From the Burgundy Chairs

Caregivers exist in all areas of our communities, whether it’s a family member providing physical support to their loved one or a friend providing emotional support to their neighbour. Caregiving has recently taken center stage with government decision makers considering policies like the National Caregiving Strategy, compensation for caregivers, and implications for the caregiving community with the introduction of the Safe Long-Term Care Act.

Joined by Amy Coupal, Chief Executive Officer of the Ontario Caregiver Organization (OCO),

we delve into the complex landscape of caregiving in Ontario, focusing on the experiences of caregivers and the recent policy developments shifting the landscape for this underrepresented group.

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Amy Coupal is the CEO of the Ontario Caregiver Organization (OCO), a charitable organization that exists to support Ontario’s 4 million caregivers who provide physical and/or emotional support to family members, partners, friends and neighbours. A visionary leader with over 20 year’s experience in the not-for-profit sector, Amy is passionate about mobilizing change through knowledge exchange and building collaborative initiatives that positively impact the lives of individuals and communities.

The impact of this work is demonstrated through the breadth of direct to caregiver programs and services available through OCO, as well as the early successes of embedding caregiving in the culture of health care and the amplification of the voices of caregivers to influence decision making at a system level.

Amy has a Master of Education from the University of Calgary and is an Adler-trained coach. Her insights have been shared through speaking and media engagements, both internationally and here in Canada.

Amy has a deep understanding of the benefits and challenges associated with caregiving. As a caregiver for most of her life, Amy helped to support her brother who had Cerebral Palsy. She was also a caregiver to her mother throughout her cancer journey and now supports her father through older adulthood.

This podcast was created with support from Boehringer Ingelheim Canada.

Schizophrenia is a complex mental disorder that affects millions worldwide. Though psychosis is the hallmark symptom of this serious mental illness, cognitive impairment is another core feature that significantly impacts patients' daily functioning and quality of life. In this podcast episode, we delve into the critical intersection of schizophrenia and cognitive impairment, exploring its far-reaching effects and the challenges it presents for both patients and healthcare providers.

Our expert panel, consisting of Chris Summerville, CEO of the Schizophrenia Society of Canada and Dr. Heather McNeely, Clinical Psychologist and Neuropsychologist in the Schizophrenia and Community Integration Service at St. Joseph’s Healthcare Hamilton explores the various domains of cognition affected, including memory, attention, and executive functioning, and how these impairments manifest in patients' lives.

The conversation also touches on current assessment methods, emerging treatment options, and the importance of addressing cognitive symptoms alongside other aspects of schizophrenia management. Our guests share their perspectives on the challenges faced in clinical practice, ongoing research initiatives, and the potential for cognitive remediation therapies to improve outcomes for individuals with schizophrenia.

This episode aims to raise awareness about the often-overlooked cognitive aspects of schizophrenia, highlight the need for comprehensive care approaches, and discuss strategies for enhancing cognitive function and overall well-being in patients living with this challenging condition.

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Chris Summerville, D.Min., CPRRP, LL.D (Honorary), Chief Executive Officer, Schizophrenia Society of Canada

Chris has been a prominent advocate in the mental health field for over 30 years, driven by personal experiences with family members who have bipolar disorder, schizophrenia, and depression, and through his own journey with mental health services. Since 2007, he has served as CEO of the Schizophrenia Society of Canada. With a doctorate from Dallas Theological Seminary and certification as a Psychosocial Rehabilitation Recovery Practitioner (CPRRP), Chris also received an honorary Doctor of Laws from Brandon University for his leadership in mental health advocacy.

As a leader and advocate, Chris supports a recovery-oriented, holistic approach to mental health that incorporates bio-psycho-social-spiritual perspectives. His contributions include serving on the Board of Directors of the Mental Health Commission of Canada since 2007, where he has been involved in initiatives like the Hallway Group and the Headstrong Project. Chris has also been active on various boards, including the Mood Disorders Society of Canada and Psychosocial Rehabilitation Canada.

