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A Cross-Sectorial Look at Integrated Care and the Patient’s Perspective

HQO’s latest report on QIPs combines quality improvement data with the patient’s voice to explore the state of integrated care in Ontario.

My three-part blog series on the theme of integration is coming to a close. In previous weeks, I’ve talked about integration as the next frontier in quality, and how we might begin to move individual health care sectors toward a more cohesive system. I’ve also discussed two important aspects of integration: care coordination and communication.

Now I’d like to turn my focus toward system-wide integration, as seen through the eyes of patients and caregivers and outlined in our latest Quality Improvement Plans (QIP) report. The perspectives of patients and caregivers can help us review and improve the health system in a way that goes beyond the story we might find in data and statistics. Health Quality Ontario’s QIP report, Advancing Integrated Care, released today, combines both the patient perspective and quality improvement data to paint a picture of integrated care in Ontario.

Based on the 2014-15 Quality Improvement Plans , this is our first report that reviews QIP data from hospitals, primary care practices, Community Care Access Centres (CCACs), and long-term care homes all together to show cross-sectorial integration. One theme that emerged quite strongly was the overwhelming desire of many health care organizations to collaborate with each other to improve patient transitions, and by extension patient experiences and overall satisfaction with care. Since we started reviewing QIPs almost five years ago, we’ve noticed more organizations than ever before are emphasizing the need to work together to improve on these aspects of care.

Case in point: the following graphic from the report, shows the percentage of times a certain sector, like hospitals or CCACs, mentioned another sector within its QIP and identified it as a collaborative partner. There has been a definite increase in mentions, which is indicative of new integration efforts taking shape across the province.

It’s exciting to see how many organizations are looking outside their walls for solutions that require a strong group effort. The idea of shared responsibility can only strengthen our health system at-large.

Of course, what do percentages like these actually mean? It’s hard to get a feel for them when they stand on their own. However, we can begin to see what they look in real-life terms when we explore patient stories and listen to individual voices behind such numbers.

In the report, a young man shares the story of his unexpected turn as a caregiver for his ailing grandfather. Kirk Mason stepped into the role of caregiver in his early 20s, after his grandfather Peter fell and fractured his hip. During the course of both of their journeys as patient and caregiver, Peter and Kirk felt very frustrated and often overwhelmed as they tried to navigate the health system.

This video of Kirk’s story drives home the need for a well-integrated system. After the video, we asked him more what an ideal health system might look like to him:

“Entering a hospital, the staff would be able to pull up a file and know of any pre-existing conditions, dietary restrictions, and medications I take, etc. Upon leaving the hospital, I’d know when a care worker would meet me at my house, and I’d know that my family doctor would be informed of all of this – as well as any family members designated to be my contact in the event that I’m unable to take care of myself.” Above all, he says, “An integrated health system would be fluid and quick.”

I appreciate insights like the one Kirk shares, because they show us what patients want and need from their health system. I hope you’ll read the report, and share your thoughts with us about what a well-integrated health system looks like to you.

I’d love to hear your thoughts on our recent integration series. Please Tweet me @DrJoshuaTepper or email


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