetdesServicesSociauxdelaMontérégie,attheQuebecHealthandSocialServicesMinistryandattheMontrealPublicHealthDepartment.

Dr.RoyholdsanMDfromLavalUniversity.Inaddition,heearnedaMasterofPublicHealthatUniversityofCalifornia,Berkeley,andaMasterofScience(Epidemiology)atMcGillUniversity.AfellowoftheRoyalCollegeofPhysiciansinCommunityMedicine,hehasbeenhonouredwithsomeprestigiousawards,includinganExcellenceAwardbytheQuebecAssociationofCommunityHealthPhysicians.HeiscurrentlytheonlyCanadiantohavereceivedtwicetheCanadianHealthResearchAdvancementAward,whichheobtainedduetohisoutstandingworkwithtwodifferentteams,intheMontréalandMontérégieregions.

Dr.JayShaw,PhysiotherapistandScientist,InstituteforHealthSystemSolutionsandVirtualCare,Women’sCollegeHospital’s

JayShawisaphysiotherapistandScientistatWomen’sCollegeHospital’sInstituteforHealthSystemSolutionsandVirtualCare.Jayworkedasaphysiotherapistinthehomecaresectorfor2yearsbeforecompletinghisPhDworkonfallpreventionforolderpeopleinthecommunity,proceedingontostudytransitionsoutofhospitalandcommunity-basedintegratedcareforolderpeoplewithcomplexhealthneedsinhispostdoctoralresearch.AsaScientist,Dr.Shawbringstogetherhispracticalexperienceseekingto

workinintegratedwaysasaphysiotherapyinthehomehealthcaresideofthehealthsystemwithhisacademicexpertiseinhealthpolicyandimplementationscience.Drawingonsocialsciencemethodstounderstandwhyandhowhealthandsocialcareproviderscanbetterworktogether,hisresearchhelpstoinformpracticalapproachestointegratingcareatpolicy,organizational,andproviderlevels.Hehasongoingcollaborationswithresearchersandpractitionersinhomehealthcare,primarycare,andrehabilitationcare.

Dr.CarolynSteeleGray,Scientist,ResearchandInnovation,Lunenfeld-TanenbaumResearchInstitute,BridgepointCollaboratory

Dr.CarolynSteeleGrayisaScientistattheBridgepointCollaboratoryinResearchandInnovationattheLunenfeld-TanenbaumResearchInstitute,aswellasanInvestigatorwiththeHealthSystemPerformanceResearchNetworkattheUniversityofToronto.Dr.SteeleGrayisahealthservicesresearcherwithaPhDinHealthPolicyfromtheUniversityofToronto(2013),andaMaster’sinPublicPolicyandAdministrationfromRyersonUniversity(2008).Priortohercurrentroleasa

ScientistDr.SteeleGraywasapostdoctoralfellowworkingattheUniversityofTorontoandtheHealthSystemPerformanceResearchNetwork.Dr.SteeleGray’sprogramofworkfocusesontheroleofhealthinformationtechnologyinsupportingpatient-centredcaredeliveryforpatientswithcomplexcareneeds.Amongtheareasoffocusaretoexplorehowtechnologycanbeleveragedtoenableimplementationandsustainabilityofinnovativemodelsofcareasameanstosupporthealthsystemtransformation.Aspartofthisworkshehasbeendevelopingandevaluatingnewtechnologies,mostnotablytheelectronicPatientReportedOutcome(ePRO)mobileapplicationandportal,andisdevelopingchangemanagementandimplementationframeworkstosupportimplementationofnewandexistingtechnologies.Dr.SteeleGrayadditionallyfoundedandleadsthemulti-nationaleHealthResearchPartnershipforpatientswithComplexChronicDiseaseandDisability(theeCCDDNetwork).Thenetworkincludesaninternationalgroupofresearchersandpolicymakerswhoareseekingwaystoadoptnewtechnologiestosupportpatientswithcomplexcareneeds.Thenetworkhasrecentlypublishedtheirfoundational

workinHealthcareQuarterlywhichoutlinestheopportunitiesandchallengesinadoptingeHealthtechnologiesinCanada,theUSandScotland.Dr.SteeleGrayhaspublishedworkintheareasofeHealthandmHealthtechnologiesforpatientswithcomplexneeds,organizationalchange,healthpolicyandpatient-centredcaredelivery,aswellasspokenatnationalandinternationalconferences.ShehastaughtHealthPolicyatYorkUniversityanddeliveredinvitedlecturesonorganizationalchange,researchmethods,andprogramevaluationattheUniversityofTorontoandRyersonUniversity.

Dr.KerryKuluski,Investigator,Lunenfeld-TanenbaumResearchInstitute,SinaiHealthSystem

Dr.KuluskiisanInvestigatorattheLunenfeld-TanenbaumResearchInstitute,SinaiHealthSystem(BridgepointHospitalsite),AssistantProfessorattheInstituteofHealthPolicy,ManagementandEvaluation(UniversityofToronto)andResearchAffiliateattheCentreforEducationandResearchonAgingandHealth(LakeheadUniversity).SheisanAppliedHealthServicesResearcherandaSocialWorkerbytraining.

