City of Lakes FHT is pleased to share a video that covers their mission, vision and introduces their interdisciplinary healthcare team and services.
Whether or not you’re their patient, you may not be aware of all the things they do. From services to programs to digital health, they’re constantly working to create a better healthcare experience for their patients.
For more information on City of Lakes FHT, please visit their website.
What is Breast Cancer?
Recommendations for Breast Cancer Screening
Initiatives by Teams
Our teams are doing some great work with breast cancer screening. Below are some initiatives that your team can implement if you’re looking to enhance cancer screening.
Resources and Research
Support Services for Patients and Caregivers
Upcoming QI Events:
Other Resources:
References
In Case You Missed It: Check out eBulletin #90 or other back issues here!
Questions? Comments? Contact us at improve@afhto.ca.
Elliot Lake Today article published September 17, 2019
By Brent Sleightholm, Elliot Lake Today
Elliot Lake’s Family Health Team representing 10 family physicians along with two nurse practitioners and a cadre of other health care providers, allied staff who work with them, is looking for $72,000 from the City to set up a virtual health clinic at their downtown facilities, next year.
The clinic, said health team Executive Director Nancy Ewen, would operate five days a week, weekdays, with Dr. Maria Celia Raquel Lopez interacting with Elliot Lake non-rostered patients on a video link.
Ewen said Lopez has previously served as a locum (a person who stands in for an absent doctor) in their clinic. Non-rostered patients are patients who do not have a family doctor.
The health team’s initial ask is $300 a day, two days a week, to fund the trial project which will run from the last week in September through the end of December, this year. As well, the health team wants City Council to approve spending $72,000 in 2020 which Ewen said it would cover their operating expenses for the five-day-a-week program next year.
The virtual clinic concept was raised at Monday afternoon’s meeting of the Elliot Lake Finance and Administration Committee.
The Committee voted unanimously in favour of a $3,900 trial for the rest of this year and a priority spot on the 2020 city budget roster for $72,000 for all of next year. Two members of the standing committee, Mayor Dan Marchisella and Councillor Chris Patrie, were absent from the meeting. The recommendation will go on to City Council. The City’s budget process is expected to get started in October.
“They (virtual clinics) are temporary solutions to deliver care to non-rostered patients,” Ewen told the committee. “Virtual clinics are popping up all over Ontario.”
“A couple of cases I have heard of, New Liskeard has had a successful virtual clinic,” she said.
Once a doctor was recruited there the virtual patients were absorbed into the new practice and the New Liskeard virtual clinic was disbanded, Ewen added.
“Peterborough still has a virtual clinic in place, looking after non-rostered patients and Kapuskasing has something called a locum clinic, where they actually bring in locums, so it’s not virtual,” she said.
“At the Family Health Team, we were established in 2007. We have 10 family physicians on site right now. Three of these are over the age of 65. Three are between 55 and 65 so they are starting to wind down, starting to look at retirement.” She added that the health team has some 10,000 rostered patients who come through their doors every month.
The elephant in the room, though, was the crush to the system from the estimated 1,300 non-rostered patients who live in Elliot Lake.
Ewen provided that figure which she said was derived from the Ontario Ministry of Health and Long Term Care, “As well as conversations with our physicians.”
The virtual clinic will be operated on the second floor of the health team’s downtown headquarters.
Later in the meeting, during the public question period, Elliot Lake resident Mike Thomas told the committee he had been an advocate of the clinic idea for years. He said, “I think that would be great.” But at the same time, he wondered if the virtual clinic would be effective.
He added that he has seen both sides of the Elliot Lake healthcare system, as a non-rostered patient and one who is rostered with a doctor. In Mr. Thomas’ words, “As you know, I was in an accident in 2017. Some of the forms, prescriptions, referrals, they’re pretty tough.”
