Nick Goodwin: making a success of care co-ordinationThe King's Fund
Nick Goodwin, Chief Executive at the International Foundation for Integrated Care, looks at how care could be better co-ordinated around people with complex needs, and the challenges around delivering joined-up care.
Apresentação realizada no I Seminário Internacional de Atenção às Condições Crônicas, pela diretora do Programa da Gestão de Doenças Crônica dos Serviços Sanitários De Alberta/Canadá, Sandra Delon.
Belo Horizonte, 11 de novembro de 2014
Northumberland County Project Presentation February 2024.pdfDataNB
Primary healthcare often lacks the integration and coordination of care for complex-needs patients: patients with a combination of multiple chronic conditions, who are high-cost users, and are often older. Care is benefitted from coordination among health and social services, and community organizations. A new care coordination model is needed to assist these complex-needs patients.
This presentation will discuss and summarize this project, which developed a new care coordination model, with the goal to strengthen primary healthcare in the community for complex-needs patients. Using a novel, technology-enabled, integrated case-management approach, the overall goal was to decrease rates of ER visits and acute hospital admissions.
Safe transition for young people to adulthood
Dr Jacqueline Cornish,
National Clinical Director Children, Young People and Transition to
Adulthood - NHS England
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Weitzman 2013 Relative patient benefits of a hospital-PCMH collaboration with...CHC Connecticut
Anuj K Dalal presents information on a PCORI research grant: Relative patient benefits of a hospital-PCMH collaboration within an ACO to improve care transitions.
Nick Goodwin: making a success of care co-ordinationThe King's Fund
Nick Goodwin, Chief Executive at the International Foundation for Integrated Care, looks at how care could be better co-ordinated around people with complex needs, and the challenges around delivering joined-up care.
Apresentação realizada no I Seminário Internacional de Atenção às Condições Crônicas, pela diretora do Programa da Gestão de Doenças Crônica dos Serviços Sanitários De Alberta/Canadá, Sandra Delon.
Belo Horizonte, 11 de novembro de 2014
Northumberland County Project Presentation February 2024.pdfDataNB
Primary healthcare often lacks the integration and coordination of care for complex-needs patients: patients with a combination of multiple chronic conditions, who are high-cost users, and are often older. Care is benefitted from coordination among health and social services, and community organizations. A new care coordination model is needed to assist these complex-needs patients.
This presentation will discuss and summarize this project, which developed a new care coordination model, with the goal to strengthen primary healthcare in the community for complex-needs patients. Using a novel, technology-enabled, integrated case-management approach, the overall goal was to decrease rates of ER visits and acute hospital admissions.
Safe transition for young people to adulthood
Dr Jacqueline Cornish,
National Clinical Director Children, Young People and Transition to
Adulthood - NHS England
NHS Improving Quality held an event in London on 31 July 2013 to progress the children and young people transition to adult services work with a focus on turning the rhetoric into practice entitled “Working to Define a Generic Service Specification for Transition”
Weitzman 2013 Relative patient benefits of a hospital-PCMH collaboration with...CHC Connecticut
Anuj K Dalal presents information on a PCORI research grant: Relative patient benefits of a hospital-PCMH collaboration within an ACO to improve care transitions.
2.5 Partnership working - Anne Forletta, Katherine HewittNHS England
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Making Seven Day Services a reality, pop up uni, 2 pm, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
Better Care
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AHRQ pbrn webinar electronic health record functionality needed to better sup...Vince Pereira, MHA
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Person Centered Care through Integrating a Palliative Approach: Lessons from ...BCCPA
Aging adults are entering residential care facilities with more advanced disease than in the past and their length of stay is shorter. Most health care providers in these facilities do not receive targeted education and training in palliative care, nor are they confident to have crucial conversations about goals of care and end of life challenges with residents and their families. Due to limited capacity to manage predictable symptoms related to end of life and insufficient planning, many residents are transferred to hospital in crisis and die in the Emergency Department or acute care wards.
This presentation will showcase some of the initiatives by identifying common themes, unique features of each and strategies for success. Opportunity will be given for delegates to ask questions and brainstorm how lessons learned from these initiatives could inform the care provided at their own facility.
