The Network is partnering with the three Toronto Stroke Networks to improve flow for patients with complex needs who experience a hip fracture or stroke.

These patients, a subgroup of hip fracture and stroke populations, experience extended ALC stays in hospital for a variety of reasons, including co-morbid medical conditions, time needed for functional recovery and lack of support systems at home or in the community.

The Networks held a joint consultation with leaders from several health service providers across the GTA earlier this year. They discussed common system issues that prolong hospital stays for these patients and identified shared priorities.

At the end of May, the Networks coordinated a Think Tank to understand complexity in these patient groups. Over 80 frontline staff and managers across the five GTA LHINs attended the event, and validated the profiles of patients post-stroke and hip fracture with complex needs. Attendees also provided recommendations on cross-sector processes, principles and policies in our current system that need to change to support successful transitions of patients with complex needs to rehab and community.

The Networks intend to develop demonstration project(s) to test some of the recommended cross-sector solutions.

For more information, contact Sanja Milicic Iafrate, Project Manager at