It's About Time: Rapid Implementation of a Hub-and-Spoke Care Delivery Model for Tertiary-Integrated Complex Care Services in a Northern Ontario Community

Nathalie Major; Marie Rouleau; Chantal Krantz; Karen Morris; François Séguin; Megan Allard; Jia Lu Lilian Lin; Mary Ellen Salenieks; Roxana Sultan; W Gary Smith

doi:10.12927/hcq.2018.25624

It's About Time: Rapid Implementation of a Hub-and-Spoke Care Delivery Model for Tertiary-Integrated Complex Care Services in a Northern Ontario Community

Healthc Q. 2018 Jul;21(2):35-40. doi: 10.12927/hcq.2018.25624.

Authors

Affiliations

¹ A pediatrician and the medical director of the Complex Care Program at the Children's Hospital of Eastern Ontario and Ottawa Children's Treatment Centre. She works on national and provincial initiatives, advising on integrated care models. The focus of her research is on models of care coordination for children with complex chronic conditions.
² The executive director of the Cochrane-Temiskaming Children's Treatment Centre in Timmins, ON. She is from Smooth Rock Falls in northern Ontario and has worked for close to 30 years in various domains related to persons with special needs who live in northern Ontario.
³ The manager of Connected Care for Development and Rehabilitation at the Children's Hospital of Eastern Ontario and Ottawa Children's Treatment Centre. She has a keen interest in integrated healthcare systems and care coordination to improve health outcomes for children, youth and their families.
⁴ A complex care nurse practitioner at the Children's Hospital of Eastern Ontario and Ottawa Children's Treatment Centre. She is a member of a working group dedicated to bringing tertiary-level complex care to northern families and communities.
⁵ The operational lead for the Project Management Office at Hawkesbury General Hospital. He was previously the project coordinator for the Timmins Community Complex Care Clinic.
⁶ The mother of a medically fragile child assisting the Champlain Complex Care Program with a parent's perspective.
⁷ A doctoral student in health services research at the Institute of Health Policy, Management and Evaluation, University of Toronto, and a research analyst at the Provincial Council for Maternal and Child Health. She is broadly interested in health policy and the social and ethical dimensions of healthcare.
⁸ Senior program manager for the Provincial Council for Maternal and Child Health has focused on project work within and across tertiary and community healthcare organizations.
⁹ The executive director of the Provincial Council for Maternal and Child Health. She has a keen interest in demonstrating tangible, patient-centred outcomes associated with the implementation of quality improvement initiatives in maternal, neonatal and pediatric healthcare services.
¹⁰ W. Gary Smith, MD, FRCP, FAAP, MHSc, CHE, CCPE, is an associate professor at the Department of Paediatrics, University of Toronto and the chief of Neonatal and Paediatric Medicine at Timmins and District Hospital.

PMID: 30474590
DOI: 10.12927/hcq.2018.25624

Abstract

Children with medical complexity (CMC) in rural and northern communities have more difficulty accessing subspecialty health providers than those in urban centres. This article describes an alignment cascade in which leaders engaged peers and staff to rapidly roll out the implementation of a sustainably designed complex care model, integrated in the Champlain Complex Care Program and delivered in Timmins, Ontario. The Provincial Council for Maternal and Child Health's Complex Care for Kids Ontario (CCKO) strategy supports the implementation and expansion of a hub-and-spoke model of interprofessional complex care for CMC and their families. A nurse practitioner is the primary point of contact for the family and oversees coordination and integration of care; regional CCKO programs are committed to building capacity to provide safe, high-quality care for CMC in communities closer to their homes.

MeSH terms

Child
Chronic Disease / therapy
Delivery of Health Care, Integrated / methods
Delivery of Health Care, Integrated / organization & administration*
Family
Hospitals, Pediatric / organization & administration
Humans
Ontario
Patient-Centered Care / organization & administration
Rural Health Services / organization & administration*
Tertiary Care Centers / organization & administration
Tertiary Healthcare / organization & administration*