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An Opportunity for Quality: The Need for Better Evaluation of Ontario FHTs
An Opportunity for Quality: The Need for Better Evaluation of Family Health Teams in Ontario

Article in Healthcare Quarterly 21(4) January 2019 : 28-31.doi:10.12927/hcq.2019.25744

Special Focus on Building Effective Primary Care Systems

Abstract

In the past decade, primary care has undergone significant changes toward system improvement, which has improved patient outcomes and reduced costs. Family health teams (FHTs) were introduced in Ontario as part of primary care renewal. FHTs address a lack of capacity and integration among providers and service inaccessibility experienced by the population. We explore, the potential for positive impact of FHTs and the lack of built-in evaluation strategies to assess performance. We provide four suggestions to better support rigorous evaluation of FHTs. This commentary considers Ontario’s efforts to improve capacity, quality and evaluation in primary care through FHTs.

Authors
- Shannon L. Sibbald, PhD, Assistant Professor, Western University
- Keri Selkirk, MBA, Centre for Organizational Effectiveness
- Avinash Cherla
- Vaidehi Misra, Faculty of Health Sciences, Western University
Full article pdf here.
March 22, 2019
Erythromycin Ophthalmic Ointment Shortage Update

Memo from Chief Medical Officer of Health

Mar 19, 2019

TO: Medical Officers of Health
RE: Erythromycin ophthalmic ointment shortage

We would like to take the opportunity to provide a further update to share new information regarding the ongoing national shortage of erythromycin ophthalmic ointment, indicated for the prophylaxis of ophthalmia neonatorum.

We are aware that limited supply has returned to the market in February and March, with reported estimated end dates in March and April. We will keep monitoring the supply and will provide updates as they become available. Please continue to work with your LHIN Drug Shortages Lead for further information and to support reallocation requests.

Based on this ongoing shortage we continue to urge hospitals to conserve and prioritize access to the highest risk cases (i.e. high risk sexual behaviour, partner with STI, is homeless/under housed, has new or multiple sexual partners or partner does, and/or no prenatal care).

The Ministry of Health and Long-Term Care (MOHLTC) has engaged the Provincial Council for Child and Maternal Health (PCMCH) to leverage their expertise on provincial supports for the shortage. To this end, with involvement from the ministry, PCMCH’s Maternal-Neonatal Committee and London Health Sciences Centre have developed algorithms for screening and response to lab results in order to support local decision making.

It should be noted that PCMCH advises at this time that there is no recommended safe alternative medication to be used prophylactically for newborns instead of erythromycin. Therefore, it is recommended that the supply of erythromycin be monitored closely, and if adequate supplies are not available, administration be based on the attending health care professional’s assessment of the situation. Attached to this letter are the algorithms that attending health care professionals may wish to take into consideration in making their assessments. They can also be downloaded from PCMCH’s website at the following link: http://www.pcmch.on.ca/erythromycin-ophthalmic-ointment/

Additionally, in order to support newborn primary care, facilities should include a note in the newborn health record that is provided to parents indicating whether erythromycin ophthalmic ointment was administered. Parents and all neonatal healthcare providers should also be made aware of the symptoms of ophthalmia neonatorum and advised to monitor for these symptoms within the first four weeks of life and to seek medical treatment at any signs of infection.

The ministry will provide updates as further information becomes available. We would also like to remind all healthcare professionals that once the supply of erythromycin is returned to normal stock levels, routine administration of the ophthalmic prophylaxis to the eyes of newborns should continue as required under Regulation 557 Communicable Diseases – General under the Health Promotion and Protection Act.

We request that you share the information in this memo with hospitals and other health system partners (e.g. primary and emergency care; midwives) in your jurisdiction.

