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  • Powassan and Area FHT officially opens new home

    The North Bay Nipissing article published on January 21, 2019

    By Laurel J. Campbell

    Powassan Town Square building gets thumbs up from residents, politicians, medical professionals

    POWASSAN — Over 100 people toured the new medical clinic during its grand opening on Jan. 18.

    “This is a wonderful centre,” said Nipissing MPP Vic Fedeli. “Its state-of-the-art technology and equipment provides the utmost in quality care and the layout and services offered here really put the patient first.”

    The new home of the Powassan and Area Family Health Team encompasses over 6,700 square feet in the Powassan Town Square building at 507 Main Street; five physicians, a nurse practitioner, two registered practical nurses, a mental health co-ordinator, and administrative and support staff work out of the space, which is also home to a foot care nurse, a certified diabetic health care educator, and a home and community care co-ordinator.

    “Integrating family health care services, such as are provided here, with the rest of our health care system is critically important,” said Fedeli. “The advantages offered by this medical centre will attract new health care professionals and allow for even more expansion of practices and acceptance of new patients in the future. This facility goes a long way in helping to cut hospital wait times and hallway care by providing for patients in their own community.”

    “For this building to happen partnerships had to be established with the province, the municipality, the developer, the health team and board, and be the doctors. A lot of negotiation went on and a lot of trust had to be established.” — Peter McIsaacSheila Latour, chair of the family health team board, smiled at the irony of Fedeli’s comment.

    “We helped define the term ‘hallway medicine’ at our previous location on King Street,” she said. “We had nurses in the halls delivering medications because we didn’t have enough office space. We played musical rooms. If someone wasn’t in on a given day, we’d put the foot care nurse in their space. Then she’d be in a different office next time. We had patients being weighed in the corridor, and when we wanted to hold patient education sessions we had to close the reception room, because it was the only place we could meet.”

    The new clinic has 10 examination rooms “so we don’t have to shuffle patients in and out of rooms during their visit,” said family health team executive director Anna Gibson-Olagos. “The doctors also have a large bullpen, a shared collaborative space for their office needs, and all the charting and notes that are involved outside of actually seeing the patient. It’s nice and big, so they can use it for meetings as well.”

    There are also rooms dedicated to dietary consultation, counselling, board meetings and public and patient education, IT storage, administration, a procedure room that fits a family, and a large staff kitchen.

    “If we wanted to have a staff lunch meeting before, we had to do it in the reception area when there were no patients waiting,” said Gibson-Olajos. “Our fridge, like our medications, was in the hallway. Now we have a room where we can have informal meetings, and a space where staff can just get away for a few minutes of solitude on a rough or emotional day.”

    The close quarters at the former medical centre also caused concerns over patient comfort and privacy, especially in the case of an emergency.

    “On occasion, we do have to call 911 for a patient,” Gibson-Olajos said. “At the previous clinic, the ambulance came to the front door and the stretcher came in through the waiting room, and had to stop in the hallway while the patient got dragged out of the examining room. There was no dignity or privacy for anyone.

    “We now have a separate entrance at the side of the building that leads directly to the examination hallways, and is designed for emergency use of stretchers and other equipment without anyone in reception or the counselling rooms being any the wiser. We’ve already had to use it once and it worked so much better for the patient, the EMS and the doctors involved.”

    Mayor Peter McIsaac said that the Powassan Town Square building “will be the corner stone of the community for the next 100 years or more,” and credited developer Sante Tomaselli for his foresight.

    “Mr. Tomaselli has made a huge investment in Powassan,” said McIsaac. “For this building to happen partnerships had to be established with the province, the municipality, the developer, the health team and board, and the doctors. A lot of negotiation went on and a lot of trust had to be established.”

    The vision of getting the Ministry of Health and Long Term Care to award a family health team to Powassan came from the former Municipality of Powassan Economic Development (MoPED) committee that did the work on the proposal and application in 2010.

    “After the health team was granted, one of the first things the ministry did was send someone to look at our medical clinic,” recalled Latour, who was a MoPED board member at the time. “He took one look around and said we would need a new building. It’s taken us eight years to get this far, and thanks to Mr. Tomaselli working with us in designing his building, we hope to make this a health care hub for Powassan and surrounding communities.”

