Simplifying Access to Community Support Services

Doleweerd Consulting assisted a network of 25 community support service agencies in the Waterloo Wellington region to create an coordinated, access process to over 150 services. This involved observing processes at numerous organizations to map processes. We facilitated workshops to create a shared understanding of the capability of the current system to meet demand and provide client value.

The solutions developed by Doleweerd Consulting enabled a simplified and unified intake approach.  In the words of one physician, the referral process is now “as easy as ordering pizza”. The solution was designed and implemented in a few short months, and over 15,000 patients have since been helped.  Efforts are underway to spread this improvement to chronic disease, rehabilitation and specialized geriatric services.

You can learn more about the process at the Waterloo Wellington coordinated access website.

Understanding Northern Surgical Services

28 Northern Ontario first nations communities are serviced by Sioux Lookout Meno Ya Win Health Centre (SLMHC).  Many surgeries were being cancelled, clinicians were frustrated and patients were not getting care.  The process is tremendously complex, involving over 10 organizations providing flights, lodging, medical services, telemedicine, insurance approvals, and more. Doleweerd Consulting was asked map the process, to make the entire surgery access process clear and visual to the many organizations involved. The investigation involved observing the process and gathering facts from all personnel who provide care, transportation, accommodation, and administrative approvals.

We created digitized current state process maps and video walkthroughs of the entire process. This enabled all parties to have a deep understanding of the current system. In doing this, the facts about causes of failure could be agreed upon and ideas for improvement actioned.

To help other organizations learn from SLMHC’s experience in improving northern surgical services, SLMHC has shared their process maps and video walkthroughs here.

Reducing Wait Times

Doleweerd Consulting has  helped many community care organizations to make access to their services quicker and better. Two of these organizations initially possessed the longest provincial wait times from referral to assessment. We did process mapping of the current state, identified change ideas and then worked directly with staff to design and implement solutions.

Their wait times reduced to among the shortest in the province.  The 90th %ile waiting time was reduced from about 30 days to just 5-9 days, without increasing base staffing.  Results were realized within 3 months of providing recommendations.

Improving the Patient Experience

The purpose of the ‘Having Their Say and Choosing Their Way’ project was to help funders and providers of care more deeply understand the experience of the client during the ‘hospital to home’ transition. This transition takes place thousands of times each month in Ontario. If we understand the experience of some of these patients, we can think about the changes needed to make everyone’s experience better.

Doleweerd Consulting was recruited by the Change Foundation and Ontario Association of Community Care Access Centres to speak directly with patients and caregivers. Our goal was to understand what their perception of “value”, and compare it with an in-depth process investigation of how service was actually delivered. South East Community Care Access Centre and Quinte Health Care (Trenton Memorial Hospital) worked with Doleweerd Consulting to map all the steps and decisions that patients and their caregivers must take as they prepare to leave hospital for home, wherever “home” may be.

Studying the processes in detail revealed that the move from hospital to home included 69 handling operations, 36 forms, four (often long-distance) family trips to the hospital and 15 delays.

This initiative helped form several new programs and policy shifts across the province. For example, patients are now encouraged to go ‘home first’ to make long term care decisions and phone and paper based communications were redesigned to provide a warmer experience. The final 2 reports were described by the Toronto Star as “required reading for every health administrator in the province”.

  1. Catch 22 – People’s experience going to long-term care after being hospitalized
  2. I don’t know – People’s experience receiving home care after being hospitalized

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