Access resources | Resources by OHT building block

RISE provides a ‘one-stop shop’ for four types of resources that can support rapid learning and improvement among Ontario Health Teams (OHTs): 1) RISE resources, including RISE briefs (RB) and webinars, among others; 2) resources prepared by other partners; 3) resources prepared by the Ministry of Health; and 4) hyperlinks to curated searches of Health Systems Evidence and Social Systems Evidence for systematic reviews of the research literature and related document types (for when no dedicated OHT resources exist).

Here we focus on resources by OHT building blocks. The full description of these building blocks can be found in RISE brief 1 on OHT building blocks, and this infographic summarizes the building blocks and how they can be drawn on to support a population-health management approach. To support teams invited to submit an application to join cohort 2 of OHTs, we note links to relevant questions in the .

If you know of a resource that would be helpful to other OHTs, please send it to rise@mcmaster.ca.

Building block #1: Defined patient population within a population-health management approach (who is covered and are their needs being equitably addressed?)
[Part of ‘Section 1: About your population' (question 1.1 about who you will be accountable for at maturity) in the full application]

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Domains	RISE resources	Partner resources	Ministry resources	Curated searches
All or most domains	RB28: Identifying how Ontario Health Teams can meet the needs of rurally based patients and community partners in mixed urban-rural and predominantly rural environments RISE brief for citizens: Identifying how Ontario Health Teams can meet the needs of rurally based patients and community partners in mixed urban-rural and predominantly rural environments Rapid synthesis: Supporting population-health management to meet the needs of patients and community partners in rural and mixed urban-rural environments Webinar on how OHTs can approach their work with an attributed population RB32: Enhancing the implementation supports available to support population-health management by northern Ontario Health Teams RS: Identifying community-based models of care that address the needs of ethno-racial communities RS: Exploring models to support trans individuals’ access to care RS: Strategies to improve health outcomes and care experiences for black women with cancer	HCSL tool on unpacking an attributed population The Public and Patient Engagement Collaborative has developed the which highlights key considerations with tailored resources to support OHTs to bring a stronger equity focus to their engagement work
1) Target-population definitions
2) Geographic-area definitions
3) Patient-access targets	Plain language summary - LEAN healthcare can improve length of stay and wait times in outpatient care
4) Service-delivery (volume) targets
5) Sustained care-relationship targets	Plain language summary - Increased continuity of care can lead to reduced mortality rates

Building block #2: In-scope services (what is covered?)
[Parts of ‘Section 2: About your team' (question 2.1 in the full application and sections 2.1.1 and 2.1.2 in the supplementary template) and ‘Section 3: Leveraging lessons learned from COVID-19’]

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Domains	RISE resources	Partner resources	Ministry resources	Curated searches
All or most domains	RB29: Examining intersections between Ontario Health Teams and specialty service lines RISE brief for citizens: Establishing intersections between Ontario Health Teams and specialty service lines RS - Examining the intersections between Ontario Health Teams and Specialty Service Lines RISE brief for citizens: Establishing intersections between Ontario Health Teams and broader human services RISE brief 30: Examining intersections between Ontario Health Teams and broader human services RS - Establishing intersections between Ontario Health Teams and broader human services RS - Examining the intersections between Ontario Health Teams and public health RS - Examining intersections between Ontario Health Teams and home and community care RS - Engaging physicians in Ontario Health Teams RS - Intersections between Ontario Health Teams and long-term care
6) Service-inclusion definitions
7) Service-exclusion definitions
8) Service site decisions	Plain language summary - Integrated care can increase access and patient satisfaction, but the effect on admissions, emergency admissions, length of stay, service usage, and costs

Building block #3: Patient partnership and community engagement (how are patients engaged?)
[Parts of ‘Section 4: How will you transform care’ in the full application (question 4.4 about patient partnership and questions 4.3.1-4.3.4 about working with Indigenous, Francophone, COVID/flu-vulnerable and other populations), as well as part of ‘Section 1 About your population’ (question 1.3 about equity considerations within your population)]

