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  • HQO Releases Report On End-of-Life Care in Ontario

    Dec. 15 – Health Quality Ontario’s (HQO) End-of-Life Health Care in Ontario report was released today. Click here to download the full report and recommendations. The report addresses where the health system must improve to ensure the best end-of-life care for all Ontarians, and highlights the need for an increased number of professionals trained in palliative care. The report also identifies the need for a more patient-engaged approach to end-of-life care, encouraging productive, informed conversations about end-of-life care between patients, their loved ones and their care providers. The End-of-Life Health Care in Ontario report is accompanied by recommendations from HQO’s Ontario Health Technology Advisory Committee (OHTAC) and builds on important work by Cancer Care Ontario, the Local Health Integration Networks, the Registered Nurses’ Association of Ontario, and the Ontario Medical Association, among others. For more information:

  • EDAC News: Ensuring Value, FHT Evaluation, & Work Ahead

    AFHTO’s Executive Director Advisory Council (EDAC) met yesterday. This update provides an overview and highlights key items discussed:

    • Ensuring EDAC Value
    • FHT Evaluation Report
    • Towards the Next Ministry Contract
    • PHC Branch Meeting
    • QIDS Program Update

    Ensuring EDAC Value

    EDAC plays a significant role in enabling EDs to surface operational issues, provide a sounding board on operational matters and give advice to AFHTO staff as needed. EDAC provides a platform for our members to work together to advance best practice knowledge transfer, enhance collaborations and foster leadership communications. In order to continue with the effectiveness of EDAC, the Terms of Reference have been updated and a clear work plan and set of objectives has been developed to guide the course of work over the next 6 months. EDAC members recognize the need to support their ED colleagues. An initial priority is to develop an ED Resource Toolkit consisting of standardized resources and best practice templates pertaining to governance and operations. EDAC members also shared how they communicate, engage and consult with the group of EDs they represent within their group (i.e. LHIN region or by special focus – aboriginal/inuit, academic, blended salary model or NPLC) and keep them informed of EDAC’s work as it progresses. Click here for a list of all EDAC members.

    FHT Evaluation Report

    In 2008 the MOHLTC commissioned an external five-year evaluation of the FHT model of primary care. An embargoed copy of the final evaluation report, led by the Conference Board of Canada has been shared with AFHTO, FHTs and NPLCs. A membership webinar was held on December 10th to review the results and AFHTO has developed a summary to aid in the assessment and interpretation of the document.  It is anticipated that MOHLTC will release the report in the next few weeks. The report points to areas of focus for optimizing FHT/NPLC value, function and operations. EDAC’s work plan is aimed at some of the key points in the report – enhancing leadership capacity, strengthening governance and fostering collaborative working relationships as crucial components for achieving high-performing primary healthcare teams.

    Towards the Next Ministry Contract

    MOHLTC-FHT contracts expire on Mar.31, 2016. The templates that are developed to replace them could significantly reshape the relationship FHTs have with the Ministry. For this reason, under the direction of the board, AFHTO is moving along the journey to work with and on behalf of members to achieve a contractual relationship that is much more conducive to achieving the vision that all Ontarians will have timely access to high-quality comprehensive primary care that is delivered by the right mix of professionals, informed by the social determinants of health, anchored in an integrated and equitable system, and sustainable.

    • Performance Measurement & Accountability

    A central component for new contract development is the process to determine the performance measures to be reported under Schedule A. The ministry is looking to our members, in collaboration with other relevant stakeholders, to recommend performance measures aligned with the ministry’s focus on enhancing access/integration and supporting quality and sustainability in primary care. We are well-positioned to do this, by leveraging our collective work on the next iteration of Data to Decisions (D2D 2.0) and continuing to engage our members and other stakeholders (ICES, HQO, AOHC, OMA).  Encourage your team members to participate in the D2D 2.0 indicator selection process – details to be emailed on Dec. 15.

