Author: sitesuper

Theme 4. Building the rural health care team: making the most of available resources    

Presentation Materials (members only)

Project ECHO – Managing Complex Chronic Conditions without Sweating Bullets

Learning Objectives

Understand the basic ECHO principles:

• Leveraging telemedicine to move knowledge, not people and create a community of practice for continuing professional development
• Multiplying specialist expertise by connecting an expert team (HUB) with multiple primary care providers (SPOKES)
• Using case-based learning
• Sharing best practices to improve quality of care for complex patients.

Identify how ECHO addresses specialist shortages in rural and urban settings, raises primary care providers’ skills to their maximum scopes, and enhances interprofessional team performance. Review the MOHLTC-funded ECHO Ontario Chronic Pain/Opioid Stewardship demonstration project and other ECHO’s under development (Mental Health/Addictions, Hepatitis C, Rheumatology).

Summary

In 2003, Dr. Sanjeev Arora, a New Mexico hepatologist, developed ECHO (Extension for Community Healthcare Outcomes) to reach > 30,000 hepatitis C patients requiring treatment. By holding weekly video-conferencing rounds, distant primary care providers (SPOKES) managed their own hepatitis C patients with the support of an interprofessional expert team (the HUB). Cure rates were identical in both groups (NEJM 2011 364:23). There are now >20 complex chronic disease ECHO projects throughout the US and other countries. In April 2014, the MOHLTC announced funding for the first Canadian ECHO replication: ECHO Ontario chronic pain/opioid stewardship. ECHO sessions start with brief didactics on chronic pain management. Next, a de-identified case is presented by a community SPOKE following a standard template. Their “virtual” colleagues ask questions and provide advice first, with HUB experts acting as “guides on the side.” SPOKES’ knowledge and comfort levels rise and HUB experts also learn from the SPOKES. Hands-on “boot-camps” teach specific skills (the chronic pain sensory exam, myofascial pain, challenging conversations, and managing mental health problems or aberrant opiate behaviours). Curriculum themes include pain fundamentals, opioids and addictions, management (mind, movement, self-management, and medical) and special topics (e.g. medical marijuana). This presentation will educate attendees on the basic principles of ECHO, demonstrate how the model works, and discuss promising ECHO programs under development in Ontario for other complex chronic conditions such as Mental Health/Addictions, Hepatitis C, and Rheumatology.

Presenters

• Ruth Dubin, PhD, MD, CCFP, FCFP; Project ECHO Co-Chair, Asst Professor (adj), Dept of Family Medicine, Queens University; ECHO Ontario
• Leslie Carlin, PhD, Medical Anthropologist, University of Toronto
• Allison Crawford MD, FRCP, Medical Director Northern Psychiatric Outreach Program; Telepsychiatry Centre for Addiction and Mental Health; CAMH
• Other co-presenters TBD

Authors and Contributors

• ECHO Ontario
• Andrea Furlan, MD, PhD, University of Toronto
• Paul Taenzer PhD, Psychologist
• Jane Zhao MSc, Research Coordinator
• Eva Serhal, MBA, Manager, Telepsychiatry, Centre for Addiction and Mental Health

Theme 7. Clinical innovations keeping people at home and out of the hospital

Presentation Materials (members only)

Integrated LTC: An Innovative Initiative to Reduce Potentially Avoidable Hospitalizations for Seniors

Learning Objectives

The objectives are to share lessons learnt from the pilot project including:

1. Establishing shared milestones/goals with stakeholders in acquiring real-time data to inform rapid-cycle changes and perform program evaluation.
2. Diversifying activities decreases risk of over-relying on a particular strategy – Program resilience is a key requirement for success. Accordingly, we have developed parallel activities (i.e. Nurse Practitioner support, telemedicine case conference rounds, knowledge translation materials, and quality improvement), in order to support our pilot LTC homes.
3. Impact of pilot:
   • Potential for healthcare sustainability – Estimated cost savings approx $70K (In the first 10 clinical days, the NP was able to change LOC for 6 of 13 residents, eliminating future ER transfers for the subsequent 6 months).
   • Resident outcomes – improved pain and symptom management, in-house palliation (avoiding stressful transfers at the end of life, respect for wishes and best interests
   • Support for families – goals of care enables proactive care plan development.

