Sesi ketiga panel pertama seminar ‘Pengembangan AHS dalam Menyongsong Era Pasca MDGs’ menghadirkan video conference format Webinar dengan narasumber Prof Kevin Wamsley, MD, PhD dari South Western Academic Health Network (SWAHN), Canada. Prof Kevin berbagi pengalamannya menjalankan sebuah program inovasi di bidang kesehatan untuk meningkatkan kualitas kesehatan komunitas, khususnya di daerah South-Western Ontario (SWO). SWAHN adalah organisasi yang terdiri atas beberapa universitas, rumah sakit, dan pusat kesehatan masyarakat yang berbasis di daerah SWO. Dengan jumlah populasi di Kanada sekitar 36 juta orang, mayoritas populasi di SWO memiliki edukasi yang baik dan kapasitas pelayanan kesehatan mencukupi. Sejumlah 98% kebutuhan kesehatan telah terpenuhi di daerah SWO. Beberapa tantangan yang yang dialami SWO adalah kondisi ekonomi yang melemah, kendala transportasi dari area rural yang membutuhkan 6-7 jam untuk mencapai pelayanan kesehatan di area kota, terdapat peningkatan angka penyakit kronis serta kemiskinan (kaum imigran). Permasalahan tersebut menggambarkan masih belum meratanya pelayanan medis, dan hanya di daerah tertentu yang memiliki pelayanan medis prima. Belum lagi kendala transportasi bagi penduduk di daerah terpencil yang miskin dan sulit mencapai pusat fasilitas kesehatan. Solusinya adalah dengan membentuk kemitraan (partnership) antar institusi kesehatan di area SWO (univerisitas, rumah sakit, dan pusat kesehatan masyarakat) yang berkolaborasi meningkatkan kesehatan masyarakat SWO, mengingat berbagai sumber daya yang ada sangatlah baik dan mencukupi tetapi belum semua orang dapat mengakses. Ditanamkan nilai bahwa tanggung jawab bukan hanya untuk lingkungan sekitar tetapi untuk seluruh wilayah. Dilakukan sharing sumber daya dan keahlian. Pertama-tama, pemimpin dari berbagai institusi harus memiliki visi yang sama, mengenali kemungkinan dan kesempatan, mematahkan halangan antar institusi misalnya kompetisi, dan memberikan dukungan bagi orang-orang yang bekerja di level operasional. Harus tercapai kesepakatan terhadap beberapa prinsip yang dijadikan sebagai acuan. Semua pihak yang terlibat diperlakukan sebagai mitra yang setara. Fokus harus diarahkan kepada kebutuhan masyarakat, bukan masing-masing institusi. Organisasi SWAHN dipimpin steering committee yang membawahi 5 kelompok kerja: clinical outcomes, research, education, community, communication. Kelompok kerja pendidikan (education working group) bertugas meningkatkan kualitas pendidikan mitra dengan membentuk kurikulum dan mengadakan pelatihan tenaga kesehatan, sedangkan kelompok kerja riset (research working group) mengembangkan penelitian di bidang kesehatan termasuk mencari pendanaan riset. Masyarakat juga harus dilibatkan, dengan melakukan survei untuk mengetahui apa yang diinginkan oleh masyarakat dan mitra. Selanjutnya akan dapat dibentuk tujuan jangka pendek dan panjang. Sangat sulit untuk mendirikan organisasi ini tanpa infrastruktur dan budget yang mencukupi. Kesuksesan dari terbentuknya SWAHN telah membawa faktor pembentuk pelayanan kesehatan di area SWO ke arah yang lebih baik sehingga organisasi yang belum lama tebentuk ini (3 tahun) telah sukses menjalankan visinya: transforming health in Southwestern Ontario through integrated excellence in research, education, and clinical practice.

Transforming health through integrated excellence in research, education, and

clinical practice.

Kevin B. Wamsley, PhDFaculty of Health SciencesWestern University , Canada

Southwestern Ontario Region• General Population =

1,602,539

• 3 Community Colleges

• 3 Universities

• Myriad Health Care

Partners /Organizations

• 2 Local Health Integrated

Networks (LHINs)

Our EnvironmentOur Assets

• Extensive, highly skilled capacity across Southwestern

Ontario (SWO):

• Education

• Research

• Healthcare

• Community

• 98% of healthcare needs in SWO are met in SWO

• Excellent examples of collaboration, innovation and

cooperation

Environmental Challenges• High unemployment across the region

• Worrisome rate of Ontario Works (Welfare) participation

• Elevated usage of Food Banks

• Limited access to public transit in rural areas

• Healthcare system is at full capacity• Long waiting lists for service

• Too many people living in poverty• Children and Families• Immigrants

Health Outcomes• Disproportionately elevated rates of chronic

disease in SWO• Diabetes

• Cancer

• Obesity

• Neurological diseases

• Respiratory diseases

• Hypertension

• Concerning incidence in rural communities

• Impact worsened due to aging population

Why Work Together?

