Network Conference a Success
Eighteen months of planning paid off handsomely as the 4th bi-annual Toronto ABI Network conference was a resounding success.
The conference, held at the Hilton Toronto on November 3 & 4, 2008, reached a maximum capacity of 425 registrants early in October. This makes the third time in a row that registration for the Network conference has sold out in advance of the event. Registrants came from across Ontario and from six provinces, as well as New York State.
The conference featured four dynamic and interesting keynote speakers, 32 podium presentations in four streams of concurrent sessions, as well as 20 poster displays. We were very pleased to have the support of 43 sponsoring organizations, the most number of sponsors to date. Most of the sponsors had exhibit booths set up in the main concourse area, which allowed participants to stop by the booths during the breaks and between sessions. Conference delegates had plenty of opportunities to visit the displays, chat with colleagues or engage presenters in informal discussion.
People's Choice Award for Outstanding Posters
For the first time at the Toronto ABI Network conference, registrants were asked to vote for their favourite poster presentations. Out of 20 posters on display, two were selected as outstanding by conference delegates, both speaking to the importance of goals:
- "A Student Who Never Stopped Learning - A Journey of Faith, A Future for a Better Life" by brain injury survivor Matthew Murdoch and his mother, Grazia Murdoch. This poster celebrated the successes that can be achieved in the face of adversity by the persistence of the human spirit.
- "Transforming Adult Day Services" by Jennie Hawking, Victoria Musgrave, Martha Northey and Kristen Pirie at COTA Health. This poster addressed the challenges of resistance to change while making the shift from a recreational group model to a multi-disciplinary, goal-oriented program structure. One of the stated objectives of this poster was to highlight how we are bringing back the idea of achieving dreams and goals to individuals with acquired brain injury.
With a conference featuring concurrent sessions, it can be difficult, if not impossible, to attend all the sessions that are of interest, especially if they are offered at the same time. To assist with the dissemination of information, presentations for most of the concurrent sessions have been posted on our website.
Visit www.abinetwork.ca/conference2008.htm for these presentations and additional highlights from the conference.
Starting in the new year we will begin planning for the next conference, which we anticipate will be held in November 2010. We hope to see you there!
Ontario Alliance for Action on Brain Injury
As reported in the last issue of the ABI Update, the Toronto ABI Network has been working closely with four other organizations — the Ontario Neurotrauma Foundation, Ontario Association of Community Based Boards for ABI Services, Provincial Acquired Brain Injury Advisory Committee, and Ontario Brain Injury Association — to raise the profile of acquired brain injury. This partnership makes up the Ontario Alliance for Action on Brain Injury. The Alliance is working to increase the awareness of the public and to foster partnerships with government to develop and implement the necessary system frameworks, strategies and supports for those affected by ABI.
Over the summer and fall, members of the Alliance have been working on an advocacy document in response to a meeting earlier this year between the Alliance and the Premier’s Office.
The primary objectives of the document are to:
- Call attention to some of the key contextual issues around ABI, outline the scope of the problem, and demonstrate the impact on clients, families and the respective ministries.
- Build on discussions with representatives from the Premier’s Office and key ministries affected by ABI.
- Provide an action plan for addressing priorities, along with identified solutions.
In addition, members of the Alliance, together with a public relations firm – PR Post – have been on an 8-city tour of the province to enhance awareness of ABI and call attention to identified issues. The tour has included stops in Ottawa, London, Hamilton, Thunder Bay, Kitchener-Waterloo, Sudbury, Windsor and Barrie. While in each city, a member from the Alliance, together with an ABI survivor and/or family member, have met with local media.
The tour, media launch and individual media releases together have been highly successful in obtaining media attention across a variety of radio, newspaper and television reports, resulting in:
- 27 articles appearing in daily newspapers,
- 32 published website stories,
- 12 television reports for a total of 22 broadcasts, and
- 23 radio reports for a total of 38 broadcasts.