Summary

Seniors suffer from increased morbidity and mortality when transferred to hospital versus receiving care in their place of residence. In long-term care (LTC) 25-55% of transfers to the Emergency Room (ER) are potentially avoidable and a 15% reduction in Ontario could save over $76 million per year. US & UK QI initiatives have shown 17-25% reduction in ER transfers. The Integrated Long Term Care (ILTC) program, recently featured in the Ontario Medical Review (April 2015), is composed of 3 pillars – capacity building, access to specialist consults, and acute care provision. Juxtaposed to the supporting evidence for the program, there have been some challenges in the first year of implementation. These include identification of a target population, nurse practitioner recruitment and retention, competing demands for staff on the floor, need for palliative care training for front line staff and family’s insistence of ER transfer. Each of these challenges has an associated mitigation strategy which will be discussed during the presentation, as will next steps for the program.

Presenters

• Candy Lipton, Vice President, Operations, Sienna Seniors
• Irene Ying, MD, Palliative Care Consultant, Sunnybrook Health Sciences Centre; Assistant Professor, University of Toronto DFCM

Authors and Contributors

• Joe Pedulla, CHE, RRT, ACP MHSc, BASc, BSc
• Candace Tse, MHSc
• Jason Xin Nie

Theme 2. Optimizing capacity of interprofessional teams

Presentation Materials (members only)

Collaborative Practice – Messy, Time-Consuming and Worth It.

Learning Objectives

To describe our Family Health Team experience developing and implementing a new interprofessional team process for complex medical patients identified through Health Links and older adults within the TAPESTRY study. We will show the participants how new eyes on a patient can develop new solutions and strategies and expand the ability to provide a preventive health care plan.

Summary

McMaster Family Health Team is an Academic Family Health Team located in Hamilton, Ontario with two sites serving over 31 000 patients. Our broad-based interprofessional team collaborates to maximize primary health care delivery and educational opportunities. We currently provide placements for 81 family practice residents and interprofessional learners. TAPESTRY (Teams Advancing Patient Experience: Strengthening Quality) is a twelve-month randomized control trial that fosters optimal aging for older adults living at home using an interprofessional primary health care team delivery approach centering on meeting a person’s health goals with the support of trained community volunteers, system navigation, community engagement, and use of technology. We are the lead organization for one of three Hamilton Health Links. Health Links targets individuals who use the health care system the most, particularly the use of the emergency department and frequent hospital admissions. The intent of the program is to change the way this population receives health care, driven by the development and implementation of coordinated care plans, and utilizing the insights learned to advocate for system-level change.   By targeting specific at-risk populations for more intensive care planning, we uncover significant health and social issues. When these issues are addressed by the interprofessional team before they become crises, we can shift our focus to health promotion and prevention. The energy created when like-minded professionals work collaboratively is amazing and motivating. Through this process, we have developed greater insight into the scope and skills of our team members to enhance the quality of care of our patients.

Presenters

• McMaster FHT:
  • Kiska Colwill, Clinical Pharmacist, Assistant Clinical Professor
  • Martha Bauer, Occupational Therapist
  • Michael Spoljar, Nurse Practicioner, Assistant Clinical Professor
  • Dan Edwards, RSSW, System Navigator
  • Laura Cleghorn, Research Coordinator TAPESTRY, School of Nursing and DFM

Authors and Contributors

• McMaster FHT/McMaster University Department of Family Medicine:
  • Betty Delmore, Nurse Practictioner, Assistant Clinical Professor
  • Dale Guenther, MD, co-director, Professor
  • Doug Oliver, MD, Associate Professor
  • Glenda Pauw, Registered Dietitian, Assistant Clinical Professor
  • Jessica Peter, MSW, Research Coordinator, TAPESTRY & MedREACH

Theme 1. Population-based primary health care: planning and integration for the community

Presentation Materials (members only)

Presentation Slides: Moving Gestational Diabetes Care into the Community.

Learning Objectives

Participants will learn about the successful and seamless transitioning of the Gestational Diabetes program from a hospital based model of care to primary care. During our presentation, we will highlight the transition process from start to finish and will elaborate on key aspects that made it a success. We will review our training strategies for new staff, referral process and evaluation of our program. We will conclude our presentation with opportunities and aspirations to continue to enhance our program to continue to serve women with Gestational Diabetes in our region.

