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Best Practices Day 2015
Rehabilitation and Integration: Perspectives across the Continuum

Best Practices Day 2015 presented a dynamic program featuring today’s leaders in rehabilitation and healthcare transformation. Clinicians, researchers and administrators from across the province presented on the latest organizational initiatives, research and practice. The conference provided all participants with the opportunity to step outside of their professions, specialties and organizations to discuss common challenges and issues in rehabilitation. 

This Year's Conference Featured:

  • 3 keynote speakers
  • 3 workshops
  • Rapid podium presentations
  • Poster displays
  • Opportunities to network and collaborate with colleagues

Program Highlights

Download the full conference program HERE.

Download full abstract summaries for all posters HERE

Download a listing of posters by number, primary author and title HERE

Opening Keynote Speaker  

Dr. Joshua TepperDr. Joshua Tepper - Data, Skills & Leadership: Building a Quality agenda for health in Ontario


Quality Improvement (QI) holds tremendous promise for revolutionizing the way we deliver care and more importantly achieve health outcomes. However success often eludes us on our QI journey. We will explore key enablers to achieving more effective QI and seek to understand the broader shifting landscape in healthcare as QI is evolving.



The Patient Perspective

Josephine McMurrayJosephine McMurray - Rehabilitative care: Listening to the voice of the patient from bedside to boardroom 


At their heart, health systems are human systems, with each encounter connecting a giver of care, and a receiver of care. Increasingly we seek to understand this encounter from the patient’s perspective. The value of taking a patient-centred approach is evident from improved outcomes, greater efficiency as a result of informed and engaged clients, and greater satisfaction with the care received. But how do we know if our organization is providing care that is meaningful to our clients? We will explore the value of measuring patient experience versus patient satisfaction, and the results of a comprehensive review that identified measures of patient experience in the rehabilitative care sector. Collecting patient experience data outside of hospital settings is challenging but of growing interest to system stakeholders - we’ll look at an innovative technology that has the potential to disrupt this field. Finally, engaging your entire organization, from bedside to boardroom, in a discussion about the importance of listening to the patient voice, is critical to the success of an integrated rehabilitative care system.

Closing Keynote Speaker

Dr. Onil BhattacharyyaDr. Onil Bhattacharyya - Rethink health care by thinking like a startup: Using creativity and managing uncertainty to design the next generation of health services 


How can health services be reconfigured so that they can promote health, support people’s aspirations and be financially sustainable? These solutions are not likely to come from incremental improvements in quality of care. Manufacturing methods have been successfully applied to health services to reduce practice variation and improve outcomes where best practices exist. However, other methods may be needed when best practices and even appropriate outcomes are unclear, like care of people with complex physical, mental and social needs. Tech companies have become adept at designing simple seamless interfaces for complex tools. Health care is complex on the front and back end, and could adapt approaches from startups to redefine problems, improve the user experience, and reduce cost. This presentation will explore the potential of design thinking and the Lean Startup method, and ways for individuals and teams to move past obvious solutions to possible breakthroughs for health services.

  


Concurrent sessions: Ideas, innovations, insights

Workshop A: From Ideas to Action: Identifying Change Ideas for Quality Improvement

Every organization has capacity for improvement, but sometimes it can be a challenge to know just what changes will actually lead to improvement. This practical session will provide attendees with tools to help identify and organize change ideas to accomplish quality improvement in their organization or health system.

Presenter:

  • Jim Handyside, Consultant in healthcare safety and quality improvement; Principle of Improvision Healthcare Inc. 

Workshop B: Hospital to Home...and Back Again? Stories from the Bridge to Home Team on Improving Discharges for Complex Patients

Patients with complex chronic conditions can experience significant health changes during a hospital stay and typically have higher than average needs following discharge. Upon returning to the community, these patients are at high risk of hospital re-admission and ER visits, many of which could be avoided in the presence of integrated transition care that follows the patient post-discharge.

The Bridge to Home (B2H) program is a 1-year demonstration project, jointly funded by the MOHLTC and the OMA. It is comprised of a comprehensive interprofessional team designed to “bridge” the transition between the hospital setting and the patient’s home/community. The primary objectives are to support and sustain the direction of the hospital discharge plan and to connect and collaborate with community partners to address the changing needs of patients and families post-discharge.

Members of the B2H Team will highlight themes through actual case-based examples that identify key risks and opportunities at discharge. Workshop participants will engage with the panel and with each other in directed activities in order to: (1) deepen their understanding of the small- and large-scale challenges that arise in transitions of care, and (2) explore how the findings of the project might apply in their own practices.

Presenters:

  • Puja Bansal, RD, CDE, Certified Diabetes Educator, and the Dietetic Facilitator, B2H demonstration project, Bridgepoint Hospital
  • Katherine Dittmann, PT, Physiotherapy Facilitator, B2H demonstration project, Bridgepoint Hospital
  • Katelyn Jutzi, OT Reg. (Ont.), Occupational Therapy Facilitator, B2H demonstration project, Bridgepoint Hospital
  • Leslie Nickell, MSW, MD, CCFP, Associate Dean, Health Professions Student Affairs in the Faculty of Medicine at the University of Toronto and a family physicianon the B2H demonstration project, Bridgepoint Hospital
  • Shawn Tracy, PhD (cand.), Health Services Researcher with the Bridgepoint Collaboratory for Research and Innovation and Team Lead, B2H demonstration project, Bridgepoint Hospital

Additional Authors/Team Members:

  • Jennifer Aronson, MSW, RSW,Social Work Facilitator, B2H demonstration project, Bridgepoint Hospital
  • Janet Chong-Lee, RPh, , Pharmacy Facilitator, B2H demonstration project, Bridgepoint Hospital
  • Jason Xin Nie, MSc, Health Services Researcher and Research Coordinator, B2H demonstration project, Bridgepoint Hospital
  • Ross Upshur, MD, MSc, CCFP, Scientific Director of the Bridgepoint Collaboratory for Research and Innovation and a family physician, B2H demonstration project, Bridgepoint Hospital
  • Dorothy Wedel, RN, BScN, Telemedicine IMPACT Plus (TIP) Facilitator for the Don Valley Greenwood Health Link, and the Nursing Facilitator, B2H demonstration project, Bridgepoint Hospital

Workshop C: Supporting Transitions and Reintegration through Telehealth

In this workshop, there will be 3 presentations from different organizations who will share their experiences and learnings from using Telehealth. 

1. How Telehealth is changing the way Health Care is delivered: One Organization's Experience!

The goal of this presentation is to share how William Osler Health System and the Ontario Telemedicine Network (OTN) collaborated to successfully implement an innovative model of virtual care to support patients living with chronic conditions. Telehomecare brings health care services into the home for patients with CHF and COPD with easy to use equipment. Telehomecare Nurses monitor each patient's health status remotely; provide telephone support for medication management, self-management strategies for their disease, education and health coaching. Together, the goal is to inspire individuals to manage their own health at home. The patient's primary care provider is kept informed through calls and reports.

This presentation will focus on the strategies required to implement this pilot program, including the integration of Telehomecare referral into standard care processes through the implementation of order sets, clinician engagement, and linkages with the CCAC, the Central West LHIN and Health Links. Outcome data measured by ER visits and readmission before, during and after Telehomecare will be discussed.

The objectives of this presentation:

  1. To explore the critical success factors in implementing a Telehomecare program
  2. To identify organizational enablers/challenges in adoption of the program
  3. Lessons learned and next steps 

Presenters:

  • Jane DeLacy, RN, MHSc; Executive Director, Clinical Programs, William Osler Health System
  • Mary Brougham, RN, MHS; Corporate Interim Director, Cardiovascular, Renal & Chronic Disease; William Osler Health System
  • Charmaine Burke; Engagement & Implementation Lead, Telehomecare; William Osler Health System
2. Telehealth Assessment and Follow-Up in Respiratory Rehabilitation

There is increasing interest in the implementation of telehealth technologies to improve issues of access and capacity by overcoming geographic and healthcare resource barriers. For those referred to pulmonary rehabilitation, this includes assessment and follow-up of those enrolled as well as providing part of the rehabilitation program on-line in real time.  For ventilator assisted individuals technology is now used for ongoing clinical monitoring, enabling ventilator users and their families to be followed by a healthcare team while remaining in the community. 

Presenter:

  • Jacinthe Dubois-Webster, BSc. OT, OT Reg. (Ont.); West Park Healthcare Centre
3. Tele-home exercise coaching for frail seniors following illness and/or falls: An assess and restore proof of concept initiative

Interprofessional assessment and restoration of functional mobility in geriatric day hospitals and community health centres is a common feature of the transition to optimal wellness following illness and/or falls for frail seniors. For frail seniors challenged by complex and chronic health conditions these restorative services require subtle design and ongoing calibration that are difficult to achieve in settings for healthier seniors. And, for housebound seniors with restorative potential, functional disabilities can prevent access to specialized restorative services. In order to assist housebound seniors in this dilemma and to facilitate continuing restoration of frail seniors discharged from specialized programs, a tele-home exercise coaching service was developed. This proof of concept project was funded by the Toronto Central LHIN’s  2012/13 Assess &Restore initiative, the Regional Geriatric Program of Toronto’s Specialized Geriatric Services at Sunnybrook Health Sciences Centre, the Anne Johnston Health Station, and the Ontario Telemedicine Network.  

Topics covered in this workshop include:

  1. The seated exercise development process
  2. Video demonstration of the exercise process
  3. Technical and socio-technical issues in the delivery of telehome exercise coaching
  4. The clinical issues and successful outcomes identified in a small group of frail seniors
  5. Discussion of next steps , scalability and a pilot study

Presenters:

  • David Ryan, Ph.D. Director of Education, RGP Toronto
  • Daryl Mahabir, Physiotherapy Assistant, W.P. Scott Geriatric Day Hospital , Sunnybrook Health Sciences Centre
  • Rosamund Levy, Implementation Lead - Telehomecare, Ontario Telemedicine Network

Additional Authors:

  • Brenda McNeill, BSc, MA, MBA Executive Director, Anne Johnston Health Station
  • Betty Matheson, MScN, Patient Care & Specialized Geriatric Services Manger, Sunnybrook Health Sciences Centre
  • Fareeha Khizar, Project Manager, Ontario Telemedicine Network

Rapid Podium Presentations

These popular presentations are unique, 8 minute-long presentations on innovative initiatives and research from a variety of sectors and disciplines. Presenters provided key 'take-away' messages for the audience and answered questions from audience members.

Please see the conference program for details of the rapid podium presentations. 

The People's Choice Award Competition

These awards recognize the high quality work presented at the conference and favourites as selected by delegates. The awards honour the work presented in both rapid podium presentations and poster displays. Five People's Choice Awards will be presented to:

  • The top rapid podium presentation
  • The top three posters
  • The top student poster

 

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