• Great resources in individual institutions

• Leaders, Practitioners, Facilities, Equipment

• Highly-trained individuals in particular locations

• Specialized equipment in regional locations

• Health care services in centralized locations

• Mobilize institutions with capacity to serve the

region

SHARING RESOURCES AND EXPERTISE

• Small investments for long-term gains

• Small investments for specialized projects to serve the region

• Share research findings – database

• Streamline research processes – ethics review

• Mobilize training in larger centres to serve smaller communities

HOW?• LEADERS OF INSTITUTIONS MUST SHARE THE

VISION

• RECOGNIZE POSSIBILITIES AND OPPORTUNITIES

• BREAK DOWN TRADITIONAL BARRIERS BETWEEN INSTITUTIONS

• LEADERS SUPPORT THE OPERATIONAL COMMITTEE TO DO THE WORK

WHAT DOES SWAHN

INCLUDE?

School of Pharmacy

Chatham Kent Health Alliance Bluewater Health

Community Partners

Long-Term

Care

Facilities

Community-

Based

Service

Providers

Public

Health

Municipalities

SWAHN Guiding Beliefs

• All governance and committee structures are required to have

representation that reflects the regional and interdisciplinary

nature of SWAHN.

• SWAHN partners are considered equal and are respected for

their contributions, irrespective as to whether they are large or

small, urban or rural, etc.

• A fundamental principle of SWAHN is that all residents of

SWO are entitled to an optimal standard of care wherever

they live, and that we strive to equalize health outcomes

throughout the region.

• SWAHN also strives to distribute academic activities

throughout the region via research and innovation, education,

community participation and advocacy

SWAHN VALUES

We are community

focused.

We share accountability.

We collaborate and cooperate.

We are respectful and

inclusive.

We build trust-based

relationships.

We innovate.

We transform.

Education Working Group

Education Working Group

SimulationInterprofessional

Education

Palliative Care/End of Life Care

Education Initiatives

• Establishing interprofessional education opportunities

• Determining which health and human services

professionals have palliative care curriculum and then

embedding curricula

• Completing a gap analysis of simulation education

curricula and research in simulation

Sampling of Research and

Clinical Initiatives

• Developing a database of researchers and

research programs

• Streamlining ethics approval across the region

• Developing catalyst grants

Community Initiatives

• Community participatory research in Nutrition

• Survey of current community and academic health networks in SWO to determine their relationships with academia and their ideas on how to move SWAHN forward

Regional Survey Results

Five overarching themes in short- and long-term goals:

• Public Health (improving policy, advocacy)

• Education (interprofessional, public, patient)

• Research (knowledge translation, community-based)

• System Delivery (resources, infrastructure, funding)

• Special Populations (aging population, mental health)

What do our rural and small community partners want?

Lessons Learned

• Tremendous desire to improve health

• Excitement to integrate community with academia across

the region

• Countless opportunities to make a difference

• Extensive array of community health networks and fewer

academic health networks

• People identify with the SWAHN Vision

Lessons Learned• Difficult to establish with no dedicated infrastructure

• Challenge to engage vast number of stakeholders across the region

• Need for multiple “influential champions” across the SWO region

• Need for a strategic plan and governance structure

• Communicating the vision and values of SWAHN on an ongoing basis

Lessons Learned• Develop an “urgency to change”

• Being realistic about the time it takes to develop the

network

• Need to have one or two “projects” to engage individuals

and institutions

• Build on existing collaborative activities

Lessons Learned

• Identifying gaps in academic areas and capitalize on

them

• Need to develop shared measurement to track progress

towards goals

SWAhN SUCCESS• HIRED A FULL-TIME PROJECT MANAGER –

small annual investment from many institutions ($5,000, $2,000, $1,000)

• Simulation inventory for the region

• Simulation conference – region

• Nutrition conference – region

• Working group on palliative care

• Stroke network – regional training

Our Vision

Transforming health in Southwestern Ontario through integrated excellence in research, education and clinical practice