Summary

Careful planning with all stakeholders was necessary for the successful transition of the GDM program from GGH to DCG. We plan to outline our processes that promoted a coordinated health care experience for women in Guelph with GDM. Perhaps the most crucial element to be elaborated during our presentation is ongoing communication with stakeholders including face–to- face meetings, shadowing of care, training of staff and sharing of knowledge. Appropriate training of DCG staff was supported by GGH, DCG and ongoing devotion to professional development. DCG’s close working relationship with the Endocrinologists in Guelph also promoted collaborative patient care and inter-professional development. In addition, we are also fortunate to have Registered Kinesiologists and Mental Health Counsellors on our DCG team to help support women with GDM, which is unique to community programs. Presentation highlights will include program flow process, resource allocation, educational strategy and expansion. The results of our one-year transitional evaluation outcomes will be shared and of course would not be complete without a review of lessons learned and next steps.

Presenters

• Diabetes Care Guelph, Guelph FHT:
  • Sarah Duff, BScN RN CDE, Clinical Coordinator
  • Lee Kapuscinski, MSc RD CDE
  • Julie Goodwin, BScN RN CDE

Authors and Contributors

• Jess Voll, Health Promoter, Guelph FHT

Theme 1. Population-based primary health care: planning and integration for the community

Presentation Materials (members only)

Presentation Slides: Reaching out to Adolescents in the Community.

Learning Objectives

At the end of this workshop, participants will have the tools to build their own Adolescent Outreach program. Specific learning goals for this workshop include:

1. How to engage local high schools and build relationships with them
2. Create a program that is aligned with the school’s curriculum
3. Create a dynamic interprofessional team to deliver your program
4. Link with local Adolescent Psychiatry / Mental Health professionals
5. Incorporate learners and teaching in this model
6. Evaluate your program
7. Helpful resources, links and services.

Summary

The Adolescent Outreach Program was created in 1988 to allow adolescents in our community an opportunity to ask questions and have their health concerns addressed by physicians in a confidential and non-judgmental setting. The program was also aimed to increase Family Medicine residents’ exposure to the health issues and concerns facing adolescents, a group that traditionally does not visit their Family Physician regularly. In 2011, with the establishment of Sunnybrook Academic Family Health Team, interprofessional teams consisting of a physician, residents, dietitian and social worker as appropriate started visiting local high schools to provide education on topics such as mental health, sexual health, body image etc. Each session is approximately one hour in duration, with approximately 20 – 25 students in attendance. Students have the opportunity to submit written questions anonymously and ask questions directly on pre-identified topics. Teams led by residents use various interactive methods such as games/quiz/small group activities to engage adolescents. With information technology available at finger tips of adolescents, it’s necessary to have a secure platform to provide correct health education early. Therefore, primary care involvement in Adolescent health needs to be increased across the province. Our program is one such example of platform to educate and promote health for adolescents. This session will outline the process of creating a formal interprofessional Adolescent Outreach program in a Family Health Team, whether it be in an Academic setting or not. We will share our best practices as well as lessons learned since the establishment of the program.

Presenters

• Sunnybrook Academic FHT and University of Toronto DFCM:
  • Dr. Purti Papneja, MD, CCFP / Staff Physician, Co-Program Director
  • Dr. Anne Wideman, MD, CCFP / Staff Physician, Co-Program Director

Authors and Contributors

• Ingrid Wirsig, BA

 

Theme 3. Transforming patients’ and caregivers’ experience and health

Presentation Materials (members only)

HERSTORY Peer Directed Group Exercise Programs Improving Clinical Outcomes Group medical visits, including peer-led and peer-facilitated exercise groups, and care-based focus groups, are emerging as an efficient and effective way to care for patients with complex needs. Four teams describe how they have implemented group visits and share their results.

(I) HERSTORY: An Innovative Group Model for Mental Health Care Using Peer Facilitation and Patient Co-design

Learning Objectives

WHAT MAKES A PATIENT COMPLEX? The Bridgepoint FHT would like to present an approach for dealing with a complex and underserved population- those with a past history of sexual childhood trauma. In this interactive presentation you will learn about the impact of this model, be provided with the tools to spread this model to your FHT and hear directly from the voice of patients and peer facilitator.