Thank you for your assistance.
David C. Williams, MD, MHSc, FRCPC
Chief Medical Officer of Health

c: Roxana Sultan, Executive Director, PCMCH

Relevant Documents

public://2019-03/1. Screening Algorithm – shortage of erythromycin 2019March14.pdf

public://2019-03/2 Response to Lab Algorithm-shortage of erythromycin 2019March14.pdf

public://2019-03/CMOH Memo Erythro Shortage.pdf

March 21, 2019
Data to Decisions eBulletin #85: Building Together Synopsis
In this issue
- Building Together: How to become a high-performing team Workshop Synopsis
Building Together: How to become a high-performing team Workshop Synopsis

On March 6th and 8th, 2019, 51 healthcare professionals working in primary care teams across Ontario came together in Ottawa and Toronto for the Building Together: How to become a high performing team workshop.

Dr. Judith Belle Brown led the plenary session through an exploration of the foundational elements that teams are built on. These elements include having a common philosophy toward teamwork, strong relationships, open communication, and a shared commitment to good patient care. Dr. Brown also discussed the evolution of primary care teams throughout her research journey, as well as the preliminary results from the QI Enablers Study.

Wisdom from the Field: Participants share ideas they plan on trying with their team.

Throughout the day, participants learned about three pillars of teamwork identified from the QI Enablers Study that contribute to interdisciplinary collaborative teamwork in primary care. These pillars include leadership, team building and optimizing physical space. During these small group sessions, participants were able to brainstorm ideas on how they can strengthen these pillars within their teams. At the end of the day, individuals were able to vote on their favourite ideas they plan on bringing back to their teams.

Leadership

In small groups, participants were asked to answer the following questions:
- What opportunities are there in your team to take part in leadership activities?
- How can your team create opportunities for leadership?
- How can your team share leadership within your team?
- How can your team support leadership?
Click here for the list of top ideas participants voted on to take back to their own teams.

Team Building

In small groups, participants were asked to answer the following questions:
- What informal activities happen in your team?
- Who leads them?
- How do they make it happen?
- What would it take for your team to have regular team meetings (e.g., time, location, who is involved)?
- How can your team increase awareness of your team members’ scope of practices (through formal and informal activities)?
Click here for the list of top ideas participants voted on to take back to their own teams.

Optimizing physical space

In small groups, participants were asked to answer the following questions:
- What are the innovative strategies you have used to address issues with physical space?
- Successful
- Unsuccessful
- What effective relationship building activities have you used to optimize your physical space?
Click here for the list of top ideas participants voted on to take back to their own teams.

More ideas from the small group sessions

More ideas for Leadership

More ideas for Team Building

More ideas for Optimizing Physical Space

We would like to thank everyone who came out to the sessions. If you have any questions or comments regarding the session or its content, please contact improve@afhto.ca.

Thank you to our supporting partner
We are grateful to our research partners at the Centre for Studies in Family Medicine, Western University, through the INSPIRE2-PHC program funded by the Ontario Ministry of Health and Long-Term Care. Our partners have provided practical support for the research and funding for the workshops.

In Case You Missed It: Check out eBulletin #84 or other back issues here!

Questions? Comments? Connect with the QIDS team at improve@afhto.ca.
March 21, 2019

Bits & Pieces: Restructuring of the Health Care System webinar, Nutrition month & more

Your Weekly News & Updates

In this Issue:
Restructuring of the Health Care System: What You Need to Know March is Nutrition Month! Reminder – AFHTO 2019 Conference call for working groups deadline Mar. 26 OHA board self-assessment tool	Health Quality Ontario updates Reminder – deadline to sign up for Harvard ManageMentor Mar. 25 OHIP+ updates Upcoming events such as a Collaborative Mentoring Network conference and more

Restructuring of the Health Care System: What You Need to Know
The health care system is undergoing a major structural overhaul. The People’s Health Care Act was introduced on February 28, the Ontario Health board of directors was announced on March 8, and the first Expression of Interest for Ontario Health Teams is expected soon.

Join AFHTO and Hill+Knowlton Strategies on Tuesday, April 2, from 12 PM to 1:30 PM to discuss what this may look like, expected timelines, and how teams can be leaders in health system restructuring.