Dr. Heather McNeely Clinical Psychologist and Neuropsychologist in the Schizophrenia and Community Integration Service at St. Joseph’s Healthcare Hamilton

Dr. Heather McNeely is a practicing clinical psychologist and neuropsychologist in the Schizophrenia and Community Integration Service at St. Joseph’s Healthcare Hamilton where she is also Clinical Lead for the Clinical Neuropsychology Service. She is also a Full Professor and Academic Lead of the Schizophrenia Division in the Department of Psychiatry and Behavioural Neurosciences at McMaster University.

In addition to her clinical work, Dr. McNeely is actively involved in teaching, psychology training and research aimed at improving clinical and social outcomes for adults with schizophrenia and related disorders. She has been extensively involved in leading quality improvement initiatives at St. Joseph’s Healthcare, Hamilton, and she has been an invited contributor to provincial and national expert panels on implementation of quality care standards for adults with schizophrenia.

Since the 2004 Paul Martin deal to fix health care for a generation, which guaranteed federal health transfers would increase by 6% annually, the Government of Canada has sought to constrain the growth of the Canada Health Transfer (CHT). First, the Harper Government lowered the annual CHT growth rate to align with economic growth.

Upon forming government in 2015, the Trudeau Liberals successfully provided time-limited funding outside of the CHT - an approach that has been used on several occasions since to provide funding to PTs. From COVID-19 support, to home care and mental health, and the most recent set of bilateral health deals - the Government of Canada is providing time-limited funding to provinces largely outside of the CHT.

Our latest podcast reflects on the process of landing the first set of bilateral health agreements in 2017, and this approach continues to be used. Joined by four individuals that had intimate knowledge of the 2017 agreements including former health minister Jane Philpott, Marcel Saulnier, Dave Clements and Peter Cleary, this podcast will explore some unique insights on the formation of these agreements and how effective they can be in impacting improvements to health care services led by Provinces & Territories.

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Jane Philpott

Dr. Jane Philpott is the Dean of the Faculty of Health Sciences, Director of the School of Medicine at Queen's University, and CEO of the Southeastern Ontario Academic Medical Organization in Kingston, Ontario. She is a medical doctor, a Professor of Family Medicine, and former Member of Parliament. From 2015 to 2019 she served as Canada’s Minister of Health, Minister of Indigenous Services, President of the Treasury Board and Minister of Digital Government. Prior to politics, Jane spent the first decade of her medical career in Niger, West Africa and then she was a family doctor with Markham Stouffville Hospital for 17 years, including six years as Chief of Family Medicine. Jane has recently published her first book called Health for All: A doctor’s prescription for a healthier Canada.

Marcel Saulnier

With nearly 30 years of experience in the federal government focusing on strategic policy, health care policy, and intergovernmental relations, Marcel serves as an advisor to the Santis team and its clients on key health initiatives and supports them in achieving their strategic policy, health care policy and government relations objectives. Prior to joining Santis, Marcel served as an Associate Assistant Deputy Minister for the Strategic Policy Branch of Health Canada. In his role he advised the Minister and Deputy Minister on health care policy and led Federal-Provincial-Territorial negotiations on bilateral agreements for mental health, home care and virtual care. Marcel has since various other leadership positions as the Director of Policy Research for the Canadian Medical Association, Director General of Policy Coordination and Director General of Health Care Strategies for Health Canada, and Executive Director of the Secretariat supporting the Advisory Council on the Implementation of National Pharmacare for Health Canada.

Dave Clements

Dave has nearly 30 years experience in the healthcare and higher education industries and brings expertise in health and science policy, communications and stakeholder engagement. He has served in executive roles in organizations that include the Canadian Institute for Health Information, the Canadian Institutes of Health Research, and Queen's University's Faculty of Health Sciences. He spent nearly a decade working for the federal and BC provincial governments, including as Director of Communications and Senior Advisor for the Hon. Jane Philpott, Canada's former Minister of Health. In 2014 and 2015, he served as executive director for the Advisory Panel on Healthcare Innovation, appointed by the Hon. Rona Ambrose, then Minister of Health for the Government of Canada. He is an adjunct professor in the Department of Health Sciences at Carleton University.

