NPLC Debrief – April 17, 2019

NPLC Monthly Teleconference

Wednesday April 17, 2019

11am – 12:00

Conference Dial-in Info:

Conference Dial-in Numbers:

Toronto                                              1-416-764-8607

Toll Free – North America            1-888-886-8047

Guest Code:                                       3471300

Co-chairs: Leanna Lefebvre and Jenn Clement

Agenda

Check in and roll call: 9 /25 clinics in attendance

1. Debrief following OHT discussion

Key themes extracted and reviewed:

• Financially driven decision making:
  • Regional funding changes may provide opportunity to access regional or local funding envelopes, or bundled care type of funding
  • “Funding following the clients” – we need to review what money is coming into our geographic region and what proportion of the funds the clinics should and can access to maximize our impact; what work has already been done on this and how do we learn more?
  • Better understanding how the funding models are expected to change can put is in a good position to mobilize opportunities for expanding services
• OHIP and fee for service discussion:
  • OHIP billing and FFS for NPs is a broader provincial discussion beyond the NPLCs
  • General consensus at this meeting is that our model works very well for clients and provides predictability and outcomes that may not continue if FFS were to be implemented as it currently exists for MDs
  • Rather than FFS at the granular level, how can we better understand bundled care funding or other funding measures that may be implemented?
  • If there is a change to the funding provided to the clinics, how do we manage that?  Better yet, how can we predict and propose what we want and need for funding to maintain and grow our strengths?
• Workforce and Sector Empowerment
  • NPLCs are providing highest quality care, excellent outcomes, client favorite, change agent, good access to team based care
  • Government knows that investments will be helpful
  • Take advantage of the message – we are doing the work in a lean financial manner that is getting desired outcomes
  • Don’t be afraid to be assertive for what you need to continue to grow and meet community demands
• Alignment of discussion with OHT public information
  • Message – Funding is not going to change any time soon
  • Discussed that OHT application is different from information from consultant (i.e. groups vs geography); unclear what this means; MOH clear message that geography will drive change
  • NPLCs need access to date regarding financial investments and outcomes to show worth and role for OHT success

• Key principles:
  • “Think like business people” – these are business people in the government
  • “Under- promise and over-deliver”
  • Showcase the work and what we are doing
  • Continue to be a unique model and represent a unique opportunity

• Pan Provincial Scan re: OHT process and NPLC engagement
  • In general OHT groups are evolving from Sub LHIN groups (i.e Health Links or sub regional planning)
  • Huronia – has been approached to join Couchiching OHT led by FHT; NPLC board has discussed and is examining risk – want to learn from the work underway – can we come up with our own ideas as we learn more?
  • WPSHC – hearing that there is local and regional variation expected in governance, oversight and development; currently working in a similar model to OHT as is governed by the hospital; may be a learning and sharing opportunity for others as this has been positive; has submitted expansion proposal to demonstrate model; will share
  • Ingersoll –meetings with OHT group regularly; encouraged to independently continue forward year to year; “don’t halt work underway”: – continue to request increases, demonstrate need and develop business plans for growth
  • Peterborough – getting linked into the work that is being led by hospital, first meeting upcoming
  • Sudbury – hospital is starting conversations and hiring consultants to lead this work; five site clinic; big potential
  • Smith’s Falls – invited to a collaborative governance workshop – KGH; provides information about Arnprior’s development of similar model and may be able to access further sources of support
  • Waterloo – is between to geographies – big variation from both communities – Cambridge – looking at setting up a separate sub-entity for OHT oversight, Kitchener has hospital as driver
  • Muskoka – OHT group is forming from a mix of sub regional planning and Health Links table; encouraging collaborative leadership, some local politics at play
  • How will we navigate regional infighting which feels, in many areas, inevitable?

NEXT STEPS:

Q – What more can the QIMSS do to fill in the missing gaps for data (i.e. can the information that we are not getting form the Alliance for complexity come from the QIMSS)?

A – Host sites – consensus is that NPLCs need to standardize data entry across clinics and use standardized coding systems to allow for data access; this is a topic for June meeting

Suggestion – don’t wait – prioritize this work for the QIMSS to have movement on standardization ASAP

Q – Can standardized NPLC client experience survey (HQO) be expanded and to collect additional information?

A – Most clinics are using HQO surveys – what additional information may be useful to gather from clients at this time?  Penelope has some ideas and will circulate

Q – Can clinics collectively gather information about the economic impact – Penelope presented ideas surrounding overall administrative cost per total expenditures, costs per client visits, etc and has trial several of these indicators at her clinic

A – Penelope will distribute the information that is being collected to the group to review feasibility of spread and utility

Q – What are the barriers to NP linkage via OHIP?

A – Need follow up with Nadia and we need to think about provincial in roads to make this happen – Leanna will discuss with NPAO to determine strategy and how to move this

TAKE AWAYS –

Take the call for what it was and use this opportunity to expand our thinking of what we are; continue innovation and think strategic and business-focused as to what can we do; better value, better quality

Reach out to other NPs in the province not working as MRPs to engage with them; is this an area for NPLC growth?

Aim to get representation of NPs at OHT governance tables across the province

Use this year’s annual operating plan (template not yet received) to request that ALL surplus dollars get re-invested into front line care; may open a door to expand staffing

Learn more about financial models and what these changes might mean for NPLCs – ? conference topic?