Thomas went on, “I don’t see that changing, with the transfer to a rostered patient.” Regarding the virtual clinic platform from ELFHT, Mr. Thomas said, ” I wish we could bring more of their services forward. We need to know how much of their services they’re going to roll over.” He also said he believes the Health Ministry’s estimate of 1,300 non-rostered patients in Elliot Lake is low.
“We have had a non-opioid policy as long as I’ve been here,” Thompson said.
He wondered how family health team physicians would be able to carry out prescription requisitions for senior retirees, many of whom have been prescribed opioids elsewhere, in light of the family health team’s strictures.
“So are you going to get into the details of that when it goes forward to Council?” he asked the committee.
“For any of those people, those seniors, who come to Elliot Lake, are you going to have them write their prescriptions? Because most of their prescriptions are opioids,” said Thomas.
Committee Chair Councillor Norman Mann responded.
“On an operational level, it is up to the Elliot Lake Family Health Team Directors to decide how to proceed,” Mann said. “So I would suggest their Board of Directors will decide on the clinic and what form of mandate it will have. That is not something I can discuss.”
“But (The City) as a funder of the Elliot Lake Family Health Team, we would ask them for their consideration of your concerns.”
Ewen said she needs an answer from the city on the Elliot Lake Family Health Team clinic funding proposal by November.
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Dr. Linda Lee wins Joule grant for MINT Memory clinics
Dr. Linda Lee, Centre for Family Medicine FHT won a Joule 2019 Innovation grant for access to care on Sep. 10. A $100,000 grant has been allocated to help scale up the MINT memory clinic model beyond their 112 clinics in Ontario.
New resources, including an infographic, are also available at their site.
Members in the media
Couchiching FHT: feature on their Bright Lights award-winning trans health program
Elliot Lake FHT: Virtual Clinic coming to Elliot Lake Family Health Team
OHT Webcast Series: The Shift to Shared Leadership video and slides available
On Sep. 12 we held a webinar reviewing approaches to creating shared leadership tables and/or working groups and offered practical “OHT Starter Kit” tips and tools. We were joined by our partners at the Ontario Community Support Association and Advantage Ontario as co-hosts.
The webcast was facilitated by Karima Kanani, Partner at Miller Thomson LLP, and Keri Selkirk and Maria Sanchez-Keane from the Centre for Organizational Effectiveness.
Slides and video are on our site, along with other resources.
HQO quality standard updates including mental health transitions
Seeking volunteers for quality standard advisory committee on inpatient mental health transitions– This quality standard will outline care for people moving between the hospital and home after a mental health or addictions related stay. Deadline to apply Oct. 8.
Draft diabetes quality standards and patient conversation guides- feedback needed by Oct. 10:
Ministry of Health news and updates
Memo – seasonal influenza update CMOH – overview of actions they’re taking to help partners mitigate and prepare for health system pressures.
Situation report #2: RYUK security incident advisory – a second hospital was hit with RYUK ransomware Wednesday, Sep. 25. As there is a risk of further incidents beyond hospitals, the ministry is issuing a second advisory and is expanding distribution to the broader health system. Read the advisory and the recommendations.
Drug Shortage / Supply Health System Alert: Fresenius Kabi – Oxytocin 1ml vial – due to higher than anticipated demand, their stock of Oxytocin Injection Synthetic 10 USP units/mL SD vial 1mL has been depleted earlier than expected and will be going on backorder effective September 30th, 2019. Read the update here.
Canadian Conference on Dementia, October 3, 2019
Held in Quebec City and featuring plenary and parallel sessions, an exciting debate, interactive workshops, as well as oral and poster presentations. Find out more here.
Palliative and End-of-Life Care & MAiD Educational Opportunities, October 16 – December 11
Take a look at this 5-part webinar series developed by Queen’s University Faculty of Health Sciences, in partnership with the OCFP. Find out more here.
BoneFit, October 5, 2019 to March 28th, 2020
Osteoporosis Canada is holding these evidence-informed exercise training workshops around Ontario at the Basic and Clinical levels. See the locations and dates here.
