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  • City of Kawartha Lakes FHT nurse practitioner helps minimize doctor shortage gap

    Kawartha Lakes This Week published an article  on June 2, 2023

    By Catherine Whitnall Kawartha Lakes This Week 

    To say Kelsie Jeffery is perfectly suited to working as a nurse practitioner in the Kawartha Lakes is an understatement.

    The fact she is also the primary care provider for the City of Kawartha Lakes Family Health Team’s recently launched urgent care clinic further underscores the crucial need for her expertise.

    Jeffery is one of two nurse practitioners joining the local health team following the approval of provincial funding earlier this year.

    “To get someone of Kelsie’s calibre, it’s not only difficult, it’s impossible,” said Health Team executive director Aasif Khakoo. “Not only is it hard to find a nurse practitioner who can work autonomously, but with her extensive background as a clinician, she’s exactly what this community desperately needs.”

    An estimated 26,000 residents — close to one-third of the municipality’s population — do not have a family doctor or nurse practitioner.

    Initially, Jeffery wanted to be a family doctor but, after high school, opted to go into nursing. She worked at small cottage hospitals in British Columbia before moving to the Northwest Territories, where she worked for nine years in remote, fly-in communities as a community health nurse.

    During this time, Jeffery completed nurse practitioner master’s studies, capitalizing on her 17 years of nursing experience in emergency, obstetrics and acute care, as well as specialty focuses in geriatrics, cognitive assessment, pediatrics, sexual health care and primary health care across the lifespan.

    Prior to joining the health team in Lindsay, the Newtonville resident worked in Port Perry.

    While one reason behind the move was to be closer to home and family, Jeffery also wanted to help address the doctor and nurse shortage impact on rural areas like the Kawartha Lakes.

    “That’s where the health care need is. We’ve seen a huge vacancy of health-care professionals and that has affected thousands of patients over the years … And even when a new family doctor is recruited, they’re not taking the same number of patients,” said Khakoo.

    Jeffrey noted that this has contributed to a documented increase in acute illness, as people are more likely to wait until an issue is so serious that it validates an emergency department visit.

    “So not only are they in more urgent need of care, but if they have chronic conditions, they have often contributed to additional health-care issues,” said Jeffrey.

    The COVID-19 pandemic only served to make matters worse.

    Jeffrey noted that virtual care helped fill some of the void created during restrictions, but had limited applications.

    “It served its purpose, but there are facets that you don’t catch virtually. That’s where in-person care is key,” said Jeffrey.

    After-hours clinics have helped address need; however, demand has increased significantly over the years and were not truly meant to service chronic or urgent issues.

    “The urgent care clinic is designed to treat episodic issues, meaning the individual needs the care now,” said Jeffrey, who has also been taking on new patients, the priority being those without a primary care provider. “The clinic also has a mental health component that offers single-session therapy to immediately address a crisis and develop a systematic plan for ongoing support.”

    The clinic runs Fridays — with the exception of statutory holidays — from 10 a.m. to 2 p.m. at 55 Angeline St. N. in Lindsay. The clinic is by appointment, and only those with a valid OHIP card are eligible.

    Although uptake has been slow, both Jeffrey and Khakoo suspect clinic use will increase as awareness spreads.

    To book an appointment at the urgent care clinic, call 705-328-9853, ext. 296, or online at cklfamilyhealthteam.com/urgent-care-clinic/ on Fridays between 8 and 9:30 a.m.

    Click here for the full article

  • Expression of Interest Application Due June 16th + New Information- Expanding and Enhancing Interprofessional Primary Care Teamsterprofessional Primary Care Teams – Expression of Interest Now Available

    Dear AFHTO Member EDs, Lead Physicians and Board Chairs,
     
    As many of you know, the government recently announced new funding to expand existing interprofessional primary care teams and/or create up to 18 new teams in communities with the greatest need. The expression of interest (EOI) form, important information on applying, and tools are available at https://www.ontariohealth.ca/system-planning/funding-opportunities-primary-care . This message is a reminder that completed applications are due to Ontario Health by 5 pm Eastern Daylight Time on June 16, 2023.
     