Canada is experiencing an HIV crisis and we’re moving in the wrong direction. By the end of 2020, there were 62,790 Canadians living with HIV. The following year, there were 1,472 additional diagnoses in Canada — a 11.3% increase from the previous year.

PrEP (pre-exposure prophylaxis) is a once-a-day pill that reduces the risk of transmission by 99% if taken consistently. This breakthrough medication has offered protection for those at risk of contracting HIV. While gay, bisexual and men who have sex with men (gbMSM) still make up over 40% over new HIV cases, there has been a notable decline in these numbers, largely attributed to the increased uptake of PrEP within this community.

Worryingly, however, is that in groups where PrEP uptake is virtually non-existent, transmission rates are on the rise. Indigenous Peoples, immigrants, and members of African, Caribbean and Black communities are all seeing increasing impacts of HIV. Women are also disproportionately affected, especially among Indigenous populations, where one third of new HIV infections were among women in 2020. Yet, less than 10% of the population that would benefit is using PrEP.

During a 2022 Montreal conference, the Government of Canada committed to 2030 global targets of zero new HIV infections, zero AIDS deaths, and zero stigma and discrimination. With only six years to go, Canada is further away from this goal than when we committed. So how do we increase awareness of this issue? How can we increase uptake of PrEP and other person-centric options for at-risk groups? How can we increase the urgency in the fight against HIV?

As part of Pride Month conversations, and in collaboration with Gilead Life Sciences Canada, Danielle Flieler sat down with Patrick O’Byrne, a Nurse Practitioner and Full Professor of Nursing at the University of Ottawa; Mia Biondi, Assistant Professor and the Nurse Practitioner program coordinator at York University School of Nursing; and Ken Monteith, Executive Director of COCQ-SIDA.

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Patrick O’Byrne NP PhD is a Nurse Practitioner and Full Professor of Nursing at the University of Ottawa. Dr. O’Byrne’s work focuses on the prevention, diagnosis, and treatment of sexually transmitted and bloodborne infections. Dr. O’Byrne set up the first nurse-led HIV PEP and PrEP clinics in Canada, and Canada’s first mailout HIV self-testing program.

Mia Biondi is trained as a Primary Health Care Nurse Practitioner and is PhD prepared in Microbiology. Mia is an Assistant Professor and the NP program coordinator at York University School of Nursing. Clinically and her research is focused on refugee health, street outreach, HIV prevention and viral hepatitis. 

Ken Monteith is the Executive Director of COCQ-SIDA (la Coalition des organismes communautaires québécois de lutte contre le sida). Trained as a lawyer, he worked in the community youth sector and in the HIV/AIDS sector. He participates actively in research, especially projects concerning the quality of life of people living with HIV and prevention for men who have sex with men. He holds degrees in Industrial Relations, Common and Civil Law from McGill University and was a member of the Québec Bar from 1991 to 2001, when he resigned to devote himself more fully to his community work on HIV/AIDS. Ken Monteith was diagnosed with advanced HIV infection in 1997.

Primary care is the foundation of Canada’s health care system; however, the sector is facing a multitude of pressing challenges. Currently, more than 6.5 million Canadians do not have regular access to primary care and the one third of Canadians who have a family doctor find it difficult to get an appointment. Physicians themselves are facing intense burnout coupled with a health human resources (HHR) crisis. In a May 2023 survey by the Ontario College of Family Physicians, 65% of respondents cited plans to leave office-based family practice or reduce their hours in the next five years.

Across Canada, health leaders have identified team-based models of care as a tool to help combat these challenges. Team-based primary care offers a broader range of health services to patients by health care providers committed to the delivery of comprehensive, coordinated, and high-quality care through intentionally designed collaborative practices.

No one profession can do it all. Team-based primary care will help build a stronger, more resilient health system and provide quality care for all and less burn-out for our health workforce.

Joined by three primary care leaders, this podcast explores the importance of the use of consensus driven definitions, principles, standards and indicators for team-based primary care implementation that is in aligned, yet contextually specific to the unique systems and populations within provinces and territories in this country.