Summary

The Bridgepoint FHT in partnership with our patients have developed a cutting edge women’s trauma program entitled “HERSTORY”. The current community wait times for referral to trauma therapy are measured in YEARS. In order to respond better to our patient needs we developed an inter professional group model of care using focus groups, peer leadership and ongoing patient and provider feedback. This presentation will illustrate our process, review our outcomes both qualitative and quantitative, provide insights into the challenges and victories of this unique group and allow the audience to hear directly from our patient representative and peer facilitator.

Presenters

• Bridgepoint FHT
  • Lora Judge, MSW,RSW
  • Lora Cruise, Medical Director

Authors and Contributors

• Christine Gordon

(II) Shared Medical Appointments: The Why, the How, the Impact

Presentation Materials (members only)

• Materials will be posted following the 2015 Conference.

Learning Objectives

• Summarize SMAs – what they are, evidence for their use.
• Describe our process to initiating and adapting SMAs in busy practices -listen to/hear experiences of SMA participants (practitioners and patients).

Summary

Shared Medical Appointments are an exciting and innovative way to provide care to patients with chronic diseases. Our interdisciplinary teams introduced Shared Medical Appointments (SMAs) to patients living with diabetes in 2012. An SMA is a 90 min appointment held simultaneously with 5-10 patients and 2 providers in an interactive visit. All parameters of diabetic care are monitored as with any individual diabetic visit, patient questions are addressed by both peers and providers and true collaboration is encouraged between patient and health care professionals. Participants (providers and patients) experiences will be highlighted in this presentation. 

Presenters

• Hamilton FHT:
  • Anneli Kaethler, MSc, RD, CDE
  • Cornelia Mielke, BSc, MD, CCFP

Authors and Contributors

• Hamilton FHT:
  • Catherine Bednarowski, Clinical Pharmacist, CDE, Hamilton FHT
  • Sheilah Lamb, MD
  • Barbara Teal, MD
  • Robert Kerr, MD

(III) Peer-Directed Group Exercise Programs Improving Clinical Outcomes

Learning Objectives

Attendees will learn about how building group exercise programs with peer co-leaders and patient directed educational discussions not only cn affect A1c, BMI, BP and MaxMETs in a population with metabolic syndrome or diabetes, but also improves patient attitude towards being physically active. The program leaves participants confident and prepared to maintain activity levels after completion. This model increases patient independence and thrives off of group cohesion and the support of peer co-leaders. In addition, attendees will learn how to implement similar programs with varying resources in their own community.

Summary

Supervised group exercise programs have been proven effective in improving outcomes in patients with diabetes. At the Guelph FHT we have implemented group exercises classes that incorporate peer co-leadership and patient directed educational discussions. The program runs on a rotating basis twice per week for 12 weeks. Participants complete cardio, strength, balance, and flexibility activities during each session. Upon completion, patients have the option of undergoing training to become peer co-leaders. The program’s goal is to improve outcomes (a1c, BP, BMI, WC, lipids, MaxMET) for people with diabetes and metabolic syndrome and increase physical activity levels and leave patients confident with their ability to maintain after program completion. Results are collected and analyzed in an ongoing basis. As of April 2015, average days completing cardio exercises increased from 1.8 to 4.5 and resistance training from <1 to 3.5 days. Perception of exercise improved during the program and 90% of graduates believed they had attained the necessary confidence, skills, and strategies to maintain their activity levels. Average a1c decreased 0.3%. Estimated MaxMETs increased approximately 20%. Both WC and BMI showed decreasing trends. Using a highly peer directed group exercise program can increase physical activity levels and improve outcomes. Similar programs could be created using partnerships with community gym facilities or with minimal equipment. This model also places the focus on the patient and empowers them make positive and hopefully lifelong changes in their perception of and motivation to be physically active. 

