Ontario Health Team Expressions of Interest

As expressions of interest from OHTs are submitted, they will be posted below for potential fellows to view. Please check back regularly for updates to this page.

OHT Name Location Project Summary Bilingual Need? Can Contact? Expression of Interest
Algoma OHT
Sault Ste Marie The Fellow will provide support to advance a standardized approach to performance measurement across the AOHT, as part of an effort to become a learning health system. To validate the approach, the Fellow will be tasked with working with one of two identified subpopulations:

  • Healthy Aging: Community-dwelling frail older adults and their caregivers
  • Chronic Disease Management: Higher users of hospital-based services with complex chronic conditions

As an evaluation expert supporting established teams, the Fellow will analyse newly collected data to segment the population, support prioritisation of community-based interventions, and facilitate performance measurement across organizational settings.

No Yes EOI
All Nations Health Partners
Kenora All Nations Health Partners are requesting a Fellow to create a streamlined process to collect accurate localized information of the ANHP attributed population that will inform a specifically implemented process to enable a quality improvement framework. Data will be collected by following the path of the patient through the diverse and unique healthcare systems that our community members access (inter-provincial MB/ON, indigenous and non-indigenous primary care, non-insured medical services, provincial and federal, and inter-ministerial systems). No Yes EOI
Brampton Etobicoke (BE) OHT Brampton, Bramalea, Malton,
Etobicoke, Woodbridge
The BE OHT is launching a population health management approach for the frail elderly population. You will have an unique opportunity to contribute to the BE OHT by:

  1. Developing, implementing and evaluating integrated care models for a chosen population segment within the frail elderly population, which includes rapid learning and improvement during implementation. The integrated care model should ensure the diverse population of the region is contemplated, measured and evaluated, including leveraging the OHT’s Diversity Framework.
  2. Creating and implementing an evaluation framework for current integrated care projects that can be adapted to future OHT projects.
No Yes EOI
Brantford Brant OHT Brantford and Brant County Two potential projects are proposed, both with an evaluation focus:

  1. Mental Health & Additions. The BBOHT is streamlining access to services and targeting care pathways in order to provide a more integrated system of care. We require expertise to support the design, iteration and evaluation of this change, with a focus on developing specific metrics that allow evaluation of quadruple aim.
  2. Homelessness. The BBOHT is working to better support persons experiencing homelessness. There is a particular focus on primary care, street outreach, connection with community based services and making every contact count. We require expertise to support the design, iteration and evaluation of this change.
No Yes

EOI #1

EOI #2

Burlington OHT Burlington System Navigation Project: Supporting patients, families and physicians in navigation to home & community-based services.
Goal: Progress toward the Ministry’s OHT milestone to provide 24/7 System Navigation to our Burlington OHT Priority Populations.
Approach: Apply proven models of system navigation functions, standards/frameworks, including people and technology solutions, within primary care setting.
Outcomes: Users of the system and primary care are provided an accessible method to access community-based supports and services, and they will have knowledge of and use this method . Using the quadruple aim framework focused on patient and provider experience (e.g. application of the new surveys from HSPN).
No Yes EOI
Chatham-Kent Ontario Health Team Chatham-Kent The overall aim of the fellow will be to lead a series of initiatives that contribute to the maturation of the CKOHT decision support and performance evaluation framework. The fellow will establish foundational decision support tools and processes such as the creation of its balanced scorecard, the inclusion of diversity and equity into its measurement framework, and the process for population segregation of the CKOHT priority population expansion. The fellow will work closely with the Strategy and Performance Working Group, and play a key leadership role in helping the CKOHT partners understand how to measure collective impact. No Yes EOI
Connected Care Halton Ontario Health Team
Halton Region The CCHOHT’s priority populations are Mental Health & Addictions, Palliative Care and Home and Community. Two potential projects are proposed for fellows. The first is to support the OHT’s Digital Health Working Group. The second is to support Mental Health & Addictions initiatives at the OHT. No Yes