HOW YOU CAN HELP
Visit the Alliance website to use the online form to send a pre-written letter to your Member of Provincial Parliament (MPP) about the importance of brain injury awareness. The form is very easy to use. You just enter your postal code and the form will automatically add the name of your MPP. You have the option of changing the letter if you choose but if you choose not to make changes, all you have to do is to press the 'send' button to send a message to your MPP.
Please take a minute and inform your MPP about the importance of understanding more about the effects of acquired brain injury. Visit www.see-us.ca today!
Brain Injury and Family Intervention
The Best Practice Committee of the Toronto ABI Network is collaborating with investigators and clinicians to support knowledge mobilization activities related to the Brain Injury Family Intervention (BIFI) model of support and the recently adapted version for adolescents with ABI and their families (BIFI-A).
We are working with Caron Gan of Bloorview Kids Rehab, Dr. Jeffrey Kreutzer and Taryn Stejskal, both of Virginia Commonwealth University, to develop a two-day workshop that will:
- Introduce participants to the BIFI and BIFI-A models of support.
- Provide participants with the tools to better support families in the topic areas that families have identified as important (e.g. common changes after ABI and its effects on the family, being a teen and achieving independence, emotional and physical recovery, problem solving, stress management, and preparing for school/work).
- Provide an opportunity to problem-solve around particularly difficult case scenarios.
We anticipate offering this workshop again; therefore, if you are unable to register this time, other opportunities will become available.
Addressing Referral System Issues
Recently the Systems Coordination Committee has been investigating current issues related to capacity and access for ABI rehab. A recent review of our data illustrates some of the issues we have been concerned about for a number of months:
- Wait times have increased for referrals from acute care to inpatient rehab (up by 5 days in 2007 as compared to 2006).
- There has been a change in length of time from date of injury to date of referral (decreased from average of 56 days in 2005 to 28 days in 2008), indicating referrals are being sent to the Toronto ABI Network in half of the time. Further, if we measure wait time from date of injury to date of admission to inpatient rehab, the time to admission has remained stable.
- The number of referrals sent to inpatient rehab but not accepted has increased (6% increase from 2005 to 2007).
- There has been an increase in the number of referrals for individuals with behavioural issues (9-20% in previous years to 27% in 2008).
- There are increasing lengths of stay in ABI rehab (from 50 days to 55 days).
- Discharge from inpatient rehab is made more difficult by lack of capacity in long-term care/community resources.
To determine an appropriate response, we have been considering the desired system goals which may require addressing:
- Increase appropriate access to inpatient rehab for more complex patient populations.
- Increase or reallocate resources of inpatient rehab to manage more complex patients.
- Increase access to outpatient rehab for patients coming from acute care that may not need an inpatient rehab program.
- Improve process issues that may be impeding patient flow (e.g., different approach to triaging referrals).
Therefore the following plan of action is being considered:
- Investigate the feasibility of conducting a pilot to evaluate the impact of sharing observers between acute care and inpatient rehab to facilitate access for patients who are rehab ready but continue to require an observer. The first step in this process will be to examine the scope of the issue. We will be asking acute care providers to track the number of patients they have who require a sitter but in all other ways are ready for rehab. This will begin to inform us of the potential to realize cost savings if we are able to move a patient (with their observer/sitter) into rehab sooner.
- Consider further stratification of the inpatient rehab wait list to maximize patient flow and ensure timely access for rehab candidates. We are in the process of developing transparent, evidence-based criteria that can support consistent and equitable decision-making.
- Standardize the language of referrals and information exchange through the use of measures such as the Disability Rating Scale (DRS) or Agitated Behaviour Scale (ABS).
- Investigate the feasibility and value of ABI System Rounds to support challenging referrals.
- Explore potential opportunities to reallocate resources, ensuring the best use of our limited resources.
