Ultimate Blogging Championship

Author: sitesuper

  • Nov.21 is deadline for applications for Primary Care Low Back Pain pilot

    The Ministry of Health and Long-Term Care (MOHLTC) announced one-time pilot funding to support inter-professional primary care teams to provide better patient care through more effective treatment and management of Low Back Pain (LBP). Funding is available to teams/ organizations that operate in the following primary care settings: Nurse Practitioner-Led Clinics, Family Health Teams, Aboriginal Health Access Centres and Community Health Centres. The pilot will provide one-time, time-limited funding for a minimum of 12 months to a maximum of 24 months, to support primary care organizations in the design, planning and implementation of a LBP management program within their organizational context.  Funding can be used to either enhance an existing program or create a new one if one does not exist. For more information and to complete an application please click on the following:

  • Report from quarterly meeting with MOHLTC FHT Unit, Sept.18, 2013

    The main focus of the meeting was on budget flexibility and accountability. FHT representatives presented to MOHLTC the position proposed by the Executive Director Advisory Council at their meeting of August 28 and endorsed by the AFHTO board and the AOHC’s group of CFHT EDs. Other topics covered in the meeting:

    • Process to address current budget pressures
    • Status of the BSM review
    • Sessional fees
    • Transfer of rostered patients
    • Quality Improvement Plans
    • QIDSS Program
    • IHPS in non-FHT models
    • Physiotherapy in FHTs

    AFHTO members can access the full report by logging in then going to the Members Only News page.

  • Report from quarterly meeting with MOHLTC FHT unit – September 18, 2013

    FHT Directors representing AFHTO and AOHC members met with the FHT Unit on Wednesday. To access the full report, please click here. The main focus of the meeting was the discussion on budget flexibility and accountability. The FHTs presented the position proposed by the Executive Director Advisory Council at their meeting of August 28, which was to achieve:

    • A global budget divided into two envelopes, one for HR and the other for operations, such that:

    The EDAC position was approved by the AFHTO board and is supported by the AOHC C-FHT Executive Directors. (To access the briefing note on this position, please click here.) The MOHLTC FHT unit agrees that, given the current fiscal constraints and the stage of development of some of the FHTs, moving towards increased budget flexibility and reviewing the accountability framework is the right direction.  All parties agreed that a staged approach that would be developed with a goal of moving a number of FHTs to a hybrid global budget for the next fiscal year, contingent on final ministry decisions. All have committed to collaborate on the first two steps to move this forward:

    1. Readiness assessment: Through EDAC, AFHTO will prepare initial draft of criteria for assessing FHTs in terms of their readiness to govern and manage a more flexible budget.
    2. More meaningful accountability reporting:  MOHLTC will share their initial work to review the reporting structure as a starting point for further discussion on changing the accountability framework.

    There remains the need to find ways to ensure decisions about the size of budgets can remain consistent with changing demands and conditions over time. The meeting also provided the opportunity to review with the Ministry the process to address current budget pressures. The Ministry re-affirmed its commitment to ensure that the budget reductions do not impact negatively on patient care.  The Ministry coordinators have been instructed to be flexible and to work with FHTs on a case-by-case basis to free up funds within the approved FHT budget, or if necessary consider other measures. The Ministry provided updates on a number of issues identified by EDAC:

    • Status of the BSM review
    • Sessional fees
    • Transfer of rostered patients
    • Quality Improvement Plans
    • QIDSS Program
    • IHPS in non-FHT models
    • Physiotherapy in FHTs

  • AFHTO 2013 Conference: Registration is open until Oct. 18

    Tuesday, October, 22 and Wednesday, October 23, 2013. The AFHTO 2013 Conference will be at the Westin Harbour Castle, One Harbour Square, Toronto, Ontario

  • AFHTO 2013 Conference: Early-bird rates end Sept. 20; preferred accommodation rates end Sept.18

  • EDAC Update: background on 2013/14 budget reduction and input on future budget flexibility

    AFHTO’s Executive Director Advisory Council (EDAC) met on August 26 with the main purpose of preparing for the quarterly meeting with the FHT unit later in September. At the same meeting, EDAC invited Phil Graham, (manager, Family Health Teams & Related Programs, Primary Health Care Branch) and Fernando Tavares (program manager) to clarify the context and the process for 2013/14 budget adjustment experienced by many FHTs. EDAC’s mandate is to advise the AFHTO board and staff on matters affecting the operations of our member organizations. Budget Reduction in 2013/14: Phil Graham, manager of MOHLTC’s FHT Unit, gave EDAC the following background on the ministry’s decisions to adjust the budgets of a number of FHTs:

