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Canadian Respiratory Journal
Volume 2016, Article ID 3185389, 10 pages
Research Article

Building a Comprehensive System of Services to Support Adults Living with Long-Term Mechanical Ventilation

1Respirology/Critical Care, London Health Sciences Centre and Western University, London, ON, Canada N6A 5A5
2London Health Sciences Centre and St. Joseph’s Health Care London, London, ON, Canada N6A 5A5

Received 13 July 2015; Accepted 27 August 2015

Copyright © 2016 David Leasa and Stephen Elson. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Increasing numbers of individuals require long-term mechanical ventilation (LTMV) in the community. In the South West Local Health Integration Network (LHIN) in Ontario, multiple organizations have come together to design, build, and operate a system to serve adults living with LTMV. Objective. The goal was to develop an integrated approach to meet the health and supportive care needs of adults living with LTMV. Methods. The project was undertaken in three phases: System Design, Implementation Planning, and Implementation. Results. There are both qualitative and quantitative evidences that a multiorganizational system of care is now operational and functioning in a way that previously did not exist. An Oversight Committee and an Operations Management Committee currently support the system of services. A Memorandum of Understanding has been signed by the participating organizations. There is case-based evidence that hospital admissions are being avoided, transitions in care are being thoughtfully planned and executed collaboratively among service providers, and new roles and responsibilities are being accepted within the overall system of care. Conclusion. Addressing the complex and variable needs of adults living with LTMV requires a systems response involving the full continuum of care.