EOI #1

EOI #2

Downtown East Toronto
Ontario Health Team
Toronto The DET-OHT Impact Fellow will work with the DET-OHT work group leads, including those of the digital work group, as well as community members using a community-based participatory approach to develop a process that ensures repeated measures of these client-reported indicators for participants of all initiatives. The project will start with the two initiatives that plan to have clients recruited during year one (MHA – Stepped Care Model Pilot and PEH – Emergency Department Outreach Worker Program) and will be designed to be scalable to other DET-OHT initiatives. No Yes EOI
Durham OHT Durham Region The Fellow will develop, implement and evaluate a performance and measurement framework for two priority populations: paediatric clients with complex care needs, older adults living with frailty, and individuals living with complex conditions. Initiatives tied to priority populations will be used as test cases to measure success and innovation. No Yes EOI
East Toronto Health Partners
Toronto The project focuses on helping ETHP OHT to create a learning health system and assess the impact of increased delivery of integrated care by building internal evaluation capacity, creating an OHT evaluation framework, and supporting decision making and KT. No Yes EOI
Frontenac Lennox and Addington OHT Kingston The primary goal for the fellow will be to support the co-design and implementation of the “Aging Well at Home” strategy, including the development of the evaluation framework for this priority population. The project focused on aging well at home aims to identify then address the needs of seniors from across our community. Design and implementation of this system must be done in partnership. We will work to integrate care and support services in ways that are meaningful to patients, families and providers. No Yes EOI
Guelph and Area OHT Guelph A foundation of the Guelph and Area OHT is the Integrated Primary Care Team (IPCT). The IPCT model builds on the already high performing and highly organized primary care services in our community. We are currently launching 3 IPCT pilot sites with a plan to spread to six additional sites in the next year. Within this strategic priority, we are prioritizing patients with mental health and addictions, chronic disease and/or palliative care needs as well as those requiring in-home care. We are seeking the support of a fellow to support evaluation of this primary-care led, relationship-based, population health-focused integrated care model. No Yes EOI
Hills of Headwaters Collaborative Ontario Health Team Dufferin Caledon This project will involve the development of the Hills of Headwaters Collaborative’s performance measurement framework, which will include a strategy map and logic model that will be used to showcase our value and the impact of the OHT model. Further, we are looking for leadership and support in developing our Collaborative Quality Improvement Plan (cQIP). It is expected that this work is done using a co-design and co-creation approach in collaboration with our partners, stakeholders, and investor groups. Finally, to ensure the sustainability of this work, the latter portion of this fellowship opportunity will focus on training and capacity-building initiatives. No Yes EOI
Huron Perth and Area
Ontario Health Team
Huron, Perth, Stratford Looking for an enthusiastic fellow to support the use of a population health management approach and the tools required to do this across all OHT sectors. Must be passionate about analytics/decision making, evaluation, building relationships and striving for excellence! No Yes EOI
KW4 OHT Kitchener, Waterloo, Wellesley,
Wilmot, Woolwich
Serve as key support to the overall Strategic Plan leader. Lead the environmental scan process through research and data analysis and participate as a team member in stakeholder engagement sessions to inform the development of a 5-year strategic plan.  Then with an understanding of care pathways, unmet care needs and service delivery gaps in a couple of focused areas, participate as a team member to begin to implement and evaluate change. No Yes EOI
Lanark, Leeds and Grenville OHT Lanark, Leeds and Grenville Counties The OHT is seeking the assistance of a fellow to develop and begin implementation of a digital strategic roadmap that will create and optimize digital health across the local system. The OHT is also seeking assistance to develop a plan to leverage both digital assets and information to build an effective management system to assist in the monitoring, performance management, data analytics and evaluation of the OHT. No Yes EOI
Mid-West Toronto Ontario Health Team
Toronto The MWT-OHT is seeking a dedicated, experienced health quality researcher to assemble diverse stakeholders in development of its Collaborative Quality Improvement Plan (cQIP). This Impact Fellow will work closely with the MWT-OHT’s partners and people with lived experience in defining quality metrics and goals against which the MWT-OHT’s work will be assessed. The Impact Fellow will be responsible for robust data analysis and qualitative engagement in the development of their final deliverable, the cQIP, due June 2022. The Impact Fellow will also be instrumental in developing the MWT-OHT’s internal capacity to continue evaluation and quality improvement initiatives into the future. No Yes EOI
Mississauga Ontario Health Team Mississauga Our vision is to improve the health of people in our community by creating an interconnected system of care across the continuum, from prenatal care to birth to end of life. To help achieve this vision, there are two priority areas where we would benefit from a fellow’s leadership and expertise:

  1. Advance our partnership and engagement with OHT partners through the development of new strategies to involve members beyond our governing body and through the implementation and continuous improvement of existing strategies (e.g., primary care engagement).
  2. Evaluation of our priority populations and care models to progress our work in population-health management. This would include data analysis and evaluation of our population needs, risks and barriers and our care models to surface insights and to inform continuous improvement.
No Yes EOI
Muskoka and Area
Ontario Health Team
Muskoka The MAOHT has a group of highly motivated and committed partners who have identified improving digital assets and use of information technology as a key enabler to improve care and integration. MAOHT is proposing four potential projects:

  1. Digital Strategy
  2. Population Health Management
  3. Hospital to Home
  4. Medication Reconciliation

Depending on the fellow’s interest and skills, they could choose to work on any of these projects.

