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  • Frontline Psychology Newsletter – new issue March 2014

    Frontline Psychology is a newsletter brought to you from your Family Health Team Psychologists.

  • Central Hastings FHT- LEADing Practice award recipient

    Central Hastings FHT is a LEADing Practice award recipient as announced by Canada Health Infoway (Infoway), in partnership with Accreditation Canada. Given for their leadership in the advanced use of technology in clinical practice, the award is part of Infoway‘s pan-Canadian Knowing is Better clinician education campaign developed to generate awareness of the benefits of digital health in Canada. Click here for full details.

  • Healthcare Team Model Best for Patients and Healthcare System

    The Conference Board of Canada has published a new report Getting the Most out of Health Care Teams: Recommendations for Action.  Click here for the full report. Key points from the report are summarized in the Conference Board of Canada’s press release, reproduced below: Billions of dollars in savings could be realized Ottawa, March 10, 2014 – Making interprofessional primary care (IPC) teams the standard model for delivery of primary health care services across Canada could help improve patient outcomes while reining in costs. Canada’s population is aging, prevalence of chronic conditions is growing and, in turn, demand for health care and health care costs are rising. IPC team care could save the health care system almost $3 billion in direct and indirect costs of diabetes and depression complications alone. An IPC team is a group of professionals from different disciplines who work together and communicate under an arrangement to provide health services in a community. A new Conference Board of Canada publication, the last in a four-part series, outlines the actions required to improve IPC team care in Canada and increase access to team-based care for Canadians. “The evidence tells us that team-based care significantly improves the health and wellness of patients with and at risk for chronic conditions, reduces emergency room visits, and offsets costs in other parts of the health care system,” said Thy Dinh, Senior Research Associate. “There has been an increased use of the interdisciplinary team model for delivering primary care, but barriers, such as funding and how we pay team members, still exist.” HIGHLIGHTS

    • Increasing access to IPC teams for Canadians with Type 2 diabetes could reduce medical complications by 15 per cent annually.
    • IPC team care could also save the health care system almost $3 billion in direct and indirect costs of diabetes and depression complications.
    • IPC teams have been shown to produce multiple benefits, compared to care provided by a solo provider.

    Barriers to implementing IPC exist among individual team members, within practices, and throughout the primary care system. These barriers include inappropriate governance, leadership, and pay structures, and inadequate inter-professional education and training programs. The Conference Board study, Getting the Most out of Health Care Teams: Recommendations for Action, outlines what governments, health care providers and administrators, and patients can do to ensure IPC teams function well and deliver quality primary care services for Canadians. Recommendations for federal, provincial and territorial governments:

    • Adopt a funding and payment system that supports IPC.
    • Mandate and support the development and use of interprofessional education and training programs on the core competencies of collaboration for all health professionals.

    Recommendations for health care providers and administrators:

    • Provide appropriate mix of service providers to meet service requirements in the most cost-effective way and within the available funding and supply of health care professionals.
    • Establish protocols for and implementation of standardized patient hand-offs, referrals, and care coordination among providers on the team and across the health care system.
    • Optimize use of communications technology, physical space, and other supports to facilitate collaboration.

    Recommendations for all three of the above:

    • Engage in, support, and establish a strong and stable governance structure.
    • Make it easier for Canadians to access team-based care.
    • Monitor and evaluate cost-effectiveness, performance and knowledge sharing on a regular and consistent basis.
    • Adopt accountability measures for IPC team models, which are linked to performance.

    Recommendations for patients:

    • Be open to receiving care from and consulting with different health providers.
    • Request greater access to inter-professional health teams.

    This is the final report in the Canadian Alliance for Sustainable Health Care’s (CASHC) research series Improving Primary Health Care Through CollaborationLaunched in 2011, CASHC is a program of research and dialogue, investigating various aspects of Canada’s health care challenge, including the financial, workplace, and institutional dimensions, in an effort to develop forward-looking qualitative and quantitative analysis and solutions to make the system more sustainable. The report findings will be presented at a Conference Board of Canada webinar, Improving Primary Health Care through Collaboration, on April 22, 2014 at 02:00 p.m. EST.