Improving timely access to primary care, Oct. 9, 2019
HQO webinar to share findings from 2019/20 Quality Improvement Plan indicator measuring timely access to a primary care provider. Register here.
ECHO Chronic Pain/Opioids evening series, Oct. 7- Nov. 4, 2019
A 4-part evening ECHO series on Buprenorphine/Naloxone prescribing in primary care. Register here.
Liver Disease in Primary Care: Approach to Fatty Liver, Oct. 17, 2019
Part of ECHO Liver quarterly evening series. Find out more here.
September 25, 2019
MEMORANDUM TO: Health System Partners
FROM: David C. Williams
Chief Medical Officer of Health
Ministry of Health
Dear health system partners,
In advance of the expected annual increase in health system demand due to the approaching influenza season, the ministry would like to provide an overview of actions we are taking to help partners mitigate and prepare for health system pressures. While concerns have been raised regarding the early season Australia has experienced in 2019, it is unclear what this means for Ontario given our very different preceding season and inter-season activity. Monitoring and preparedness for any early or unusual influenza activity in 2019-20 has begun and will continue throughout the season as per usual. This is also a year of change in the health system, and it is important that all parts of the system work together to manage the potential impact.
We are updating the annual ministry Planning Guide for Respiratory Pathogen Season, expected to be released by end of September. The guide will include sector-specific resources, planning considerations/expectations and recommended practices. This guide will also include an overview of response actions undertaken by the Health System Emergency Management Branch (HSEMB) throughout the influenza season.
HSEMB will hold its annual Respiratory Pathogen Surge Knowledge Exchange Webinar in October with partners from across the Ministry, Public Health Ontario (PHO) and other health system partners to provide an overview of the upcoming influenza season and readiness activities, highlight process changes from last year, and answer any questions. An invitation for this webinar will be sent to health system partners.
Please see the complete memo below for recommendations for health care providers in Ontario:
Orillia Matters article published September 24, 2019
By Jessica Owen, Village Media
The Couchiching Family Health Team was given a major honour last week for shining a light on an under-served segment of the population.
The group won a Bright Lights Award for community and social accountability from the Association of Family Health Teams of Ontario (AFHTO) on Sept. 19, recognizing the work they’ve done on their Trans Health Services program, which launched late last year.
“I was there with our peer support navigator, and we were both pretty close to tears,” said Angela Munday, director of clinical services with the Couchiching Family Health Team in Orillia. “It’s quite an honour to be recognized by your peers to be doing something innovative and shows we are accountable to our community.”
“When I think about how little there is out there for the transgender population… it makes me very proud to work here, on a team that’s able to say we’re on the cutting edge of services that are coming out,” she added.
Started last year through the North Simcoe Muskoka Local Health Integration Network (LHIN) in collaboration with Orillia Soldiers’ Memorial Hospital (OSMH), the program was created to fill a gap in services.
“(OSMH) was looking to make their services more inclusive for the LGBTQ population. They put in a proposal (for this program) to the LHIN, but they were turned down because they wanted this program to be in the community, not in the hospital,” said Munday.
“They kind of came to us in the eleventh hour and asked (us), and we said ‘Absolutely,’ with no hesitation,” she said.
The funding went toward hiring a four-day-per-week nurse practitioner and a full-time peer support navigator who is, themselves, transgender. The duo work in collaboration to provide the best service they can for transgender patients throughout their journey.
“Patients generally will see both of them, but it just depends on the patient’s needs,” said Munday. “The team will help them work through the patient’s thought process and help them with whatever they need.”
The reasoning behind starting the program comes from major barriers transgender people face when trying to access health care.
According to a Trans Experience Study done in North Simcoe this year, Munday said 54 per cent of transgender people avoid needed health care, 33 per cent avoid going to the local emergency department while 16 per cent will even avoid calling 911 when they are in urgent crisis.
