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March 2017 title banner. Image of crafted children holding hands.
Connecting in care

SickKids eNewsletter

Welcome to the new SickKids eNewsletter. Distributed quarterly, this publication will focus on a topic and highlight where we’ve been, where we are and where we are going: the THEN, the NOW and the NEXT. Please enjoy our most recent publication, and if you like what you see, subscribe now!

Message from Dr. Michael Apkon | Then - Florence Charters: Soother of suffering | Now - A shared vision for an integrated mental health system | Next - A solution of Epic proportions


Title banner. Connecting in Care.
Mike Apkon


As we celebrate Canada’s 150th birthday this year, it is an opportunity to consider how far we have come as a nation. As innovators in paediatric health care and research for almost 145 years, SickKids can point to our vital role in the history of innovation and health care transformation and the fundamental ways the delivery of care has progressed in Canada and around the world.

SickKids has always been at the forefront of providing leadership in child health systems by striving to integrate with the community and our partners. In this issue, we explore three examples where we have helped to advance health care, providing better access to high quality care, more efficiently: from our early days as the centre of a hub-and-spoke model of child welfare to our recent integration with The Hincks-Dellcrest Centre and our future health information system, Epic.

Health-care is like a symphony; a symphony where the members are all in different rooms, playing a complex piece of music and the score is being written as they go. We have made great steps forward in bringing these “musicians” together, but there are still connections to be made. As we continue to expand beyond our walls, and working in partnership with others, we strive to ensure the paediatric system provides world-class, seamless care to children and their families here at SickKids and in the broader health-care system.

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THEN banner. Florence Charters: Soother of Suffering
Photo of Florence Charters, the first social service nurse at SickKids.

Our current health care system is focusing increasingly on home and community care. SickKids pioneered an early outpatient model by developing innovative ways to reach out to the community.

In 1908 Florence Charters became the first social service nurse at SickKids. Originally visiting the homes of outpatients on foot or streetcar, Charters was able to double her patient visits thanks to the motor car John Ross Robertson, Chairman of the Board of Trustees, purchased for her use in 1909. This was at a time when there were very few motor vehicles in the city. According to one report, there were just over 2,000 cars on the streets in 1908.

Charters criss-crossed the city visiting the homes of an average of 33 families a day. In addition to reapplying dressings, instructing parents in proper hygiene, and checking in with patients recently released from the hospital, a primary role of Charters’ was to supervise the feeding of children whose parents had applied to the hospital for pasteurized milk.

This was the first time in hospital history that a District Nurse had a motor vehicle to do her work, attracting the attention of the media and medical professionals across the continent. Through the program, Charters made over 10,000 visits a year, to roughly 1,000 families.

As the program spread, across the city and eventually across Ontario, SickKids became the centre of a hub-and-spoke structure for child welfare and health. Charters and her team, under the supervision of Dr. Alan Brown, were tasked with coordinating nurses responsible for welfare and health, home visits, follow-ups and discharge from the hospital.

To read more about historical SickKids innovations, read the recently published The History of The Hospital for Sick Children.

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Now banner: A shared vision for an integrated mental health system.
Photo of the leadership teams from SickKids and Hincks-Dellcrest at a staff launch event.

For families of children with complex mental illnesses, navigating the current mental health system to access the care their children need, in a timely manner, can be challenging. Through their historic integration, SickKids and Hincks-Dellcrest Centre (HDC) seek to help address these problems so families can focus on what matters most — the psychological and physical wellbeing of their children.

Currently, many families are challenged with coordinating their children’s care as they navigate often long wait lists to see appropriate specialists. It is also not unusual to experience gaps in care between a visit to the Emergency Department and accessing ongoing treatment for mental illness. SickKids’ and The Hincks-Dellcrest Centre’s shared vision is to address these challenges by creating a continuum of integrated, inter-disciplinary and evidence-based mental health treatment and supports for children, youth and families.

Our organizations have spent the past two years working in partnership to develop a joint vision for integrated services bridging hospital and community mental health services.  Along the way, we consulted with patients and families, staff at both organizations, and our partners in the mental health sector. The consultations reinforced for us the pressure points and the major disconnects between medical and mental health care.

The integration of our two organizations will create a clear point of entry to access the mental health care, no matter where a child has first been assessed. It will also created clearly defined pathways for families to easily navigate between the hospital care offered at SickKids and community-based programs at HDC.

With improved access to HDC and SickKids’ combined mental health resources, health-care professionals working in other areas will be able to better manage the complex care needs of patients who experience multiple medical challenges. This interdisciplinary system of care will provide the best evidence-based treatments for the mental health needs of patients and their families integrated with other treatments they receive for existing health conditions.

Over time, as we implement our new electronic health information system (see the next story!) we will be moving to shared health records at both our SickKids and HDC sites, where all health-care providers involved in a child’s care will be able to easily share information. This will ease the burden on patients and families, who will no longer need to explain their medical history multiple times.

In addition to more timely access to mental health expertise, through the integration of SickKids and HDC we are combining our strengths in the education of mental health professionals, family education and research.  Together we will continue to develop the evidence base for innovative mental health-care practices, and ensure that others are trained in their use. These practices, in turn, will drive capacity to support children all across Ontario with complex mental illnesses.

We look forward to the development of this exciting new partnership over the coming years, and have no doubt that over time we will see significant improvements to mental health care, research, education, and training.

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