    • In a managed-growth budget environment, the MOHLTC wants to maximize the use of existing dollars available within the FHT program.
    • In reviewing expenditure trends over the past three years, the MOHLTC determined there is on average a ~12% gap between what is allocated by the ministry and what is spent by FHTs. This means that $20-$40 million has been recovered following the end of each fiscal year.
    • Based on this data, the ministry undertook a budget right-sizing effort to bring the ministry’s allocation in better alignment with FHT expenditures. This included a 0.5% base funding adjustment for FHTs with budgets between $1-$2 million and a 1% base funding adjustment for FHTs with budgets in excess of $2 million. FHTs with budgets less than $1 million were not impacted by this adjustment nor were FHTs who were utilizing their full allocation.
    • The ministry also looked at Specialist Sessional funding and found that this area in particular was considerably underspent. Adjustments were made to Specialist Sessional funding based on historical trends.
    • Looking forward, this adjustment will help to enhance financial flexibility for other FHT initiatives and to address service needs.

    A total of 105 out of Ontario’s 185 FHTs experienced this adjustment. While each of these FHTs received notice of the reduction to their own FHT’s budget, based on the feedback received, the communication process will be improved in the future. Phil acknowledged there may be some gaps that have resulted from this approach, particularly but not exclusively related to Specialist Sessional adjustments. To ensure that the budget reductions do not impact negatively on service delivery, he noted that the Ministry coordinators have been instructed to be flexible and to work with FHTs on a case-by-case basis to free up funds within the approved FHT budget. Other options will be considered if solutions can’t be found within the FHT’s current budget.  He also confirmed the Ministry is looking at enhancing budget flexibility in future years, to give FHTs greater ability to manage their budget to meet patient need. Preparation to address Budget Flexibility and Accountability with MOHLTC: The ministry’s interest in greater budget flexibility is welcome news for FHTs, however the question for FHTs is, what is the “desired future state” to aim for?  To help answer this question, a group of EDAC volunteers looked into the advantages, constraints and risks associated with global budgets. Having reviewed and discussed the issues, EDAC members are recommending to the AFHTO Board the following position to take in discussions with the FHT Unit:

    • A global budget divided into “two buckets”, one for HR and the other for operations.
    • The HR “bucket” should allow for complete flexibility in determining the positions.
    • A provincial salary grid for each position should continue to be enforced to avoid unproductive competition for staff.  (AFHTO continues to join with our primary care partners in advocacy for a more competitive primary care compensation structure.)
    • Ask MOHLTC for clarity on existing funding formulas, in order to understand and advise on ways to ensure global budgets remain current with service needs and market conditions.

    Accountability for wise use of the funds goes hand-in-hand with the desire for greater budget flexibility; EDAC will engage in further discussion on this topic. Agenda items for the quarterly meeting with the Ministry FHT unit: The EDAC members are recommending the following agenda items for the September meeting with the MOHLTC FHT unit:

    • Preparing for the 2014/15 Budget process
      • Budget flexibility is a particular focus
    • Current fiscal year budget issues
    • Request for updates on:
      • Transfer of Rostered patient issue
      • QIDSS program
      • IHPs in non- FHT models
      • Physiotherapy in FHTs
      • QIP – process for determining mandated domains for next year.
      • Possible review of sessional fees in MOHLTC-OMA negotiations
    • “Good news” items: AFHTO conference and Bright Lights Award nominees

  • FHTS to receive QIP feedback in next week (+ other support to come from HQO)