“They’re afraid of how others will react to their identity,” she said. “That’s really what we’re trying to target with this program.”
Another component of the program sees the nurse practitioner providing training for ways to deal with transgender patients for primary-care providers, in partnership with Rainbow Ontario.
“So, we’re not only trying to provide front-line care… we’re also trying to build the capacity within our region, so trans healthcare becomes part of regular healthcare,” she said.
Munday said currently in Ontario, programs that serve primarily the transgender population are extremely rare, and ones that receive provincial funding to do so are even rarer.
This program is the only one of its kind in Simcoe County. It’s based on a project originally undertaken by The Gilbert Centre in Barrie in conjunction with a local university.
“This is the first one,” said Munday.
In the first year of the program, which officially launched on Oct. 26, 2018, it has seen roughly 90 patients reach out for care.
Looking forward, Munday said they’ve been approved for funding from the LHIN to add a mental-health therapist to the team.
“We’re excited about that because we know the rates of depression and suicide are much higher for the transgender population. That is coming in the next few weeks,” she said.
Another new addition is a speech therapist through OSMH who specializes in voice feminization therapy. It will be one of only two places in all of Ontario that provide the therapy (the other is St. Michael’s Hospital in Toronto).
“We have two people working through that therapy right now… and we are hopeful we will be able to continue to have that therapy free of charge,” said Munday.
Overall, Munday said winning the award wasn’t just a win for the Couchiching Community Health Team.
“It felt like it was a win for the transgender population as well, who have been stuck in the dark for a long time,” she said.
For more information on the program, click here.
This email is being sent to EDs, Lead Clinicians and Board Chairs of AFHTO member organizations.
The Ministry of Health is undergoing significant Health Sector Supply Chain Transformation in partnership with the Ministry of Long-Term Care, Ministry of Government and Consumer Services and the Treasury Board.
They’re trying to integrate the various vendors currently in the health care space by coming up with seamless supply chain management practices – this voluntary initiative will initially be focusing on streamlining the work of OHTs but they hope to offer this across all sectors eventually.
The Ministry wants to have an AFHTO-focused workshop in October and we’re looking for volunteers to participate in person or virtually through Zoom to provide insight on how supply chain works now and how it could work in the future – they’re hoping to have a variety of professions at the workshop including physicians, NPs and executive directors. The workshop is scheduled for:
Date: Oct 10th – 9:30 – 11:30 am
Location: 18 York Street or via Webex
If you would like to participate please contact Beth MacKinnon at beth.mackinnon@afhto.ca. More details can be found in this one-pager.
AFHTO has named the winners of our annual Bright Lights Awards.
These innovators have improved primary care through their leadership, outstanding work and significant progress made toward improving the value delivered by interprofessional primary care teams throughout Ontario. Bright Lights Award winners are innovators and team players whose work has an impact on the healthcare system.
The review committees made up of AFHTO members chose the winners from among dozens of nominations. AFHTO gave awards for each of our six conference themes, as well as a spotlight award for excellent work by an underrepresented primary care team.
In addition, AFHTO’s board presented a special award to an organization whose work improves patients’ lives and enhances the quality of primary care in Ontario.
In recognition of: Collaboration to Ensure the Success of Community Paramedicine as Part of the Interprofessional Primary Care Team
This year, the board has recognized the County of Simcoe paramedicine program supported by Director Meredith Morrison and Community Paramedicine Coordinator Kyle McCallum. The program monitors vulnerable patients, including those who might call 911 and go to the emergency room, and has successfully reduced unnecessary dependence on primary care among the vulnerable.
The six theme recipients of Bright Lights Awards and the winner of the spotlight award are listed below. Click on the links to read a summary of their achievements:
The Team Care Centre (TCC) has successfully made interdisciplinary team care available to patients with mental health, addictions, and complex care needs, including patients of solo practitioners who do not have access to team-based care.
