Complex care clinic for kids a first in northern Ontario

CHEO expertise coordinates with Timmins care providers to improve care for most vulnerable children and their families

Timmins and Ottawa, ON — Lydia Allard sings, talks and signs, but the two-year-old from Timmins whose mother describes her as silly and incredibly patient has a rare condition making it impossible to lift her limbs and head. She also can’t roll over on her own. To move against gravity, Lydia is dependent on others, primarily her parents Megan and Tyler. She needs 24-hour care.

Lydia and her parents are among the first Timmins-area families to benefit from a new clinic for medically complex and fragile children. Run out of the Cochrane Temiskaming Children’s Treatment Centre with many care providers in Timmins and Ottawa’s Children’s Hospital of Eastern Ontario – Ottawa Children’s Treatment Centre (CHEO – OCTC), the Timmins Complex Care Clinic works to coordinate her care team, with Lydia and her parents at the centre.

“This clinic creates an open conversation between CHEO and Timmins,” said Megan Allard, Lydia’s mom, full-time caregiver and manager. “Timmins is our home, but CHEO’s our second home, and it’s very important that everyone is informed and well-versed in Lydia’s ever-changing condition. The clinic bridges the gaps and chances of missing something, or not being able to get a hold of somebody for answers.”

Joining the Allard’s complex care team is Karen Morris, a nurse practitioner from CHEO – OCTC’s Complex Care Program who leads the clinic’s assessments and consultations with all the local and Ottawa providers, calling upon specialist physicians when required.

“Karen will come down and have eyes on Lydia, assess her physically and then return with the questions we have, speak to the right people and get the answers we need,” said Allard. “It just makes it easier because it takes a lot of the work off us.”

That’s something Morris and all the partners involved in this clinic want to hear.

“Families like Lydia’s face extraordinary pressures and have to navigate so many providers and systems just to care for their children on a day-to-day basis,” said Morris. “By coordinating her medical care and working with all of Lydia’s health-care providers in Timmins and Ottawa, we are making their lives easier and improving care.”

In addition to making lives easier, everyone involved anticipates the Timmins Complex Care Clinic will reduce the number of days in hospital and the need for visits to Emergency. Over the last three years, children seen in the clinic of CHEO – OCTC’s Complex Care Program in Ottawa have spent less time in hospital by an average of a full month (30 days) every year and have had 42% fewer visits to the Emergency Department.

Morris travels to Timmins as needed, especially when bringing families into the program, but the CHEO – OCTC specialists are consulted using the Ontario Telehealth Network, bringing their expertise closer to home for the Allards.

On the flip side, the Allards hope the Timmins Complex Care Clinic will reduce the number of trips they need to make to Ottawa, although they will still travel to CHEO – OCTC to see Lydia’s specialists twice a year. Yet, any reduction would be significant. The family’s trips to Ottawa are emotionally, organizationally and financially taxing. Lydia, Megan and another family member travel to Ottawa by Ornge. Tyler follows by car with all the necessary equipment. Each trip is a week long and means Tyler has to take time off. Then there are hotel and meal costs, plus the stress of travelling.

“This is an outstanding collaboration between all the partners to best meet the needs of children who are medically complex and technologically dependent,” said Dr. Gary Smith, pediatrician and Clinical Chief of Pediatrics and Neonatal Medicine at Timmins and District Hospital, who along with pediatrician Dr. Willem Verbeek helped bring this complex care clinic to northern Ontario.

This clinic is only possible because of the great collaboration among the partners who want to improve care for children and youth with complex medical conditions in Ontario’s north. They are:

• Children’s Hospital of Eastern Ontario – Ottawa Children’s Treatment Centre (CHEO – OCTC)
• Cochrane Temiskaming Children’s Treatment Centre (CTCTC)
• North East LHIN
• pediatricians from Timmins
• Provincial Council for Maternal and Child Health (PCMCH)
• Timmins and District Hospital

Children with medical complexity and fragility in Canada account for less than 1% of the pediatric population, and yet use about one-third of pediatric health resources, account for 10% of hospital admissions and one-quarter of hospital days. (Source)

Partner quotations 

“I’m so pleased that we are able to work with our partners in Timmins to improve the model of care for this most vulnerable group of patients and their families by bringing CHEO – OCTC’s expertise in complex care closer to families like Lydia’s in Ontario’s north. ”
—Alex Munter, President and CEO, Children’s Hospital of Eastern Ontario – Ottawa Children’s Treatment Centre (CHEO – OCTC)

“We are thrilled to host this clinic and partner to bring together expertise so that families of children with complex medical conditions can feel, see and experience the connection between their child’s care team at home and in Ottawa.”
—Marie Rouleau, Executive Director, Cochrane Temiskaming Children’s Treatment Centre (CTCTC)

“The joint efforts of all the partners involved will provide timely access to the care needs of these very special children within our district and provide support for the clinical staff providing the care.”
—Debbie Cecconi, Corporate Clinical Educator, Timmins and District Hospital

“Our North East LHIN team is working with many health care partners to wrap care around medically complex and fragile children like Lydia and her family so that they don’t need to spend time in the emergency department and can reduce their costly travel for specialist services. We know the heroic efforts these families are making and, as a LHIN, we are working on ways to bring care closer to home for them. We will continue to work with partners to bring complex care clinics for kids to Northeastern Ontario communities.”
—Kate Fyfe, Interim CEO, North East Local Health Integration Network (LHIN)

“The Complex Care for Kids Ontario initiative operationalizes key principles of the Ministry of Health and Long-Term Care's Patients First strategy. Specifically, the implementation of the model, as demonstrated by the partnerships supporting the Timmins Clinic, a satellite of CHEO, supports improved access to coordinated and integrated care closer to home for some of the most complex pediatric patients in Ontario and their families.”
—Roxana Sultan, Executive Director, Provincial Council for Maternal and Child Health

Media contacts

CHEO – OCTC
Paddy Moore
o. 613-737-7600 ext. 3536
m. 613-769-5553
pmoore@cheo.on.ca

Cochrane Temiskaming Children’s Treatment Centre
Denise Osipenko/Marie Rouleau
o. 705-264-4700 ext.239 / 705-264-4700 ext.245 
m. 705-365-8336 / 705-363-0645
denise.osipenko@ctctc.org 
marie.rouleau@ctctc.org

About CHEO – OCTC

The Children’s Hospital of Eastern Ontario – Ottawa Children’s Treatment Centre (CHEO –OCTC) is the leading provider of specialized pediatric health services in Canada's capital. CHEO’s programs help over 500,000 children and youth each year in Eastern Ontario, Western Quebec, Nunavut and parts of Northern Ontario. As a world-class research centre and teaching hospital, for over 40 years CHEO has changed young lives in our community, while our innovations change young lives around the world. For more than 65 years, OCTC has been providing specialized care for children and youth with disabilities, including cerebral palsy, complex needs associated with congenital conditions, developmental delay, autism spectrum disorders and brain injury. The two previously separate organizations recently joined forces to become one organization, stronger together for kids and families.

About Cochrane Temiskaming Children’s Treatment Centre

The Cochrane Temiskaming Children’s Treatment Centre serves children and youth with various physical, development, and communication challenges who reside in the districts of Cochrane and Temiskaming as well as those who live in the communities of Moosonee and Moose Factory in the James Bay area. Using a family-centered approach, we deliver rehabilitation and supportive services in occupational therapy, physiotherapy, speech-language therapy, social work and therapeutic recreation through individual and group sessions, programs and clinics in Centre offices, homes, schools and other community settings.