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During Nursing Week the Registered Nurses Association of Ontario share plan to give a system reform direction, via ECCO … 3.0 report. 

Just what the Nightingale’s ordered for the emerging health teams approach in the age of Covid.

“My view you know is that the ultimate destination is the nursing of the sick in their own homes…I look to the abolition of all hospitals and workhouse infirmaries. But it is no use to talk about the year 2000.”

Florence Nightingale, 1867


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“What is ECCO?

Enhancing Community Care for Ontarians (ECCO) calls on government and health system partners to strengthen community care and anchor the health system in primary care to better meet the health needs of all Ontarians. First released in 2012 and next in 2014, ECCO 3.0 aligns with much needed health system transformation that responds to the COVID-19 pandemic.

See the report here


... The critical question – which has been asked since the release of ECCO 1.0 in 2012 – is whether the government will strengthen community care and establish primary care as the anchor of our health system, locating the care co-ordination role within it. Doing so is a marker of any high performing health system, and is central to improving access, equity and integration while providing person-centred care that delivers optimal health outcomes. ... 

... COVID-19 also revealed a health system in Ontario that relies excessively on hospital care and neglects other sectors until it’s too late. Public health units performed unevenly and inconsistently. Primary care offices remained mostly closed. Home health care received little attention. And nursing homes and retirement homes received vigourous attention only after 500 lives had been lost. Outbreaks in shelters, correctional facilities, and Indigenous communities are only now being identified as we write this report. Our summary position is that Ontario’s overall performance during COVID-19 calls for speeding up the formation of OHTs, with a clear mandate of full and urgent integration of all sectors and populations. ...



I am fired up by this work of the RNAO that builds on the numerous reports and initiatives by organizations to move out of silos, yet... not really. That includes myself as a clinician in everyday practice.  As a front line worker, the policy and system change directions are difficult to understand how they would be implemented. 

What are the gains and losses of such whole system approaches to the local systems, if we value the local? It would be useful to hear from actual managers, systems planners, patient/client, family caregivers seeking reforms through the often framed mechanism called - co-design.



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Last edited by Registered Member
Original Post

The financing and organization of home care services must be adapted to 21st century realities, with a long-term care public insurance established.

by Réjean Hébert

... The Canadian care system and the Canada Health Act have placed hospitals at the heart of the health response. While this choice was justified in the last century to meet the needs of a younger population, it is much less appropriate today in a context of an aging population with chronic diseases and disabilities. ...

See the article here:

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