Presenters

• Krista Crozier, R.Kin, CDE Diabetes Care Guelph, Guelph FHT

(IV) Group Medical Visits (GMV) for Primary Care Diabetes: The McMaster Family Health Team Experience

Learning Objectives

1. To gain knowledge about how to organize and implement a group medical visit
2. To learn the value of using group medical visits effectively within primary care
3. To hear positive patient accounts about their experience with group medical visits

Summary

The increasing prevalence of diabetes poses a threat to the sustainability of Canada’s health care system. Group medical visits (GMVs) are emerging as an efficient strategy to deliver care to multiple patients and have been shown to improve glycemic control, patient satisfaction and patient self-efficacy in disease management. The purpose of this study was to examine a number of process and quality of care outcomes measures to compare GMVs to traditional care and a diabetes clinic model that existed within the McMaster Family Health Team. This was a cohort study comparing GMVs to traditional care and a diabetes clinic model over the period 2008-2012. During each visit, patients saw a family physician and registered practical nurse with foot care certification and one of the following diabetes educators: nurse practitioner, dietitian or pharmacist. Group visit content included physical exam, medication review, group diabetes education review, question and answer time and goal setting. The numbers in each group were small so data was analyzed descriptively. The benefits and challenges of GMVs as compared to conventional care will be highlighted during this presentation and suggestions on how GMVs can be used effectively for diabetes care within primary care will be provided.

Presenters

• McMaster FHT:
  • Inge Schabort, MB ChB CCFP FCFP
  • Michele MacDonald Werstuck, RD MSc CDE

Authors and Contributors

• Kalpana Nair, PhD, McMaster University
• Christie Tasch, BA, McMaster University

Theme 7. Clinical innovations keeping people at home and out of the hospital

Presentation Materials (members only)

Aging at Home Indicator Management

Learning Objectives

Our Aging at Home program’s focus is to provide interdisciplinary home care to seniors and reduce unnecessary emergency department visits. We will share our experience with team building, physician engagement as well as collaboration with CCAC and Joseph Brant Hospital. Our team were participants in the IDEAS program. We will discuss how the resources made available assisted in developing tangible goals and performance indicators and how this carried over into our QIP. The goal for our presentation is to have the attendees benefit from our learnings in:

• Program Development
• Team Building
• Internal and External Collaboration
• Embedding QI into a program.

Summary

The LHIN’s Aging at Home Strategy identified that a wider range of homecare and community support services will be needed. They project that the population of seniors will double in the next 16 years. Approximately 40% of the population of Burlington is over the age of 50. For our aging population, the Burlington Family Health Team has developed a program through clinical innovations to keep seniors at home and out of hospital. The Aging at Home program aims to reduce preventable emergency department visits and helps to promote optimal health for our patients in the community. This is achieved through assessment and intervention by the FHT Occupational Therapist and Nurse Practitioner for patients who have difficulty accessing services, and who are at high risk for repeat emergency department visits and hospitalizations. Several aspects of the program will be highlighted, including monthly rounds with physicians and members of the interprofessional team as well as ongoing monitoring of emergency department data for quality improvement purposes. A key feature of the program is the ongoing collaboration and integration with our local CCAC and Joseph Brant Hospital. The Burlington FHT will also continue to build on our close relationship with Burlington Health Links. Future goals include utilization of emergency department data to screen for high risk patients who may benefit from the program.

Presenters

• Burlington FHT:
  • Shawna Cronin, Occupational Therapist
  • Theresa Hubley, Nurse Practitioner
  • Caitlin Grzeslo, Program Coordinator

Authors and Contributors

• Joanne Pearson, Executive Director, Burlington Family Health Team
• Courtney Field, MD, Burlington Family Health Team

Theme 6. Leadership and governance for accountable care

Presentation Materials (members only)

Presentation Slides: Culture Eats Accountability for Breakfast

Learning Objectives

This workshop will invite participants to rethink the importance of team culture by:

1. Understanding ‘whole-mind’ thinking
2. Leading inter-professional collaboration
3. Shifting the leadership culture of their teams.

Summary

Team-based primary care in Ontario is driven by a ‘left-brain’ approach to healthcare. Accountability, fiscal restraint, governance, policy, structure, patient statistics- these are the things that drive Ministry-funded primary care organizations. But for the people leading these teams, the need to embrace ‘right-brain’ thinking brings a healthy balance to the experience. Purpose, collaboration, trust, creativity, relationships and patient stories- these are the things that inspire a high performance team culture. Participants will be invited to reflect on their own team’s ethos and identify new ways of balancing the demands of accountability with the desire for a thriving team environment. They will hear how taking a ‘whole-brain’ approach to leadership can create a healthier high performance team culture. And they will be invited to consider how they might shift the leadership culture of their team by unleashing the leadership potential of all team members.