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Dr. Ivy Oandasan is the Co-Lead Team Primary Care: Training for Transformation, an initiative aimed at accelerating transformative change in the way primary care practitioners train to work together. She is also a professor, Department of Family and Community Medicine Temerty Faculty of Medicine and Director of Education, College of Family Physicians of Canada and an active family physician who has been involved in teaching and research since 1997. She led a national research team that conducted the environmental scan and literature review on the evidence for interprofessional education for collaborative patient centred practice that was funded and ultimately used by Health Canada in 2004.

Leslee Thompson is the Chief Executive Officer of Accreditation Canada and Health Standards Organization (HSO), two organizations united in common vision for safer care and a healthier world. With over 30 years of senior executive and corporate director experience working at provincial, national and international levels, Leslee is a leader who makes things happen. Her clinical roots as a Registered Nurse continue to influence her relentless pursuit of quality and safety in health care, and Leslee has become internationally recognized for her work on partnering with patients to improve outcomes. She has also been Board Chair of the Canadian Foundation for Healthcare Improvement, Chair of Council of Academic Hospitals Ontario and is currently executive in residence at Rotman School of Management at University of Toronto.  

Dr. Tara Kiran is a family physician and scientist at the MAP Centre for Urban Health Solutions at St. Michael’s Hospital, Unity Health Toronto and the Fidani Chair of Improvement and Innovation at the University of Toronto. She is also principal investigator at OurCare, a national public engagement initiative focused on the future of primary care, the public's expectations, and what policy changes they recommend to shape the system. Over the last decade, Dr. Kiran has led a program of research evaluating the impact of primary care reforms on quality in primary care in Ontario. She and her team have studied the impact of financial incentives on diabetes care and cancer screening, compared chronic disease prevention and management between various practice models, evaluated the impact of mandated after-hours provision on emergency department use, explored the association between the access bonus and healthcare use, and highlighted the quality gaps for patients left out of enrolment models.

Delivering world-class care and research, Ontario’s hospitals play a pivotal role in diagnosing, treating and coordinating care for a growing population.

But Ontario’s health system is under incredible pressure. Hospitals are faced with a series of unique challenges including capacity restraints, staffing shortages, rising infrastructure costs and the evolving needs of patients. Tackling these challenges is top of mind for hospital leaders with the ultimate goal to deliver efficient, accessible and high-quality care.

Hosted by Santis Health Executive Associate, Saäd Rafi, this podcast episode offers a pulse check on Ontario’s hospital system. Bringing together three hospital leaders from across the province, we explore the shared challenges and overarching themes for sector-wide improvements.

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Dr. Frank Martino is the President and Chief Executive Officer of William Osler Health System, one of Canada’s largest community hospital networks, serving Brampton, Etobicoke and the surrounding region with over 1.1 million patient visits each year. A strong advocate for quality patient care, Dr. Martino has dedicated his over 30-year career to improving the health of individuals and communities to effect change for the betterment of patients. Dr. Martino joined Osler in 1991 and has held progressively senior roles – including serving as Interim Vice-President of Quality & Medical Affairs, Chief of Staff, and Chief of Family Medicine. He has practiced family medicine in Brampton for decades.

Lynn Guerriero is the President and Chief Executive Officer of Niagara Health. She came to Niagara Health as an accomplished leader in the Ontario health care system, with more than 30 years of leadership, management and clinical experience within a variety of health care provider settings. Lynn has also held senior roles at Cancer Care Ontario and prior to joining Niagara Health was Assistant Deputy Minister for the OHIP Division of the Ontario Ministry of Health.  

Cynthia Davis is the President and Chief Executive Officer of Lakeridge Health. A registered nurse by profession, Cynthia has a passion for patient-centred care, which she fosters through engagement and partnerships. Over the course of her time in this position, she has led the organization through many transformative changes as it continues to realize its vision as the integrated health system in Durham Region. She has also advanced the development and opening of a new long-term care home and the site selection process for a potential new hospital in Durham Region

The COVID-19 pandemic illuminated capacity and health human resource (HHR) challenges across health systems in Canada, and around the world. The extent of these challenges has necessitated governments, providers and organizations to think differently about their respective roles and commit to real change.