ShereceivedherPhDinHealthServicesandPolicyResearchfromtheUniversityofTorontoin2010followedbyaPrestigiousPostdoctoralVisitingFellowshipattheUniversityofOxfordwheresheworkedwiththeHealthExperiencesResearchGroup.ShehasfundingfromtheCanadianInstitutesofHealthResearch,hasgivenover60invitedtalksandhasover25publicationsinpeer-reviewedjournals.Herresearchfocusesonqualityandhealthsystemperformancethroughtheeyesofpeoplewithmultimorbidityandtheircaregiversinthecontextsofcommunitybasedprimaryhealthcare,homecare,hospitalcare,delayeddischargeandtransitionsbetweencaresettings.Shedrawsonbothquantitativeandqualitativemethodstouncoverpopulationleveltrendsincareutilizationaswellaspatientandcaregiverexperiencesinthehealthcaresystem.Herultimateresearchgoalistousepatientandcaregiverexperiencestoinformqualityimprovementsinthehealthcaresystemincludingapproachestocaredeliveryandperformancemeasurement.AttheUniversityofTorontosheteachesafoundationalcourseonCanada’sHealthCareSystemandsupervisesanumberofMastersandPhDstudents.

Dr.JennaEvans,StaffScientist,EnhancedProgramEvaluationUnit,CancerCareOntario

Dr.JennaM.EvansisaStaffScientistintheEnhancedProgramEvaluationUnitatCancerCareOntario(CCO)andaCertifiedHealthExecutivewiththeCanadianCollegeofHealthLeaders.Sheisinterestedinhowcharacteristicsofhealthcareorganizations,theirleaders,andstaffcontributetotheirabilitytoworkcollaborativelytoimplementchangeandimprovethequalityandintegrationofcare.Inparticular,sheenjoysexploringsocialandpsychologicalfactorsinfluencing

performanceusingqualitative,surveyandmixedmethodsresearch.Dr.EvansholdsaBachelorofHealthStudieswithHonoursinHealthManagementfromYorkUniversity(2008)andaPhDinHealthServicesResearchfromtheInstituteofHealthPolicy,ManagementandEvaluationattheUniversityofToronto(2014).Herdoctoralwork,entitled'HealthSystemsIntegration:CompetingorSharedMentalModels?'wasfundedbyaVanierCanadaGraduateScholarshipandtheHealthSystemPerformanceResearchNetwork,andreceivedanOutstandingDoctoralResearchAwardin2015fromtheEuropeanFoundationforManagementDevelopmentandEmeraldGroupPublishing.

Dr.MylaineBreton,AssistantProfessor,UniversitédeSherbrooke

Dr.MylaineBretonisanAssistantProfessorintheDepartmentofSocialScienceandMedicineattheUniversityofSherbrooke.SheisalsoaResearchScientistattheCharles-LemoyneHospitalResearchCenter.ShereceivedherPhDinHealthServiceManagementfromtheUniversityofMontréalin2009,followedbyaPostdoctoralattheUniversityofSherbrookeandMcGillUniversity.Hercurrentresearchfocusesonprimaryhealthcaretobetterunderstandpromisingorganizationalinnovationsthatimproveaccessibilityandcontinuity,suchastheimplementationofacentralizedwaitinglistforpatientswithoutafamilyphysicianandadvancedaccess.

Sheisaco-leadoftheinternationaliCOACH(implementingIntegratedCareforOlderAdultswithComplexHealthNeeds)projectandtheleaderoftheQuebecteamwithintheproject.ShehadpreviouslyanalysedcasestudiesonanintegratedhealthnetworkinQuébecinthecontextofmandatedreform.Shehasongoingcollaborationswithresearchersandpractitionersinprimaryhealthcareandhealthservicesresearch.

Dr.JeanLouisDenis,Professor,l’ÉNAP,DepartmentofAdministration,UniversitédeMontréal

Jean-LouisDenisisprofessorofhealthpolicyandmanagementattheSchoolofPublicHealth-UniversitédeMontréal,seniorscientistonhealthsystemandinnovationattheResearchCenteroftheCHUM(CRCHUM)andholdstheCanadaResearchChair(tierI)onGovernanceandTransformationinHealthCareOrganizationsandSystems.HeisavisitingprofessorattheDepartmentofManagement,King'sCollegeLondon.Hiscurrentresearchlooksatintegrationof

careandservices,healthcarereformsandhealthsystemtransformation,medicalcompensationandprofessionalleadershipandclinicalgovernance.Inrecognitionforhisacademiccontributiontothefieldofhealthpolicyandmanagement,hewasnominatedmemberoftheAcademyofSocialSciencesoftheRoyalSocietyofCanadain2002andfellowoftheCanadianAcademyofHealthSciencesin2009.RecentpapershavebeenpublishedinJournalofHealthPolitics,PolicyandLaw,OrganizationScience,AcademyofManagementAnnals,MilbankQuarterly,AdministrationandSociety,ImplementationScienceandJournalofPublicAdministrationResearchandTheory.Since2016,heisco-editorofThePalgraveOrganizationalBehaviourinHealthcaremonographseries.

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