Presenters

• Dave Courtemanche, Principal and Founder, Leading Minds Inc

Theme 5. Advancing manageable meaningful measurement

Presentation Materials (members only)

Presentation Slides: Measlesgate

Learning Objectives

Review the clinical signs and symptoms associated with Measles and the appropriate tests to confirm the diagnosis. Outline the infection control steps to prevent measles exposure as well as other airborne infections to patients and staff present in the office setting. Emphasize the importance of collaboration with local public health for contact tracing after an office measles exposure. Discuss the recommendations by the Markham FHT Occupational Health & Safety Committee to collect immunity data on staff and providers with respect to vaccine preventable diseases (e.g. MMR, varicella, Hep B) and institute baseline TB skin testing.

Summary

Measles is a viral infection that classically presents with fever, rash and the 3 “Cs” – cough, coryza and conjunctivitis. While most people with measles are sick for a few days and recover completely, it can lead to complications and even death. In Canada, due to high immunization rates, measles is rare. However, several factors have contributed to recent outbreaks including patients who only received one immunization against measles, those who refuse to be immunized due to a discredited claim that there is a link to developing autism, and unintended exposures in countries endemic to measles. Given the virus spreads through respiratory droplets, multiple exposures can occur when an infected patient presents to a primary care practitioner’s office. Providers need to be comfortable responding to such a scenario and this session will provide a practical approach on how to manage a measles exposure based on our FHT’s experience from earlier this year. Consistent with the theme of “Advancing manageable meaningful measurement”, we will highlight the importance of leveraging one’s EMR system to access patient health records for contact tracing. Topics including collaboration with public health, and the importance of transparent messaging to patients and staff will be reviewed. Providers will also be imparted with valuable lessons learned such as the importance of infection control practices to prevent spread, and knowing the immunization status of office staff/providers to ensure protection in the event of a measles outbreak. A review of the diagnostic tests for measles will also be provided.

Presenters

• Markham FHT
  • Dr. Allan Grill, MD, CCFP, MPH, Lead Physician
  • Lisa Ruddy, RN, Clinical Program Manager

Authors and Contributors

• Anthony Pallaria, Clinical/IT Manager, Markham Family Health Team

Theme 3. Transforming patients’ and caregivers’ experience and health

Presentation Materials (members only)

Extending the EMR with Patient Tablets Using an automated patient reminder service and survey to collect information on patients’ experiences Add some SaaS to your patient experience surveys Collecting meaningful data on patient experience can be a time-consuming and challenging, but it can have invaluable results. Four different approaches that have proven successful are explored in this session.

(I) Extending the EMR with Patient Tablets: Using Interactive, Point-of-Care Patient Surveys in the Waiting Room to Generate Clinical Content and Save Time

Learning Objectives

Learn how mobile devices and a cloud-based platform can unlock and extend your EMR, enhance patient communication, and save time. In this session, you will hear how primary care clinics are using mobile tablets and a large library of clinical content with their existing EMRs to allow patients to securely update contact information, provide a detailed patient history, or complete forms like the Nipissing Well-Baby Screen. Data entered by the patient can be automatically used to calculate scores, recommend treatment based on clinical guidelines, add a clinical note to the EMR, and even generate customized patient educational materials and handouts.

Summary

In this presentation, you will see firsthand how one physician is using tablets to transform his practice. Learn how online patient questionnaires – completed on tablets in the waiting room, or from home before the appointment – are reducing appointment time requirements by as much 65%, while allowing more time spent face-to-face with the patient. By automating administrative tasks like email consent and demographic updates, you will also hear how clinics are becoming more efficient and reducing the burden on front-desk staff. Finally, you will see how replacing the scanning of paper forms with digital data entry, patient records can become more structured, more accurate, and minable. Learn how Ocean’s EMR-agnostic, integrated support for mobile tools and the largest library of openly available clinical questionnaires is transforming primary care across the province. With over 300,000 patient record EMR updates completed by patients in waiting rooms and exam rooms in just under two years, this technology is making it possible to access and share crucial healthcare resources in a whole new way.

