Français Links Search Contact Us
Home CHCA on the Issues
Access to Care
Caregivers (Carers)
Dementia / Alzheimer's Disease
Human Resources
Information Technology
Pediatric Home Care
Person Centred Care
Quality End of Life Care
Rural Home Care
Safety at Home
Am I Safe?
Wound Care


 Follow us on Twitter





CHCA on the Issues - Integration

Facilitating Collaboration and Integrated Care

Home Care Lens Tools

The Home Care Lens Tool (HCL Tool)  is a decision support tool that will support planning activities and program / model development.  Through the use of the HCL Tool, policy planners and program managers will have access to a guideline that poses a series of critical questions that address key issues and challenges facing the home and continuing care sector.  The HCL Tool will support policy options and increase understanding of the unique dynamics and context of providing care in the community.

The Home Care Lens Tool will help achieve the CHCA’s vision of an integrated system that provides accessible, responsive services which enable people to safely stay in their homes with dignity and independence and quality of life.  Specifically, it will: 

  • Increase awareness and understanding of the home care sector’s capacity and capabilities within an integrated health care system.
  • Provide a tool to facilitate collaboration and joint planning for integrated models of care including home care.
  • Support the goal of delivering the right care in the right place at the right time.

Learn more about the Home Care Policy Lens


Integration Report 2012

Health Systems Integration

Synthesis Report

A synthesis of the current body of research on the integration of health systems in the context of home care including key elements of integration and models of integrated care involving home care and various parts of the health system including: primary health care, acute care, chronic care, palliative care and paediatrics.   



Home Care Integration

Alignment of Home Care with Other Health Care Sectors

Believing that there is enormous value in sharing knowledge and experience as a catalyst to further action, the CHCA undertook, with funding from Health Canada, to increase awareness, uptake and implementation of integration models involving home care and other health care sectors in communities across Canada.  


Through stakeholder surveys and interactive workshops, a number of home care related integration initiatives were identified and explored.  Participants shared thoughts about how to sustain their projects and transform the health system to one where there is a shared accountability (both fiscal and clinical) for the outcomes of the population served. 


This report is a summation of the observations and findings arising from the project. 




Integration Workshops

Materials presented at the CHCA sponsored Integration Workshops held in March 2008

  Presentation by Integration Coach Carol Slauenwhite 
  Presentation by Integration Coach Mike Hindmarsh
  Presentation by Integration Coach Dr. George Southey

Tools Introduced at the Integration Workshop


Chronic Care Model

This model was originally developed by Dr. Ed Wagner at the MacColl Institute for Healthcare Innovation (Seattle).  It was based on the growing recognition worldwide that chronic disease management needs greater attention due to increasing prevalence of chronic disease in an aging (and longer living) population.

  Click here to download the Chronic Care Model



Plan-Do-Study-Act (PDSA)

The Plan-Do-Study-Act (PDSA) cycle was developed by W. Edwards Deming and it used to test and implement changes in real work settings. The PDSA cycle guides the test of a change to determine if the change is an improvement.


  PDSA Model – Presentation (Institute for Healthcare Improvement)


  PDSA Concept Worksheet for Learning and Improvement


  PDSA Worksheet for Testing Change (Calgary Health Region) 


Partnership Project - Outcomes Report

Home Care & Primary Health Care Integration

CHCA Partnerships in Practice Outcomes Report

The CHCA Partnership Project showed that by taking two key strategies within home care, we can create a new approach to care integration. The two new directions are:


1.      Aligning home care case managers with primary health teams / family physicians through partnership, thereby creating health teams who are uniquely equipped to provide optimal patient care.


2.      Expanding the role and scope of home care in chronic disease management, so home care can serve a broader upstream population, including a focus on health promotion.



Click here to download the report









Last Updated: 2015 11 11