    “Powassan is the heart of good living,” said McIsaac, “and the opening of this new medical facility today has proven it.”

    Click here to access the North Bay Nipissing article

  • Essex County NPLC expanding to Amherstburg

    The Windsor Star article published on January 15, 2019

    By Mary Caton, The Windsor Star

    Renovations will begin soon on the shuttered St. Bernard’s elementary school in Amherstburg in order to transform part of the building into a new nurse practitioner-led clinic.

    The town purchased the school from the Windsor-Essex Catholic District School Board last year with an eye towards making it a community hub.

    “Shovels will be flying once the construction companies are in place,” said Amherstburg Mayor Aldo DiCarlo.

    Town council approved the necessary renovations Monday on the heels of receiving approval from the Ministry of Health and Long-Term Care for $650,000 in funding for the clinic.

    The Essex County Nurse Practitioner-Led Clinic (ECNPLC) will expand its services into Amherstburg under a 10-year agreement.

    The group presently has clinics in Essex and Windsor.

    Pauline Gemmell, ECNPLC’s executive director, wrote a business case for an Amherstburg location last summer.

    “We had been told there was a need in the community,” Gemmell said. “Now that we’ve got the expansion funding, we’re very excited.”

    Gemmell said the Amherstburg clinic will have three full-time nurse practitioners, one full-time registered practical nurse, one half-time social worker, one half-time registered dietitian, one half-time health promoter and physiotherapy services.

    She said each nurse practitioner takes care of approximately 800 patients, meaning the clinic could serve 2,400 patients.

    “We have all kinds of (patient) applications already,” she said. “We are anticipating we’ll probably be full pretty quickly.”

    The ECNPLC’s website explains its clinic model “is designed to improve access to care for the thousands of individuals and families who do not currently have a primary health-care provider.”

    A nurse practitioner can assess, diagnose and treat a wide range of health issues in consultation with physicians and other health-care professionals.

    “We do a lot of education in our clinics,” Gemmell said.

    Gemmell said the Amherstburg clinic will require approximately 4,000 square feet of space within the defunct school’s 30,000-square-foot imprint.

    The goal is to have the clinic up and running by spring or early summer.

    DiCarlo said discussions continue with other possible tenants, including “at least one more big client” he hopes to announce in the near future.

    He’d like the hub to offer a mix of services “that generally spreads across the generations. I don’t like the old idea of putting seniors in the corner. I like the idea of mixing young and old. We’d like to see some shared use agreements.”

    Click here to access the Windsor Star article

  • Madawaska Valley opens family health team

    The Bancroft this Week article published on January 15, 2019

    By Chris Drost, Bancroft this Week

    The waiting area of the new Madawaska Valley Family Health Team was full of smiling faces on Friday, Jan. 11 as dignitaries, physicians and community representatives gathered with staff to celebrate the official ribbon cutting for the new family health team.

    Dr. Alex Otfield, who was introduced as a driving force behind the project, highlighted the fact that it has only been about a year since the application for the new family health team was submitted.

    Local physicians have collectively enrolled over 1,000 patients in the past six months and on Dec. 10, 2018, the FHT began seeing its first patients.
    The FHT currently includes two nurse practitioners Craig O’Brien and Tierney Lunney who work in cooperation with local physicians.

    Recruitment is actively underway for one full-time social worker, a part-time dietitian and part-time physiotherapist, according to executive director Susan Farrar.

    Champlain West clinical lead, Max Buxton, said “this is the model that physicians want to work in and it provides the best arrangement that patients can benefit from. It will provide access to services that patients won’t otherwise have locally, or what physicians working on their own could not provide. It is optimal for both young and older physicians.”

    Beginning Monday, Jan. 14, the FHT will begin taking a limited number of urgent care patients for those who do not currently have a family doctor.
    Farrar explained, “we will continue to expand our services as our team grows, to provide the community of Madawaska Valley with improved access to primary health care in the future. We eventually expect to be able to help provide care to all patients in need in our local area.”