    • MOHTLC-FHT  Contract Template

    The contract template itself identifies the terms and conditions of funding in addition to some programmatic elements. Reviewing current MOHLTC-FHT contract templates provides the opportunity to develop more mature and meaningful contracts that will support interprofessional teams to continue to deliver high-quality primary care and improve the health of the people in the communities served. A number of EDAC members volunteered to participate on a working group that will provide recommendations on possible amendments to the contract template that will support FHTs in achieving their objectives.  All members will be kept informed and engaged as this process unfolds.

    Meetings with the Ministry’s PHC Branch

    The most recent quarterly meeting between AFHTO and the Primary Health Care (PHC) Branch was held on November 21st and an email update was circulated to members on November 24th. Following from this, EDAC members discussed:

    • 2015/16 Operating Plan & Funding Envelope

    The PHC branch has requested input from EDAC on the process, timelines and draft materials. Over the next week all members of EDAC will review the draft documents and compose feedback. A number of EDAC volunteers will synthesize the feedback received and provide a report back to the Ministry.

    • 2013/14 Annual Report Feedback

    It was noted that over half of the EDAC members polled have received an annual report feedback from their Ministry consultants. While overall there is consensus that these scorecards are valuable, it is recognized that many of them contain transcription and statistical errors. Members are encouraged to provide feedback to their Ministry consultants to rectify errors accordingly. EDAC will develop a summary of recommendations and advice to the PHC branch to support the development of more accurate and useful feedback.

    • Physiotherapy Allocation Updates

    All physiotherapy allocation letters have been circulated. The PHC Branch acknowledged that while the application was open to about 300 interprofessional teams (FHTs, NPLCs, CHCs, AHACs) there was only limited funding available. For those members who wish to discuss their application, they can contact Sue Hache (Senior Program Consultant, Interprofessional Programs Unit MOHLTC) at 613-536-3206.

    • Recruitment & Retention

    This continues to be the area of primary focus for AFHTO. EDAC members received an update on advocacy activity. Again members are encouraged to meet with MPPs so that political pressure will continue to keep this issue on the front burner.  (And thank you to EDs and others who have been active. The Minister has faced a number of questions in the legislature.)

    • Need for timely, robust and helpful feedback from Ministry

    Drawing some threads through these discussion items, EDAC members observed the need to work in a more meaningful and mature partnership with the Ministry. Feedback is critical to improving the delivery of care. In order to be useful, the feedback must be timely, with sufficient context and specificity to understand and act on it, and be constructive, so it can lead to solving problems and improving performance. AFHTO will be taking this message forward to PHC Branch to work together to improve.

    QIDS Program Update

    A brief update was provided on the status and current work of the QIDS program. Key highlights are identified below:

    • Build capacity to measure and improve interprofessional primary care by applying the lessons learned from D2D 1.0 to the next iteration (ie 2.0) tentatively scheduled for mid-May 2015.
      • Reminder that indicator survey will go out Dec.15, for reply by late January.
      • Advocate for manageable meaningful measurement and accountability in the upcoming renewal of the FHT contract with MOHLTC
      • An evaluation of the QIDS program will be conducted and will include direct input from QIDSS and host and partner EDs. Surveys will be circulated over the next few weeks.

    The next meeting of EDAC will be held in late January/early February. For any further questions, please contact your EDAC representative (click here for list) or:

    Kavita Mehta (Chair, EDAC) Executive Director, SETFHT kavita.mehta@setfht.on.ca Bryn Hamilton Provincial Lead, Governance & Leadership Program 647-234-8601 Bryn.Hamilton@afhto.ca

     

  • Chief Medical Officer of Health Memo: new and updated on Ebola virus disease resources

    The Chief Medical Officer of Health has released the following new and updated resources on Ebola virus disease for primary care and paramedic services:

    • updated Chief Medical Officer of Health Directive for Paramedic Services
    • summary of changes to the Chief Medical Officer of Health Directive for Paramedic Services
    • new Chief Medical Officer of Health Directive for Primary Care Settings
    • screening tools for paramedic services and primary care settings

    These resources are now posted in English at www.ontario.ca/ebola and in French at www.ontario.ca/virusebola.