One of the key challenges in addressing the HHR crisis is identifying how to retain health workers in their roles amidst long-standing and systemic pressures on the workforce – including a high-needs, aging population, staffing shortages, and inadequate focus on worker well-being and retention in recent history. Improvements to workplace culture and workplace mental health are critical to retention efforts.

In this podcast episode, Victoria Wiebe sits down with Eduardo Castro, Ashley Kim, and Nancy Hood from CMHA Ontario to discuss Your Health Space – a free workplace mental health program developed by CMHA Ontario to support health workers’ psychological health and safety in the workplace. 

This is the third part of Santis’ three-part series on health human resources. In November, we held a webinar with thought leaders from across the country to speak about “what it will take” to advance change for Canada’s health human resources crisis. In January, we held the second part of this series, exploring the government perspectives on what it will take to advance change for Canada’s health workforce, current initiatives underway, and the role of collaboration in driving the change we wish to see. You can view both of these webinars on the Santis Health YouTube channel.

In 2015, the Truth and Reconciliation Commission released its report “Honouring the Truth, Reconciling for the Future.” The report detailed how colonization historically undermined the health of Indigenous Peoples and how past policies continue to contribute towards the persistent health gap between Indigenous communities and the general population.

At the same time, the Commission released 94 calls to action for reconciliation between Indigenous Peoples and Canadians. Among them was a call to action to “those who can effect change within the Canadian health care system to recognize the value of Indigenous healing practices and use them in the treatment of Indigenous patients in collaboration with Indigenous healers and Elders”.

One example of an organization effecting change is St. Joseph’s Care Group. Located in Thunder Bay, St. Joseph’s Care Group is a catholic health care organization with a unique focus on caring for those with unmet needs. They operate a hospital and several long-term care facilities, while also providing housing support, mental health and addictions support, rehabilitation and palliative care. Given their northern location, they also provide care and support for a large Indigenous population.

In this episode, Pia Lindemann Kristensen is joined by Paul Francis Jr., Vice President of N’doo’owe Binesi, the Indigenous Health, Partnerships and Wellness division of St. Joseph's Care Group. They discuss the importance of culturally safe care for Indigenous Peoples and explore St. Joseph’s Care Group’s journey to recognize and implement Indigenous healing practices in its health care settings.

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Paul Francis Jr. is the Vice President of N’doo’owe Binesi (Healing Thunderbird), the Indigenous Health, Partnerships and Wellness division of St. Joseph’s Care Group in Thunder Bay, Ontario.

A registered social worker, Paul is a graduate of the Master of Social Work Indigenous Field of Study Program at Wilfrid Laurier University and a member in good standing with the Ontario College of Social Workers and Social Service Workers. Since 2019, he has maintained a small private practice, Shkode Mkwa Counselling. Paul is committed to his Anishinaabe spiritual practices and enjoys attending and helping with traditional ceremonies. Paul believes in the power of Indigenous healing practices and that possibilities exist to integrate them within the mainstream health care system for the benefit of all.  

Paul is Odawa (Anishinaabe) and mixed European ancestry, a member from Wiikwemikong Unceded Territory on Manitoulin Island and is a member of the Bear Clan. Paul is a proud father to Tristan, Royal, Harlow, Ailee and Siinese, with his wife Kyla.

Pharmacists’ scope of practice has expanded and evolved in recent years, and Canada's pharmacists are doing more for their patients than ever before. Pharmacists in British Columbia, Saskatchewan and Ontario have seen their prescribing powers expand significantly this year — with Ontario further expanding the list of common ailments pharmacists can treat just a few weeks ago.

There is increasing evidence that better health outcomes are achieved when patients are able to access pharmacist-delivered health services. While all pharmacists across Canada currently have some level of prescribing authority, this varies greatly by jurisdiction. From both a cost and patient wellness perspective, the role of pharmacists in the health system is key. However, when red tape, jurisdictional complications and an increased workload prevent pharmacists from practicing to their full scope, patients don’t receive the best possible care.

