2023 Health Check-Up!

Administrative Services

Goal: To provide effective and efficient support to all DRHD divisions, programs and services that help to enhance the delivery of the Ontario Public Health Standards and to meet all requirements of internal and external customers.

Accomplishments:

• A total of eight staff were trained in creating accessible documents and obtained an Accessible Documents Specialist Certificate.
• Provided support to the implementation of myDurham311 in collaboration with all DRHD divisions.
• Developed strategic partnerships with DRHD divisions to support financial management, facilities planning, program delivery objectives and corporate initiatives.
• Coordinated renovations at 419 King St. in Oshawa to create a new health clinic space that will support DRHD’s immunization and breastfeeding programs. 

Community & Resource Development

Goal: To provide support to all DRHD divisions, programs, and services, helping to enhance compliance with the Ontario Public Health Standards.

Accomplishments:

• Began recruitment for a Communications Specialist role.
• Relaunched and posted two Medical Officer of Health blogs/messages.
• Provided ongoing support to DRHD programs and services related to media relations, graphic design, web production, social media, and the Resource Centre.
• Expanded services to include assistance with creation of online modules to assist with e-learning activities and expanding the development of electronic forms to enhance programs' customer service needs.
• Developed and produced, "Nice to meet you, Public Health", a National Public Services Week promotional video to promote the roles and responsibilities of DRHD staff.

Health Analytics & Research Team (HART)

Goal: To ensure public health practice responds effectively to current and evolving conditions and contributes to the public’s health and well-being with programs and services that are informed by the population’s health status, including social determinants of health and health inequities.

Accomplishments:

• Provided weekly updates on respiratory virus activity in Durham Region, integrating both influenza and COVID-19 data into the new Respiratory Virus Tracker (durham.ca/resptracker).
• Released the Health Neighbourhoods 2021 Census update, refreshing 32 of the 96 indicators, available at durham.ca/neighbourhoods.
• Launched the Maternal and Infant Health Data Tracker (durham.ca/birthstats).
• Conducted work in collaboration with the Health Protection Division (Healthy Environments Program) to develop the Draft Primer Report and Draft Extreme Heat Report as part of the Climate Change Health Vulnerability Assessment.

Health Policy & Equity Team

Goal: Public health practice results in decreased health inequities so that everyone has equal opportunities for optimal health and can attain their full health potential without disadvantage due to social position or other socially determined circumstances.

Accomplishments:

• Established a new Financial Empowerment Champions Committee in collaboration with Durham Region Social Services Department.
• Conducted three virtual learning sessions for staff on the topics of housing, homelessness, and financial empowerment.
• Developed and implemented a Health Equity FAX About series to communicate important information to health care providers to address the social determinants of health and distributed two FAX Abouts on “Improving Health Through Financial Empowerment”.
• Updated the Health Care Professionals web page to include income support resources.
• Completed two literature reviews and a survey of DRHD management staff to inform collection and application of sociodemographic data in DRHD programs and policy work.

Privacy & Information Security

Goal: To provide effective and efficient privacy and information security support to all DRHD divisions, programs and services that help to enhance compliance with applicable privacy and public health related legislation, information security standards and information management best practices.

Accomplishments:

• Conducted work on developing a privacy audit framework, including types of privacy and information security policies, frequency of updates and a communication plan for new and revised policies.
• Updated and launched the online privacy training module for staff, with a completion rate of 96 per cent.
• Recruited and onboarded a new Privacy Analyst.
• Received and responded to 29 access requests made under the Municipal Freedom of Information and Protection of Privacy Act.
• Received and responded to 71 access and/or disclosure requests made under the Personal Health Information Protection Act, 2004.
• Investigated and closed 15 privacy incidents.
• DRHD provided 16 staff members with access to a health information system that provides real-time access to digital health records from health care providers across Ontario.
• Launched the Privacy Consult Intake Form to support and streamline the review of program projects, initiatives, applications, and process reviews by staff.
• Developed guidance documents, related to Microsoft collaborative tools such as, MS Teams, MS OneDrive, MS OneNote and MS SharePoint.
• Commemorated Cyber Security Month in October 2023 with weekly email blasts on topics including protecting yourself against phishing, securing information when teleworking, creating strong passwords and strategies for enhancing digital health and well-being.
• Created a Virtual Group Care Guidance document and Tip Sheet for Facilitators to assist programs with the secure delivery of virtual group care to clients.