No Yes

EOI #1

EOI #2

EOI #3

EOI #4

Niagara Ontario Health Team
Équipe Santé Ontario Niagara
Niagara The project will include two parts: 1) using administrative data from Integrated Decision Support (IDS) Business Intelligence Solution and locally collected data, the fellow will gain a better understanding of the care pathways currently in existence and will identify unmet needs and service delivery gaps experienced by the five Year 1 populations, and 2) focusing on Indigenous and Francophone priority populations,  the fellow will assist with developing and implementing indicators and data collection methodologies across the five Year 1 populations to advance measurement for the priority populations. Yes Yes EOI
North Toronto OHT Toronto The fellow will analyze primary care clinic rosters to determine need for inter-professional staff support and classify clinics into either high/rising/low/no need for each particular type of support. Using this data, the fellow will support the creation of relationship-based teams with co-location or regularly scheduled virtual support once weekly (high-needs practices), 1-2 times per month (rising-needs practices), or on an as-needed basis (low-needs practices). No Yes EOI
North Western Toronto OHT Toronto The North Western Toronto OHT is seeking expertise from a Fellow to support planning, implementation and/or evaluation of integrated service models for our MHA priority populations. Our priority populations include individuals with psychotic disorders and repeat hospital admissions (Year 1) and individuals with substance use disorders and repeat emergency department visits (Year 2). The opportunity involves supporting the evaluation of the service model for our Year 1 population (currently implemented) and supporting the development, implementation and evaluation of a service model for our Year 2 population. Additionally, the Fellow would support implementation and evaluation of quality standards for both populations. No Yes EOI
North York Toronto Health Partners
North York NYTHP is seeking a post-doctoral fellow to use process evaluation methodology to study the implementation and evolution of North York CARES. CARES is focused on providing increased service offerings for patients deemed to need alternate levels of care (ALC) to live safe and supported in the community, especially during the COVID pandemic. We feel this is a rare and ideal “natural experiment” which we can use to learn about how these new models of integrated care are implemented and how evaluation can support a learning health system paradigm for future scale and spread across Ontario. No Yes EOI
Northumberland OHT Northumberland County We are proposing a program of work focused on our rural and vulnerable population and rural outreach. The nature of this work is to include: (a) Understanding our rural population and recommending a population health strategy (including demographics, health & social indicators, service maps, identify gaps, environmental scan of comparative communities and leading practices); (b) Further implementation, spread and evaluation of the OHT-N Outreach model based on population health data, targeting the rural and underserved. No Yes EOI
Ottawa Health Team –
Équipe Santé Ottawa
Ottawa We are looking for an OHT Impact Fellow to lead the development of a data-driven population health management plan for our attributed population, with a strong focus on health equity. This plan will support decision-making and growth within the OHT with the goal of maximizing short-term impact, while laying the groundwork for a long-term overall strategic plan and sustainable change that meaningfully addresses health inequities within our community. Yes Yes EOI
Rainy River District Ontario Health Team (RRDOHT) Rainy River District The Fellow will be expected to be fully immersed in the operations of the RRDOHT from getting to know the individual and group dynamics of members, supporting all meetings, and helping establish the councils. System mapping and development of Data Framework are key deliverables to help establish our baseline data. The Fellow is coming at a good time in our OHT development as there will be significant work in helping develop our branding, social media presence and RRDOHT processes. Development of robust performance metrics is another key work pillar for this project. No Yes EOI
Scarborough Ontario Health Team (SOHT) Scarborough This project focuses on Scarborough’s frail seniors living with MHA challenges. Scarborough OHT is asking for help to: 1) map ‘current state’ MHA services for seniors in Scarborough, 2) identify gaps/improvement opportunities through analysis of the ‘current state’ and through engagement with healthcare and support providers, clients and families/caregivers; 3) research ‘best practice’ models of care; and 4) lead us through defining, implementing and evaluating rapid cycle tests of change. SOHT has an MHA Table representing Scarborough’s MHA service providers and a Client Family Advisory Committee. We are committed to improvement and a successful year. No Yes EOI
South Georgian Bay
Ontario Health Team
Collingwood The SGB OHT is seeking a fellow’s expertise to advance the development of innovative and equitable health system digital advancements, co-designed with patients, families, and caregivers. The fellow will have the opportunity to co-lead the implementation, monitoring and evaluation of this project and explore opportunities to expand it regionally. No Yes EOI
Western Ontario Health Team
London and Middlesex County The fellow will be engaged in the design of an evaluation framework and performance measurement plan with a focus on primary care engagement strategies that aligns with the WOHT’s commitment to a Health Equity-Driven Quadruple Aim. Working with our OHT team, local stakeholders (including patients/clients, caregivers, and providers), and local researchers, the fellow will select an area of the Framework or Plan that aligns with their personal interests and goals; for which they will be responsible. The fellow will engage in integrated knowledge translation and co-design throughout the duration of the fellowship, with opportunities to present and publish work. No Yes EOI
Western York Region Ontario Health Team
Richmond Hill, Vaughan, King The WYR OHT is focusing on the growing seniors population of medically complex older adults as our priority for integrated care and are considering people with mental health needs in our expanded scope. We have three early integration projects with data available for analysis and evaluation. These projects support the goal of seniors remaining healthy in place longer through coordinated care and patient engagement that is digitally enabled and sustained across providers. The focus of this role will be to evaluate our integration projects that support frail seniors and make recommendations that will inform the broader expansion of related projects. No Yes EOI

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