  • Interprofessional Collaboration in Ontario’s Family Health Teams: A Review of the Literature

    We are pleased to share the following literature review exploring current research on interprofessional Family Health Teams (FHTs) across Ontario. This review collects and analyzes existing evidence on the initial improvements to primary healthcare access, patient outcomes and reduction of system costs. A Review of the Literature – Click here for full article Authors: Sophia Gocan, RN, MScN; Mary Ann Laplante, RN, BScN; & A. Kirsten Woodend, RN, BScN, PhD Abstract: Background: In Ontario, 200 interprofessional Family Health Teams (FHTs) have been established since 2005 to improve primary healthcare access, patient outcomes, and costs. High levels of interprofessional collaboration are important for team success; however, effective team functioning is difficult to achieve. FHTs are in their infancy, and little is known about the determinants that have influenced the quality of team collaboration or the outcomes that FHTs have achieved. The objective of this article is to examine current knowledge regarding FHT team functioning. Methods and Findings: A search of the literature resulted in eleven articles for final analysis, which were primarily qualitative in nature. A narrative synthesis of study findings was completed. A number of common challenges to interprofessional collaboration were identified. Nevertheless, patients and providers described improved healthcare access, greater satisfaction, and enhanced quality of healthcare using a FHT approach. Collaboration was fostered by effective leadership, communication, outcome evaluation, and training for both professionals and patients alike. Conclusions: Ontario FHTs have generated improvements in healthcare access and outcomes. Collaborative team functioning, while present, has not reached its full potential. Supportive public policy, education for patients and providers, and evaluation research is needed to advance FHT functioning. Click here for the full article.

  • Important Update: Privacy and Data Sharing Tools and Learning Opportunities

    Protecting patient privacy while enabling data sharing and quality improvement has emerged as a critical issue for all FHTs, regardless of whether or not they’re involved in the Quality Improvement Decision Support Initiative.  These issues apply to data sharing between a FHT and its physician groups or with any other partner organization.

    Webinar Open to All Members:

    Registration is now open for the webinar: “Overcoming privacy issues in partnership agreements” on March 21, 2014 at 9 am to 10 am EST.

    Memorandum of Understanding for Collaboration and Data-Sharing:

    A template Memorandum of Understanding (MOU) for Quality Improvement Decision Support Specialist Collaboration and Data-Sharing Agreement is now available for all members’ use. This template was prepared by Dykeman Dewhirst O’Brien LLP (DDO Health Law) based on advice from a working group of AFHTO members.  It can be adapted to meet the needs of individual partnerships. Members are encouraged to share their improvements to this template or other model agreements with us to support system wide collaboration and learning.

    Privacy Toolkit to be launched March 14, 2014

    The Privacy Toolkit will provide information about how to best navigate QIDS related privacy such as:

    • Obligations of FHTs and their affiliated physicians to protect patient privacy when engaged in quality improvement and data analysis
    • Steps that should be taken where QIDS Specialists are shared among multiple FHTs
    • Decision making on data access
    • What happens if there is a privacy breach related to QIDS work

    Help us to meet your needs!

    Please review these materials and send your questions or suggestions  to Denise Pinto (improve@afhto.ca) by March 19, 2014 at 12.00 pm and we will try our best to address them in the webinar.

    And special thanks to the working group:

    This work owes a great deal to the efforts of a reference group that shared its time, knowledge and expertise: Randy Belair, Sunset Country FHT; Stephanie Dudgeon, Brockton and Area FHT; Dr. Michelle Griever, North York FHT; Sherry Lynn Harrington, Primary Health Care Services of Peterborough; Monique Hancock, STAR FHT; Jill Murphy, Thames Valley FHT; Melonie Young, Sunset Country FHT and Kavita Mehta, South East Toronto FHT.

  • Important Update: Privacy and Data Sharing Tools and Learning Opportunities

    Protecting patient privacy while enabling data sharing and quality improvement has emerged as a critical issue for all FHTs, regardless of whether or not they’re involved in the Quality Improvement Decision Support Initiative.  These issues apply to data sharing between a FHT and its physician groups or with any other partner organization. Webinar Open to All Members: Registration is now open for the webinar: “Overcoming privacy issues in partnership agreements” on March 21, 2014 at 9 am to 10 am EST. Memorandum of Understanding for Collaboration and Data-Sharing: A template Memorandum of Understanding (MOU) for Quality Improvement Decision Support Specialist Collaboration and Data-Sharing Agreement is now available for all members’ use. This template was prepared by Dykeman Dewhirst O’Brien LLP (DDO Health Law) based on advice from a working group of AFHTO members.  It can be adapted to meet the needs of individual partnerships. Members are encouraged to share their improvements to this template or other model agreements with us to support system wide collaboration and learning. Privacy Toolkit to be launched March 14, 2014 The Privacy Toolkit will provide information about how to best navigate QIDS related privacy such as:

    • Obligations of FHTs and their affiliated physicians to protect patient privacy when engaged in quality improvement and data analysis
    • Steps that should be taken where QIDS Specialists are shared among multiple FHTs
    • Decision making on data access
    • What happens if there is a privacy breach related to QIDS work

    Help us to meet your needs! Please review these materials and send your questions or suggestions  to Denise Pinto (improve@afhto.ca) by March 19, 2014 at 12.00 pm and we will try our best to address them in the webinar. And special thanks to the working group: This work owes a great deal to the efforts of a reference group that shared its time, knowledge and expertise: Randy Belair, Sunset Country FHT; Stephanie Dudgeon, Brockton and Area FHT; Dr. Michelle Griever, North York FHT; Sherry Lynn Harrington, Primary Health Care Services of Peterborough; Monique Hancock, STAR FHT; Jill Murphy, Thames Valley FHT; Melonie Young, Sunset Country FHT and Kavita Mehta, South East Toronto FHT.

  • Health Links: Current status and update on resources

    Whether you are in one of the 47 Health Links have been approved to date, or will be participating in a future Health Link, the presentations listed below will give you an update on the progress of Health Link implementation to date. These presentations were made at a meeting last week for all the associations whose members are involved in Health Links. Points to note:

    • AFHTO continues to hold monthly teleconferences for FHTs leading Health Links to raise and resolve common issues.  Please contact Clarys.Tirel@afhto.ca for further information.
    • The 47 Health Links currently approved cover a geography that encompasses just over half of Ontario’s population.
    • Expectation is that there will be 90+ Health Links covering the full province by some point in 2015.
    • Initial “rapid cycle evaluation” is tracking four domains to understand how Health Links are evolving:
      • Identification of Complex Patients
      • Care Coordination
      • Patient Care
      • Patient Experience
    • Future evaluation will address impact of Health Link model on system performance.
    • A “Care Coordination Tool” is being developed for roll-out across the province.

    Please click on the links below to access the following presentations:

  • Seeking AFHTO members to guide the 2014 Conference

    We invite board members, clinical providers, staff and patients of AFHTO member organizations to participate in a conference program working group and earn a $50 discount on registration for the AFHTO 2014 Conference. This is a valuable opportunity to discover the thought leaders in your chosen topic area, and to apply your expertise to shape the content of the AFHTO conference for your peers. The theme for the 2014 Conference is In Partnership with Patients: True Integration of Care. Seven concurrent streams will focus on:

    1. Accountability and governance for patient-centred care
    2. Engaging the patient in their care
    3. Responding to community needs
    4. Team collaboration in patient-centred care
    5. Integrating the community around the patient
    6. Using data to improve transitions of care and care coordination
    7. Clinical innovations in comprehensive primary care

    Working groups are being set up for each of the seven concurrent streams and for the Bright Lights Awards program. Concurrent program working group members: The task requires a total of 4-10 hours of effort between April and early June, specifically:

    • Between April 7 to 11, each working group will have an initial teleconference to brainstorm ideas on specific topics and speakers to pursue.
    • AFHTO staff will manage the call for proposals process from April 1 – May 9.
    • Between May 10 to 23, each working group member individually reviews and scores presentation abstracts for their program.
    • Between May 26 to 30, working groups will teleconference to review scores and determine the program for this theme.

    Click here to sign-up by March 31, 2014. “Bright Light” Awards Review Committee: The task requires a total of 6-12 hours of effort in July to September, specifically to individually review and score nominations followed by a group teleconference to determine the award winners. Click here to sign up by March 31, 2014. This message is sent to leaders of AFHTO member organizations; we encourage you to participate and to invite your colleagues, staff and patients to consider this as well. Conference key dates:

    • First week of April: Applications for concurrent session and poster abstracts open
    • May 9: Deadline to submit concurrent session and poster abstract
    • June: conference registration opens
    • October 15 & 16: AFHTO 2014 Conference

    Conference registration fees for AFHTO members remain the same as last year. Conference working group members and presenters receive an additional $50 discount. Patients participating in the working groups will be offered registration at the membership rate and the working group discount. For more information, contact Sal Abdolzahraei by phone (647-234-8605) or e-mail (info@afhto.ca).