Presented by:
- Jane Webley, RN LLB Regional lead, End of Life, Vancouver Coastal Health (EPAIRS and the Daisy project)
- Dr Christine Jones, Island Health (SSC project: Improving end of life outcomes in residential care facilities: A palliative approach to care)
- Kathleen Yue, RN, BSN, MN, CHPCN (c) Education Coordinator, BC Center for Palliative Care
Patients are receiving disjointed care in the present expensive system. Changing the model:
- Identifying the components of The Transformed System; affordable, accessible, seamless, and coordinated plus high quality, person and family centered, and clinically supportive
- Listing ways to develop partnerships that create strong symbiotic teams
- Creating Care and Operation Interventions that integrate with Care Transitions, Guided Care in the PCMM(H), and ACO models
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This webinar was presented May 5, 2016 3:00 p.m. Eastern Time
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Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
Cold Sores: Causes, Treatments, and Prevention Strategies | The Lifesciences ...The Lifesciences Magazine
Cold Sores, medically known as herpes labialis, are caused by the herpes simplex virus (HSV). HSV-1 is primarily responsible for cold sores, although HSV-2 can also contribute in some cases.
2.5 Partnership working - Anne Forletta, Katherine HewittNHS England
Partnership working. Building partnerships with acute hospitals, voluntary and community services. Featuring examples from Birmingham and Coventry. Anne Forletta, My Healthcare Birmingham; Katherine Hewitt, Gateway Family Services, Birmingham.
Making Seven Day Services a reality, pop up uni, 2 pm, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
Better Care
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A preliminary proposal for an application to the Health Care Innovation Challenge sponsored by CMS. Focus of this proposal include gestational diabetes, maternal obesity, postpartum weight loss, and as well as patient engagement / health literacy
AHRQ pbrn webinar electronic health record functionality needed to better sup...Vince Pereira, MHA
Feb 28, 2014 presentation by AHRQ - "Electronic health record functionality needed to better support primary care: Joint Statement AAFP, AAP, ABFM, and NAPCRG"
Person Centered Care through Integrating a Palliative Approach: Lessons from ...BCCPA
Aging adults are entering residential care facilities with more advanced disease than in the past and their length of stay is shorter. Most health care providers in these facilities do not receive targeted education and training in palliative care, nor are they confident to have crucial conversations about goals of care and end of life challenges with residents and their families. Due to limited capacity to manage predictable symptoms related to end of life and insufficient planning, many residents are transferred to hospital in crisis and die in the Emergency Department or acute care wards.
This presentation will showcase some of the initiatives by identifying common themes, unique features of each and strategies for success. Opportunity will be given for delegates to ask questions and brainstorm how lessons learned from these initiatives could inform the care provided at their own facility.
Presented by:
- Jane Webley, RN LLB Regional lead, End of Life, Vancouver Coastal Health (EPAIRS and the Daisy project)
- Dr Christine Jones, Island Health (SSC project: Improving end of life outcomes in residential care facilities: A palliative approach to care)
- Kathleen Yue, RN, BSN, MN, CHPCN (c) Education Coordinator, BC Center for Palliative Care
Patients are receiving disjointed care in the present expensive system. Changing the model:
- Identifying the components of The Transformed System; affordable, accessible, seamless, and coordinated plus high quality, person and family centered, and clinically supportive
- Listing ways to develop partnerships that create strong symbiotic teams
- Creating Care and Operation Interventions that integrate with Care Transitions, Guided Care in the PCMM(H), and ACO models
Innovations conference 2014 catherine adams integrating a multidisciplinary...Cancer Institute NSW
Catherine Adams - Integrating a Multidisciplinary Stepped Care Model of Psychosocial Care for Cancer Survivors and Families into routine Clinical Practice in Rural and Remote Regions
Advancing Team-Based Care: Complex Care Management in Primary CareCHC Connecticut
This webinar investigated the ways that team members can contribute to the care of patients with complex medical and/or social needs. The focus was on developing the expanded care team and ensuring ready communication between the core and expanded care teams. Models for effective care management were presented.