March is Nutrition Month!
Please join our Registered Dietitians in celebrating the impact of good nutrition on our patients’ health outcomes. Primary health care dietitians provide medical nutrition therapy which can lower A1c by 1-2%, lower blood pressure as well as 1 medication.

The Mediterranean Diet gives evidence- based interventions. The recent SMILE and HELFIMED studies clearly demonstrate that the Medi Diet can also have a positive impact on mental health – depression. Please see the attached patient handout that highlights the link between Medi Diet and mental health.

There’s also a presentation created for waiting room monitors. Your Registered Dietitians are proud to serve our primary health care team patients!

Reminder – AFHTO 2019 Conference call for working groups deadline Mar. 26

Get the scoop on the latest innovations in Ontario primary care. Join a working group today.

We have officially launched our 2019 conference, Health System Integration Built on the Foundation of Team-Based Primary Health Care, and working group members also receive a $50 discount off their registration fee. Deadline Mar. 26, 2019.

OHA board self-assessment tool
Boards that self-assess can better identify the areas in which they are performing well as a board, areas for improvement and areas of concern. The Ontario Hospital Association is once again offering the Board Self-Assessment Tool, an online, questionnaire which must be completed by each board member individually. Free to OHA members, it’s available until June 4, 2019.

Health Quality Ontario updates

New quality standards:

Health technology assessments:

Reminder – deadline to sign up for Harvard ManageMentor Mar. 25
Recently we had a lunch and learn session hosted in partnership with Harvard ManageMentor. The video is now on our members only site.

For demo access:
•   url: http://courses.edls.com/login/dames_leads
•   username: afhto_demo
•   password: harvard (all lower case)

If you have any questions about Harvard ManageMentor and/or Spark, please contact Candace Dames at cdames@edls.com or (647) 838 2555. If you’re interested in participating, please contact Bryn Hamilton, by March 25.

OHIP+ updates
The Ministry is hosting weekly webinars to provide an overview of the redesigned OHIP+ and to answer questions regarding changes to Ontario Drug Benefit program coverage for children and youth aged 24 years and under. The next webinar is on Wed. March 20, 2019 from 12:15-1:00 pm.

Teleconference information will be available at this link 10 minutes prior to the start of the webinar. Please mute your phone by pressing *6 once you have dialed in. If you don’t have the latest version of Adobe installed on your device, please click on the link a few minutes early in the event you are prompted to update your software.

Patient and pharmacist FAQs in English and French are also available on the Ministry’s website.

Transforming Primary Care for Older Adults Living with Frailty, Mar 21, 2019
Learn how to better care for older patients in this interactive webinar supported by the Canadian Frailty Network & AFHTO. Suitable for all team members. Register here.

Governance Webcast Series: Risk Management, Mar. 27, 2019
Join us to discuss risk management and the board’s role and leading practices in this. Register here.

Leadership in Primary Care Collaborative Mentoring Network Conference, Mar. 25, 2019
OCFP’s inaugural conference for the Leadership in Primary Care Collaborative Mentoring Network, ‘Connected Leadership for Greater Competence, Confidence and Capacity‘. Register here.

A Successful Nurse-Led Program in Primary Care For Patients With Chronic Pain, Apr. 18, 2019
Learn about the feasible, evidence-based and cost-effective program based on SMS. Held by the CNCP. Find out more here.

Big White Wall and BounceBack: Free Psychotherapy Services For Adults And Youth With Mild To Moderate Depression And Anxiety, Apr. 4, 2019
Attend this accredited webinar to learn more about these free mental health services. Register here.

March 19, 2019

Building Together: How to Become a High Performing Team – Post Workshop Synopsis
Building Together: How to become a high performing Team

Post Workshop Synopsis

On March 6th and 8th, 2019, 51 healthcare professionals working in primary care teams across Ontario came together in Ottawa and Toronto for the Building Together: How to become a high performing team workshop.

Dr. Judith Belle Brown led the plenary session through an exploration of the foundational elements that teams are built on. These elements include having a common philosophy toward teamwork, strong relationships, open communication, and a shared commitment to good patient care. Dr. Brown also discussed the evolution of primary care teams throughout her research journey, as well as the preliminary results from the QI Enablers Study.