Goal: To respond to inquiries and requests for service, including applications for new businesses and special event vendors from the community.

Accomplishments:

• Received and responded to 5,359 public inquiries through DHCL in the Health Protection Division.
• Continued efforts to collaborate with myDurham311 Change Agent Network.

Goal: To enable consistent and effective management of emergency situations.

Accomplishments:

• Completed a review of the current DRHD Emergency Management program activities against the current Emergency Management Guideline under the Ontario Public Health Standards to identify gaps and program priorities.
• Planned and launched three potassium iodide (KI) communication campaigns to raise awareness regarding the availability and ordering process for obtaining KI tablets.
• Developed a new animated video to promote awareness of KI to residents and businesses within 10 kilometres of the Pickering and Darlington Nuclear Generating Stations.
• Hosted five Durham Nuclear Health Committee meetings, providing a forum for discussing and addressing potential radiation and environmental human health impacts with nuclear industry representatives and the public.
• Participated in a tabletop tritium liquid emission exercise with other departments and external agencies.

Goal: To prevent or reduce the burden of food-borne illness.

Accomplishments:

• Reviewed 684 vendor applications and reviewed and approved 300 special events applications.
• Conducted 19 special events inspections and 12 farmers’ markets inspections.
• Developed and conducted two staff consistency training sessions on special event processes, mobile food truck inspections, and Healthy Menu Choice Act, 2015 inspections.
• Reviewed and streamlined special event procedures and inspection processes.
• Developed a new Icing and Frosting Guidelines resource for the public.
• Created a new canning policy and procedure in response to the increase in home canned products available for sale in the region.

Goal: To prevent or reduce the burden of illness from health hazards in the physical environment.

Accomplishments:

• Completed an internal draft Primer Report for DRHD’s Climate Change and Health Vulnerability Assessment (CCHVA).
• Initiated engagement with representatives of Mississaugas of Scugog Island First Nation to review and comment on DRHD’s CCHVA reports.
• Launched the new Climate Change and Health web page on durham.ca.
• Developed a new Heat Hacks for Keeping Cool infographic, designed for at-risk populations who may not have air-conditioning.
• Doubled the number of community partners subscribed to receive heat warning notifications.
• Hosted the Heat Warning and Information System Spring Forum for community partners and provided key resources for developing a heat response action plan (e.g., for municipalities, child care settings, etc.).
• Engaged with two local area municipalities to review and comment on their climate change action plans to provide a health lens and vulnerability assessment framework.
• Released health promotion and health hazard awareness social media campaigns related to wildfire smoke, flooding, heat, hazardous plants, radon, and air quality.
• Completed 262 inspections of housing accommodations for International Agricultural Workers (IAWs) and engaged and supported local community partners to support IAWs in Durham Region.

Goal: To prevent diseases in humans and contamination of the physical environment due to on-site private sewage systems.

Accomplishments:

• Developed a social media strategy to raise awareness of the building permit and inspection process of sewage systems.
• Produced a building permit application checklist to assist community partners with understanding building code requirements and inspection process and requirements.
• Inspected 304 sewage systems within 100 metres of the shoreline/tributary of Lake Simcoe to prevent contamination.
• Continued to collaborate with Township of Scugog officials to renew the contract for the mandatory sewage systems maintenance inspection program.
• Transitioned to electronic records, including updating relevant policies and procedures and establishing new processes in collaboration with the administrative support program, information management staff and the Hedgehog 5 team.

Safe Water

Goal: To prevent or reduce the burden of water-borne illness related to drinking water and to prevent or reduce the burden of water-borne illness and injury related to recreational water use.

Accomplishments: 

• Adapted a public resource describing critical topics relevant to the ownership of a private well.
• Developed an online training module for recreational water facility operators available on durham.ca.
• Monitored 14 beaches in Durham Region weekly from June to August, including 910 samples collected, 47 beach advisories issued and one blue-green algae advisory issued.
• Completed 100 per cent of inspections in recreational water facilities in accordance with the Ontario Public Health Standards and issued Section 13 Orders under the Health Protection and Promotion Act.
• Engaged in a social media campaign on blue-green algae and E. coli in fresh water.

