BY NORM TOLLINSKY

The North West Local Health Integration Network (LHIN) isn’t short of ideas for improving the health-care system following a groundbreaking online community engagement exercise earlier this year.

The Share Your Story, Shape Your Care exercise drew responses from more than 500 people anxious to help the LHIN map out priorities for a three-year integrated health services plan scheduled to be unveiled in November.

The online engagement tool provided respondents with an overview of the health-care challenges facing the region, reviewed the priorities from the first integrated health services plan in 2006 and asked for comments on priorities and possible initiatives for the future.

Respondents were also invited to share their stories about positive and negative experiences they have had in the health-care system, and suggest ideas for improvement.

A so-called Choice Book set the stage with some dire statistics on obesity, smoking, and alcohol use in northwestern Ontario. According to the LHIN, 55 per cent of people living in the region are obese or overweight, compared with 49 per cent in the province as a whole. Twenty-two per cent are smokers (compared with 17 per cent provincially) and 29 per cent are classified as heavy drinkers (compared with 21 per cent provincially). A lack of exercise and poor nutrition are attributed to the region’s long winters and the high cost of fresh fruits and vegetables in remote communities. Other factors affecting the health of people in the northwest include the region’s ailing economy, which impacts on emotional health and well-being, and the long distances people have to travel to access health care.

The Northwest LHIN has held many face to face meetings to gather input from citizens over the years, but the Share Your Story, Shape Your Care online engagement tool was the first time a LHIN has solicited public input using the Internet, said Kristin Shields, the North West LHIN’s senior consultant for planning and community engagement.

“Provincially, there’s been a lot of excitement about the project and other LHINs are looking to see how it goes,” she said. “When we do face to face meetings, we get a great turnout, but with this model we’re really seeing a good cross-section of our population, different age groups, different education levels and people from different parts of our region.”

Stories
The stories submitted by respondents and published online make for interesting reading. One respondent suggested that registered nurses in emergency rooms should be permitted to provide patients with test results, especially if they are negative and could result in an early discharge.

“I know nurses are currently not allowed to do this, but I have never been clear as to why,” wrote the respondent, an RN herself. “An experienced nurse is perfectly capable of passing on a negative test result along with qualifiers like, if the situation changes or your condition doesn’t improve, come back to the hospital. Doctors have been the only gatekeepers for far too long.”

Several other respondents were critical of the provincial government for not offering sufficient operating funds for a proposed residential hospice in Thunder Bay.
“I believe that allowing dignity when dying should be a provincial responsibility and should not depend on local fundraising capabilities,” wrote one respondent.
A parent, whose child was flown to Sick Children’s Hospital in Toronto said she “was shocked to learn” that she was not permitted to join her child on an air ambulance flight back to Thunder Bay and had to borrow money to pay for her own airfare.

Another mother complained that her child had to be flown to Sick Children’s Hospital because nurses at Thunder Bay Regional Health Sciences Centre didn’t have the training required to apply a peripherally inserted central catheter, or PICC line.
“I suggest that we have nurses, nurse practitioners, or doctors receive training so that such procedures can be done locally instead of having to move the patient,” she wrote.
Yet another mother complained that she had to drive two and a half hours to a hospital that allowed her midwife to deliver her baby.

“I could have driven 15 minutes to the (local) hospital, instead of two and a half hours. My midwife is an amazing person, with a multitude of experience, wisdom and intellect, who only wants to assist women in having wonderful birth experiences and to deliver healthy babies,” she wrote. “I wish that the doctors in my area would open their eyes to this, stop being so close-minded, and think about how much midwives could contribute to the community.”

The online engagement tool also included an introductory YouTube video welcoming respondents and a weekly blog by North West LHIN CEO Gwen Dubois-Wing in which she provided updates on findings and participation rates.

Hard copy questionnaires were made available to people without Internet access and discussion guides were provided to members of the community interested in organizing their own focus groups.