    It is important to note that there will no longer be an opportunity for in-year unsolicited funding requests to the Ministry of Health, so now is the time to make your asks. This EOI application, while time consuming, is the best way to show the Ministry of Health what the current need in our sector is. We also want to clarify that the $30M of funding associated with this EOI is currently based on a two-year commitment. From the 2023 Ontario Budget:
                 
    “Primary care and family physicians are the foundation of Ontario’s health care system. To help make care more convenient for people, the government is investing $60 million over two years to expand existing teams and create up to 18 new primary care teams in communities with the greatest need.” (Additional budget highlights can be found here.)
     
    While this EOI does not presently commit to long-term, sustainable funding, we are hopeful that future funding announcements will be used to sustain the initiatives for successful applicants and enable the provision of base funding. There is also the possibility that there will be federal funding coming to sustain investments and to support other areas/teams that were unsuccessful in this initial EOI.

    AFHTO is confident that showing a comprehensive assessment of the current need will help encourage additional investment, and we strongly encourage members to apply to the EOI to demonstrate the current need in your communities.
     
    On May 18th, the Ministry of Health and Ontario Health hosted two technical webinar sessions to guide applicants through the EOI application. The release of these webinar recordings is still undergoing the Ministry of Health approval process, so they are currently unavailable. Below you can find some of the key questions and answers from the technical briefings. Additional questions and answers from Ontario Health can be found here.
     
    We request that applicants send AFHTO a copy of their submission once finalized, so that we can use the applications for our ongoing advocacy efforts. If you have any questions about the EOI application, you can contact your Ontario Health region. You can also direct questions for AFHTO to info@afhto.ca or Michael Scarpitti, Director of Strategic Communications and Government Relations at michael.scarpitti@afhto.ca.
     
    Q and A from Technical Briefing
     

    1.Max funding for individual EOIs?
    a. No, there is no maximum funding per application. Having said this, there is a lot of work that goes into the EOI, so MOH will spread funds across where the greatest need is. This process will help MOH and OH understand the gaps and help plan for the future and make decisions across the system.

    2.Should EOIs only submit what they think will likely get funded?
    a. No, put a full request in so that MOH understands the needs. You can reach out to OH contacts for thoughts on this.

    3.How important is OHT involvement?
    a. It is important but not mandatory to have an OHT endorsement. The vision overall is to have OHTs progress so that care is integrated. If you don’t have OHT endorsement, you should give a rationale as to why not so that MOH understands the issue.

    4.Will funding be given on a recurring basis?
    a. This is a two year funding commitment as articulated in the budget.

    5.Is there an Excel spreadsheet for the budget?
    a. No there is not, but MOH will provide an Excel spreadsheet via the OH website or through the OH regions so that applicants have an Excel spreadsheet (update: you can ask your regional OH contact for the recommended budget template. It is not posted on the website).

    6.Is MOH looking for expansion proposals or net new?
    a. MOH is looking for both. MOH encourages innovative models and existing models. Could be net new site of an existing team as well. Readiness to get started is a very important component.

    7.Is more money going to FHTs and CHCs only?
    a. No, this is an open process. Existing teams have governance in place, but there can be new groups applying.

    8.Can family docs in multiple FHOs apply together to become a FHT?
    a. Yes. Relationship with FHTs is to support operating and allied health. Part of this agreement is affiliated physician groups and this includes FHOs. Having multiple FHOs affiliated with an FHT is fine. They can remain separate FHOs.

    9.Can applicants submit multiple EOIs?
    a. MOH doesn’t understand the question. If you’re a single organization, have one EOI. You can put multiple ideas in the same EOI.

    10.When are decisions made and dollars flowing?
    a. Goal is to have successful applicants announced in the Fall 2023 and then executing agreements.

    11.Will the MOH review lead to partial funding?
    a. EOIs could get partial funding. Applicants should submit their full request based on needs.

    12.What will the evaluation process look like? Does the applicant discuss with OH and MOH during review?
    a. Yes, there will be a back and forth discussion with the applicant. Applicants should submit the full request. Ontario Health will use an evaluation process, including criteria to assess equity, to review and assess EOI submissions. Based on the evaluation framework, OH will make recommendations to the Ministry for funding approval to expand and/or create interprofessional primary care teams.

    13.Can OHTs endorse multiple EOIs?
    a. Yes.