Goal: To ensure Durham Region residents have access to health information and counselling and referral to appropriate resources on health issues as outlined in the Ontario Public Health Standards.

Accomplishments:

• Responded to inquiries from the community through 13,367 telephone contacts and 943 email inquiries.
• Collaborated with staff across the division to deliver health education, counselling and referrals on topics identified in the Ontario Public Health Standards.

Goal: To achieve optimal preconception, pregnancy, newborn, child, youth, parental and family health.

Accomplishments:

• Completed 351 Partners in Parenting Education activities.
• Conducted 340 Parent-Child Interaction Scale assessments of which 25 per cent were repeat assessments.
• Observed improvement in caregiver and child interactions among 68 per cent of families.
• Screened 4,558 families for risk, including 127 prenatal Healthy Babies Healthy Children (HBHC) screens, 4,266 postpartum HBHC screens, and 165 early childhood HBHC screens.
• Provided 200 hospital liaison visits and four presentations to community agencies to increase program referrals.
• Posted 288 social media posts across Facebook, Instagram, and X.
• Launched the Better Outcomes, Registry & Network - Integrated Services for Children Information System electronic screen transfer.
• Conducted two public health nurse (PHN)-led Cognitive Behavioural Therapy (CBT) groups for clients experiencing perinatal mood disorders, of which 88 per cent experienced a reduction in symptoms on the Edinburgh Perinatal/Postnatal Depression Scale.
• Developed consent processes and virtual group guidelines in collaboration with the Privacy & Information Security team.
• Observed a 68 per cent increase in breastfeeding home visits in North Durham.
• Collaborated with four hospitals outside Durham Region to continue partnerships for referrals and resource sharing.
• Collaborated with the Uxbridge Health Centre and Brock Community Health Centre to increase awareness of breastfeeding services in Durham Region.
• Implemented one communication campaign to promote breastfeeding home visits available in North Durham.
• Completed one literature review to identify areas of focus, protective factors, risk factors associated with infant and child mental health, and best practices that support infant and child mental health.
• Completed a situational assessment on the topic of infant and child mental health using the Community and Safety Well-Being Plan Framework.

Goal: To enhance the growth and development of children, including those with a developmental disability and/or risk of developmental delay by partnering with families to provide support, information, and early intervention services.

Accomplishments:

• Provided intervention services to 902 children through a home visiting consultation model.
• Provided consultation and completed a transition to school report for 69 children transitioning to kindergarten to assist families with connecting to their home school and establishing a plan to best support their child with school entry.
• Provided support to 80 per cent of children transitioning to a licensed early learning and care program.
• Participated in 27 community events and serviced approximately 370 adults and 137 children.
• Facilitated early intervention practices with families in community settings to increase community awareness for inclusion and family networking.
• Attended eight Sunnybrook neonatal clinics to support families with accessing services in Durham Region to support their child’s growth and development needs.

Chronic Disease Prevention

Goal: To reduce the burden of chronic diseases of public health importance* and improve well-being.

*Chronic diseases of public health importance include, but are not limited to, obesity, cardiovascular diseases, respiratory disease, cancer, diabetes, intermediate health states (such as metabolic syndrome and prediabetes), hypertension, dementia, mental illness, and addictions.

Accomplishments:

• Developed the 2023 Price of Eating Well in Durham Region Report and 2023 Food Poverty in Durham infographic, to raise awareness of food insecurity and support advocacy efforts that address food insecurity.
• Implemented the Monitoring Food Affordability provincial guidance, collecting and calculating food survey data from nine different local grocery retailers to determine the cost of the Nutritious Food Basket for a family of four.
• Collaborated with the Food Insecurity Working Group of the Ontario Dietitians in Public Health and the Association of Local Public Health Agencies to develop an advocacy letter to the Ontario Minister of Health regarding food affordability.
• Implemented a food insecurity promotion campaign to communicate the 2022 and 2023 Nutritious Food Basket and provide information about the status of food insecurity in Durham Region.
• Observed 20 schools utilizing the Comprehensive School Health model to address the topic of vaping.
• Implemented two strategies (e.g., Durham Youth Drug Awareness Conference and Not an Experiment) to support schools to create an environment supportive of tobacco/vaping-free living.
• Developed health promotion tools to support public health nurses working with the school community on vaping.
• Endorsed single-use plastics and waste related to e-cigarettes and vapour products.
• Endorsed the Ontario Vape Tax through the Alliance for a Tobacco Free Ontario.
• Launched a social media vaping campaign targeted to parents and caregivers and updated the durham.ca web page.