Wisdom from the Field: Participants share ideas they plan on trying with their team.

Throughout the day, participants learned about three pillars of teamwork identified from the QI Enablers Study that contribute to interdisciplinary collaborative teamwork in primary care. These pillars include leadership, team building and optimizing physical space. During these small group sessions, participants were able to brainstorm ideas on how they can strengthen these pillars within their teams. At the end of the day, individuals were able to vote on their favourite ideas they plan on bringing back to their teams.

Leadership

In small groups, participants were asked to answer the following questions:
1. What opportunities are there in your team to take part in leadership activities?
2. How can your team create opportunities for leadership?
3. How can your team share leadership within your team?
4. How can your team support leadership?
Click here for the list of top ideas participants voted on to take back to their own teams.

Team Building

In small groups, participants were asked to answer the following questions:
1. What informal activities happen in your team?
2. Who leads them?
3. How they make it happen?
4. What would it take for your team to have regular team meetings (e.g., time, location, who is involved)?
5. How can your team increase awareness of your team members’ scope of practices (through formal and informal activities)?
Click here for the list of top ideas participants voted on to take back to their own teams.

Optimizing Physical Space

In small groups, participants were asked to answer the following questions:
1. What are the innovative strategies you have used to address issues with physical space?
2. Which were successful?
3. Which were unsuccessful?
4. What effective relationship building activities have you used to optimize your physical space?
Click here for the list of top ideas participants voted on to take back to their own teams.

More ideas from the small group sessions
We would like to thank everyone who came out to the sessions. If you have any questions or comments regarding the session or its content, please contact improve@afhto.ca.

Thank you to our supporting partner

We are grateful to our research partners at the Centre for Studies in Family Medicine, Western University, through the INSPIRE2-PHC program funded by the Ontario Ministry of Health and Long-Term Care. Our partners have provided practical support for the research and funding for the workshops.
March 15, 2019

Bits & Pieces: revamped website, our 2019 conference, March deadlines & more

Your Weekly News & Updates

In this Issue:

Introducing our revamped website
AFHTO 2019 Conference call for working groups
Leadershift 2019 spring cohort deadline
Reminder- transforming primary care for older Canadians living with frailty
Harvard ManageMentor video available-deadline Mar. 25

Health Quality Ontario draft quality standards
Advance Care Planning Day 2019
Save the date: LeaderShift Conference, July 11, 2019
Ontario Works Handbook
Upcoming events on risk management and more

Introducing our revamped website

We’re pleased to introduce our new website, updated with a new look and layout. Now updated to become an even better resource to the public and members alike. Changes include:

Individual login for members
Improved search experience
Making it easier for people to find teams

To learn more, please see our Frequently Asked Questions. Adjustments to all the content we’ve brought over are ongoing, but if you spot a glitch, please feel free to contact us.

AFHTO 2019 Conference call for working groups

We have officially launched our 2019 conference, Health System Integration Built on the Foundation of Team-Based Primary Health Care.

Play a vital role in shaping the conference by joining a working group today. Come behind the scenes and be the first to learn about new developments in the field, influence conference programming and discover the latest innovators in your areas of interest. Working group members also receive a $50 discount off their registration fee. Deadline Mar. 26, 2019.

Leadershift 2019 spring cohort deadline

As the LeaderShift Project enters its final year, we’d like to strongly encourage you to apply for a spot in an upcoming LEADS Learning Series cohort.

The upcoming cohorts are in Oshawa, Hamilton and Toronto in May/June 2019. There are zero registration fees for members and travel subsidies are available. No formal educational prerequisite is required.

For more information on HOW TO APPLY TODAY click here. Deadline Mar. 18, 2019.

Reminder- transforming primary care for older Canadians living with frailty

Remember to register for the upcoming webinar, Transforming Primary Care for Older Canadians Living with Frailty scheduled for Thurs., Mar. 21 from 12-1pm. This webinar is for all members of the team. For more information, click here.

