Start Submission Become a Reviewer

Reading: Exploring system resiliency within the North York Toronto Health Partners North York Communi...

Download

A- A+
Alt. Display

Poster Abstracts

Exploring system resiliency within the North York Toronto Health Partners North York Community Access to Resources Enabling Support Program – A pragmatic case study

Authors:

Kimia Sedig ,

University Of Toronto, Canada North York General Hospital, CA
X close

Katie Dainty

University Of Toronto, Canada North York General Hospital, CA
X close

Abstract

Ontario Health Teams (OHTs) were implemented in 2019 as a Canadian model of health system organization meant to improve integration of care across Ontario. According to a broad spectrum of literature, health system integration and health system resilience (HSR) are closely intertwined. Under the umbrella of the North York Toronto Health Partners (NYTHP) OHT, the program North York CARES (NYCARES) was developed to support patients with complex care needs transitioning from the hospital to the home. NYCARES provides core services in a collaboration between VHA Home Healthcare, North York General Hospital and NYTHP. The purpose of this study was to use NYTHP (with specific focus on NYCARES) as a case study of the OHT model’s integrative characteristics in practice, and its ability to respond to large scale crises, using the COVID-19 pandemic as a natural experiment. We used a combination grounded theory, qualitative case study approach to explore the presence or absence of integration and resilience in the OHT model. The case’s parameters were limited to the NYCARES program due to its explicit focus on integrating care and its initial implementation a few months prior to the pandemic’s start. A combination of semi-structured interviews, non-participant observation, and document analysis was used to explore program partners’ individual and collective experiences with the program’s integrative characteristics, and how those experiences did or did not impact the program’s response to COVID-19. Results showed that the program’s operation included key integrative characteristics: regularly facilitated virtual communication between and among partners; an open, trusting culture of collaboration; and clearly-defined program goals and values that were emergent from partners’ willing consultation. These characteristics allowed for adaptability, innovation, and operational resilience in the face of the pandemic’s strain on various sectors of the healthcare system. Participants described how, despite not being designed to address the burden of COVID, NYCARES shifted its focus to alleviate COVID-related strain imposed on hospitals, homecare, and long-term care through its strong sense of constructive cooperation, shared passion and patient-centric vision, and a diverse network of multi-professional resources that allowed for effortless flexibility and the ability for partners to easily “think on their feet”. However, the program’s apparent resilience also remained limited by the fragmented macro systems it existed within. Participants regularly noted that without their continued, yet tenuous provincial funding, they remained unsure of the program’s longevity or scalability. Additionally, few participants felt truly connected to the OHT as a whole: its relevance to their work was entirely resource-based, and they did not feel ownership over their understanding of its vision. NYCARES’s experience throughout the COVID-19 pandemic has presented a clear case for a connection between integrated care and systemic resilience. However, lack of wider systemic support for such integrated programs limits their ability to flourish past their immediate contextual circumstances. Scalability and self-sustainability are both key principles of HSR, and better understanding how to extend to the rest of the healthcare system the integrative principles that have enabled NYCARES’s success to date is critical to achieving wider systemic resilience.

How to Cite: Sedig K, Dainty K. Exploring system resiliency within the North York Toronto Health Partners North York Community Access to Resources Enabling Support Program – A pragmatic case study. International Journal of Integrated Care. 2022;22(S3):325. DOI: http://doi.org/10.5334/ijic.ICIC22357
8
Views
Published on 04 Nov 2022.

Downloads

  • PDF (EN)