Advocates across Canada are calling on governments and the broader health sector to not only recognize the essential role of pharmacists in the health system and utilize this valuable resource accordingly, but also to explore the innovative tools and resources that are rapidly becoming available to the pharmacy sector. By enabling innovation, pharmacists can be empowered to drive forward positive change in how Canadians access high-quality health care.

Joined by Sandra Hanna, CEO of the Neighbourhood Pharmacy Association of Canada, and Blair Laufman, Vice President of Medication Management Solutions at BD-Canada, we explore the evolution of pharmacists’ scope of practice and the role of technology within the sector.

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Sandra Hanna is the CEO of the Neighbourhood Pharmacy Association of Canada. Sandra is a graduate of the Faculty of Pharmacy at the University of Toronto, a practicing pharmacist, and has completed her masters in law and the ICD-Rotman Directors Education Program. She has served as CEO of Neighbourhood Pharmacies since 2019, after serving for two years as the Vice President, Pharmacy Affairs at the Association. Sandra is focused on helping to navigate the pharmacy industry through transformation while continuing to build strong, productive relationships with stakeholders. Prior to her role at Neighbourhood Pharmacies, Sandra’s counsel was sought by pharmacy retailers, manufacturers, and service providers in her capacity as Chief Innovation Officer at Gold Links Health Solutions. She continues to practice in an independent pharmacy in Guelph, Ontario and has a passion for innovation in health care.

Blair Laufman is the Vice President of the Medication Management Solutions (MMS) business unit at BD (Becton Dickinson and Company) Canada. Blair leads a customer-centric and innovative team focusing on the safety of medication delivery and management for better patient outcomes. Blair is responsible for driving and executing the MMS business strategy in Canada and overseeing the growth and P&L responsibilities for a category growing with recent mergers and acquisitions. Having joined BD in 2007, Blair has held several commercial roles in sales, business development and marketing with increasing scope and responsibilities. Blair holds an Honours Bachelor of Science in Biology from McMaster University and a Master of Business Administration from the Schulich School of Business at York University.

In February 2023, the Government of Canada announced it will increase health funding to the provinces and territories by $196.1 billion over the next 10 years. Included in this funding, in an effort to address Canada’s overdose crisis, is targeted support for mental health and substance use to ensure Canadians have equal access to “timely, equitable, and quality mental health, substance use, and addictions services.”

With rates of addiction rising across the country, community organizations like Addiction Services Central Ontario (ASCO) offer services including bed-based treatment slots, drop-in programs, peer support, counselling, case management, harm reduction and psychoeducation to those affected by addictions.

On International Overdose Awareness Day, the world’s largest annual campaign to end the overdose crisis and acknowledge those who are affected by addiction and overdose, Santis Health is proud to share this conversation with Penny Marrett, Executive Director of ASCO. We discuss the current state of addictions services in Ontario and across Canada, some of the challenges being faced today and the steps we can take together to strengthen the addictions sector.

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Penny Marrett is the Executive Director of Addiction Services Central Ontario (ASCO), a leading government funded clinical treatment provider for substance use, problem gambling and mental health concerns. 

Under Penny’s leadership, ASCO operates more than 13 programs from different locations in York Region, South Simcoe and North York, embracing a holistic, biological, psychological, social and spiritual approach to understanding addiction. This year, ASCO celebrates their 40th anniversary. Since 1983, the organization has served thousands of clients each year, providing a range of addiction and mental health programs and services, supports and referrals for adults, youth (12+) and their families. 

Over the span of her 40-year career in the not-for-profit sector, Penny has also been an active volunteer. Her volunteer experience has included serving a Board Member of Addictions and Mental Health Ontario, the Windsor Family Health Team, the National Youth Orchestra of Canada, the Trillium Chapter of the Canadian Society of Association Executive and the Canadian Soccer Association. She has also volunteered at Distress Centres of Greater Toronto and the Assaulted Women’s Helpline, among others.