  • Operating plan updates from quarterly meeting with MOHLTC FHT unit – February 28, 2014

    Primary objective of the meeting of FHT Directors (representing AFHTO and AOHC members) and MOHLTC’s FHT Unit concerned operating plan submissions and cash flow challenges in first half of next fiscal. Click here for the full report. One topic was staff compensation. AFHTO, together with AOHC and NPAO, is continuing to advocate at political levels on the challenges to recruiting and retaining the staff needed to fulfill government’s commitment to deliver interprofessional primary care.  (Click here to see the joint report and recommendations.) Recruitment and retention will also be a key message in AFHTO’s upcoming pre-election work – more on this to come.

    • Your help is needed to reinforce this message in your operating plans.  Section 5.1 of the submission package asks, “Is there anything else the Family Health Team would like to communicate to the ministry regarding their planned activities for 2014-2015?” If your FHT is facing recruitment and retention challenges, please use this as the opportunity to tell the Ministry about your concerns, and illustrate with specific stories. For example, point out:
      • vacancies you have experienced and their impact on the FHT’s ability to deliver care
      • better-paid positions that staff members have left to take
      • likelihood of losing staff in the next year (e.g. is there recruiting in other sectors in your community that’s threatening to draw staff from the FHT)
      • We have gained some traction on this issue, and your reinforcement with real-life illustrations will help. After entering it into your plan, please send a copy of your stories to info@afhto.ca so we can draw from them in our on-going work.

    Other topics covered in the full report include:

    • Funding for additional QIDS positions and overhead costs for QIDS employers
    • Clarification of what the funding priority — “Innovative low cost expansion opportunities” — means
    • Restitution of specialist sessional funding
    • Guidance for FHTs incorporating Diabetes Education Programs
    • Funding, cash flow and audit requirements Health Link leads
    • Accountability Reform Initiative
    • And more … click to read the full report
  • Help for your operating plan development: QIDS and Accountability Reform

    As you finalize your 2014-15 operating plan proposals over the next three weeks, here is help to:

    • Strengthen your case for Quality Improvement Decision Support (QIDS) positions
    • Meet the Accountability Reform Initiative requirements
    • Learn more about incorporating chiropractic services in primary care

    Increasing access to QIDS positions Click here to access advice for both AFHTO members and the ministry on allocating additional QIDS positions for both FHTs and NPLCs.  The ministry has stated building quality improvement capacity will be one of the priorities for “the limited resources available for new investments.” This new report presents the facts about the current state of the QIDS program – the make-up of QIDS partnerships, the number of FHTs, EMRs, physicians and rostered patients per QIDS FTE, and the current status of partnership agreements. The advice has been developed with feedback from AFHTO members on the QIDS Steering Committee, ED Advisory Council and at the QIDS Host Town Hall. If you are not part of a QIDS partnership and are seeking to join one, or if you are part of a partnership seeking additional QIDS capacity, this report will provide you with useful information. FHT Accountability Reform Application Package FHTs interested in moving towards greater budget flexibility must complete the Accountability Reform package included with the operating plan 2014/15. (This option is not yet available to NPLCs but is being considered for the following fiscal year.)  The application should reflect the work that you have completed over the years to ensure sound governance and accountability. If you have any questions about the application, you can contact AFHTO’s Governance and Leadership Lead at bryn.hamilton@afhto.ca Completing the application will also help identify development needs. Fundamentals of Governance  is now available on line to give teams the tools and resources to improve governance and address the deficiencies identified this year in the ministry accountability assessment.  The toolkit, guidance documents and peer facilitator support will ensure that primary care organizations can meet the requirements for the next fiscal year. Chiropractic in Primary Care The Ontario Chiropractic Association has produced a brochure on the role chiropractors could play on interprofessional teams. In the past other health professions have created similar resources for teams to consider incorporating their professions into the primary care team.