  • Data to Decisions: Alignment with other initiatives

    STARFIELD FRAMEWORK DEVELOPMENT PROJECT   AFHTO’s approach to primary care measurement is based on the Starfield principles.  These principles include a focus on the relationship with patients and ability to deliver the comprehensive care patients value.  (see The Starfield model: Measuring comprehensive primary care for system benefit).  AFHTO has invested recently in an effort to “get started” with membership-wide performance measurement in the form of Data to Decisions 1.0: Advancing Primary care.  The next steps for D2D 1.0 are intended to advance meaningful measurement in primary care in a way that is consistent with Starfield principles.   The scope of the Starfield framework development project includes a series of activities by AFHTO members and external partners, ranging from confirmation of the theoretical basis to establishing weights for the components of the measures of doctor-patient relationship to developing technical solutions for reporting, analyzing and disseminating data and evaluating the impact on quality of care. Project Coordinator Role Reporting to the Provincial Lead for the QIDS program, the Project Coordinator will play a critical role in delivering on this objective. The role will be responsible for coordinating and aligning the efforts of external partners with AFHTO’s members in a way that leverages the ongoing work of the QIDS program.     The specific role of the position includes the following:

    • Manage work plan: Under the direction of the Provincial Lead for the QIDS program, the project coordinator will collaboratively develop and implement a detailed work plan focused on incorporating Starfield principles into AFHTO’s ongoing efforts to advance manageable meaningful measurement, based on an existing high-level summary of proposed work streams.
    • Recruit partners and participants:
      • Facilitate the development and application of criteria by which projects proposed by external partners will be judged for inclusion in the overall work plan, based on each project’s capacity to achieve the goals of the defined work streams.
      • Recruit patients, research partners and AFHTO members for relevant roles in the project
      • Contribute to positive relationships and effective communications with other QIDS program partners including other primary care providers, research partners, the Ministry, LHINs  and related agencies (e.g. HQO, eHealth Ontario, OntarioMD, CIHI) and EMR vendors, among others
    • Facilitate access to external funding opportunities: Identify and facilitate applications for opportunities for funding for research program, including tracking revenue and spending
    • Communicate:
      • Develop and implement communication processes to increase awareness and support of Starfield principles and their importance in demonstrating the value of interprofessional comprehensive, patient-centered primary care
      • Provide secretariat support to the Research Advisory Team (Starfield), including providing ongoing progress reports to AFHTO membership and external partners
      • Contribute to a culture of learning and continuous improvement in performance measurement within AFHTO member organizations.

    High-level work plan

    1. Validate theoretical constructs of the Composite Indicator of quality (a fundamental component of the approach), including examination of compliance with best practice in constructing composite indicators.
    2. Recruit primary care teams to participate in an expanded pilot of measurement consistent with Starfield principles.
    3. Establish a sustainable process for generating “patient expectations”, to be used as weights in the composite indicator
    4. Establish a sustainable process for generating “threshold” levels for performance on the components of the composite indicator
    5. Establish a sustainable process for data capture from patient surveys (ie patient experience input), administrative data sources and, where necessary, EMRs.
    6. Establish a sustainable process for data submission, data management and analysis to generate the scores for composite indicator, capacity and cost.
    7. Establish a sustainable process aligned with best practices for providing feedback that leads to action on primary care outcomes.
    8. Evaluate impact of the reporting/feedback process on primary care outcomes in the candidate teams and measurement culture in primary care.

     

  • Data to Decisions 1.0

    Cost data drill down Reminder that all teams who requested data from ICES for D2D 1.0 can access drill-down detail on the cost of care indicator from ICES Web stats afhto_d2d1.0_pageanalytics

  • Data to Decisions 2.0

    Indicator selection process for D2D 2.0 is getting started.  The survey for membership-wide voting will be released mid –December to give teams approximately 6 weeks to complete by the end of January.  We hope this is enough time for teams to convene their physician groups, Quality Improvement committees, Boards or whatever other groups want to provide input into the indicator selection process.  The exact dates. instructions and actual survey link will be released no later than Dec 15, 2014.

