Ministry of Health and Long Term Care

Minister’s Patient and Family Advisory Council Meeting Minutes

Purpose:
Inaugural Meeting of the Minister’s Patient and Family Advisory Council (PFAC)

Date:
Friday, November 24 and Saturday, November 25 2017

Council Members:
Mansour Asrani, Rita Boutette, Julie Drury (Chair), David Fasano, Christina Gillman, Robert Hale, Bernice King, Mario Lopez, Ann Matte

Ministry Staff:
Jackie Houston, Michelle MacKinnon, Madi McNitt, Jillian Paul, Kathryn Sirotnik, Mark Weir

Guests:
Minister of Health and Long-Term Care Dr. Eric Hoskins,
Melissa Farrell (Assistant Deputy Minister, Health System Quality and Funding Division, Ministry of Health and Long-Term Care),
Deputy Minister Dr. Bob Bell (Ministry of Health and Long-Term Care),
Nancy Naylor (Associate Deputy Minister, Delivery and Implementation, Ministry of Health and Long-Term Care),
Lisa Hawthornethwaite, Mim O’Dowda and Lauren Lee

Regrets:
Council Member Colin Mullaley

Objectives of Inaugural Meeting:
1) Welcome and Introduction — allow members to meet and explain their motivations for joining the PFAC, as well as to meet the PFAC Secretariat, and senior ministry leaders.

2) Become familiar with the PFAC’s role — explain to members the origin, goals and vision of the PFAC, how it is situated within the Ministry, the role of the Council and Chair.

3) Orientation and Onboarding — to overview the structure, function, resourcing and legislative and regulatory frameworks within the Ontario healthcare system so that members can become oriented to the inner workings of the healthcare system.

4) Council Theme Prioritization — to determine priority areas the Council wants to focus on and to allow council members to reflect on where the Council should have the biggest impact.

Day 1

Welcome Address

Discussion Points

• Julie Drury provided an official welcome to everyone and introduced Dr. Eric Hoskins, Minister of Health and Long-Term Care.
• Each Council member introduced themselves to Minister Hoskins.
• In the Minister’s introduction the Minister referenced that the Minister’s PFAC is “unprecedented and historic and critically important.” The Minister encouraged members of the Council to “look down the other end of the lens of the telescope” — from the patient rather than provider perspective — to base our decisions on the patient, the individual and those around them.
• Minister Hoskins provided an overview of the Patients First Act; spoke about the importance of the Council in achieving a health system that puts patients first; spoke about the Minister’s expectations of Council and the importance of the Council’s advice to the Minister; thanked members for serving on the Council.
• Specifically the Minister spoke to what is important to us, as patients — quality of care — this includes care and services that: patients have access to; and is coordinated and seamless.

Icebreaker

Discussion Points

• Mark Weir, Team Lead, Minister’s Patient and Family Advisory Council Secretariat, lead an icebreaker session focused on the following question: What if… Healthcare? — A visioning exercise for our healthcare system. The purpose of this exercise was to create a collaborative vision of a future healthcare system.
• Members of the Council and Minister Hoskins participated in the discussion.
• Participants wrote their ideas on thought bubbles, described them, and posted the thought bubbles on the wall. At the end of the exercise, the Secretariat team collected these ideas, which will allow Council to revisit these over the course of the next year as a reminder of what we are aspiring to achieve.

Action Items/Points

• Secretariat staff to collate thoughts and present to members.

Getting to Know each other

Discussion Points

• Julie introduced Melissa Farrell, Assistant Deputy Minister, Health System Quality and Funding Division, Ministry of Health and Long-Term Care.
• Julie asked that each member briefly explain what brought them to the Council and to share any aspects of their health care journey that they would like and feel comfortable sharing.
• Ministry staff introduced themselves.
• Melissa thanked Council for sharing their stories and provided an overview of her background, experience and role.
• Melissa thanked the members for being part of the Council and indicated that including their voice in health system decision making is a key commitment of the MOHLTC.
• Members of Council and ministry staff paired up together to learn about one another. Each introduced one another to the group.

Action Items/Points

• Secretariat staff to consider what went well during the ice breaker and ‘getting to know each other’, and areas of improvement to implement at second meeting.

