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Transitions in Care - updated June 7, 2012 

The Central East LHIN has embarked on exciting new initiatives to further improve transitions of care for area residents.  Building from past and current success – such as Home First – the Central East LHIN sought to enhance the strategic and operational coherence of various quality improvement initiatives that aim to improve patient/client flow through the health system with the establishment of a Central East Transitions in Care Steering Committee and applicable Tier 1 and 2 Committees.  

Central East Transitions in Care Steering Committee

The Central East Transitions in Care Steering Committee is:

  • comprised of senior healthcare leaders from all sectors and co-chaired by Rik Ganderton (CEO, RVHS) and Sally Davis (Senior Director, CE CCAC);
  • focused on business and quality improvement processes or enablers specifically related to care transitions (unlike other committees or structures that are focused on coordination of regional services – the Vascular Strategic Aim Coalition or the Central East Regional Specialized Geriatric Services Entity);
  • ensuring alignment of initiatives, for example Resource Matching and Referral (RMR) rollout and Home First processes; and
  • supporting the spread of quality improvement approaches and tools

Please click here to view the Terms of Reference for the Central East Transitions in Care Steering Committee.

Committees/Working Groups

The Transitions in Care Steering Committee is supported by Tier 1 and Tier 2 Committees or Working Groups.   At the present time, the Tier 1 and Tier 2 Committees include:

Resource Matching and Referral Oversight Committee (Tier 1)   

In partnership with Ontario’s LHINs, and specifically in collaboration with other GTA LHINs, the Central East LHIN is implementing the Resource Matching and Referral (RMR) system.  RMR will focus on improving (and eventually automating) patient pathways from hospital to Complex Continuing Care/Rehab, Home Care, and Long Term Care.  The Central East LHIN’s immediate focus is on the Hospital acute to CCC/Rehab. 

The Resource Matching and Referral Oversight Committee is:

  • led by executive leadership to ensure RMR implementation and alignment with provincial RMR deliverables.  The Committee is time-limited according to the implementation of the RMR automated solution (expected 2013).
  • populated according to the RMR scheduled rollout (e.g., first phase CCC/Rehab; second phase – LTC)
  • supported by a selected CE LHIN RMR vendor (RWS Advisory) who has been responsible for hospital specific, and regional implementation of current and future state / standardized work for patient flow to targeted care destinations.

Please click here to view the Terms of Reference for the Resource Matching and Referral Oversight Committee.

Please click here to view the Final Project Report of the Resource Matching and Referral Oversight Committee - posted June 7, 2012

Home First Sustainability Steering Committee (Tier 1)

Under the leadership of the CE CCAC, the Home First Sustainability Committee has evolved into an operations committee that is focused on sustaining the fidelity and performance of Home First processes.  A new Terms of Reference has been drafted and is attached.  This committee meets bi-monthly.  

Please click here to view the Terms of Reference for the Home First Sustainability Steering Committee.

Home First Operational Sustainability Committee (Tier 2)

This committee supports operational issues and trends identified through hospital specific TRAC reports and meets weekly.  The Terms of Reference has been attached.  Each health service provider involved in Home First has one member with home first operational responsibility.

Please click here to view the Terms of Reference for the Home First Operational Sustainability Committee.