    14.Is there funding to support small groups of physicians to apply to the EOI?
    a. No, but primary care stakeholders (associations) have supports. But no dedicated funding from MOH and OH.

    15.Any work being done on retention for IHPs that want to work in team-based care? Are there salary levels suggested?
    a. There is a salary guide, but the relationship between IHPs and their employer is between them and their employer. Recruitment and retention is an ongoing challenges across health care. Recruitment and retention strategies are ongoing. MOH will follow up on this to summarize.

    16.One month isn’t enough time to connect with Indigenous people.
    a.That is the timeline that applicants have. Reach out if engagement support is needed.

    17.Can an office add in IHPs?
    a. Yes, this would be a new team.

    18.Which model is preferred?
    a. You can apply for whatever model you want. MOH is agnostic on the model.

    19.Is there Indigenous evaluation on the EOI? What about equity?
    a. MOH will look at increased access for unattached patients and patients with poorer health outcomes. PHO marginalization index and data can be used in the application. MOH is open to new data, which will be considered.

    20.Is there access to data on unattached patients?
    a. Yes, health care experience survey has some info. There are other sources that MOH can share info on unattached places (i.e. Inspire). OH will supply this data to applicants.

    21.What about the 50% nursing or IHP guideline?
    a. This guideline will be looked at in proposals.

    22.Proposals can be submitted in French?
    a. Yes.

    23.Do we need to include the Operational Overhead required for our expansion as part of our EOI?
    a. No. MOH/OH will add in the overhead when developing budgets against each position. That is why the budget template is actually an optional bit. In the end the FTEs is the important component.

  • Bits & Pieces: nominations to the Board of Directors are open and more

    Bits & Pieces: nominations to the Board of Directors are open and more

    Your Weekly News & Updates


    In This Issue  
    • Nominations to the AFHTO Board of Directors are open until July 28, 2023
    • Member stories
    • Workplace mental health training series for health care workers
    • Reminder – member renewal deadline is June 30
    • News and updates- memo re iGAS, effect of free medicine on health care costs and more
    • Upcoming events- Screening for Risks for Development of Substance Use Disorders and more

     

     

    Nominations to the AFHTO Board of Directors are open until July 28, 2023

    Are you interested in serving on the AFHTO board of directors? The Governance Committee of AFHTO’s board invites anyone who works within an AFHTO member organization to apply. Please share this top 10 reasons to join the board, and call for nominations with all who work in your team and with members on your Board.

    Six (6) positions are to be elected for a 3-year term on the 14-member AFHTO board. The AFHTO by-law calls for balanced representation on the board to include the various forms of governance, the regions of the province, and the mix of the professions/individuals working within FHTs, NPLCs and other interprofessional models of primary care. Visit our site for more information.


    a group stands outside the team building underneath their sign.

    Member stories

    Arnprior & District FHTVTAC project might be short-term fix for family doctor shortage

    Aurora-Newmarket FHT – MPP Dawn Gallagher-Murphy, Newmarket-Aurora visited to discuss “how our government can #cutredtape to reduce admin workload as this contributes to #burnout”.

    Belleville NPLCFinancial boost for Belleville Nurse Practitioner Led Clinic

    City of Lakes FHT – Federal Minister of Health, Jean-Yves Duclos visited to learn more about team-based care.

    North York FHT – MPP Robin Martin, Eglinton-Lawrence visited last week to discuss the importance of team-based care and reducing administrative burden.

    Plantagenet FHTimpact of the Military Doctors Network on military family


    Workplace mental health training series for health care workers

    CMHA Ontario’s Your Health Space is launching a free workplace mental health training series for Ontario’s health care workers. This 12-week virtual series provides access to self-directed eLearning modules and trainer-led skill building sessions. Participants will learn strategies to manage and mitigate the effects of stress in the health care workplace and improve their mental health literacy. Digital certificates of completion will be awarded after each course.

    Learn more and register here. Registration will close on Monday, June 12th.


    Reminder – member renewal deadline is June 30

    Thank you to most members who have already renewed membership for 2023-24. If you haven’t received a confirmation of payment from info@afhto.ca, this means we haven’t received your fee yet. Please consider sending your membership fee via Interac or electronic funds transfer and your renewal form via email. If you’re unable to switch from paying via cheques, please send them instead. Unpaid and unconfirmed memberships will be cut-off on June 30.