Council Business: Part I

Discussion Points

• Julie provided an overview deck on Council Business to explain the origin, goals and vision of the Minister’s PFAC, how it is situated within the ministry and the role of the Council, and the PFAC Chair and Ministry’s Patient Engagement Secretariat.
• Specific topics included:
• Overview of the inaugural meeting
• Role of the PFAC Chair
• Goal and Values of the PFAC
• How advice will be provided, applied and acted upon
• Julie also briefly discussed what other means of involvement, including subcommittees, may be available to Council members.
• A discussion around the Minister’s PFAC role and the local LHIN level ensued. It was communicated that the work of the Minister’s PFAC and the LHINs Patient and Family Advisory Committees should intersect. Julie indicated that a structure to ensure communication and collaboration with the LHINs is being established.

Action Items/Points

• Secretariat to provide some key slides as well as key points to members for them to reference and/or use if they are speaking to others about the work of the Council.
• Secretariat staff to identify and map out other opportunities for Council members to be involved in working groups, subcommittees, and so forth, as appropriate, at the ministry.

Council Business: Part I

Discussion Points

• Julie provided an overview deck on Council Business to explain the origin, goals and vision of the Minister’s PFAC, how it is situated within the ministry and the role of the Council, and the PFAC Chair and Ministry’s Patient Engagement Secretariat.
• Specific topics included:
• Overview of the inaugural meeting
• Role of the PFAC Chair
• Goal and Values of the PFAC
• How advice will be provided, applied and acted upon
• Julie also briefly discussed what other means of involvement, including subcommittees, may be available to Council members.
• A discussion around the Minister’s PFAC role and the local LHIN level ensued. It was communicated that the work of the Minister’s PFAC and the LHINs Patient and Family Advisory Committees should intersect. Julie indicated that a structure to ensure communication and collaboration with the LHINs is being established.

Action Items/Points

• Secretariat to provide some key slides as well as key points to members for them to reference and/or use if they are speaking to others about the work of the Council.
• Secretariat staff to identify and map out other opportunities for Council members to be involved in working groups, subcommittees, and so forth, as appropriate, at the ministry.

Council Business: Part II

Discussion Points

• Mark lead a discussion about code of conduct (each member took turns at reading out loud different portions of the code of conduct); Terms of Reference; and the Council’s reporting process, including the yearly reporting through an Annual Report.
• In discussing the Code of Conduct, members of the Council agreed that members should not leave the meeting and have “side bar” discussions after the meeting– it is important to discuss issues/questions as a group in the meeting.
• Madi McNitt, Policy Consultant, Minister’s Patient and Family Advisory Council Secretariat, went through a discussion about privacy and confidentiality requirements. A discussion followed about what can be shared about the Council through communications and social media.
• Madi reviewed the consent and release form for Council photographs and a discussion about the posting of Member bios on the ministry website also occurred. There were no objections from Council members regarding the posting of their photos and bios on the ministry website.
• Council discussed timing and location of future meetings. Julie noted that not all meetings will occur in Toronto.

Action Items/Points

• Secretariat staff to set up a Social media tutorial for Council (e.g. twitter)
• Secretariat to send list of future meeting dates
• Secretariat was asked to look into whether it is better for Council members to have a separate email for their Council work
• Secretariat to send a deck for Council members to use if they are speaking to different groups accompanied by speaking notes — in speaking notes and deck to be in English and French
• Council members asked that key messages be sent to them after each meeting regarding information that can be shared publicly.

Council Theme Prioritization

Discussion Points

• Mark led a discussion on theme prioritization by describing the importance of the Council discussing areas to focus future work. Five theme areas (1) Integrated and Coordinated Care; (2) System Navigation; (3) Access to Care and Information; (4) Health Literacy; (5) Patient Partnership) were brought forward for members to discuss.
• Mark, along with members of the Secretariat, led Council members through a discussion on each theme. Members were asked to consider what each theme meant with a focus on their experiences. All comments were noted on flip chart paper. Council members were also asked to identify any themes that may not be captured in the five themes presented.
• Once Council discussed the themes, a voting exercise proceeded where each member voted for the themes they would like to focus on going forward by level of priority.

Action Items/Points

• Secretariat to summarize themes along with a work plan and priorities to the next meeting of Council.
• It was explained to members that the Secretariat will identify key policy/programs/initiatives/opportunities to fit with each theme. These opportunities would be charted on a draft Council work plan, to be discussed at the next meeting of Council.