    Service covers a wide area from Whitney to Eganville, Combermere and Madawaska Valley.

    Service covers a wide area from Whitney to Eganville, Combermere and Madawaska Valley.

    Funding for the FHT has come through the Ontario Ministry of Health and the Champlain LHIN.

    Dr. Otfield expressed his hope that this new FHT in Madawaska Valley will be the start of a new wave of family health teams across the province.

    The Ministry and the LHIN identified our community as in need based on hard data, according to Otfield.

    Funding came through a new budget line called “Interprovincial Primary Care Funding.”

    Following the official ribbon cutting and official photos, attendees enjoyed refreshments and cake in celebration of this important milestone for the community.

    Click here to access the Bancroft this Week article

  • Bits & Pieces: reminder to learn how to advocate for team-based care, free CAMH course & more

    Your Weekly News & Updates


    Reminder: This Friday, learn how to advocate for team-based care

    Join Hill+Knowlton Strategies, our government relations firm, this Friday, January 18, from 12 p.m. to 1:30 p.m. to hear about the new government’s priorities, to discuss how to work with your MPP, and to review the prepared key messages that will resonate.

    It’s important that MPPs are champions for team-based care as the government reviews primary care in the province and how it’s delivered. Learn how to effectively communicate with yours! Register for the webinar here.


    Leading transformation: building adaptive capacity

    This Advanced Learning Program offered by the Institute of Health Policy, Management and Evaluation (IHPME) has two modules, starting Feb. 28, 2019. Learners are presented with a leadership framework that focuses on building the capacity within themselves, their teams and their organizations to respond adaptively to the depth, pace and scope of change. You can learn more here and apply here. Early bird deadline is Jan. 17, 2019.


    Buprenorphine-Naloxone treatment for opioid use disorder: Free course from CAMH

    The Centre for Addiction and Mental Health (CAMH) is offering a free course on buprenorphine-naloxone treatment for frontline providers who provide treatment for opioid use disorder. The course fee ($350) is waived and covered by the Opioid De-Implementation Project if you use the link below to register.


    OISE Psychology Clinic welcomes child/youth and family therapy referrals

    Ontario Institute for Studies in Education (OISE) Psychology Clinic, a University of Toronto training site, has expanded services and is currently welcoming child/youth and family therapy referrals. Sliding scale fees are available. The clinic also offers opportunities for onsite visits to talk about the services being offered. To learn more, visit their site and see their poster.


    What are your clinical needs as a primary care provider?

    The Centre for Effective Practice (CEP) needs your help to select topics to inform their tool development process. What areas of patient care do you believe need clinical tools (e.g. decision aid, medication algorithm or evidence summary)? What topics interest you and would serve your needs as a primary care provider?

    Make your voice heard by participating in a short survey. It only takes five minutes and your answers will directly inform the clinical tools developed this year. All individual responses will remain anonymous.

    The CEP develops new clinical tools each year based on feedback from primary care providers such as yourself. All of the clinical tools and resources can be freely accessed on cep.health.

    Click here to take the survey.


    Prescription to get active

    Prescription To Get Active uses the power of a doctor or NP’s prescription to help encourage deconditioned, sedentary at risk patients to get more active. There are no costs associated with becoming a prescribing member and prescribers are asked only to commit to the program and reporting total Rx’s written on a quarterly basis.

    The only standardized provincial program to offer this level to all Ontarians, it’s now running in Markham, Stouffville, London, Toronto and Bancroft. You can find out more below:


    Volunteers needed for post-stroke rehabilitation research study

    Research has shown that music engages the brain bilaterally throughout extended networks.  Volunteers between the ages of 30 and 79 who have had a stroke more than 6 months ago and have difficulty with arm and/or hand movements are needed for a clinical research study using music and rhythm in post-stroke rehabilitation.

    For further information:

    ,or contact the investigator, Catherine Haire, at 647-521-5381; catherine.haire@mail.utoronto.ca.


    Predicting the Future: Charitable sector careers for the workforce of 2020: Jan. 22, 2019

    Learn what’s driving the Future of Work and the value of incorporating new tools and approaches into how you address staffing challenges. Register now!