Oral Health

Goal: To enable all children in Durham Region to attain and sustain optimal oral health and development potential, and to support adults who require assistance in accessing oral health information and services.

Accomplishments:

• Identified 2,086 children as requiring urgent dental care and 2,500 children with non-urgent dental needs.
• Participated in four health fairs at long-term care homes (LTCHs) which included 532 participants.
• Conducted eight “Train the Trainer” workshops in LTCHs providing oral health caregiver training to 45 staff.
• Provided grade-specific classroom education in 38 priority schools which included 6,975 children and 473 teachers.
• Responded and participated in 77 community events promoting oral health programs and the importance of good oral health to 4,344 participants.
• Received 14 clients for the Ontario Works Dental Pilot.
• Launched the LTCH Dental Program which included 90 annual assessments and 230 residents seen.
• Identified 26 LTCH residents as requiring urgent dental care, 111 residents requiring preventive services, 58 restorative cases, 38 residents requiring dentures, and 16 residents requiring extractions.
• Provided dental services to 2,016 unique Ontario Seniors Dental Care Program (OSDCP) clients via 7,421 appointments.
• Provided dental services in 772 appointments to Healthy Smiles Ontario (HSO) recipients.
• Provided dental services to 55 clients not enrolled in HSO or OSDCP.
• Continued work to develop a business case to begin planning to build a dental clinic in the western part of Durham Region.

Goal: To reduce the burden of preventable injuries and substance use.

Accomplishments:

• Updated the alcohol and cancer Rapid Risk Factor Surveillance System module, based on Canada’s Guidance on Alcohol and Health.
• Developed new health communication resources, including an infographic, updated web pages, a media release and social media posts, and a FAX About to health care providers.
• Created five new curriculum support resources for students in Grades 7 to 12.
• Worked with secondary students on one youth engagement/prevention strategy focused on the impact of alcohol marketing on youth consumption.
• Continued advocacy efforts regarding Bill S-254, an Act to amend the Food and Drugs Act (warning labels on alcoholic beverages).
• Conducted a literature review to identify barriers and facilitators to safe supply/opioid agonist treatment prescribing.
• Updated school support resources to include new information on edible cannabis and protective factors.
• Developed a communication campaign on Mindful Consumption, including updated web pages, a media release, social media posts, television and radio interviews, an online published article and advertisements in theatres, public transit, post-secondary schools, recreational centres and online.
• Implemented a community wide campaign to increase awareness about naloxone. Metrics indicate that 326,194 people saw or heard the online portion of the campaign and there were 4,041,182 impressions for the in-person portion of the campaign at various locations across the region.
• Onboarded seven new agencies to the Ontario Naloxone Program and distributed 5,025 naloxone kits, and 1,232 naloxone refills throughout the year.

School Health

Goal: To achieve optimal health of children and youth in schools through partnership and collaboration with school boards and schools.

Accomplishments:

• Completed 172 school assessments, 55 Healthy School Action Plans, 16 Healthy School Action Plans for priority neighbourhood schools, 1,551 school interactions, and 156 school interactions related to kindergarten readiness initiatives in the 2022/2023 school year.
• Completed 222 school assessments, 30 Healthy School Action Plans, nine Healthy School Action Plans for priority neighbourhood schools, 644 school interactions, and 30 school interactions related to kindergarten readiness initiatives from September to December 2023.
• Vision screening for senior kindergarten students provided in 15 high priority schools which resulted in 517 senior kindergarten students screened, 246 referrals sent home, and one automatic referral between May to June in the 2022/2023 school year.
• Screened 3,013 senior kindergarten students for vision, with referrals sent home for 1,290 students and five automatic referrals completed between September to December 2023.