    News and updates- memo re iGAS, effect of free medicine on health care costs and more


    Sharing Our Stories: Using the Arts to Explore Lived Experiences of Autism and Mental Health, May 31, 2023
    Part of a series of monthly interactive workshops where we discuss different topics that are important to Autistic adults. Learn more.


    Screening for Risks for Development of Substance Use Disorders, June 2, 2023
    Session in Paediatric Project ECHO’s Opioids and Substance Use in the Management of Pain in Children and Youth. Register here.


    Connected Communities: Building Equitable Integrated Healthcare, June 7-8, 2023
    Alliance for Healthier Communities’ annual conference. Find out more.


    New Horizons: A Conversation with Sarah Polley, June 9, 2023
    DFCM welcomes Academy Award-winning screenwriter and acclaimed actor and director Sarah Polley to explore how an interdisciplinary lens to the practice of family medicine can help family doctors challenge their personal assumptions and biases and become more thoughtful and empathic practitioners. Register here.


    CPA Ontario’s Ethics Conference: Navigating Grey Areas, June 22, 2023
    Relevant for all CPAs and finance professionals who want to incorporate ethical best practices in their operations. Find out more.

  • AFHTO 2023 Conference: If you submitted an abstract, make sure you received confirmation

    AFHTO 2023 Conference: If you submitted an abstract, make sure you received confirmation

    text says Team Based Care: Making it a reality for all in white font on a blue streaked background, like hyperspace

     

    We received over 65 abstracts for the AFHTO 2023 Conference. Thank you to all those who applied!

    A confirmation email has been sent to the contact person for each abstract.

    If you are part of a group that has prepared a submission, please ensure your group contact has received the email with the subject: “Thank you for your AFHTO 2023 Conference Submission!”. (Please have them check their junk mail as well.)

    If your contact person has NOT received this confirmation, please contact info@afhto.ca by May 31.

    The confirmation email is your assurance that your submission has been received and will be reviewed by volunteers for participation at the conference.

    Final sessions and posters will be selected mid June and notifications of acceptance sent by late June.

    We look forward to seeing you at the AFHTO 2023 Conference!
    Team-Based Care: Making it a reality for all
    October 25, 2023

  • The Impact of Interpersonal Continuity of Primary Care on Health Care Costs and Use: A Critical Review

    By Andrew Bazemore, Zach Merenstein, Lara Handler and John W. Saultz

    The Annals of Family Medicine May 2023, 21 (3) 274-279; 

    DOI: https://doi.org/10.1370/afm.2961

    Abstract

    PURPOSE: Interpersonal continuity has been shown to play an essential role in primary care’s salutary effects. Amid 2 decades of rapid evolution in the health care payment model, we sought to summarize the range of peer-reviewed literature relating continuity to health care costs and use, information critical to assessing the need for continuity measurement in value-based payment design.

    METHODS: After comprehensively reviewing prior continuity literature, we used a combination of established medical subject headings (MeSH) and key words to search PubMed, Embase, and Scopus for articles published between 2002 and 2022 on “continuity of care” and “continuity of patient care,” and payor-relevant outcomes, including cost of care, health care costs, cost of health care, total cost of care, utilization, ambulatory care–sensitive conditions, and hospitalizations for these conditions. We limited our search to primary care key words, MeSH terms, and other controlled vocabulary, including primary care, primary health care, family medicine, family practice, pediatrics, and internal medicine.

    RESULTS: Our search yielded 83 articles describing studies that were published between 2002 and 2022. Of these, 18 studies having a total of 18 unique outcomes examined the association between continuity and health care costs, and 79 studies having a total of 142 unique outcomes assessed the association between continuity and health care use. Interpersonal continuity was associated with significantly lower costs or more favorable use for 109 of the 160 outcomes.

    CONCLUSIONS: Interpersonal continuity today remains significantly associated with lower health care costs and more appropriate use. Further research is needed to disaggregate these associations at the clinician, team, practice, and system levels, but continuity assessment is clearly important to designing value-based payment for primary care.

