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Ontario Medical Review
Aug. 16, 2021
EM
Eva Marley
OMA Member Relations, Advocacy and Communications

Spotlight: Physicians and community will co-design how health care is delivered

Dr. Kim Morrison shares her vision for a successful OHT

Dr. Kim Morrison has been passionate about bringing health-care providers together to discuss solutions to common challenges for years. She is excited about the opportunity to transform how wellness and health can truly be addressed in the community, co-designed by those who receive care and those who provide it.

“The introduction of the OHT is important because what it will be able to achieve for the whole community is bigger than what any individual silo or agency could have done on their own,” said Dr. Morrison.

The physician, who has been involved with the Frontenac, Lennox and Addington (FLA) Ontario Health Team (OHT) for almost two years, had this to share with us. 

Building something special

Through her career as a family physician, Dr. Morrison has experienced many attempts at health-system transformation. She has seen her fair share of health-system reforms between the Local Health Integration Networks (LHIN), Health Links and the shift to LHIN sub-regions. But to Dr. Morrison, OHTs feel different. For the first time in a long time, physicians and the community have been asked to co-design how care will be delivered in their region. The move to integrated care by way of OHTs potentially represents the most significant health-system reform that Ontario has experienced in decades.

As a primary care physician taking on the role of chief of staff of Lennox and Addington County General Hospital in 2013, Dr. Morrison had the opportunity to work with hospital leadership to develop relationships with other hospitals.

“When the ministry announced the introduction of the Ontario Health Teams, it was a natural fit with our sub-region work, and that’s how I landed here. The concept of relationship building and increased collaboration made getting involved compelling.” 

Being in primary care gives physicians like Dr. Morrison line of sight into the entire system, including an up-close look at what patients see and experience. Evidence is clear from around the world that physician leadership in health-system transformation is key to successful implementation. Therefore, the OMA continues to support doctors who want to be involved or lead OHTs through guidance from OMA regional managers and resources and tools found on oma.org.

The pandemic expedited the need for enhanced integration

The positive impact on patient care of well-organized OHT groups where family physicians and specialists were collaboratively organized became apparent during the pandemic. Physicians who were more closely connected through a physician network were able to quickly come together to share information about COVID, personal protective equipment (PPE) allocations, set up local assessment centres, and were able to rollout local vaccination clinics.

“The FLA OHT response to COVID-19 demonstrated how effectively the team could work together,” said Dr. Morrison. She believes that the OHT shared principles of collaboration were propelled forward because of the pandemic. Discussions began before the pandemic and some aspects of the OHT were already forming. “When COVID-19 came along, we were grateful that we didn’t have to start from square one in identifying local physicians to come together and share information – we already had built a network of physicians that could work together on addressing COVID. The value of a physician network has been cemented.”

Throughout the pandemic the same physician group working to co-design the OHT pivoted to work on PPE shortages, setting up assessment centres, and vaccine rollout efforts to ensure all patients had access to care.

To help ensure and support physician leadership within OHTs, the OMA recommends that physicians within communities form local physician associations that will provide a mechanism for physicians to self-organize and provide a unified voice at the OHT leadership table.

Building together delivers the most significant value

Building trust and relationships takes commitment, time and effort. Dr. Morrison mentions years of relationship building and previous work done on Health Links, through the former South East LHIN combined with the FLA’s natural geographic fit as stepping-stones in successfully engaging physicians to join. “We had already established relationships with our rural physicians in areas outside of Kingston who were also coming together to see what they could do better together. We already had a foundation to build on when we decided to connect more closely with the other primary care doctors in our OHT geography,” said Dr. Morrison.

Joining the OHT means committing to the concept of a shared vision and recognizing everyone’s value and contribution by listening. It is an ongoing process that requires continuous engagement.

“My advice to physicians who are reluctant to join would be to give it a try. You have everything to gain. It’s about truly listening to one another, seeking others’ input and recognizing what others have to contribute and building on this.”

The OHT represents an excellent opportunity for physicians to come together and participate in making decisions and co-designing the care pathways instead of it being imposed on them. By getting involved early physicians can influence the OHT from the ground up. Additionally, as they move toward maturity OHTs will reduce some of the administrative burden on physicians and allow them to do what they love most – focus on patient care.

Dr. Morrison’s efforts have been demonstrated in the enrolment of almost 100 per cent of family physicians in her area. She looks forward to the next phase in engaging with the community and hospital-based specialists.

Moving forward in the FLA region the continued goal is for partnership, and Dr. Morrison reiterates that each partner will bring their expertise to the table. “We see the value of specialists and primary care coming together. We need to begin by focusing on our population health goals and then consider how we function as one system and one team in true partnership engaging the entire population.”

Top image: Dr. Kim Morrison is a family physician practicing in Napanee. She has been involved with the Frontenac, Lennox and Addington Ontario Health Team for almost two years and is working with area physicians to co-design how health care will be delivered in their region.