Abstract
Introduction/Background: Ontario Health Teams were introduced in 209 as a new way of providing integrated care. The Mid-West Toronto Ontario Health Team (MWT-OHT) consists of more than 50 partner organisations across social and health sectors, including five major tertiary hospitals in downtown West Toronto collectively serving over 550,000 people. Patients, Caregivers and Family members have been at the heart of the MWT-OHT growth and evolution.
Approach: This presentation will share the evolution of our embedded approach to centering the voice of patients, families, and caregivers at the MWT-OHT. Since the inception of our OHT, our engagement model has been driven and co-developed by our patient, caregiver, and family partners. The limitations of the traditional Patient and Family Advisory Council (PFAC) model were identified early by people with lived experience, which led to the exploration of a novel approach.
Results:This approach has served the OHT well, strengthening the voices of patients, families, and caregivers throughout our OHT, including our shared decision-making framework.We will outline the evolution of engagement at our OHT through four critical milestones:) Recruiting patients and family partners to the Executive Advisory Committee, the OHT executive body, at the inception of our OHT set the stage for meaningful engagement and shared decision-making. 2) The early decision for our OHT to implement an embedded model of engagement instead of a traditional Patient and Family Advisory Council. 3) The recent change to our governance structure by creating a Chair and three Vice-Chairs model for our OHT. This includes a patient Vice Chair at the highest level of shared leadership in our OHT. 4) The planned re-introduction of a Patient and Family Advisory Council in a hybrid model to complement the initial embedded approach to engagement. These four milestones were implemented through an iterative approach, with continuous re-evaluation. Moreover, they would not have been implemented without continuous advocacy and support from people with lived experience. Continuous advocacy and support from people with lived experience, members of the Executive Advisory Committee, and the Secretariat helped our OHT move towards the highest level of engagement.
Implications: At the core of the MWT-OHT, partnership is a shared value. We believe that designing a system that works for the most vulnerable in our communities ensures a system that benefits everyone. Initially driven by a commitment to co-designing a system with patients, families, and caregivers, the MWT-OHT evolved into a democratized leadership space with shared power and decision-making. We encourage other OHTs to challenge the status quo and embed patients, families, and caregivers into the highest levels of leadership. This approach has been successfully implemented in a highly complex OHT which includes around 50 partners and serves over 550,000 people demonstrating that this model is not only feasible, but essential.