Centre Stage:

Gordon Milak from Southwest Community Care Access Centre, London, Ontario

As part of our new membership benefit package and our ongoing commitment to collaboration, we are giving impassioned improvers within the Network centre stage. We would like to get to know the faces of your organization. If you have a member that should get centre stage, let us know.

“The one common denominator that can connect people between hospital, primary, long-term and community care.”

I’m Gordon Milak. I’m the Senior Director, Performance Management & Accountability for the South West Community Care Access Centre (CCAC). On January 1, 2007 the same legislation that created the LHIN’s also saw the merger of 43 CCACs into 14 new organizations with geographic boundaries that match each LHIN. Our role is to assist individuals to live independently in the community, or to support them following a hospital stay. We help them navigate the healthcare system 3 ways; by providing Information & Referral, placement to Long-Term Care facilities and coordination of home care services. The alignment of our geography with the LHIN makes us the one common denominator that can connect people between hospital, primary, long-term and community care.

It is my privilege to lead an extraordinary team who support the organization in the areas of Performance, Quality and Procurement. As a conduit linking the region, partnership with system stakeholders like hospitals is crucial. With regard to home care services our legislative mandate is to act as a broker, contracting with Service Provider agencies to deliver community based services such as nursing, personal care and therapies. With a geography that spans the tip of the Bruce Peninsula to the tip of Long Point on the shore of Lake Erie, we support a caseload of more than 16000 clients, over 60,000 annually. Care is delivered in homes across the region by several thousand front line staff who are employed by more than 60 Service Provider agencies contracted by the South West CCAC. For us, Procurement is all about partnership and quality is all about effective partnership.

“Ontario’s health system is in the midst of the most significant transformation in a generation. The opportunity to take what I had learned over the past 25-years in healthcare management and operations and participate in this expanded version, where the CCACs are aligned with the LHINs was a tremendous opportunity that I could not miss.”

I joined the Southwest CCAC this January, after coming from a six-year post as Executive Director of the Middlesex Elgin branch of the Victorian Order of Nurses (VON). Prior to home care, I worked in community pharmacy with several regional and national chains. Sustainability and quality improvement are primary drivers for change across all sectors, and the CCAC mergers are no exception. Right now, Ontario’s health system is in the midst of the most significant transformation in a generation. The opportunity to take what I had learned over the past 25-years in healthcare management and operations and participate in this expanded vision was a tremendous opportunity that I could not miss.

All of us will be in position to be users of the system at some point, so ensuring that we have a system for our children and our grandchildren is imperative. This has become very personal to me, as my parents age.

“It’s pretty easy to rush to a solution based on the perspective that an individual may think is complete, but it’s not actually comprehensive.”

My past experiences framed my value system, but it really culminated with a research project CCACs were engaged in, led by Dr. Carol McWilliam from the University of Western Ontario. Called Client Driven Care, her research takes a very practical approach to how we interact and how that affects patient outcomes. Moving away from an expert medical model, this approach are about relationships building upon strengths, including utilizing the strengths of the client to make decisions about their care. Its not that the client is deciding what diagnostic tests they should receive. But care is delivered in their homes, and is often of an intimate nature. Two clients with the same diagnosis may have very different cultural and educational experiences. The strengths their experience brings to the care plan not only empower, but improve the clinical outcome.

There is a three-pronged principle to Carol’s research. First, you build relationships which opens communication. This brings you to number two; come to a shared understanding. And once those two things are established effective problem solving can be achieved through co creation. It doesn’t just apply to the professional-client relationships, but the entire care team, in fact all relationships. It’s pretty easy to rush to a solution based on the perspective that an individual may think is complete, but it’s not actually comprehensive. This is pretty basic stuff and certainly not new, but Carol’s research showed when we use the approach consistently client satisfaction improves, provider satisfaction improves and the client uses less hospital and home care services. Given the challenges of an aging population this is pretty compelling evidence. Apply the concepts at a system level and we’re all in a better position to come to the right solution, faster and implement it far more efficiently.

“I’m not wired to deliver direct care, but the fact that I can, even in a small way, help someone else deliver that care is enormously rewarding for me.”

I am passionate about enabling that co-creation, finding that solution, making it more effective. I think there is greater satisfaction for everyone when something works the way that it should. That’s a pretty simple concept, but quite frankly, its one of the reasons that you enjoy any job that you are doing – that you go to work and the time that you invest has value. If you don’t, it’s very difficult to remain engaged.

As an operations person, I see my colleagues and others who are drawn to work in the health care field and I am awed by the enormous compassion that drives them. Their desire to help is so sincere, and clients depend on it. So for me to play a hand in enabling them to deliver care, well it’s a real kick. I’m not wired to deliver direct care, but the fact that I can, even in a small way, help someone else deliver that care is enormously rewarding for me.

“As a leader, it is important for me to think about the big picture, but also about the detail.”

I would describe my leadership as participative. I’m sometimes a bit off the cuff. In terms of thinking outside the box, I like to explore new ideas and challenge the status quo. As a leader, it is important for me to think about the big picture, but also about the detail. Many good ideas fail only because the implementation plan wasn’t half as good as the idea. Sometimes great ideas are not fully capitalized because very small details are overlooked. My goal is to try and support both vision and action; the ability to not just think big, but also to achieve.

“Being a member of the Quality Healthcare Network allows us to share and receive quality experience….Our membership in the Network will help drive excellence.”

As an evolving organization in the healthcare system where community-based care will play an increasing role, we need to share our experiences and gain from yours. Quality is not a department in our organization; it’s about a way of being. However that is easy to say, challenging to achieve. So it’s about incorporating the aspects of Client Driven Care into our daily discussions and activities, and how we connect with others in the broader system.

Being a member of the Quality Healthcare Network allows us to share and receive quality experience, build relationships on a provincial level and that provides for a shared understanding of opportunities and challenges. Ultimately it brings us back to the ability to be most effective at co-creating solutions for better health outcomes.

I believe our membership in the Network will help us gather information and data that will assist us in making better decisions for our clients, stakeholders and our staff. Our membership in the Network will help drive excellence.

Centre Stage Index

To view past profiles of impassioned improvers within the Network, click the one that you want to read.

December, 2007, Gordon Milak from Southwest Community Care Access Centre, London, Ontario

January, 2008, Glenna Raymond from Whitby Mental Health Centre, Whitby, Ontario

February, 2008, Michael Heenan from St. Joseph’s Healthcare, Hamilton, Ontario

Spring, 2008, Carol Annett from CEO of VHA Home HealthCare, Ontario

Summer, 2008, Ben Chan, CEO, Ontario Health Quality Council