After a local mass casualty, the team realized that primary care teams have a contribution to make during a crisis and, in collaboration with their hospital, revamped its Code Orange procedures.
Given the long wait times for access to mental health services provincially, the team offers group interventions to patients with more severe symptoms and psychiatric diagnoses.
They used methods of citizen engagement to gather recommendations from a representative group of patient advisors to prioritize areas for improvement to service delivery.
Couchiching FHT integrated transgender healthcare into primary care delivery with the services of a Nurse Practitioner with expertise in hormone replacement therapy and surgical referrals and a peer support navigator and implemented Safer Spaces training for employees.
These rural teams and partner organizations have created an active, voluntary digital partnership that boosts the efficiency of their practices through coordinated form creation, testing, communication and distribution.
Presented in recognition of underrepresented primary care teams, the Spotlight Award is presented to Trent Hills Family Health Team. Nurses on the team identified a gap in care and developed a program to support families in rural area in providing better care of children from birth to school age.
To see all our nominees please visit the 2019 Hall of Fame. The call for nominations for the 2020 Bright Light Awards will go out in June 2020. All AFHTO members are welcome and encouraged to participate. For additional event photos, please contact info@afhto.ca.
Shared Oct 2019
There is renewed commitment towards truly integrated patient-centred care and an emphasis for all sectors of the health system to work more closely together to build Ontario Health Teams (OHTs).
Creating shared leadership across participating organizations within an OHT is key to encouraging committed behaviour, optimizing collective strengths, and fostering collaboration. However, establishing a culture of shared leadership isn’t something that can be mandated overnight. Partnerships take time and must be built on the foundation of trust. How can OHTs develop an approach to shared leadership that creates a level playing field, that balances the division of powers, and that values all partners at the table?
AFHTO partnered with the Ontario Community Support Association (OCSA) and AdvantAge Ontario to develop an OHT Starter Kit and host webcasts that will help members be leaders at this time of change
This kit contains a suite of tools to support OHTs in formalizing partnerships, clarifying expectations, and identifying a shared sense of purpose. The use of tools may be leveraged by OHTs and amended to meet individual team needs. These stepping-stone documents may also evolve as OHTs develop and partnerships mature.
The OHT Starter Kit is here:
This kit contains the following sample templates:
On September 12, the “Shift to Shared Leadership” webcast was the first of four webcasts that will help teams with these significant changes to the health care system. Stay tuned for more details on the next three webcasts!
It’s now less than one week to the AFHTO 2019 Conference on September 19 & 20! We look forward to seeing you all as we welcome delegates from across the province.
Our fireside chat with Deputy Minister Helen Angus has now been approved for Mainpro+ accreditation. This is a great opportunity to hear the Deputy speak about Ontario Health and the formation of Ontario Health Teams in this time of health system transformation.
If you haven’t registered for it yet, you can add it by clicking on the link in your confirmation email to modify your registration.
And to ensure a smooth experience, please see below for some helpful tips for planning your arrival and stay at the conference:
Early On-site Registration open from 4:00 – 7:00 pm on Sep. 18
DEEP discount available – if you’d like up to 50% off your current registration, volunteer roles are still up for grabs, including spots at the registration desk, breakfast and lunch assistance and helping your peers find their way. Please contact info@afhto.ca for more details asap.
Sharing your AFHTO experience
Hotel Registration, Directions & Rate Changes
From Pearson Airport & Billy Bishop
Around Toronto and the GTA
Additional Information
We look forward to seeing you at the AFHTO 2019 Conference!
This Group Learning program has been certified by the College of Family Physicians of Canada and the Ontario Chapter for up to 12.50 Mainpro+ credits.
MAINTENANCE OF CERTIFICATION
Attendance at this program entitles certified Canadian College of Health Leaders members (CHE / Fellow) to 6.5 Category II credits towards their maintenance of certification requirement.