Harvard ManageMentor video available-deadline Mar. 25
Last Tuesday we had a lunch and learn session hosted in partnership with Harvard ManageMentor. The video is now on our members only site.

For demo access:

url: http://courses.edls.com/login/dames_leads
username: afhto_demo
password: harvard (all lower case)

Health Quality Ontario draft quality standards

Send feedback on the following draft quality standards by Mar. 18:

Advance Care Planning Day 2019
Advanced Care Planning Day 2019 is on Tues., April 16. Hospice Palliative Care Ontario invites you to consider planning an educational or promotional event within your organization or community.

The National ACP Day Campaign Toolkit developed by the Canadian Hospice Palliative Care Association (CHPCA) and the National Speak Up Campaign has resources that can help. Find out more here.

Save the date: LeaderShift Conference, July 11, 2019
Mark your calendars! LeaderShift will be hosting a one-day leadership conference on July 11, 2019, at the BMO Institute for Learning in Toronto. You won’t want to miss out on this exciting, ground breaking leadership development conference for leaders in community and primary health care. This event could not be timelier, so stay tuned for more detail and check out www.leadershiftproject.ca, which will be updated regularly.

Ontario Works Handbook
OpenLab has created An Insider’s Guide to Ontario Works handbook that was co-designed by people with lived experience with being on Ontario Works.

Done in partnership with City of Toronto Employment & Social Services, Working for Change, this City of Toronto-specific handbook is packed with practical tips, tools and strategies that will help someone navigate the Ontario Works system.

You can access the guide here or if you wanted printed copies, you can email openlab@uhn.ca. Any questions can be directed to Tai Huynh, Creative Director, at tai.m.huynh@gmail.com.

Governance Webcast Series: Risk Management, Mar. 27, 2019
Join us to discuss risk management and the board’s role and leading practices in this. Register here.

Charting the Future of Primary Care: Leadership, Teams, and Culture, Apr. 11-12, 2019
The Ivey Academy’s new executive education program for physicians, delivered in partnership with Harvard Medical School. Find out more here.

March 13, 2019

AFHTO 2019 Conference: create YOUR conference program. Sign up by Mar 26
AFHTO 2019 Conference
Health System Integration Built on the Foundation of Team-Based Primary Health Care

Join a working group

Play a vital role in shaping the conference by joining a working group today. Come behind the scenes and be the first to learn about new developments in the field, influence conference programming and discover the latest innovators in your areas of interest. Working group members also receive a $50 discount off their registration fee.

Please extend this invitation along to your patients, colleagues and staff. Having diverse voices, especially patients, in the working groups helps us build a varied and relevant program.

Conference Themes

We’re setting up working groups for each of the six concurrent streams and for the Bright Lights Awards program. The six concurrent streams will focus on:
1. Access to care: improving access to team-based care
2. Continuous care: ensuring seamless transitions for patients across the continuum of care
3. Comprehensive team-based care
4. Patient and family-centred care
5. Community and social accountability
6. Enabling high -performing primary health care
(Full descriptions here)

Working Group Details

Concurrent program working group members:
The task requires a total of 4-10 hours of effort between April and May, specifically:
- March 27 to April 24: AFHTO staff will manage the call for proposals process.
- Week of April 8: working groups will have an initial teleconference to brainstorm ideas on specific topics and speakers to contact/encourage to submit a presentation abstract.
- April 26 to May 10: each working group member individually reviews and scores presentation abstracts for their program.
- May 13 to 17: working groups will teleconference to review scores and determine the program for this theme.
Sign up by March 26, 2019 to confirm your participation and select your conference theme.

<em>                                                                                  AFHTO 2018 Bright Lights winners</em>

“Bright Light” Awards Review Committee:
The task requires a total of 6-12 hours in July, specifically to individually review and score nominations followed by a group teleconference to determine the award winners. Sign up by March 26, 2019.