Resource Matching and Referral
As you may know, the Toronto ABI Network recently worked with the GTA Rehab Network to develop a standardized inpatient referral form that is being used for referrals to inpatient rehabilitation and Complex Continuing Care programs. This standardized referral now forms the basis for the Toronto Central LHIN’s e-referral system, known as Resource Matching and Referral, which is currently being implemented and will reach all acute care, rehabilitation and complex continuing care hospitals and long-term care facilities by March 2009.
The Toronto ABI Network has been working with the team responsible for implementing the Resource Matching and Referral system to ensure that the centralized wait list for ABI rehab is maintained. For those making referrals for ABI rehab it is critical that the electronic referral continue to be sent to the Network and not to individual organizations in order to protect the integrity of the fair and equitable process we have so painstakingly developed. The mechanism to do this has been deliberately built into the system, allowing us to maintain our wait list and redirect the referral electronically when a bed becomes available.
If you have any questions about this implementation, please contact Judy Moir at 416-597-3057.
Data on Referrals Received
The Toronto ABI Network manages referrals for acquired brain injury services in the Greater Toronto Area. Referrals for inpatient service are triaged through the Network office to the first available bed that is appropriate to the individual's needs. The Network also facilitates the process of referring to community-based ABI providers. The following information reports only on patients/clients referred through the Network office and is not intended to reflect incidence data.
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Events Listing
The events listed here are provided for your information and are not necessarily being organized by the Toronto ABI Network. If you are interested in further details about any of the events below, please contact the appropriate individual identified in the event listing.
January 30, 2009 ~ Call for Abstracts Deadline
Provincial Acquired Brain Injury Conference:
Harnessing the Power of Brain Injury
View Call for Abstracts (Deadline is January 30, 2009)
See event flyer now
(Conference to be held on October 28-30, 2009 in Niagara Falls, Ontario.)
February 6, 2009
Toronto Rehab presents:
Mild Traumatic Brain Injury: Challenges and Controversies in Diagnoses
Location: The Old Mill Inn and Spa, Toronto, Ontario
FOR FURTHER INFORMATION:
Contact: Conference Services at Toronto Rehab
Phone: 416-597-3422 ext. 3693
Email: conferences@torontorehab.on.ca
Web: www.torontorehab.com/education/mildheadinjury2009index.html
February 11, 2009
Brain Injury Services' 4th annual conference:
I'm alright, the world's all wrong; Perspectives on Mental Health in ABI
Location: Liuna Gardens, Stoney Creek, Ontario
FOR FURTHER INFORMATION:
Contact: Brain Injury Services
Email: info@braininjuryservices.com
Web: www.braininjuryservices.com
February 17, 2009
Ontario Brain Injury Association, in conjunction with Brock University, presents:
Neurorehabilitation: Assisting Recovery and Function in Everyday Life Following Brain Injury (Level One)
Facilitators: Dr. Sherrie Bieman-Copland and Dr. Dawn Good
Location: Brock University, St. Catharines, Ontario
FOR FURTHER INFORMATION:
Contact: Debbie Spaulding or Ruth Wilcock
Phone: 1-800-263-5404
Web: www.obia.on.ca
March 8-10, 2009
Baycrest presents the 19th annual Rotman Research Institute conference:
Cognitive Aging: Research and Practice
Location: The InterContinental Centre Hotel, Toronto, Ontario
FOR FURTHER INFORMATION:
Contact: Paula Ferreira, Baycrest
Phone: 416-785-2500 ext. 2363
Email: pferreira@baycrest.org
Web: www.rotman-baycrest.on.ca
March 9, 2009
GTA Rehab Network presents Best Practices Day 2009:
Rehabilitation Transforming Healthcare
Location: Toronto Marriott Downtown Eaton Centre, Toronto, Ontario
FOR FURTHER INFORMATION:
Contact: Conference Services, Toronto Rehab
Phone: 416-597-3422 ext. 3693
Email: conferences@torontorehab.on.ca
Web: www.gtarehabnetwork.ca/bpd2009.asp
This selected listing provides details of events taking place within a few months of the newsletter’s release date. For a more comprehensive list of events of interest to the ABI community, please see the conference listing on our website.