    Click here for full page

  • Financial boost for Belleville Nurse Practitioner Led Clinic

    Quinte News Published an Article on May 23, 2023

    By Zach McGibbon

    The Belleville Nurse Practitioner-Led Clinic is receiving a financial boost of up to $30,000 funding from the City of Belleville to help attract 2.6 new Nurse Practitioners to the area.

    The funding will be used  for the installation of a required HVAC system for an expansion at its location at Victoria and Pinnacle Streets to make room for the extra staff.

    Initially, a plan was put in place to have a satellite location in Thurlow Ward.

    However, according to a report to council, an increase in development costs and the timing for construction would mean the new clinic would not be ready for at least a year.

    “Without any public transit, and even with a vehicle, the location within the city centre is a lengthy journey for many of the ward to residents,” Councillor Kathryn Ann Brown told council.

    “I hope we will continue to pursue an advocate for more opportunities for healthcare practitioners, north of the 401.”

    The addition of the new nurse practitioners will help the clinic take on an additional 2080 patients.

    There are currently four nurse practitioners on site that handle 3,200 patients.

    Click here for full article

  • Arnprior & District FHT’s contribution to VTAC project might be short-term fix for family doctor shortage

    CBC news published an article and video on May 24, 2023

    By Omar Dabaghi-Pacheco 

    When it comes to Ontario’s family doctor shortage, the paramedic chief in Renfrew County thinks he’s found a cure with a hybrid model of care.

    The model puts a family doctor just one phone call, and usually a few hours wait, away.

    “This is actually a new door into the health-care system that is connected to all other parts,” said Michael Nolan, the architect of the eastern Ontario county’s latest foray into innovative health-care delivery.

    It’s called the Renfrew County Virtual Triage Assessment Centre (VTAC), which started as a quick way for community paramedics to start testing some of the county’s roughly 100,000 residents during the COVID-19 pandemic. 

    Nearly three years and 80,000 visits later, the experiment recently received $3.2 million from the Ontario government with assurances money will continue for the long term, Nolan said.

    VTAC is team-based care where anyone in the area who needs a doctor can call a 1-800 number to reach a medical receptionist, trained to help them figure out which health-care provider they can see in the shortest amount of time.

    The receptionist will set up an appointment with one of dozens of VTAC doctors working remotely across Ontario. Next, a paramedic or nurse will either make a house call or meet them at a nearby clinic to perform the physical assessment for the virtual doctor.

    Click here for the full article

    See the previous 2021 article about VTAC here

  • Bits & Pieces: abstract deadline extended and more

    Bits & Pieces: abstract deadline extended and more

    Your Weekly News & Updates


    In This Issue  
    • AFHTO 2023 Conference: deadline to submit your abstract is now May 25
    • Member stories
    • News and updates- Ontario exploring beginning breast screening at age 40 and more
    • Seeking physician input on patients returning to work
    • Separation Pathways- a hub for separating families
    • Upcoming events- Crafting a Digital Climate Plan and more

     

     

    Shocked emoji- top of head exploding

     

     

    AFHTO 2023 Conference: deadline to submit your abstract is now May 25

    Deadline to submit your abstract now Thursday, May 25, 2023, at 5:00 PM (EDT)

    Email info@afhto.ca or call 647-234-8605 x1200 if you have any questions. We’re here to help.

     

     


     

    collage of 4 pictures, 2 with women at a podium in the corner of a meeting room, 1 showing people at a table looking at a presentation on a screen and one showing the whole room

     

    Member stories

    North York FHT – On May 17, 2023, North York Toronto Health Partners (NYTHP) welcomed Collaborative Aotearoa, a national network of primary health care and community partners from New Zealand to share their respective approaches to primary care and integrated services to improve health care for all. Learn more here.

     


    News and updates- Ontario exploring beginning breast screening at age 40 and more


    Seeking physician input on patients returning to work

    Have you had patients return to work from a work absence due to a mental or physical health problem? Trent University researchers are interested in your experiences interacting with patients experiencing sickness absence and others involved in the process.

    Your involvement: Completion of an online survey and participation in a focus group with other physicians sharing similar experiences.

    To find out more, scan the QR code in the flyer or click here.


    Separation Pathways- a hub for separating families

    Separation Pathways is a non-profit for separating couples to find cooperative, affordable, timely, and supportive options. Their services are available remotely to residents of Ontario.