    AFHTO is working on a number of fronts to support members in their work to improve quality. Last week we reported on support available to help members implement the QIDSS partnership agreements and recruitment/orientation for these new positions, and the sessions available at the AFHTO Annual Conference to help FHTs in streams such as Leadership and Governance for Quality and Using Data to Improve Care. AFHTO also continues to work with Health Quality Ontario (HQO) to ensure FHTs receive the support they need to implement their Quality Improvement Plans (QIPs). Here’s an update on the support activities HQO is rolling out: 1. HQO to send individual reports on the Quality Improvement Plan by end of August 2013: HQO will be sending individual feedback to the FHT Board Chair and Executive Director on the QIP that they submitted. The feedback is intended to support the on-going improvement efforts and provide constructive feedback that will enhance the ability of the FHT to move forward with their improvement initiatives. At the AFHTO Annual Conference in October, FHTs interested to meet with an HQO QIP specialist to discuss in person their QIP feedback will have the opportunity to do so. AFHTO will provide space and coordinate the feedback sessions with HQO staff. 2. Upcoming Webinar on Survey Methodology in mid- September 2013: In response to request from some FHTs, HQO is planning a webinar on “survey methodology” that will provide FHTs with an overview of methodologies relevant to FHTs: sampling approaches, good survey practices, focus surveys as a mechanism for improvement and change. The webinar will discuss practical strategies to answer questions from FHTs. 3. Navigator Tool to be launched in November 2013: Starting in November 2013, FHTs will be able to develop and submit their QIPs using an online tool called the QIP Navigator. Announcements will be sent out as testing opportunities are created as well training sessions. 4. Primary Care Sector Report in November 2013: HQO received 295 QIPs from the Ontario’s four primary care models this year (FHTs, CHCs, NPLCs, AHAs).  Each QIP was reviewed by QIP specialists and a quantitative and qualitative analysis of the QIPs was completed.  A complete report of the results of the analysis will be published to acknowledge the work and commitment of primary care organizations to improving quality, to identify strength and challenges encountered during the development of the QIPs, and to provide guidance and recommendations to support the strengthening of quality improvement initiatives in primary care.

  • QIDS Program: Links to information

    Links to information from Aug.21 “QIDS Program Town Hall” are posted on AFHTO’s Members-Only website.  The Town Hall gave the opportunity to share information and gather input.  Participants raised questions concerning sharing of QIDS Specialist positions, costs, and lines of accountability among other issues. To access these and other QIDS resources, login to the Members-Only site (top right of your screen — contact info@afhto.ca for assistance if needed) then click on  https://www.afhto.ca/news-events/news/qids-resource-documents/ . Keep in mind the AFHTO Annual Conference, Oct. 22-23, features a number of sessions that will help your FHT in its use of data to improve care, in streams such as Leadership and governance for quality, Using Data to Improve Care, Meaningful use of EMRs and EMR vendor sessions.

  • QIDS Program: Links to information from Aug.21 “Town Hall”

    Yesterday’s interactive QIDS Program “Town Hall” was an opportunity to share information and gather input.  Participants raised questions concerning sharing of QIDS Specialist positions, costs, and lines of accountability among other issues.  These questions and others are posted on a “Frequently Asked Questions” document that will be updated from time to time as new information becomes available.  Input received via participant polling and comments are already being used to plan next steps. Finally, in our update we indicated that funding approval for the AFHTO provincial team was “expected shortly.”  I am very pleased to share the news that this funding was confirmed almost immediately following the Town Hall.  We are very pleased to have been supported by the province to work with all of you on this exciting and timely program. Links to QIDS program information:

    Keep in mind the AFHTO Annual Conference, Oct. 22-23, features a number of sessions that will help your FHT in its use of data to improve care, in streams such as Leadership and governance for quality, Using Data to Improve Care, Meaningful use of EMRs and EMR vendor sessions.

  • Sept.13 deadline for proposals targeted to medically complex patients

    The Ministry has issued a call for applications for demonstration projects from general and family practice physicians and groups across the province to provide multidisciplinary care for individuals, who have high medical and functional care needs, may have a high number of interactions with the health care system and may have a high risk of hospital admissions and/or re-admissions. This is another call arising from provisions in the 2012 Physician Services Agreement, following last Friday’s close of the call for applications to expand IHP services in community. The key elements of such a demonstration project should include:

    • A target population of medically complex patients identified using a pre-defined identification method;
    • A core team of providers which can include physicians and inter-professional health providers;
    • Transitional Care Services including bundled evidence based services aimed to stabilize the patient at home and prevent re-admissions, and/or Medical Home Services including a wide range of services tailored to medically complex patients’ needs;
    • Collaborating partnerships.

    Demonstration projects will be funded for a 12 month period starting October 2013. Approved applicants will be expected to track evaluation metrics and to participate in a full project evaluation upon completion of the demonstration project. Funding may be paid directly to the physician or a physician group depending on the specifics within the application. The weblink to the live application is now available at http://www.health.gov.on.ca/en/pro/programs/complex/. Physicians will receive mailed information regarding this initiative starting today (Aug.19).