We will also need volunteers at the conference itself (e.g. at the registration desk). There may be other duties as we update our conference program but like other volunteers described above, onsite volunteers will receive discounted conference registration. Sign up today.

Registration Fees for Conference Working Groups:
- Conference working group members and presenters receive a $50 discount off their registration fee.
- We understand patients face additional financial and time pressures and do not want the registration fee to limit participation in a working group. Patients participating in full in a conference working group will be eligible for complimentary registration (to be determined once the working group task is complete).
AFHTO members still receive a 50% discount on conference registration fees.

Conference key dates:
- March 27, 2019: Applications for concurrent session and poster abstracts open
- April 24, 2019: Deadline to submit concurrent session and poster abstracts
- June 2019: Conference registration opens
- September 19 & 20, 2019: AFHTO 2019 Conference
For more information, you can contact us by phone (647-234-8605) or e-mail (info@afhto.ca).
March 8, 2019
Introducing our revamped website
We’re pleased to introduce our new website, updated with a new look and layout. Now updated to become an even better resource to the public and members alike. Changes include:

Individual login for members– now members can register for their own login by clicking on this button at the top of our home page. No more need to email us if you’ve forgotten your password- you can reset it yourself.

Improved search experience – not only is our search tool more sensitive, bringing you even more appropriate results, you can filter by topics and tags.

Making it easier for people to find teams – not just using Google Maps and a table. Teams can be sorted alphabetically and by region. Multiple sites can be added as well.

Other changes to improve your experience:
- Better use of roles and permission levels – members-only items are only visible once you log in, and sensitive items specific to the leadership triad are only visible to qualifying members.
- Simplified structure– we had quite a few categories and subcategories on our old site and these determined whether a specific post was public or members-only. Now we have just 9 topics, and ‘public vs. members-only’ is picked according to content instead. This makes it easier to share resources with partners as needed.
- Online job posting – now open to qualifying organizations for a moderate fee, AFHTO members can still post for free here once logged in, instead of sending an email.
- Fresh pics – we’ll be changing our home page photo throughout the year, all the better to reflect the interprofessional comprehensive care AFHTO members provide. These gear towards member photos, including those from past Bright Lights nominations, like our current picture, from McMaster FHT.
- And more!
If you have any questions, please see our Frequently Asked Questions below. Adjustments to all the content we’ve brought over are ongoing, but if you spot a glitch, please feel free to contact us. We may experience some glitches during launch, so please bear with us as we work to update your website experience.

We hope you enjoy the new site. If you have any questions, comments or suggestions please e-mail info@afhto.ca.

Frequently Asked Questions

1. Why have you changed the site?

The changes to the AFHTO website are part of an overall strategy to provide a more streamlined user-friendly experience for our members and partners, tailored for each. In our old website, members were finding it increasingly difficult to find the information they needed. We’ve taken this opportunity to re-organize the content, refine the search experience, and provide direct access to the newest and most relevant information.

2. Ok, but why are you doing it now?

We actually started this process last spring, as reported to members during our 2018-19 renewal season. It’s simply taken until now because it’s a fairly involved project and we wanted to make sure we got it right.

3. I don’t see members only news on the home page any more. Where is it?

Before, everyone visiting the AFHTO website could see the titles of webpages in Members Only News and under AFHTO Programs. Now you must log in as a member to see any members only items.

4. What is my log-in for the Members Only section?

We now have individual instead of team login. Click on Member Login to start setting up your individual login. All individuals will be verified by AFHTO staff before permission is granted, so to facilitate the process, please use your team’s email address if you have one. If you experience any difficulties, please e-mail info@afhto.ca.

5. Can I share my Members Only log-in with my colleagues?

We no longer have team log-in to the AFHTO website. Please encourage your colleagues, affiliated physicians and board members to create their own and do not share your login with anyone else.