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Domains	RISE resources	Partner resources	Ministry resources	Curated searches
All or most domains	RS: Identifying community-based models of care that address the needs of ethno-racial communities RS: Exploring models to support trans individuals’ access to care RS: Strategies to improve health outcomes and care experiences for black women with cancer	PPEC developed in collaboration with patient, family, and caregiver partners and engagement leads from OHTs, the MPFAC Chair, and the Ministry of Health. This framework outlines the competencies, supports and enablers needed to build engagement-capable OHTs along with a one-stop shop of resources to facilitate learning and development. The Muskoka and Area OHT developed an FAQ document to support learning about PFC partnership, engagement, and co-design. The Institute for Better Health created an OHT Patient, Caregiver & Community Engagement Learning Series Workbook 1: Communication, compassion & empathy Workbook 2: Bearing witness to lived experience Workbook 3: Equity, diversity and inclusion Workbook 4: Leaning into the challenges Workbook 5: Preparing for engagement activities Workbook 6: Engagement methods Workbook 7: Evaluating engagement
9) Proactive patient and public engagement	RB14 on caregiver empowerment Rapid synthesis on empowering caregivers to deliver home-based restorative care Citizen panel on engaging with patients, families and caregivers to support Ontario Health Teams Citizen brief Citizen panel summary Plain language summary - Five areas should be prioritized to increase public participation and influence in local decision-making	Change Foundation’s inventory of
10) Responsive patient relations	Plain language summary - Patient‐reported health information and patient education can improve healthcare professionals’ adherence to recommended clinical practice
11) Patient values
12) Community engagement	RB5 on community engagement RB25 on Ontario French-language health-planning entities and how they can support OHTs as a health-system partner Webinar on engaging and improving care for francophone communities Webinar on how OHTs can meaningfully engage their community and develop appropriate mechanisms for communication Plain language summary - Community engagement, culture centeredness, systems thinking, and integrated knowledge translation are key to implement health interventions in Indigenous communities	East and Downtown East Toronto OHTs' framework for community engagement ETHP community engagement event checklist HCSL community map prototype and database
13) Indigenous peoples engagement
14) Cultural sensitivity

Building block #4: Patient care and experience (how are patient experiences and outcomes measured & supported?)
[Parts of ‘Section 1: ‘About your population’ (question 1.2 about who will be your focus in year 1) and ‘Section 4: How will you transform care’ in the full application]

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Domain	RISE resources	Partner resources	Ministry resources	Curated searches
All or most domains	Webinar on population-health management OHT provincial learning and improvement forum Day 2 highlights and key messages All day 2 resources RB6: Population-health management	HSPN webinar on logic models HCSL care pathways for youth that can be used in population-health management
15) Proactive patient identification
16) Individualized care planning
17) Care pathways
18) Health literacy support	Plain language summary - Organizations can respond to the health literacy needs of patients by improving health information and services and making them easier to understand, access, and apply
19) Digital access to health information	Plain language summary - The effect of providing patients with access to their electronic health record is unclear
20) Shared decision-making	Plain language summary - Interventions for increasing the use of shared decision making by healthcare professionals Plain language summary - There is a growing interest in shared decision-making interventions for healthcare professionals, but there is uncertainty regarding how effective they are, and how to best implement them
21) Self-management planning and support		HLLN resource about health coaching
22) Virtual-care services
23) Proactive chronic-disease management
24) Population-based health promotion and disease prevention
25) Integrated-care models	Rapid synthesis on lessons learned from integrated-care initiatives in Ontario to inform Ontario Health Teams Rapid synthesis examining health hubs and their potential to inform Ontario Health Teams Rapid synthesis on leveraging integrated care during Ontario's COVID-19 response Plain language summary - New integrated-care models may improve patient satisfaction, perceived quality of care and patient access
26) Coordination services	Rapid synthesis on examining care coordination in the home-and community-care sector
27) Transition services	Evidence brief on hospital-to-home transition for older adults with complex health and social needs in Ontario Stakeholder dialogue summary on hospital-to-home transitions for older adults with complex health and social needs in Ontario Plain language summary - Building a complete list of a person’s medication before care transitions can help reduce improper usage of medications, but it is still unclear whether this improves health outcomes for patients	OH standards playbook on transitions between hospital and home
28) System-navigation services	Rapid synthesis on examining system navigation for Ontario Health Teams	HLLN resource about patient navigation
29) Patient-reported experience measures
30) Patient-reported outcome measures
31) Integration measures
32) Public-facing website describing above services

Building block #5: Digital health and information sharing (how are data and digital solutions harnessed?)
[Part of ‘Section 4: How will you transform care’ in the full application (question 4.2 about how your team will provide virtual and digitally enabled care)]