This webinar was presented May 5, 2016 3:00 p.m. Eastern Time
How to make care and support planning a two-way dynamic - presentation from webinar held on 1 October 2014
This relates to the first NHS IQ Long Term Conditions Improvement Programmes Wednesday Lunch & Learn Webinar Series. How to make care and support planning a 2 way dynamic hosted by Dr Alan Nye & Brook Howells from AQuA. This webinar discussed how to encourage patients, carers and the public to work alongside (in equal partnership) with clinicians and managers
Similar to WHO DR. Bergman Bogota 23.3.23.pdf (20)
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDr Rachana Gujar
Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
Cold Sores: Causes, Treatments, and Prevention Strategies | The Lifesciences ...The Lifesciences Magazine
Cold Sores, medically known as herpes labialis, are caused by the herpes simplex virus (HSV). HSV-1 is primarily responsible for cold sores, although HSV-2 can also contribute in some cases.
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International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
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About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
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Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
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Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
1. Quebec Alzheimer Plan
Implementation Policy Lessons
Howard Bergman MD, FCFP, FRCPC, FCAHS
Assistant Dean, International Affairs
Professor of Family Medicine, Medicine (Geriatrics) and Oncology
Institute for Health and Social Policy
Faculty of Medicine and Health Sciences
McGill University
WHO Bogota 23.3.23
3. Canadian healthcare system(s)
◆National «principles» ( public administration ,
comprehensiveness, universality, portability,
accessibility) but decentralized provincial
management
• Provincial rather than national AD plans
◆Quebec Plan (2009) implementation since 2011
◆Ontario bottom up initiatives;
◆Other provinces at various stages of preparing or
implementation of their plans
◆Approaches similar
3
4. Primary care as the way forward
Quebec (and Canada) are distinct
Canadian Consensus Conferences recommendations
since 1989
• Primary care MD: first contact, has patient and family longitudinal
experience; best trained and equipped for community older
persons with multi-morbidity
• There will never be enough specialists interested and trained in
AD and memory clinics may not be more effective-Meeuwsen et al
BMJ,2012; Le Couteur et al BMJ 2013
4
5. Primary care as the way forward
Quebec (and Canada) are distinct
◆ Possible now with primary care reform (medical
home)
• Family Medicine Groups (GMF): group practice, team based,
interdisciplinary (nurse clinician/practitioners, social worker,
pharmacists)
◆ Continuity/primary care: lower costs, ED use
hospitalizations, mortality; improved quality
Basu, JAMA Internal med 2019; Bazemore Ann Fam Med
2018; Delgado, Br J Gen Pract 2022; Godard-Sebillotte, JAGS 2021
5
6. Meeting the Challenge of
Alzheimer’s Disease and
Related Disorders
A Vision Focused on the
Individual, Humanism, and
Excellence
REPORT OF THE COMMITTEE OF EXPERTS FOR
THE DEVELOPMENT OF AN ACTION PLAN ON
ALZHEIMER’S DISEASE AND RELATED
DISORDERS
HOWARD BERGMAN, M.D., CHAIR
May 2009
Mandate from the
Quebec Minister of
Health
6
7. Seven priority actions
24 recommendations
1. Raise awareness, inform and mobilize.
2. Provide access to personalized, coordinated assessment and
treatment services for people with Alzheimer’s and their
family/informal caregivers.
3. In the advanced stages of Alzheimer’s, promote quality of life and
provide access to home-support services and a choice of high-
quality alternative living facilities.
4. Promote high-quality, therapeutically appropriate end-of-life care
that respects people’s wishes, dignity and comfort.
5. Treat family/informal caregivers as partners who need support.
6. Develop and support training programs.
7. Mobilize all members of the university, public and private sectors,
for an unprecedented research effort.