Smoke-Free Ontario Act, 2017

Goal: To ensure that tobacco, e-cigarette vendors, and other organizations that are subject to the Smoke Free Ontario Act, 2017 (SFOA) comply with the Act and to restrict youth access to tobacco products and e-cigarettes.

Accomplishments:

• Implemented legal tools to obtain compliance with facility operators in violation with the SFOA.
• Completed 352 vapour product youth access inspections.
• Completed 362 tobacco youth access inspections.
• Initiated communications with other public health units to explore alternative options to legal action when students are found to be in violation of the SFOA.
• Provided research and literature to support City of Oshawa’s proposed changes to its Licensing By-law 120-2005 and Proposed Program Enhancements to include tobacco, vape and smoke shops in its licensing program.
• Issued two automatic prohibitions to tobacco vendors in Durham Region.
• Issued a Section 13 Order of a Medical Officer of Health under the Health Protection and Promotion Act prohibiting the sale of vapour products at a convenience store which demonstrated egregious non-compliance.
• In February 2023 an application made by an operator of a hookah lounge to quash the Durham Region Smoking and Vaping By-law #28-2019 was dismissed by the Ontario Superior Court; DRHD staff continues to enforce the by-law within prohibited facilities.

Goal: To reduce or eliminate the burden of vaccine preventable diseases through immunization.

Accomplishments:

• Offered immunization clinics at 193 schools in the 2022/2023 school year for Grade 7 and 8 students. A total of 17,866 students received the hepatitis B vaccine, 20,278 students received the human papillomavirus vaccine, and 11,550 students received the meningococcal vaccine.
• Assessed and sent 66,443 immunization notices and reminder letters to school-aged children enrolled in Durham Region schools to support the Immunization of School Pupils Act.
• Administered 22,850 doses of COVID-19 vaccine at 193 community and homebound clinics throughout Durham Region.
• Administered 4,171 routine vaccines to Durham Region residents with limited access to publicly funded vaccines at 43 immunization catch-up clinics.
• Inspected 485 vaccine fridges storing publicly funded vaccine and followed up on 80 incidents where vaccine was stored outside of recommended temperatures.
• Distributed 261,659 doses of routine, flu and respiratory syncytial virus vaccine to health care providers for administration to Durham Region residents and supported inventory management of more than 31,711 doses of the COVID-19 vaccine.

Infectious Diseases Prevention & Control - Health Protection

Goal: To reduce the burden of communicable diseases and other infectious diseases of public health importance.

Accomplishments:

• Developed a quality assurance process for larval mosquito surveillance and West Nile virus vector mosquito control.
• Developed new signage, including a QR code, updated the Lyme disease webpage and launched a media campaign to raise awareness of Lyme disease within Durham Region.
• Updated durham.ca to include information on new tick-borne diseases.
• Investigated 1,543 animal bite cases with potential rabies exposures.
• A total of 38 animals were submitted to the Canadian Food Inspection Agency lab in Ottawa for rabies testing and 163 individuals received rabies post-exposure prophylaxes.
• Four specimens were sent for rabies surveillance testing.
• Reviewed and updated the Raccoon Rabies Contingency Plan.
• Promoted two low-cost rabies vaccine clinics in collaboration with the City of Pickering.
• Conducted 47 infection prevention and control (IPAC) complaint investigations, including 28 in personal service settings (PSS), three in child care centres, and one in tanning salons.
• Published two Wee Care Newsletters for child care centres (spring/summer and fall/winter) to provide information and resources to child care operators and staff.
• Conducted 2,061 inspections at PSS and child care facilities.
• Conducted 1,138 sporadic diseases investigations, including 489 for influenza, 152 for salmonellosis, 124 for Lyme disease, and 103 for cyclosporiasis.
• Investigated 496 gastrointestinal and respiratory outbreaks in institutions and hospitals.
• Collaborated with the Durham IPAC Hub to host an Education Day/Flu event, which included 158 attendees; and to issue an e-newsletter to community partners as a helpful resource on IPAC practices. 

Infectious Diseases Prevention & Control - Population Health

Goal: To reduce the burden of communicable diseases and other infectious diseases of public health importance.

