Dr. Anne Wojtak is a senior manager with 20 years’ experience in the home and community care sector. Her expertise includes corporate strategy and organizational performance as well as health system policy, risk management, quality improvement, team leadership, and communications. She is an adjunct faculty member of the University of Toronto in the Health Policy, Management, and Evaluation (HPME) Program where she is a guest lecturer on Strategic Planning, Performance Measurement, and a tutor for Canada’s Health System and Health Policy course.
Dr. Wojtak has a Doctorate in Health Leadership from the University of North Carolina at Chapel Hill, a Masters of Health Science (Health Administration) from the University of Toronto and a Bachelor of Science (Honours Biology) from the University of Western Ontario. Her doctoral research focused on evaluating the effectiveness of public reporting of health performance information on quality of care.
During the last few years, the community health sector has been hit particularly hard by the scar... more During the last few years, the community health sector has been hit particularly hard by the scarcity of qualified healthcare workers. The Toronto Community Care Access Centre and community health centres of Toronto collaborated on a research program focusing on the development of a sectoral response to the human resource issues affecting the recruitment and retention of workers. Our approach
As the research evidence on integrated care has evolved over the past two decades, so too has the... more As the research evidence on integrated care has evolved over the past two decades, so too has the critical role leaders have for the implementation, effectiveness and sustainability of integrated care. This paper explores what it means to be an effective leader of integrated care initiatives by drawing from the experiences of a leadership team in implementing an award-winning integrated care program in Toronto, Canada. Lessons learned are described and assessed against existing theory and research to identify which skills and behaviours facilitate effective leadership of integrated care initiatives.
Traditional home care delivery involves executing tasks for clients within a limited timeframe. F... more Traditional home care delivery involves executing tasks for clients within a limited timeframe. Five years ago, when surveys of clients of Toronto Central Community Care Access Centre (TC CCAC) showed the lowest client experience levels across the 14 CCACs in Ontario, TC CCAC and its contracted Service Provider Organizations developed and implemented Changing the Conversation, a philosophy and framework that focuses on asking clients "what is most important" to them and then using that information as the basis for how care is delivered. Changing the Conversation has made a measurable difference to clients' experiences and has now expanded to other parts of the province and the country. It has been recognized as a Leading Practice by Accreditation Canada.
In this era of primary-care reform, family physicians are being encouraged to work in teams with ... more In this era of primary-care reform, family physicians are being encouraged to work in teams with allied health professionals and community resources, including home care services, to ensure optimum care is provided to their patients. To learn about the experiences of physicians working with home care services as provided by the Toronto Community Care Access Centre. In early 2001, the Toronto Community Care Access Centre (CCAC) hosted focus groups designed to understand physicians' knowledge of and experiences with the home care services provided by our organization. Data analysis was conducted using grounded theory methodology. Three themes emerged: (1) family physicians have a limited understanding of home care services; (2) family physicians felt there were inconsistencies related to service provision by CCAC staff; and (3) family physicians felt that their role may not be valued when caring for mutual clients with CCACs. Better educational interventions informing physicians on CCAC services and improved organizational practices by CCACs may aid in improving the connection between family physicians and CCACs.
Now more than ever, healthcare funders are weighing options to drive better value in care deliver... more Now more than ever, healthcare funders are weighing options to drive better value in care delivery, including using bundled payments to compensate healthcare providers based on expected costs to achieve specific health outcomes for patients. Ontario is currently exploring options for expanding bundled payment beyond acute care to home care, primary care, long-term care and across the continuum of care. This paper reviews the evidence, including the Ontario experience with bundled payment, and identifies opportunities for advancing bundled payment in home care as well as with other sectors. The authors consider the most promising opportunities, offer perspectives on where to start and identify the critical success factors. They conclude that is unlikely that payment reform on its own would be sufficient to drive changes in care delivery across providers. Instead, the evidence from the review points to the need to shift the conversation on bundled payment to a larger strategy for inte...
Mandated public reporting on health care performance at the level of individual health care insti... more Mandated public reporting on health care performance at the level of individual health care institutions and providers has been in place in most Western countries for at least three decades. The capacity to evaluate and report on quality of care is widely regarded as critical for system-wide improvement of health care delivery and patient health outcomes. However, evidence from the literature indicates that evaluation of the effectiveness of public reporting is scant. The purpose of this research is to propose an approach to evaluate the impact of third-party public reporting on improving quality of health care in the province of Ontario, Canada. Starting with the research question ‘How can we evaluate and enhance the impact of third-party public reporting on quality improvement for health care’, the researcher used an explanatory sequential mixed-methods design to assess the current state of public reporting in Ontario and identify opportunities to improve its effectiveness for quality improvement. Through analysis of provincial-level publicly-reported measures, the researcher found that performance results are improving for about one-third of the measures; however, where public reporting is combined with other accountability mechanisms, such as funding agreements or legislation, there is greater indication of improvement and/or sustained improvement over time. The researcher concluded that there is insufficient evidence that public reporting improves health care quality; however, public reporting can be effective when bundled with other improvement mechanisms. The researcher identified a number of opportunities to improve the effectiveness of public reporting in Ontario based on literature evidence and the research findings. The findings may be applicable to Canada as a whole and to other countries that have nationalized health care or any large-scale health system.
