Minister’s Medal 2014

Team-Based Application Template

Please ensure the information below is included in your application for the 2014 Minister’s Medal Honouring Excellence in Health Quality and Safety, noting the word limits for each. Completed applications should be sent to the corresponding LHIN by 5:00pm on August 28, 2014.

For more information and to review the Frequently Asked Questions (FAQs) related to your application, please visit .

Name of Initiative/Program:

Name of Corresponding LHIN: Please identify only one LHIN to act as the ‘Corresponding LHIN’ – for example, this may be the LHIN that is most familiar with the program

Notice of release of information

By submitting your application, you are consenting to the use of information provided in your application for promotional purposes, such as featured on Ministry publications and other materials. The Ministry will take all measures necessary to ensure advance notice is provided of how information related to your application will be used.

OVERVIEW

Brief summary (200 words)[n.b.: this section is not scored – it is used to provide an overview of the initiative/program for the reviewer and for ministry use]

Please provide a high-level summary of the initiative/program, its objectives, its outcomes, and why it deserves consideration for the Minister’s Medal Honouring Excellence in Health Quality and Safety.

APPLICATION CRITERIA

1)Quality and value by design(400 words): 25Points

In an increasingly constrained fiscal environment, initiatives that improve the health of Ontarians should be designed and delivered keeping value for quality of care in mind. Please describe how the program embeds quality and value into process design and outcomes.Please include (at a minimum) in your response:

  • A description of how the program demonstrates a return on investment or potential cost savings;
  • A description of how the team has effectively managed to demonstrate creative solutions to drive improvement while recognizing various constraints and other pressures; and
  • An indication of the alignment of the program with the goals and objectives of Health System Funding Reform.

2)Collaboration across health system partners(250 words): 15 Points

Describe how the program relies on collaboration across sectors to drive improvements. Effective working relationships between health system partners across the care continuum must be demonstrated. Please include(at a minimum) the following in your response:

  • A description of the partners involved in the program and their role in driving success;
  • Identification of the cross-sectoral practices that have been developed or adopted and applied to support transitions in care for patients and clients;
  • A description of the governance structures established within the participating organizations that ensure key accountabilities and leadership are in place to enable the sustainability of the program; and
  • A description of how patient/clients/caregivers were involved in the planning/implementation of the program.

3)Outcomes and results (500 words): 40Points

A key feature of successful change is the ability to demonstrate the program’s impact on patient/client care. Proven and substantiated outcomes will enhance the strength of the submission. Please include a description of:

  • IMPLEMENTATION (20Points): The quality/performance measurement practices and methods that were used in the design and ongoing tracking/management of the program; How trending of performance on certain quality metrics and/or indicators (process, outcome, structure) was tracked and monitored over time.
  • OUTCOMES (20 Points): A comparison of performance and results before, during, and after the program was introduced. Examples of quality indicators and metrics can be drawn from a number of sources used by the organization(s) to inform quality planning process (e.g., Quality Improvement Plans, Health Links information, Service Accountability Agreements (SAAs), etc.). Maturity of outcomes will be considered in assessing the quality of the program.

4)Sustainability (200 words): 10Points

In your response, please make reference to:

  • The steps taken or processes in place to sustain the success of the program; and
  • How the program has shown or can show transferability to other regions/settings.

5)Patient/Client testimony (attached as an appendix): 10 Points

The Minister’s Medal aims to recognize programs/initiatives that enhance coordination of care and place the patient at the centre of the circle of care.

Note: All identifiable patient information should be removed prior to submission of the testimony to protect the confidentiality of the patient/client.

Applicants are encouraged to submit the patient/client testimony as an appendix to the application. Appendices to the team-based application must not exceed 6 (six) pages in total. Any additional pages of appendices beyond 6 pagesmaynot be considered as part of the application.

ACKNOWLEDGEMENT AND SIGN-OFF

Sign-off

Endorsement of your application acknowledges that the team has worked together to achieve the success described, and supports the nomination of the program for the 2014 Minister’s Medal Honouring Excellence in Health Quality and Safety.

Contact information

(Please include a list of each team member and their corresponding contact information).

Name of team member / Title / Affiliated organization name and address / Email address / Phone number / Signature
Primary contact
1.
2.
3.
4.
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How to submit your application

Please submit your application by 5:00 p.m. on August 28, 2014 to your local LHIN office. Only one application should be submitted for each team.

Contact with any questions related to completing your application.

2014 Minister’s Medal

Application TemplateTeam-Based