Closing Remarks

Discussion Points

• Julie introduced Deputy Minister, Dr. Bob Bell, Ministry of Health and Long-Term Care
• The Deputy Minister provided a background of his experience, spoke to his personal health care experience and communicated that he would like the Council to advise the ministry on how to be more responsive to how Ontarians want to be served.
• Council members introduced themselves to the Deputy, focusing on why they want to be part of the work of the Council.
• The Deputy Minister noted that PFACs are important — we need to hear from patients and we need to figure out a structured way to do so.
• The Deputy Minister thanked members of the Council for their interest in being part of this important work, and indicated that he looks forward to joining future meetings.

Action Items/Points

• Secretariat to explore bringing items raised by the Deputy Minister to future meetings in alignment with the theme workplan.
• The Deputy Minister asked Council and Secretariat to consider providing advice on the following areas:
• Care Communities — how to engage
• Relationship based primary care
• Consumer Digital Health

Day 2

Opening Remarks

Discussion Points

• Nancy Naylor, Associate Deputy Minister, Delivery and Implementation, Ministry of Health and Long-Term Care, welcomed members to day 2 of the Council’s inaugural meeting.
• Following the welcome, members of the Council introduced themselves to Nancy.
• Nancy provided an overview of her role in the ministry.
• Nancy spoke to some of the initiatives that Council could consider providing input into — how the ministry can do a better job at helping people to navigate through the system, and how the ministry can educate people on the services available.
• Nancy then turned to a discussion about the Local Health Integration Network (LHIN) transformation work that the ministry is undergoing and provided a placemat of the ‘blue box’ work occurring — the various workstreams that are a part of the ongoing LHIN transformation.
• Julie indicated that the ‘blue box’ work is reflective of much of the work that Council will be looking at and discussing. Julie further stated that we want to align what the Council focuses on with the ‘blue boxes’. We continue to identify what we are interested in focusing on and will bring these forward in our work plan at our February meeting.

Storytelling Part I and II

Discussion Points

• Julie introduced three guests — Lisa Hawthornethwaite, Mim O’Dowda and Lauren Lee to the Council meeting to introduce the importance of storytelling in patient engagement work, what to think about when preparing and presenting a story.
• Council members introduced themselves and were invited to share their experiences with the health system if they felt comfortable doing so.
• The focus of the storytelling session was: Patient and Family Storytelling — Impact for Health System
• Mim and Lauren shared their stories with the Council, with a focus on illustrating the impact of patient storytelling for health system change
• A skill based session ensued where members were provided with tools and resources to prepare and present their story
• Lisa took members through a powerpoint deck that coached members to consider key levers for change in their own story, and how to best present this information when sharing it.

Action Items/Points

• Secretariat staff to share powerpoint with Council members, for members to reference when preparing to share their story with differing audiences.
• Secretariat staff to identify opportunities for PFAC members to share their stories.

Understanding the Ontario Health Care system and the MOHLTC

Discussion Points

• Jillian Paul, Director, Policy and Innovation Branch, Health System Quality and Funding Division, MOHLTC and Jackie Houston, Manager, Minister’s Patient and Family Advisory Council Secretariat, Health System Quality and Funding Division, MOHLTC co-presented on the Ontario Health Care system and the MOHLTC:
• General history, background and legislation
• Healthcare system resources
• Ministry priorities and program areas
• General process for policy making
• How the Minister’s PFAC fits in
• The overall purpose of this session was to introduce members to the structure, function and legislative and regulatory frameworks of government.

Action Items/Points

• Secretariat to seek more clarity on the following statistic:
  94% of all Ontarians have a family doctor
• This is the start — members will continue to receive education as new topics are introduced, etc…

Reflections

Discussion Points

• Mark facilitated a round-table where Council members and staff reflected on the 2-day inaugural meeting.

Action Items/Points

• Secretariat staff to take this feedback into consideration when planning for the second PFAC meeting.

Wrap Up and Evaluations

Discussion Points

• The ministry is committed to ensuring that the PFAC is reflective of a broad cross-section of Ontarians with diverse backgrounds; the ministry is considering this as it looks to increase council membership. Julie asked members to discuss the perspectives that are important to include on the Council, including youth, visible minority, indigenous, and further geographic representation.
• Julie indicated that she would like to introduce the idea of Open Chairs, where a guest could participate as an invited member for a particular meeting, as appropriate.
• Evaluations were provided to each member to complete.

Action Items/Points

• Secretariat staff to collate and summarize evaluations, and share a summary of feedback with members.