Ontario is taking the next steps in its plan to better integrate the province's health care system to help end hallway health care. On December 2, 2019, five provincial agencies will begin transferring into Ontario Health while the 14 Local Health Integration Networks (LHINs) have been clustered into five interim and transitional geographic regions.

This is an administrative step only and not a merger of the LHIN boundaries. Further, there will be no impact to patients' access to home and community care or long-term care placement as Ontarians continue to receive the care they need from the care providers they have built relationships with at the 14 LHINs. These changes are a means of streamlining the regional oversight as an interim measure as the government continues to work toward moving home and community care supports out of bureaucracy to integrate them with Ontario Health Teams.

"Our government has said from the beginning that we are working toward ending hallway health care," said Doug Ford, Premier of Ontario. "In order to bring our world-class health care system into the 21st century, we need to get rid of the inefficiencies and back office duplication. This is how we are continuing to put patients first and ensure sustainability for future generations."

As part of this next step to cluster the LHINs, the number of chief executive officer (CEO) positions has been reduced to five to ensure alignment and to eliminate duplication of roles and responsibilities. These five CEOs will now serve as interim regional leads and will be responsible for supporting the work required to transition LHIN functions into Ontario Health or to Ontario Health Teams, and to ensure that patient services continue uninterrupted. The money saved from this change will be redirected into frontline patient care.

"As we take the next steps to integrate Ontario's health care system, continuity of patient care remains our top priority," said Christine Elliott, Deputy Premier and Minister of Health. "This transfer will combine the knowledge, strength and expertise of many talented professionals under one roof as part of our plan to better coordinate and connect Ontario's health care system to end hallway health care. We would like to acknowledge and thank the LHIN executive leadership for the ongoing professionalism, dedication and support as the government continues to modernize and strengthen Ontario's health care system."

"Ontario Health's goal is to ensure Ontarians receive high-quality health care services where and when they need them," said Bill Hatanaka, Ontario Health Board Chair. "On December 2, we bring the knowledge, skills and experience of this first wave of transferring organizations into Ontario Health and begin working with the five interim regional leads too. We are building our talent base to become one agency with one strategy and one set of priorities; applying the best of our collective expertise to all Ontario patients."

Regardless of the title – Front Line Worker, Personal Support Worker, Home Care Worker, etc. – this field within our health care system desperately needs help. Long shifts, mixed scheduling, time pressure and sometimes unsafe work conditions (as well as other factors) are all reasons for burnout. Of course, burnout in any field, is a top reason for people leaving a particular field, or worse; staying in the field and finding they are providing less than optimal care.

It’s time to start working together to support people who are providing care for our aging population. A strong statement for sure but we need to find ways to overcome the barriers and obstacles facing the people who have cared for (and are continuing to care for) people like my father, maybe your parent(s) and many others around us whom we love.

With funding being withdrawn, or lessened, in the health care field what can we do to continue to get, and keep, the right people in these positions so they know their work is valued and they feel they can continue on?

Imagine this scenario: One shift (or multiple shifts) is/are required to be filled. A notification goes out to your list of workers. One worker accepts, and the others are made aware the shift has been filled. We are now offering shifts that people can work, rather than telling them what they will work. Does this not speak to work-life balance and the potential for alleviating some of the stress that causes burnout?

Of course this doesn’t create a utopic world, but we need to start somewhere.

Any positive impact on employees will have a positive impact on patients and their care plans as well as the patients’ family. This isn’t the conundrum of which came first, the chicken or the egg. The start is clear and precise – doing what’s right for workers in a demanding field that can take its toll.

If you search online anything about health care workers and burnout or stress, the results are almost limitless and more than staggering.

Front line/personal support/home care workers are in the field they have chosen because they care about people. It’s time to start showing them they’re appreciated, and the work they do is extremely relevant in our society today.

Our society is an aging one in which the elderly require help with more routine tasks at home and the numbers are rising. The need for home care/direct care workers is increasing as direct result. There are many articles written about what can be done to improve this situation as it continues to rise. The number of workers to handle home care isn’t the only barrier, but rather, varying schedules, availability, and multiple geographic areas are further barriers of the current workforce. Having home care/direct workers on payroll can be more succinctly optimized when strong scheduling practices are in place and home care for the elderly can begin to improve.

Frontline workers are in high demand across Canada and throughout the United States of America. As our population ages, the demand is increasingly growing. This puts a higher level of stress on the workers trying to meet that demand. Effective scheduling is one way to alleviate part of that stress.

There are large numbers of frontline workers leaving the industry or quitting their jobs, but effective scheduling can decrease the effect ‘burnout’ is having on them. Breaking down shifts so they aren’t so long, and providing more predictable hours can result in frontline workers being happier in their field.

Also, being able to immediately see that a worker has overstayed a visit for a patient, or client, allows for a coordinator to reach out to determine the reason and get help if it’s needed. Another way to alleviate another of the stressors this workforce faces – an unsafe work environment. If an employee knows someone is keeping an eye on their time, while they are handling tasks during a patient visit, they can feel more secure knowing that help is potentially available should it be needed.

It seems, though, that as the demand increases this field is still one of the fastest growing fields. As cited in theatlantic.com ‘Human Capital; Health Care Just Became the U.S.’s Largest Employer by Derek Thompson, Jan 9, 2018 https://www.theatlantic.com/business/archive/2018/01/health-care-america-jobs/550079/ “Of the 10 jobs that the Bureau of Labor Statistics projects will see the fastest percent growth in the next decade, five are in the health care and elderly assistance. The two fastest-growing occupations—personal-care aides (who perform non-medical duties for older Americans, such as bathing) and home-health aides, (who help the elderly with medical care)—are projected to account for one in every 10 new jobs in that time.” These numbers beg for determining ways to ensure, that while this growth is happening, the people in these fields are taken care of.

There are many reason why frontline workers are experiencing negative impacts because of the field they want to be in and there are fixes that can manage some of this.