CHARTING A COURSE FOR THE HEALTH SYSTEM AND NURSING IN ONTARIO
 2014-20152016-20202021-2030
Public Health

The principles of equity and fairness are the foundation for creating and implementing all public health programs and services.

Dedicated funding and health equity tools determine what programs and services best promote the health of all people, especially those who are vulnerable.

All Ontarians experience care that respects their human rights.

Public health units are aligned within the mandate of Local Health Integration Networks. With their funding protected, public health units initiate whole-system regional planning.

Funding, structures and programs for public health units are designed to decrease power differentials and social inequity.

Public health nurses are working to their full scope of practice to advance an expanded primary health system.

Health considerations are at the core of all policies, programs and funding by government.

Public health units address social inequities in system planning, implementation, monitoring, and evaluation.

Public health nurses continue their work to reduce social inequities and improve population health outcomes such as how long and how well we live.

Primary Care

The Ontario government changes regulations to enable RNs to order diagnostic tests, diagnose common ailments, and prescribe medications.

Case managers working in Community Care Access Centres (CCAC) transition to primary care to work as care co-ordinators for people with complex health needs, helping to avert unnecessary hospitalizations.

RNs complete the required education to prescribe medications.

RNs focus on health promotion and provide comprehensive primary care within their expanded scope of practice. This includes: identifying and treating minor illnesses such as ear and bladder infections, managing chronic diseases, and co-ordinating care and other support services.

All Ontarians have same-day access to person-centred, interprofessional teams in nurse practitioner-led clinics, community health centres, Aboriginal health access centres, and family health teams.

Nurse practitioner-led clinics, community health centres, Aboriginal health access centres, and family health teams provide health services 24/7, rotating in their responsibility for after hours care.

Stand-alone walk-in clinics are phased out.

Hospital Care

Discharge planning becomes a priority the moment a patient enters the hospital.

Discharge planning is done by hospital care co-ordinators who ensure the health needs of patients are determined in partnership with them, their family, and their primary care co-ordinator.

NPs actively admit, treat, transfer and discharge patients in all hospitals, improving timely access, patient experience and flow, and quality care outcomes.

Hospitals focus resources and attention on patients who are very ill or those who need elective surgery.

Emergency departments are only focused on very ill people who require complex care; while others receive timely access in primary care, home care, rehab, complex care, or nursing homes.

Hospitals continue their focus on caring for the seriously ill and those who need elective surgery.

People who require alternate levels of care receive the care they need to remain within their homes or another more appropriate setting.

Births and deaths increasingly occur at home.

Home Care

CCAC care co-ordinators are now fully transitioned into primary care and initiate home care and support services as needed.

The amount of home care and support services a person needs is determined by home-care agencies, clients and their families.

The CCAC structure is fully integrated into existing areas of the health system. LHINs are now responsible for whole-system planning, service agreements, funding, accountability monitoring, and evaluation.

Home-care agencies provide around-the-clock services required by clients, eliminating the need for multiple agencies to provide the help people need.

Palliative-care services are widely available.

LHINs renew contracts for home-care agencies based on their ability to provide publicly funded, not-for-profit services, quality outcomes, and successful accreditation.

The scope of practice of RNs working in home care is maximized and expanded, and their autonomy strengthened, so they can deliver a wide range of health services including diagnosing minor ailments and prescribing medications across the continuum, from pediatric care to palliative care.

Access to publicly funded and not-for-profit home care and support services is dramatically increased, eliminating situations where people are in and out of hospital in order to get the care they need.

Rehabilitation, Complex, and Long-Term Care

Evidence-based staffing models ensure the right mix of nurses and other providers to deliver care.

Minimum staffing standards in long-term care homes, including one NP for every 120 residents, and up to four hours of care per resident, per day, with at least one hour delivered by an RN or RPN.

RNs in complex continuing care and rehabilitation are empowered to lead quality and patient safety initiatives.

Funding priority for new or expanded assisted living, retirement and long-term care homes is given to not-for-profit operators.

Complex continuing care and rehabilitation are recognized and understood for their specialized role in supporting medically fragile people as they transition from hospital to home.

Capacity is available in the community in the form of supportive housing and palliative care with access to RNs, to allow people with medically complex needs to be discharged from complex continuing and rehabilitation care.

Only people who choose or have care requirements that can’t be managed in the community become residents of long-term care homes.

Caregivers are provided with increased support including more respite, home help and peer support.

The system has the resources to effectively manage increased chronic disease rates and changing demographics.

RNs and NPs lead comprehensive care for all long-term care residents.

Ontarians who require complex continuing care and rehabilitation services enjoy the highest quality of life possible.

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