During the last few years, the community health sector has been hit particularly hard by the scar... more During the last few years, the community health sector has been hit particularly hard by the scarcity of qualified healthcare workers. The Toronto Community Care Access Centre and community health centres of Toronto collaborated on a research program focusing on the development of a sectoral response to the human resource issues affecting the recruitment and retention of workers. Our approach
As the research evidence on integrated care has evolved over the past two decades, so too has the... more As the research evidence on integrated care has evolved over the past two decades, so too has the critical role leaders have for the implementation, effectiveness and sustainability of integrated care. This paper explores what it means to be an effective leader of integrated care initiatives by drawing from the experiences of a leadership team in implementing an award-winning integrated care program in Toronto, Canada. Lessons learned are described and assessed against existing theory and research to identify which skills and behaviours facilitate effective leadership of integrated care initiatives.
Traditional home care delivery involves executing tasks for clients within a limited timeframe. F... more Traditional home care delivery involves executing tasks for clients within a limited timeframe. Five years ago, when surveys of clients of Toronto Central Community Care Access Centre (TC CCAC) showed the lowest client experience levels across the 14 CCACs in Ontario, TC CCAC and its contracted Service Provider Organizations developed and implemented Changing the Conversation, a philosophy and framework that focuses on asking clients "what is most important" to them and then using that information as the basis for how care is delivered. Changing the Conversation has made a measurable difference to clients' experiences and has now expanded to other parts of the province and the country. It has been recognized as a Leading Practice by Accreditation Canada.
In this era of primary-care reform, family physicians are being encouraged to work in teams with ... more In this era of primary-care reform, family physicians are being encouraged to work in teams with allied health professionals and community resources, including home care services, to ensure optimum care is provided to their patients. To learn about the experiences of physicians working with home care services as provided by the Toronto Community Care Access Centre. In early 2001, the Toronto Community Care Access Centre (CCAC) hosted focus groups designed to understand physicians' knowledge of and experiences with the home care services provided by our organization. Data analysis was conducted using grounded theory methodology. Three themes emerged: (1) family physicians have a limited understanding of home care services; (2) family physicians felt there were inconsistencies related to service provision by CCAC staff; and (3) family physicians felt that their role may not be valued when caring for mutual clients with CCACs. Better educational interventions informing physicians on CCAC services and improved organizational practices by CCACs may aid in improving the connection between family physicians and CCACs.
Now more than ever, healthcare funders are weighing options to drive better value in care deliver... more Now more than ever, healthcare funders are weighing options to drive better value in care delivery, including using bundled payments to compensate healthcare providers based on expected costs to achieve specific health outcomes for patients. Ontario is currently exploring options for expanding bundled payment beyond acute care to home care, primary care, long-term care and across the continuum of care. This paper reviews the evidence, including the Ontario experience with bundled payment, and identifies opportunities for advancing bundled payment in home care as well as with other sectors. The authors consider the most promising opportunities, offer perspectives on where to start and identify the critical success factors. They conclude that is unlikely that payment reform on its own would be sufficient to drive changes in care delivery across providers. Instead, the evidence from the review points to the need to shift the conversation on bundled payment to a larger strategy for inte...
Mandated public reporting on health care performance at the level of individual health care insti... more Mandated public reporting on health care performance at the level of individual health care institutions and providers has been in place in most Western countries for at least three decades. The capacity to evaluate and report on quality of care is widely regarded as critical for system-wide improvement of health care delivery and patient health outcomes. However, evidence from the literature indicates that evaluation of the effectiveness of public reporting is scant. The purpose of this research is to propose an approach to evaluate the impact of third-party public reporting on improving quality of health care in the province of Ontario, Canada. Starting with the research question ‘How can we evaluate and enhance the impact of third-party public reporting on quality improvement for health care’, the researcher used an explanatory sequential mixed-methods design to assess the current state of public reporting in Ontario and identify opportunities to improve its effectiveness for quality improvement. Through analysis of provincial-level publicly-reported measures, the researcher found that performance results are improving for about one-third of the measures; however, where public reporting is combined with other accountability mechanisms, such as funding agreements or legislation, there is greater indication of improvement and/or sustained improvement over time. The researcher concluded that there is insufficient evidence that public reporting improves health care quality; however, public reporting can be effective when bundled with other improvement mechanisms. The researcher identified a number of opportunities to improve the effectiveness of public reporting in Ontario based on literature evidence and the research findings. The findings may be applicable to Canada as a whole and to other countries that have nationalized health care or any large-scale health system.
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