    They’re a team of multi-disciplinary professionals including lawyers, mediators, mental health professionals, and financial experts, to better address the needs of separating families. They work with clients to create their unique separation plan to help guide them towards a resolution. They then connect them with a suitable and experienced mediator for a flat and affordable fee, as well as other professionals based on their needs.

    Additionally, they offer holistic referrals more wrap around care where complex needs require more support. They also extensively screen for domestic and intimate partner violence, have referral partners in this arena, and can modify their services to increase safety where appropriate. They’re in the process of seeking charitable status so that they can further subsidize low-income clients. You can read their brochure for more information.


    Crafting a Digital Climate Plan, May 25, 2023
    “Crafting a Digital Climate Plan: How Digital Sustainability can Enhance Resilience, Transform Governance and Promote Equity” webinar hosted by TechSoup and Mightybytes. Register here.


    Ontario Health’s Mental Health and Addictions Centre of Excellence Eating Disorders Webinar, May 30, 2023

    Ontario Health’s Mental Health and Addictions Centre of Excellence’s first webinar on the development of the Eating Disorders Provincial Program. Register here.


    Sharing Our Stories: Using the Arts to Explore Lived Experiences of Autism and Mental Health, May 31, 2023
    Part of a series of monthly interactive workshops where we discuss different topics that are important to Autistic adults. Learn more.


    Connected Communities: Building Equitable Integrated Healthcare, June 7-8, 2023
    Alliance for Healthier Communities’ annual conference. Find out more.


    New Horizons: A Conversation with Sarah Polley, June 9, 2023
    DFCM welcomes Academy Award-winning screenwriter and acclaimed actor and director Sarah Polley to explore how an interdisciplinary lens to the practice of family medicine can help family doctors challenge their personal assumptions and biases and become more thoughtful and empathic practitioners. Register here.

  • AFHTO 2023 Conference: deadline to submit your abstract extended

    AFHTO 2023 Conference: deadline to submit your abstract extended

    text says Team Based Care: Making it a reality for all in white font on a blue streaked background, like hyperspace

    Shocked emoji- top of head exploding

     

     

     

    Deadline to submit your abstract now Thursday, May 25, 2023, at 5:00 PM (EDT)

     

    Email info@afhto.ca or call 647-234-8605 x1200 if you have any questions. We’re here to help.

     

     

    Helpful links:

     

    Conference key dates:

    • May 25, 2023– Deadline for abstracts
    • June 15, 2023 – Bright Lights nominations
    • July 2023- Conference registration opens
    • October 3, 2023 – Early bird registration deadline
    • October 25, 2023– AFHTO 2023 Conference
  • Nominations to the AFHTO Board of Directors are open until July 28, 2023

    Dear AFHTO members:
     
    Are you interested in serving on the AFHTO board of directors? The Governance Committee of AFHTO’s board invites anyone who works within an AFHTO member organization to apply. Please share this top 10 reasons to join the board, and call for nominations with all who work in your team and with members on your Board.

    Six (6) positions are to be elected for a 3-year term on the 14-member AFHTO board. The AFHTO by-law calls for balanced representation on the board to include the various forms of governance, the regions of the province, and the mix of the professions/individuals working within FHTs, NPLCs and other interprofessional models of primary care.

    Given the composition of the continuing board members, priority for the directors to be elected will be given to candidates who are:

    • Family Physicians and Nurse Practitioners, especially individuals actively involved in OHT development and understanding of the broader health care system;  
    • Board members, especially community members in the position of Chair of the Board;
    • Interprofessional Health Care Providers, especially those actively involved in OHT development; or
    • Experienced in Government relations and/or public policy.

    To apply:

    The Governance Committee of the AFHTO board will review all applications to assist the AFHTO board to determine the slate of candidates to recommend to the AFHTO membership for ratification at the AFHTO annual general meeting.

    • Nominees will be informed of their status after September 20th, 2023.
    • The slate will be presented to the members at the Annual General Meeting which will be conducted in-person this year at the Sheraton Centre Toronto Hotel:

      Tuesday, October 24th, 2023
      (time TBD)

       

    Sincerely,
    Kevin Samson, Chair, AFHTO Governance Committee