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Domains	RISE resources	Partner resources	Ministry resources	Curated searches
All or most domains
33) Patient portal
34) Electronic medical record
35) Electronic health record	Plain language summary - The effect of providing patients with access to their electronic health record is unclear
36) Digital health tools	Plain language summary - Integrated care can increase access and patient satisfaction, but the effect on admissions, emergency admissions, length of stay, service usage, and costs Plain language summary - Clinical decision‐support systems on mobile devices aim to improve the adherence of primary-care providers to guidelines, the quality of care and patient outcomes, but their effectiveness remains unclear
37) E-consultations for patients	Plain language summary - Telehealth consultations can produce positive outcomes for acute and chronic care Plain language summary - Mobile technologies can help improve communication between different healthcare providers, however more studies are needed to confirm their effectiveness
38) E-consultation among providers	Plain language summary - Mobile technologies can help improve communication between different healthcare providers, however more studies are needed to confirm their effectiveness
39) Data privacy and security
40) Data harmonization across organizations, sectors and systems	Plain language summary - Moving from paper‐based information systems to electronic information systems can allow staff to collect some routine health information faster and with fewer mistakes, but many evidence gaps remain
41) Data modelling and analysis	RB8 on data analytics
42) Data sharing and use
43) Single point of contact for digital-health activities

Building block #6: Leadership, accountability and governance (how are governance & delivery arrangements aligned, and how are providers engaged?)
[Part of ‘Section 2: About your team’ (question 2.3 about how your team can leverage previous experiences collaborating to deliver integrated care)]

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Domains	RISE resources	Partner resources	Ministry resources	Curated searches
All or most domains	RB19 on collaborative governance templates (to be read before the BLG resources in the next column) Webinar on collaborative governance RB3 on collaborative governance REP39 on accountability models that are focused on primary-care organizations providers participating in local-health system initiatives REP41 on the functions that local-systems are responsible for and the ways in which they are held accountable for performing these functions	BLG guidance about collaborative governance templates BLG templates for a collaboration agreement, decision-making framework agreement, fund holder and indemnity agreement, and project agreement
44) Distributed cross-sectoral leadership capabilities	RB 2 on leadership infrastructure and work plans Webinar on leadership infrastructures for OHTs Rapid synthesis on supporting transitions to local-system leadership in Ontario
45) Accountable-care organizations	RB11 on accountable-care organizations Rapid synthesis on accountable care organizations
46) Network governance		AFHTO Ontario Health Team Starter Kit
47) Proactive provider engagement	RB4 on primary-care provider leadership and engagement Plain language summary - Leadership skills in primary care settings can help healthcare workers provide better care to patients involving multiple health professionals, while addressing all the patient’s needs Plain language summary - Relational leadership practices in the workplace can lead to positive outcomes for the nursing workforce, healthcare organizations, and patients
48) Culture of teamwork, collaboration and adaptability

Building block #7: Funding and incentive structure (how are financial arrangements aligned?)

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Domains	RISE resources	Partner resources	Ministry resources	Curated searches
All or most domains
49) Population costs and cost drivers
50) Integrated fund holding
51) Contracts
52) Re-investments of savings

Building block #8: Performance measurement, quality improvement, and continuous learning (how is rapid learning & improvement supported?)
[Part of ‘Section 4: How will you transform care’ (question 4.1 about performance measures you propose to use to monitor success in year 1)]

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Domains	RISE resources	Partner resources	Ministry resources	Curated searches
All or most domains	RB21 on Ontario Health (Quality) and how it can support OHTs as a health-system partner Rapid synthesis on the role of coaching in health-system transformations	Ontario Health cQIP guidance document Ontario Health cQIP technical specifications
53) Performance measurement across the quadruple aim and across sectors	Plain language summary - Patient‐reported health information and patient education can improve healthcare professionals’ adherence to recommended clinical practice Plain language summary - Five categories of factors influence the use and de-implementation of low-value care Plain language summary - Clinical networks can improve patient outcomes and allocation of health funding, but more research on their effect on patient and professional experiences is needed Plain language summary - It is unclear which approach of continuous quality improvement is most effective in health and social care
54) Guidelines and other sources of best evidence	RB9 on evidence sources Plain language summary - Clinical decision‐support systems on mobile devices aim to improve the adherence of primary-care providers to guidelines, the quality of care and patient outcomes, but their effectiveness remains unclear
55) Local area-focused rapid learning and improvement
56) Problem-focused rapid learning and improvement
57) Rapid learning and improvement collaboratives	RB13 on communities of practice Plain language summary - Quality Improvement Collaboratives used to implement clinical guidelines may save more money than they cost to implement
58) Rapid learning and improvement competencies	RB12 on rapid-learning and improvement

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