In Brief
ABI and Homelessness
The Toronto ABI Network has an exciting new opportunity to partner with the City of Toronto’s Homelessness Partnership Initiatives to develop a targeted response to the recent findings of a study on homelessness and ABI. The study — authored by Dr. Stephen Hwang, research scientist at St. Michael's Hospital, and Dr. Angela Colantonio, senior scientist at Toronto Rehab — was recently published in the Canadian Medical Association Journal. Their findings demonstrated that 53 per cent of Toronto's homeless reported a history of traumatic brain injury and 70 per cent of them did so before ending up on the streets.
Along with COTA Health, the Network office will be working with representatives from the Homelessness Partnership Initiatives to increase awareness and provide education about ABI for those working in shelters and drop-in centres. We are in the early planning stages of this initiative and are hoping to host our first forum in the spring of 2009.
If you are interested in supporting this initiative, please contact Judy Moir at 416-597-3057. For more information about the research study that led to this opportunity, please read the news release from the Ontario Alliance for Action on Brain Injury.
Family Medicine Workshop
On November 29, 2008 the Network, in collaboration with OBIA, Toronto Rehab and University Health Network, hosted a very successful workshop at the 2008 Family Medicine Forum, a national annual conference for family physicians. More than 20 family doctors attended the 3.5 hour workshop to learn how to identify, assess and treat patients with an ABI.
Dr. Vanita Gopal of Toronto Rehab opened the workshop with an overview of brain injury, focusing on the assessment and medical management of patients with mild ABI. Dr. Nora Cullen, also of Toronto Rehab, took participants through a conversation about moderate to severe brain injury and the long term management that might be required by a family physician. Dr. Chanth Seyone of University Health Network concentrated on the neuropsychiatric implications of brain injury and also presented the medico-legal issues that sometimes arise.
The primary goal of the workshop, enhancing awareness of ABI among family physicians, was most definitely achieved. The feedback from participants was overwhelmingly positive. Of those who attended, 88% rated the workshop highly at 4/5 or 5/5; and all those who responded felt this workshop should be offered again. The Network would like to thank Drs. Cullen, Gopal and Seyone for giving their time and expertise and ensuring such a successful event.
Expanding Eligibility for Wheel-Trans
Earlier this year, the Toronto ABI Network was contacted by representatives from the Toronto Transit Commission (TTC), Wheel-Trans Division, to explore the question of expanding Wheel-Trans' current eligibility criteria. A preliminary meeting was held between Network staff, representatives from ABI community-based programs and spokespersons from Wheel-Trans. Some of the discussion focused on consideration of the potential client profile as there was acknowledgement that not all clients with ABI could be supported by Wheel-Trans. In addition, there were questions about the process of assessment that would need to be employed to determine eligibility.
In response, the Network struck a small working group to develop a submission for consideration by Wheel-Trans. As a first step, a stakeholder forum was held on December 3, 2008 to:
- Define the target population.
- Review expanded eligibility criteria that are being used in other jurisdictions (e.g., York Region's Transit Mobility Plus).
- Make recommendations for Wheel-Trans to support their assessment/determination of eligibility (e.g., which healthcare providers are most appropriate to complete the application, what tools would support their assessment for eligibility, etc.).
- Identify data sources to assist in determining potential demand.
- Obtain feedback on ways we can strengthen our case and establish recommendations to take to the TTC.
Register Now for Best Practices Day 2009
The GTA Rehab Network will be holding the next Best Practices Day on March 9, 2009 at the Toronto Marriott Hotel at the Eaton Centre. Best Practices Day brings together leaders in the rehabilitation field in a forum that is recognized as an important showcase of new ideas and best practices. Many of the planned presentations will be of interest to ABI service providers and planners.
Registration has opened and you may now register online for this event. See the GTA Rehab Network website for more information about Best Practices Day 2009.