7
8. Access to personalized, coordinated evaluation and
treatment
The Challenge
◆Poor access to:
• Diagnosis, treatment (including behavioral issues), support for
patients and their caregivers
• Integrated management through the stages of the disease
Including in crises
◆Memory clinics cannot handle the volume nor assure
comprehensive continuity of care
• Resulting in very long waiting lists, delayed diagnosis and late
intervention
◆ Primary care generally not prepared to deal with
patients with ADR
◆ Many patients are not diagnosed or diagnosed late
8
9. Objectives: Provide access to
personalized, coordinated services
◆Rapid access to assessment and management of the
disease following a comprehensive process
• Pharmacological, psychological, social and environmental
approaches
◆Personalized management and innovative access
through a trusting relationship between
patient/family and a credible clinician
▪ With personalized access to a flexible range of primary
care and community well as specialized services
9
10. Objectives: Provide access to
personalized, coordinated services
Anchored in Primary care:
◆enable/empower GMF primary care clinicians to
detect, Dx, Tx, follow vast majority of AD
◆ MD-Nurse-SW-pharmacist)
1
0
11. Collaborative care model
partnership patient/caregiver and clinician team
◆Approach based on the
chronic disease collaborative
care model implemented in
Family Medicine Groups
(GMFs)
◆Patient-centred approach;
not disease centered
◆By patient’s treating
MD/Nurse (acting as pivotal
navigation nurse);
SW/pharm
◆Diabetes vs Cancer model
11
Patient -
Caregiver
Family
Physician Nurse/SW
Family Medicine Group
Case finding - diagnostic
Treatment - follow-up
Specialized
services –
Memory clinic
Home-based services,
community pharmacy, hospital,
Alzheimer society
Support/Complex cases Coordination - transition
12. Research on organization of healthcare services for Alzheimer’s
Canadian team for healthcare services/system improvement in dementia care
Ministerial policy decision
• Quebec Alzheimer Plan is a
priority
• A modest but recurrent budget
Some Key Messages
Policy
12
13. Research on organization of healthcare services for Alzheimer’s
Canadian team for healthcare services/system improvement in dementia care
Ministerial policy decision
• Anchored in primary care and
• based on a person-centred approach
(vs a disease centred approach);
• Enable/empower the patient’s
PCP/FMG Team
Some Key Messages
Policy
13
14. Research on organization of healthcare services for Alzheimer’s
Canadian team for healthcare services/system improvement in dementia care
An implementation plan with an
ambitious change management
strategy with associated funding
• Active ministerial role in inspiring,
stimulating and supporting change
• Ministry leadership with inclusive
stakeholder governance
• Diversity in application: one size
does not fit all
Some Key Messages
Policy
14
15. Research on organization of healthcare services for Alzheimer’s
Canadian team for healthcare services/system improvement in dementia care
• Integrating research providing
collaborative «developmental»
evaluation
• feed back to ministry and clinical sites
• A sequential approach to implementation
in 3 phases
• Phase I shed light on innovative
projects/approaches, mobilised clinicians and drew
key lessons to support scaling up (phase II and III)
Some Key Messages
Policy
15
16. distinctive implementation strategy
A sequential approach to implementation in 3 phases
• 2009-Plan is tabled
• 2011-Ministerial decision based on Qc AD plan
recommendations
• 2011-12 Pre implementation phase
• 2012-16 Phase 1- targeted implementation with independent
peer review evaluation to improve and scale up
Implementation projects in 40 GMF’s-urban, rural, remote chosen by
«competition
• 2017-20 Phase 2-Scaling up
• 2021- Phase 3- Post-COVID; transitions; behavior
manifestations 16
17. Research on organization of healthcare services for Alzheimer’s
Canadian team for healthcare services/system improvement in dementia care
• A “pre-implementation” study and consultations
with clinicians
• Mobilization of “Clinical Champions” (1st care &
2nd/3rd care)
• Capacity building strategies (training,
dissemination of clinical tools etc…)
• Commitment of university partners
• 4 project managers to support implementation
Some Key Messages
Initial implementation
17
18. Équipe de Recherche en
Organisation des Services sur
l’Alzheimer
Research Team on
Organization of Healthcare
Services for Alzheimer's
Produce rapid and pertinent results for stakeholders:
patients-caregivers-citizens, decision makers, managers and clinicians
Canadian Team for healthcare services/system improvement in dementia care