6. I can’t find what I’m looking for. Where can I get help?

With the reorganization of the site, some content may be in new sections. While we hope this has made things easier to find, we understand there may be a period of adjustment. A few tips for searching content:
- Keyword Search– Click on the search icon at the top right of your screen and input key words. The search results will pull all public and members only content on the website based on the key word search and your login status. You can further filter by topic and sort by relevance or date.
- Explore – you can click on ‘Explore’ at the top of the screen or explore topics in the middle of the home page to see posts in any of 9 topics. You can also click on the tags, if any, on these posts.
And if you’re still not able to find what you’re looking for, please email us at info@afhto.ca or call 647-234-8605 x200.

7. I’ve found something out of date or incorrect on the website. How can I get this changed?
Please send an e-mail to info@afhto.ca with the URL and section of the page that needs updating. We will make necessary corrections as needed.

8. How can I add an event, careers posting, member story, etc.?

For career postings: AFHTO members are welcome to post job openings on this site, free of charge, while qualified non-member organizations can now do so for a moderate fee. Both can do this online through our Careers page. Members need to be logged in to post for free.

For other content, please send an email to info@afhto.ca with your request to post content on the AFHTO website. As a rule, we accept requests as follows:
- Events: We will post conferences, webinars, education opportunities and other events that are relevant to AFHTO members and organized by AFHTO partners, non-profit organizations and/or government agencies.
- Members’ stories: both success stories and ‘members in the media’ posts are curated from Canadian news sites. We invite all AFHTO members to share their accomplishments and updates to be posted.
- Member resources and shared templates: The Members Only website holds a repository of templates and resources developed by other teams. All members are welcome to share content.
- Other resources: We will post free resources for AFHTO members on our Members Only website. Please contact us to see what information may be relevant.
Need further help? Contact us at info@afhto.ca or call 647-234-8605 ext. 200.
March 7, 2019
An Update on The People’s Health Care Act, 2019
An Update on The People’s Health Care Act, 2019

On February 26^th, the Minister of Health and Long-Term Care, Christine Elliott, announced the government’s plans for health system transformation by tabling the proposed legislation, Bill 74, The People’s Health Care Act, 2019. While some matters are still unknown with regards to the implementation of the legislation, there are two parts of the Act that may have impact for our members and are being highlighted.

Ontario Health (previously known as the ‘Super Agency’)

This new agency would deliver health care province-wide through the consolidation of 20 current Crown organizations including:
- Cancer Care Ontario
- Health Quality Ontario
- eHealth Ontario
- Trillium Gift of Life Network
- Health Shared Services Ontario
- HealthForce Ontario Marketing and Recruitment Agency
- 14 Local Health Integration Networks
Ontario Health would be an agency under the Broader Public Service Accountability Act and would be governed by a 15-person Board of Directors that will be appointed by Cabinet. A CEO search is underway, with a focus on people with a business background.

Ontario Health Teams (previously known as ‘MyCare Groups’)

Ontario Health Teams (OHTs) will be responsible for delivery of patient care in a defined geography with the intent to deliver, in an integrated and coordinated manner, at least three types of health services including:
- Hospital care
- Primary care
- Mental health and addictions care
- Long-term care
- Home and community care
- Palliative care
Although there appears to be 30 unsolicited proposals already submitted to the Ministry, all proposals will need to undergo a formal Expression of Interest (EOI) and a readiness assessment, which will also include a site visit that would include speaking to all partners identified in the proposal. At full maturation, it’s anticipated there will be 30 to 50 OHTs across the province, each serving between 50,000 to 500,000 people with an average of around 300,000.

How does this all impact team-based primary care?

