1. Implementation of a substance use NBP model in a Northern Region of Ontario- results and lessons learned
NBP was implemented in Northeastern Ontario, Canada a region with severe substance use challenges; a poor understanding of the required capacity of services in relation to overall community needs; and the reality of a diverse largely uncoordinated system of hospital and community-based services across urban, rural and remote community contexts.
The approach included stakeholder engagement; establishing the geographic boundaries, gathering population data and contextual description; estimating population level of need by severity; estimating level of need for pre-designated core services and through a systematic system mapping contrasting to current service supply and utilization. Discrepanices between the ideal and current system capacity were summarized and implications identified. System planners and service providers were engaged in all steps.
Both significant gaps and surpluses were identified with poor diversification along the continuum of care. Assumptions related to the ideal level of coverage (i.e., help seeking) challenged interpretation for some stakeholders, particularly service providers. System planners were able to reallocate $1.2 million dollars in surplus services to supplement the continuum of care for Withdrawal Management Services with an In-Home/Mobile WMS.
Service providers play an important role in implementation of NBP through context description, securing and validating the data, and aiding in interpretation. Through NBP system planners had more confidence in resource decisions, in particular re-allocations. Results also provided a longerterm roadmap to prioritize investments as new funding comes available. This evidence-based approach advances local planning and creates a more equitable balance of resources.