19. Research on organization of healthcare services for Alzheimer’s
Canadian team for healthcare services/system improvement in dementia care
Three interrelated cross-fertilizing studies
• To identify the impact of the QC Alzheimer plan on
detection, diagnosis, referral patterns, and quality of
follow-up
OBSERVATIONAL
(Quantitative) Study
• To examine the implementation strategies used in
order to identify key factors for successful
development and large-scale up-take across Canada
IMPLEMENTATION
(Qualitative) Study
QUALITY OF CARE AND USE OF HEALTH SERVICES
Administrative databases
19
20. Research on organization of healthcare services for Alzheimer’s
Canadian team for healthcare services/system improvement in dementia care
• Baseline*
• very good to excellent clinical knowledge
• Positive attitudes to disease, AD Plan
• Strongly support/appreciate/use interdisciplinary approach
and access to MD and nurse expertise within the GMF
• Identification of a champion in the FMGs
• Although received late, appreciated pathway/guidelines,
training as well as access to outside expertise
• Leading to increase competency and confidence
• Critical about delay to access memory clinic and home care
*Arsenault-Lapierre G, Henein M, Rojas-Rozo L, Sourial N, Bergman H, Couturier Y, Vedel I. Primary care
clinicians' knowledge, attitudes, and practices concerning dementia: They are willing
and need support. Can Fam Physician. 2021
Some Key Results/Impact
Clinicians in the FMG
20
21. Research on organization of healthcare services for Alzheimer’s
Canadian team for healthcare services/system improvement in dementia care
Primary care (GMFs) can detect, diagnose, manage and meet the
needs of persons living with dementia and their caregivers
• offering high quality care
• utilising specialty care for complex cases
A person-centred interdisciplinary approach by the patient’s
treating MD/clinical team resulted in
• Improved continuity of care
• Higher intensity of follow-up
• Improved quality of care
• Fewer/more appropriate specialist referrals
• Decrease ED visits and hospitalization
Room for improvement
• antipsychotics prescriptions
• evaluation of caregiver needs
• referral to community services
Vedel I, Sourial N, Arsenault-Lapierre G, Godard-Sebillotte C, Bergman H. Impact of the Quebec
• Alzheimer Plan on the detection and management of Alzheimer disease and other neurocognitive
• disorders in primary health care: a retrospective study. CMAJ Open
Some Key Results/Impact
21
D
is
a
gr
e
e
Som
ewh
at
disa
gree
So
m
e
w
ha
t
ag
re
e
Agree
Lege
nd:
22. Significant challenges
• From targeted projects to generalization
• Beyond initial innovators/leaders/champions
• MD mobilization/buy-in
• Transitions
• Behavior manifestations
• Role of persons living with dementia and
their caregivers
• Advent of Bio-markers/disease modifying
medications-the challenge of access and
equity
• Medically assisted Dying
• Post-COVID
22
23. Key elements for successful implementation
1. Clear ministerial decision
• Integration into the ministry programing
• Recurring budget, even if modest
2. An implementation plan
• With priorities (not too many at the same time)
• Change management strategy
Support/stimulate change
• Diversity in application: one size does not fit all
• Phased implementation
23
24. Key elements for successful implementation
3. Ministry leadership with inclusive stakeholder
governance
• Credible «extra- ministerial» clinical leadership
• Mobilize clinician champions
• Mobilize university and civil society
4. Guidelines necessary but not sufficient
• Clinical pathways
• Training
• Get into the trenches
24
25. Key elements for successful implementation
5. Independent evaluation to support and adapt
implementation
• Integrate university researchers; feed back to ministry
and clinical sites
25
26. Acknowledgements
Isabelle Vedel MD, PhD
Yves Couturier, Ph.D.
Maxime Guillette Ph.D. (cand)
Carolyn Boudreau, Minisitry
And
ROSA Research Team
Stakeholder partners
2
6
Canadian Team for healthcare services/system improvement in dementia care
https://www.mcgill.ca/familymed/research/projects/research-organization-healthcare-services-
alzheimers-rosa
30. • key determinants linked with indicators of access to
and use of services (e.g., continuity of care with the
family physician, potentially avoidable ED visit &
hospitalization, potentially inappropriate medication,
long-term care admission):
o Sex and gender
o Rurality
o Socioeconomic status
o Racialized and immigration
o COVID impact
o Post-dx care
o Living Lab
ROSA Group
Other studies
https://www.mcgill.ca/familymed/
research/projects/research-
organization-healthcare-services-
alzheimers-rosa