    Changing CARE: Made-in-Ontario approaches to improving the caregiver experience: Jan. 28, 2019, Toronto

    Registration is required for this free event by the Change Foundation. Learn more here.


    Government Webcast Series: Strategic Planning and Public Complaints: Feb. 20, 2019

    Attend this webcast on strategic planning and public complaints. Register now!

  • AFHTO’s 2018 Pre-Budget Submission

    AFHTO submitted its recommendations to the Ministry of Finance in February 2018, calling on the government to strengthen primary care so that it can deliver on its commitments outlined in the Patients First Act and ensure all Ontarians receive access to high quality, comprehensive, interprofessional team-based primary care.

    Key recommendations include:

    • Increase access to Interprofessional team-based care primary care
    • Invest in meaningful measurement in primary care that allows movement for improvement
    • Ensure seamless transition of care coordinators into primary care

     

    The full submission can be read here:

     

  • Getting started on a diabetes registry

    This document explains how to use a standardized query of your EMR to start building a diabetes registry.  It is intended for teams that do not yet have a reliable list of diabetes patients and don’t have the time or resources to start from scratch in reviewing all their patients to generate such a list.  Right now, it is also only for teams with PSS, Accuro and OSCAR. The following steps will help your team use the query to generate a list of diabetes patients, starting from your EMR.

    Step 1. Estimate how many patients you think this will affect.  Multiply the number of patients your team serves by 0.10 (the average rate of diabetes in Ontario) to get a rough idea of how many of your patients likely have diabetes.  If you still think this is a big enough group of patients for you to generate a registry for, carry on to step 2.

    Step 2. Import the query into your EMR.  Right now, you can only do this if have either Telus PSS or QHR Technologies Accuro EMRs.  You will likely need the help of your QIDSS, IT staff or other person who usually works with your EMR to do this.

    • For PSS, import the PSS SRX file into your EMR, click here
      • Click here for the case definition 
      • Click here for the screenshots of the query 
    • For Accuro, download the query “AFHTO Diabetes Frontend Search” from their publisher.
      • Click here for the case definition 
    • For OSCAR download the query and save locally to your computer.  Instructions on how to import the query into your OSCAR EMR can be found here.

    We are in the process of creating similar queries for OSCAR. Contact improve@afhto.ca. for more information.

    Step 3.  Run the query in your EMR.  Again, you might need the help of your QIDSS, IT staff or other person who usually runs queries in your EMR. Running the query will produce a list of patients with diabetes. The list will not be perfect – probably 15% of the patients identified by the query will NOT have diabetes. The query gets you STARTED in building the diabetes registry but doesn’t do the whole job for you.

    Step 4. Find the patients who might not have diabetes. Review the list of patients generated by the query to separate out those patients that are clearly already coded as having diabetes. What’s left will the list of patients who MIGHT have diabetes based on other data in the EMR besides formal coding.

    Step 5. Prepare your physicians to review the list  Subdivide the list of possible diabetes patients into separate, shorter lists for each physician. Work with your physicians to find out if they would prefer a list on paper or electronically and how they might like it sorted (i.e. by name or most recent visit or some other parameter).

    Step 6Invite each physician to review their list of patients.  They know their patients best and can likely quickly confirm which ones do or do not have diabetes, even though that information might not be easy for others to find in the EMR.

    Step 7Clean up your EMR data.  Add diabetes codes to the EMR for each patient that the physician confirms as having diabetes. This so-called “data cleaning” work is a great job for a student.  AFHTO has created a toolkit to assist members in recruiting and using students for data clean-up. Click here for the toolkit.

    Step 8Re-run the query . After you have corrected the EMR, re-run the query to generate a list of patients with diabetes. This is your new diabetes patient registry. Going forward, you can run the query anytime you need to generate a list of diabetes patients.  You can use the list to invite patients to a diabetes health program, track progress with outcomes on these patients once you have started such a program or any other purpose. This query was produced by and for QIDSS in support of all AFHTO members.

    If you have any questions please contact improve@afhto.ca..