  • Data to Decisions: Member input

    Share stories, photos or even limericks!

  • Five-year FHT evaluation report: Registration details for briefing on Dec. 10

    Registration details for the ministry briefing on the five-year FHT evaluation report on December 10, 2014 from 12:00 to 1:00 pm have been confirmed. This message has been sent to the Executive Director, Lead MD/NP and Board Chair of all AFHTO member organizations. Register for the webinar here: https://attendee.gotowebinar.com/register/8399439067843427073

    • After registering, you will receive a confirmation email containing information about joining the webinar.
    • You are invited to share this information with your colleagues and staff. However, due to the limited capacity of the webinar, we ask that each team limit the number of separate log-ins and view the webinar together.

    This webinar will give participants a brief overview of the findings of the report and give an opportunity to ask questions. Click here for background information on the study and ministry briefing. To help prepare members for the public release of the five-year FHT evaluation results, AFHTO will be hosting the webinar and providing supporting materials as follows:

    Monday, December 8

    		 An embargoed copy of the report and briefing slides will be shared with members in advance of the briefing.

    Wednesday, December 10

    		 Attend briefing, several methods for participation:

    1. Log-in to the webinar when it starts using the link provided in your confirmation e-mail.
      1. Participants will be able to send in questions during the session.
      2. Participants can access the webinar by computer or on their smartphone (Download the app for iPhone or Android).
    2. Phone in to the webinar. You will be able to listen but not ask any questions.

    Friday, December 12

    		 A recording of the webinar and any other supporting materials will be available on the AFHTO members only website.

  • OCFP recognises family health teams at Annual Scientific Assembly

    On Thursday, November 27, 2014 the Ontario College of Family Physicians (OCFP) held their 2014 President’s Installation and Awards Ceremony as part of their 52nd Annual Scientific Assembly. Family health teams and their affiliated physicians figured prominently in the proceedings, not the least of which was London Family Health Team’s Dr. Cathy Faulds who has been installed as OCFP’s new president.

    Congratulations are due to McMaster Family Health Team, recognized as Family Practice of the Year and to the Jane and Finch Family Health Team which received an honourable mention in this category. Dr. William Ted Osmun of Thames Valley Family Health Team was named Ontario Family Physician of the Year as well as Regional Family Physician of the Year. Among others named Regional Family Physicians of the Year were:

    • Dr. Tim Wehner, Sunset Country FHT
    • Dr. Dale Guenter, McMaster FHT
    • Dr. Kimberly Wintemute, North York FHT
    • Dr. Carl Clark, Barrie and Community FHT
    • Dr. Adam Steacie, Upper Canada FHT

    Congratulations as well to the following Award of Excellence recipients:

    • Dr. Judy Baird, McMaster FHT
    • Dr. Anne Duvall, Barrie and Community FHT
    • Dr. Sanjeev Goel, Wise Elephant FHT
    • Dr. D. Robert Kerr, Hamilton FHT
    • Dr. Frank Martino, Queen Square FHT
    • Dr. James Milligan, The Centre for Family Medicine FHT
    • Dr. Laurel Moore, STAR FHT
    • Dr. Douglas Oliver, McMaster FHT
    • Dr. David Tannenbaum, Mount Sinai Academic FHT
    • Dr. Nancy Trimble, Barrie and Community FHT

    Click here for further details.

  • AFHTO members participating in Ontario Low Back Pain pilot program

    Nov. 26 – The government of Ontario announced the launch of a pilot program as part of the province’s Low Back Pain Strategy. Six AFHTO member organizations will be participating in this pilot:

    The government announcement indicates that these organizations will be able to provide additional hours for a range of allied health providers such as chiropractors, physiotherapists, occupational therapists, kinesiologists and registered massage therapists to:

    • Provide faster, more accurate assessment of low back pain problems
    • Use a more holistic approach to treating patients suffering from low back pain
    • Educate patients on low back pain self-management techniques
    • Refer patients to an appropriate health care provider as needed

    Click below for more information: