A vision for ophthalmology services in Central LHIN

Central LHIN’s local vision care strategy for ophthalmology services was developed in April 2014, and is aligned with the provincial vision strategy recommendations to have an integrated ophthalmology service delivery model that follows best practices, and creates greater efficiencies and better quality. Central LHIN’s vision care strategy focuses on three components: maintaining current integrated ophthalmology service delivery model of two regional high-volume eye care centers; exploring the expansion of current levels of specialty eye surgeries such as glaucoma, corneal transplant and strabismus; and standardizing the process to manage emergency ophthalmology cases. As described in the vision plan:  

  • Central LHIN is engaging and working with leading ophthalmologists, hospitals and ophthalmology service providers to provide high quality, accessible, timely and cost-efficient ophthalmology services for our residents.
  • Central LHIN has a well-established infrastructure in place through two high functioning, high volume centres (North York General Hospital and Southlake Regional Health Centre) to provide low-risk eye surgeries, including all cataract procedures. In 2014-15, for example, over 11,000 cataract procedures were performed by the two Eye Care Centres with each site ranked within the top ten provincial performers for volumes. In 2014-15, North York General Hospital and Southlake Regional Health Centre together performed almost 91% of all the cataracts procedures in our LHIN. 
  • Since implemented in 2010, the two high volume centres have realized significant efficiencies, reduced ophthalmology wait times across Central LHIN and reported excellent patient satisfaction results. As a result of the cataract consolidation at the two high-volume centres, the wait time for cataract surgery in Central LHIN in 2014-15 was 92 days – that’s 69 days less than the provincial wait time. 
  • In alignment with the provincial strategy, the decision to transfer ophthalmology services to one of the two high-volume eye care centres is a hospital decision, which must only be made once their communities and stakeholders have been consulted. 
  • Central LHIN’s integrated ophthalmology service delivery model is referred to as a “best practice” model by the Ministry of Health and Long-Term Care. 
  • A key component of the vision care strategy is to expand specialty surgeries such as glaucoma, corneal transplants and strabismus within the next three to five years. 

About the provincial vision strategy

The Provincial Vision Strategy Task Force released its “A Vision for Ontario – Strategic Recommendations for Ophthalmology in Ontario” report on May 31, 2013. Central LHIN’s vision strategy was refreshed using the same considerations and findings as the provincial framework to ensure alignment.

About the two regional high volume Eye Care Centres

Since 2007, Central LHIN has been proactively planning with our health service providers to develop an integrated ophthalmology service delivery model that focuses on excellent patient outcomes, ease of access and maximum patient satisfaction. The Central LHIN strategy is aligned with the Provincial Vision Strategy Task Force’s recommendations to shift routine low risk eye procedures to an ambulatory model, and Central LHIN hospitals have worked collaboratively to create two regional high volume Eye Care Centers:

  • The north site at Southlake Regional Health Centre
  • The south site at the Branson site of North York General

Endorsed by the Central LHIN and managed through an Eye Care Committee, participating hospitals transferred base budgets to consolidate eye surgeries in 2010. These state-of-the-art high volume Eye Care Centres operate as ambulatory care centers, providing cataract surgeries as their primary surgical procedures. The centers have adopted a model of care delivery designed to reduce wait times and use the most advanced technology to achieve the best possible patient outcomes. Service excellence at both sites is delivered by experienced ophthalmic surgeons and anesthesiologists, and highly-trained teams of nurses, anesthesia assistants and support staff. Both sites perform cataract surgeries at or below the Quality Based Procedure pricing as established by the Ministry of Health and Long-Term Care.

The Central LHIN and Central LHIN hospitals are exploring the transfer of the remainder of a small volume of cataract surgeries at one non-participating Central LHIN small hospital and a low volume of specialty eye procedures to these centres.