c8 how do we move collaboration upstream?_vanessa parlette
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June 5, 2014 Prevent More to Treat Less
How Do We Move Collaboration Upstream? Building Strategies Together
Disclosure of Commercial Support
CFPC Conflict of Interest
Presenter Disclosure Presenter: Vanessa Parlette, Phd Project Manager, City of Hamilton PHS Jennifer Vickers-Manzin, RN MEd Program Manager, City of Hamilton PHS Keyna Bracken, MD Assistant Professor, McMaster University Physician Director, Maternity Centre of Hamilton Relationships with commercial interests: • Grants/Research Support: None • Speakers Bureau/Honoraria: None • Consulting Fees: None • Other: None
Outline
Low Birth Weight in Hamilton Taking Action as a Community Collaborating Upstream
Motivation: Low Birth Weight in Hamilton “Of the 20 neighbourhoods in Ontario with the worst rates of low birth weight babies, three of them are in the former City of Hamilton”
• Hamilton’s citywide LBW rate: 6.5% • Canada LBW rate: 6.2% • Ontario LBW rate: 6.6% • Code Red: Inner city neighbourhoods
see rates above 7.1%, seven above 10%
• Complex SDoH, lower SES, high inequity
LBW Risk Factors • Low Income • Smoking • Stress • Mom Age <20 or >35 • Poor Nutrition • Drugs; Alcohol • Low Education • Fetal Growth Restriction LBW Impacts • Higher costs and risk at
birth • Risk of long-term
chronic health problems • Impaired brain and
physical development
Determinants of Health and Low Birth Weight
Social Disadvantage
Strengthening Our Community by Supporting Healthy Lives and Healthy Relationships for Moms, Babies, and Neighbourhoods
Taking Action as a Community: The Healthy Birth Weights Coalition
Public Health and Primary Care PHS and Maternity Centre of Hamilton, moving in
together One-stop hub of care and services Integration of perinatal supports Collaboration with PHS, Family Health Teams,
Hospitals, Community Organizations, and School Boards
FSA LBW Low Income
Smoking during preg.
<20 Smoking during preg.
Age <20 No Prenatal in 1st Tri (1st time moms)
No prenatal classes (1st time moms)
L8M 8.6 24.5 27.3 32.4 12.3 9.5 74.7
L8L 7.9 28.6 35.5 33.3 12.1 12.1 71.7
L8K 7.6 14.7 20.4 48.2 6.7 6.5 70.9
L8H 7.6 21.3 29.5 37 8.1 9.6 63.2
L8N 7.2 33.7 29.2 44.4 8.7 9.9 74.7
City 6.5 14.0 16.7 40.1 4.8 6.3 63.2
LOR 5.6 4.0 7.4 28.6 … 3.7 49.2
L8T 5.1 10.3 17.3 16.5 … 6.2 59.7
L8S 4.9 19.2 15.5 14.1 … 6.2 59.7
Local Data
Target Priorities
3 Priority Strategies
1. Care Pathway for Young Parents
2. Professional Education
3. Smoking Cessation Supports
Smoking Cessation
Best Possible
Care
Teen Pregnancy Prevention
Care Pathway
Prof Ed
Improve Collaboration
Strengthen System
Target Risk: Smoking, Teen Pregnancy, Education and Supports
LBW
Reduce LBW Risk
Structure of Coalition and Work Groups
Current State of Collaborative Impact Broad base of local multi-sector partners Supportive local context Strategic City Initiative Media attention on SDOH LHIN Priorities; Health Links
Collaborative strategic priorities Shared goals
High potential to impact local system and experience of
care
Barriers to Moving Upstream Leadership changes Complexity Code Red Stigma “Too many tables” –competing priorities Funding models Upstream initiatives less measurable Federal and provincial austerity
Think Tank
What actions and strategies can we take to break past those barriers and move collaboration upstream?
• Leveraging Partnerships
• Overcoming system and institutional barriers
• Models of collaboration