Accomplishments:

• Managed 406 communicable disease cases and 314 communicable disease contacts.
• Managed 107 cases of Invasive Group A Streptococcal disease with 244 associated contacts, including eight cases in institutions and one outbreak.
• Managed two measles investigations with 50 contacts.
• Managed 49 tuberculosis investigations with 34 confirmed cases. A total of 1,089 clients underwent directly observed therapy.
• Managed 357 cases of latent tuberculosis infections and followed 312 individuals for tuberculosis immigration surveillance.
• Provided six education sessions to Designated Officers of Emergency Services.
• Managed 2,393 cases and 68 contacts of sexually transmitted and blood-borne infections (STBBIs) in the community.
• Supported 4,552 unique clients in sexual health clinics at 12,838 clinic appointments in Oshawa and Pickering.
• Managed 538 cases and 271 contacts of STBBIs in sexual health clinics.
• Administered 902 STBBI treatments and 688 immunizations in sexual health clinics.
• A total of 92 per cent of clients who completed the Client Experience Survey rated their overall experience at the sexual health clinics as very good or excellent.

Goal: To deliver a quality Paramedic Services system that is responsive to client needs and to reduce mortality and morbidity related to illness and injury through the provision of pre-hospital advanced life support procedures. Primary program delivery is through Region of Durham Paramedic Services (RDPS) with assistance from the Central Ambulance Communications Centre and local fire department tiered response programs.

Accomplishments:

• Continued efforts to implement the early phase of the Paramedic Services Master Plan and monitor its impact on response times, end of shift overtime, meal breaks and attendance.
• End of shift overtime was reduced by 50 per cent, and further reductions are expected in 2024.
• Continued work with Lakeridge Health to mitigate offload delay resulted in an average transfer of care time of 13 minutes for patients who arrive and are deemed Fit2Sit. More patients will be captured under this initiative by expanding the qualifying criteria.
• Continued work with the provincial government to establish a stabilized funding model for the Community Paramedicine program.
• Continued work to implement a new Medical Priority Dispatch System algorithm, to be launched in 2024.
• Public Safety Radio Network upgrades to RDPS bases have been completed through the last quarter of 2023. Towers within the region have been upgraded, and a complete switch over is scheduled for June 2024.

Quality Assurance and Improvement

Goal: To ensure that programs and services meet requirements as articulated in policies, standards and legislation and to continuously improve the efficiency and effectiveness of services provided to Durham Region clients.

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Health Information Systems – Population Health

Goal: To maintain and support the PROFILE application to meet requirements of documentation as per the applicable professional colleges, organizational policies and to meet reporting requirements for programs and services outlined in the Ontario Public Health Standards with an emphasis on continuous quality improvement. 

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Health Information Systems – Health Protection

Goal: To maintain and develop the Hedgehog application including the Check&GO! disclosure portal and to support staff working toward achieving compliance with the Ontario Public Health Standards.

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Accomplishments: 

• Completed the transfer of all Health Protection Division records into an electronic database and continued to explore opportunities to expand electronic record keeping.
• Collaborated with local municipalities and chief building officers to promote a solution for encouraging new operations in Durham Region that require routine health inspections to notify DRHD.
• Developed and launched the “Your Business and Public Health” web page on durham.ca.
• Expanded the student mentorship program to include more practicum opportunities, training, and collaboration with other public health units.
• Continued to implement and revise enhanced onboarding and offboarding processes for public health solutions.
• Implemented the updated version of PROFILE software, including the development of workflows for all programs and end-user training.
• Continued to develop a plan for the retention and destruction of health databases containing client personal and health information.
• Completed 283 project enhancements to support program changes, requirements related to documentation and reporting.
• Provided training for 19 primary care providers and LTCH staff on the COVaxON system.
• Updated the Rabies Investigation Checklist to a fillable PDF with radio buttons to improve efficiencies and processes.
• The Health Protection Division electronic database was used to monitor staffing workload and trends to assist in the strategic allocation of resources and to ensure compliance with the Ontario Public Health Standards.
• Verified publicly disclosed inspection summary signs and geolocation on the Hedgehog 5 disclosure portal with 664 disclosure checks.

2023 Revenues

• Region of Durham ($52,621,896)
• Province of Ontario ($71,552,626)
• User/Other Program Fees ($1,227,362)

Total $125,401,884