Presenters

• Dr. Douglas Kavanagh, MD, North York FHT; Founder, CognisantMD
• Dr. Robert Davis, MD, Happy Valley FHT

(II) Transforming Primary Health Care Delivery through Innovative Patient Experience Tool

Learning Objectives

1. Importance of obtaining Patient Feedback on primary health care services delivery
2. Value of Real Time innovative Patient Feedback tools in aiding analysis and relevance
3. Removing Communication Barriers between patients and health care team
4. The value of patient feedback tools on measuring quality improvement of patient experience.
5. Summary (II):

This innovative tool of collecting patient feedback has resulted in removing barriers for patients to provide feedback to their health care team about their experience due to the ease of use and accessibility. Furthermore, we are now using the provincial QIP patient questions in our survey for the past 1 month. This will allow our tool to be leveraged across primary care teams to compare patient experience in different settings and ensuring our alignment with provincial strategy. 

Presenters

• Wise Elephant FHT:
  • Sanjeev Goel, Lead Physician
  • Virgiliu Bogdan Pinzaru, Health Informatics Analyst, QIDSS
  • Lopita Banerjee, Physician

Authors and Contributors

• Jaipaul Massey Singh

(III) Using an Automated Patient Reminder Service and Survey to Collect Information on Patients’ Experiences

Learning Objectives

This session will inform participants about how to use an automated patient reminder service to survey patients on their experiences seeking and receiving care at their FHT. Participants will learn about the cost and minimal burden of this approach as well as the patients it can reach and which survey questions can be used.

Summary

In order to improve the care we deliver, FHTS need to understand patients’ experiences in seeking and receiving their health care. FHTs are also required to survey their patients annually to contribute to their quality improvement plans. At the same time, many FHTS are seeking ways to improve their care through automated reminder systems such as appointment reminders. This session will present an overview of a new approach to surveying FHT patients using automated surveys similar to patient reminder calls, emails, or texts. It will present the results and experiences from FHTs which have used this technology. The strengths and weakness of this technology including the patients it reaches and whom it may not, the burden on practices, and the cost will be shared with participants. 

Presenters

• Anthony Mar, President, Cliniconex Inc.
• Sharon Johnston, Family Physician, Clinician Investigator, University of Ottawa Department of Family Medicine, Bruyère FHT

Authors and Contributors

• Bill Hogg, University of Ottawa Department of Family Medicine, Bruyère Continuing Care

(IV) Add some SaaS to your Patient Experience Surveys

Learning Objectives

Participants will learn novel strategies for coordinating and collecting patient experience surveys that reduce FHT staff and patient burden.

Summary

While the collection of patient experience data is mandated by HQO, there is little guidance around how to collect this data with existing resources. Strategies are needed to support survey distribution that minimize burden on both FHT staff and patients. To address this challenge, the Women’s College Hospital Academic FHT has developed an automated system to collect patient experience data. We designed 3 short surveys, each focussed on a different domain of patient experience. Each survey includes:

• the questions mandated by HQO,
• questions related to chosen domain, and
• demographics questions.

Patients receive an email with survey link during their birth month, so that each patient only receives one survey annually. Our process, which involves use of SaaS (software as a service) solutions, allows us to:

• Minimize data entry and analysis burden by automating distribution, data entry, and analysis
• Minimize patient burden, while still collecting feedback on a wider variety of issues (3 short surveys)
• Monitor improvements over time (the 3 surveys are rotated throughout the year, allowing for quarterly analysis on all domains)
• Semi-automate qualitative analysis of patient comments
• Adopt best practices in electronic survey distribution, including via mobile devices
• Minimize privacy and confidentiality issues related to the US Patriot Act
• Be compliant with Canada’s anti-spam legislation (CASL) which came into effect July 1, 2014.

While subscription costs for SaaS solutions are not inexpensive, economies of scale may be achieved if a system is adopted and shared across FHTs.

Presenters

• Women’s College Academic FHT:
  • Nicole Bourgeois, Dietitian and Health Promoter
  • Holly Finn, Program Coordinator
  • Susie Kim, Family Physician and FHT QI Lead
• Craig Thompson, Director of Digital Communications, Women’s College Hospital

Authors and Contributors

• Ranjana Shardha, Quality Improvement Decision Support Specialist