*NOTE: this is speculative and would need to be verified once more information is known on the roll out of the new agency

Ontario Health:
- The legislation defines that FHTs and NPLCs will now be defined as ‘health service providers’ which means at some point, all contracts will move over to the agency BUT at the moment things will be status quo until they sort out contract management – it appears that current FHT contracts will probably stay in effect for some time and the NPLC contract will need to be opened up to allow for an assignment clause to Ontario Health. This could all take some time.
- The LHINs may be in existence for a while with the function of managing home and community care until they are transferred, possibly to the OHTs (ensuring continuity of patient care).
- Five regional entities will be established under the agency to provide more oversight of health service delivery.
- It’s not well understood if family physicians can be defined as an HSP but the legislation allows ‘any other person or entity or class of persons or entities that is prescribed’.
Ontario Health Teams:
- Primary care can apply to lead the development of an OHT in their community, especially if the size of the population that they serve are over 50,000.
- Governance structures will remain but there would be one budget that the lead would be accountable for – the focus right now is on collaborative governance, with a focus on seamless transitions of care for patients.
- There will be a readiness assessment with the early adopters and site visits – if a proposal indicates that partners are going to participate, they’ll visit and see what that means if there was true collaboration in developing the proposal.
- OHTs will have supports from the government and will also be a conduit to identify legislative and regulatory barriers to success, barriers to integration, sharing or best practices, tools for digital health and communications and change management assistance.
Overall – there aren’t many answers yet and more information will follow as the Ministry starts working on its implementation plan. AFHTO looks forward to working with stakeholders including OCFP, Section on General and Family Practice, NPAO, and others to ensure that primary care’s foundational role in health system transformation is recognized.

Next Steps:
- AFHTO will be setting up a webinar with H&K to walk through the Act and to explain the EOIs when they come out – anticipated date for roll out is mid to late March so stay tuned for more details.
- Sign up for the Ministry e-newsletter which will send you updates as they become available: https://mailchi.mp/ontario/connectedcareupdates
- As this rolls out there will be a lot of questions so please let us know at info@afhto.ca – we will be having ongoing conversations with the Ministry during the implementation of the Act and would like to let them know about concerns/questions from the field.
- If you or your team is interested in leading and/or participating in the EOI when they become available, please let us know at info@afhto.ca so that we can ensure the decision makers in the Ministry are also aware.
Reference Documents:
- Detailed memo on The People’s Health Care Act, 2019 from H&K (February 28, 2019)
- Concise memo on The People’s Health Care Act, 2019 from H&K (February 28, 2019)
- Flash Update on the Minister of Health and Long-Term Care Announcement of The People’s Health Care Act, 2019 (February 26, 2019)
- Government Transformation of the Health Care System including backgrounder of the announcement and other documents
March 5, 2019
Governance Webcast Series: Strategic Planning
Strategic planning is key to an organization’s growth and success. How to develop a strategic plan, why this is important, and the board’s role in implementation were reviewed on a webcast on February 20.

A Strategic Planning Toolkit has been designed for teams as a guide for developing a strategic planning process and a strategic plan:
- Strategic Planning Toolkit
This toolkit was reviewed on the same webcast as the public complaints toolkit. The recording of the webcast is below. Strategic planning is the first half:

Presenter: Catherine Anastakis, Collaborative Solutions

Below are some resources provided by members to use as templates, if needed:
- Leeds and Grenville Community FHT Strategic Plan
- Leeds and Grenville Community FHT Strategic Plan – one-pager
This is part of the “Raising the Bar on Governance – Webcast Series,” which has been developed in response to new governance requirements, ongoing member feedback and advice from our Board Chair Leadership Council.
March 4, 2019

Author: admin

An Opportunity for Quality: The Need for Better Evaluation of Family Health Teams in Ontario

Memo from Chief Medical Officer of Health

In this issue

Building Together: How to become a high-performing team Workshop Synopsis

Wisdom from the Field: Participants share ideas they plan on trying with their team.

Leadership

Team Building

Optimizing physical space

More ideas from the small group sessions

Your Weekly News & Updates

Building Together: How to become a high performing Team

Post Workshop Synopsis

Wisdom from the Field: Participants share ideas they plan on trying with their team.

More ideas from the small group sessions

Your Weekly News & Updates

AFHTO 2019 Conference Health System Integration Built on the Foundation of Team-Based Primary Health Care

Conference Themes

Working Group Details

Conference key dates:

Frequently Asked Questions

AFHTO 2019 Conference
Health System Integration Built on the Foundation of Team-Based Primary Health Care