HHHS Joins with Other Community Organizations to Provide Continuous Care

by HCE Exchange on February 18, 2016

Varouj-Eskedjian-thumb2Creating hospital and community partnerships is key to delivering quality, seamless healthcare for future generations. This holds true in Canada as well as the United States, where the country is focused on improving outcomes, reducing chronic disease, and responding to the increasing numbers of Baby Boomers who need healthcare services.

In Haliburton County, Ontario, Haliburton Highlands Health Services (HHHS) has joined forces with community services to develop a continuum of care under the hospital umbrella.

Bringing everyone to the table

In the fall of last year, three organizations that provided community care services, hospice services, and adult day programs and foot care transferred their programs to HHHS. This transfer took about a year and a half of planning, and HHHS is still adapting to the structural changes the transfer brought about within the organization.

“All organizations involved believed this was the best approach for the county to have one organization operating the hospital, long-term care, and community support programs,” Varouj Eskedjian, president and chief executive officer of HHHS, said.

Leading up to the transfer, Eskedjian said HHHS worked with the three community care organizations to understand the concerns for each entity involved. In addition to matters of governance, employees, and funding, those leading the initiative communicated with clients, volunteers, and the local community to make sure everyone was heard and that care could continue seamlessly throughout the transfer.

“We made sure to engage the community and clients on what they thought about a potential transfer,” Eskedjian said. “With clients, we found they weren’t overly interested in which corporation runs the services, as long as the level of service is maintained or enhanced.”

For some of the groups moving under the HHHS umbrella, this transition was a difficult and personal decision. For example, Community Care Haliburton County transferred all of its programs and services to HHHS and is winding down as a corporation.

“The decision of Community Care Haliburton County was significant on the part of that board,” Eskedjian said. “The hospice program was developed by a local community service organization who was essentially transferring their baby to our organizations. These were not easy decisions for these groups.”

Maintaining continuity of care

Remaining focused on meeting the needs of patients and their families helped the organizations come together and work to maintain the same level of service during and after the transition. Maintaining the staff was a crucial part of this process, and no jobs were lost.

The three organizations–Community Care Haliburton County, Supportive Initiatives for Residents of the County of Haliburton, and the Victorian Order of Nurses – Ontario Branch–were primarily volunteer-based service providers, and 95 percent of the volunteers stayed on after the transfer. This greatly aided in providing uninterrupted care to clients.

Employees and providers making the transition did have to adapt to a new culture and changing workloads, Eskedjian said. Some staff and providers chose to retire based on changes from the transfer.

“The organizational change has created additional work in some areas, and we had some people choose to retire based on the additional workload,” Eskedjian said. “We support that decision and feel that we have retained a staff that is able to lead the organization in this new direction.”

To keep everyone engaged, Eskedjian said it was important that he and the other leaders were champions throughout the process and maintained open lines of communication with all stakeholders.

Restructuring the organization to improve care

Bringing these services and programs under HHHS created the need for an expanded organizational structure. Previously, the system included a 14-bed inpatient unit, two emergency departments, 30-bed and 62-bed long-term care facilities, and satellite offices for other programs.

The hospital leadership is now organized into three divisions: community support services, hospital services, and long-term care. Eskedjian said everyone is working to come together and develop a common culture.

“Compared to our partners, we are a large company, but we are still a relatively small organization with a small management team, so planning and details have been a challenge and required a lot of work from myself and the leadership group,” he said. “Having the support of the board throughout this time has been critical to our success.”

Looking ahead, HHHS is planning to coordinate all of the services in order to develop a program supportive of population health. He said HHHS is looking to grow community support programs to improve community health and lessen the burden on the hospital emergency departments and inpatient unit.

“The integrated organizational structure is the vehicle whereby we are looking to enhance the quality and the range of services devoted to the healthcare needs of the county,” Eskedjian said. “We are now able to facilitate patients’ access to services and create orderly transitions between providers.”

by Patricia Chaney

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