At this year’s Canadian Pharmacists Conference, Suzanne Singh and Tejal Patel were both awarded Patient Care Achievement Awards. Congratulations to Suzanne and Tejal for their important achievements! Suzanne Singh Honoured with the CPhA Patient Care Achievement Award for Innovation, Suzanne Singh is a pharmacist at the Mount Sinai Academic Family Health Team. The Brown-Bag Medication Check-Up Program, which Suzanne launched in July 2015, helps to ensure medication safety. The program focuses on ambulatory–care sensitive conditions, such as diabetes, heart failure, angina, hypertension, asthma and COPD. It is flexible and can be adapted to suit the varying needs of different pharmacies. Suzanne’s program has shifted the landscape of pharmacy practice in the future. She has advanced innovative practice by creating a collaborative practice model. With this dynamic, team-based model, she has been able to change the lives of both her patients and their caregivers. Suzanne has helped to build a clear role for FHT pharmacists. She explains, “This has allowed me to optimize my professional scope of practice and push the limits of what an effective model of interprofessional care could look like.” With the goal of improving patients’ outcomes along with their access to health services, Suzanne recognizes that patients can be their own best advocates for proper medication use. The Brown-Bag Medication Check-Up Program was also awarded a 2015 AFHTO Bright Light Award. Tejal Patel Awarded the CPhA Patient Care Achievement Award for Specialty Practice, Tejal Patel is pharmacist at the Center for Family Medicine Family Health Team. Tejal was honoured for her work with the Memory Clinic, which she joined in 2009, at the Centre for Family Medicine Family Health Team (CFFM FHT). Providing care to those with cognitive impairment, the clinic benefitted greatly from her skillful work—reviewing medications, assessing patient and caregiver capabilities, determining drug-related problems and performing cognitive testing. In particular, she has helped many Alzheimer’s patients stay in their own homes longer. The success of her work with the Memory Clinic is having a profound effect on pharmacists across the province. Tehal has trained many other pharmacists by sharing her knowledge and expertise, noting, “It is imperative that we continue to train the next generation of pharmacists to provide meaningful care.” Her hard-work and invaluable contributions to a vulnerable population have helped Tejal to develop a deep appreciation of the preciousness of life. The Memory Clinic program has been recognized with a 2012 AFHTO Bright Lights Award and a 2014 Minister’s Medal.
Author: sitesuper
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Updates on Patients First and FHT contracts from AFHTO board meeting with Ministry
This is an update on government’s implementation of Patients First and development of new FHT contract templates. Senior representatives of the Ministry of Health and Long-Term Care met with the AFHTO board on Wednesday. This is a report on what the board learned and direction provided on behalf of the membership. Further below is current info on preparation for the new compensation funding.
Patients First
Discussion with the ministry centered on four themes:
- LHIN accountability, consistency, capacity and willingness to take on a constructive role with primary care
- Measurement & quality improvement – opportunity to leverage AFHTO members’ work on Data to Decisions
- Need for physician-team relationships to be supported and strengthened
- Potential for expansion of interprofessional care across the province
The board welcomed the openness and willingness to listen of the ministry representatives – Associate Deputy Minister Nancy Naylor, PHC Branch Director Phil Graham, and Interprofessional Programs Manager Nadia Surani. The AFHTO board remains fully committed to the direction of Patients First. While there are many unknowns and much potential for “devils in the details”, this is the case in any major change. And it is particularly challenging at a time when the biggest segment of the primary care workforce – family physicians – remain without a contract. Together with our members, AFHTO is prepared to lead – FHTs and NPLCs have the experience and innovative, collaborative approach needed to show the way. Links to further information on Patients First
- MOHLTC – Patients First Presentation to AFHTO Board (June 21 2016)
- AFHTO’s analysis (for members only)
- Opinion piece by Dr. Sean Blaine, Clinical Lead, STAR FHT and AFHTO President
- Video presentation by Dr. Bob Bell, Deputy Minister and Mr. Tim Hadwen, Assistant Deputy Minister
Developing new FHT contract templates
The AFHTO board and ministry reps also discussed the ministry’s approach to consultation leading to implementation of new FHT contracts in early 2017. The Ministry is also required to consult with the Ontario Medical Association. While these contracts will be held by the ministry, it will work closely with the LHINs – passage of the Patients First Act would enable these contracts to be transferred to LHINs at some point when they are ready to take them on. Meanwhile, AFHTO will be working with members to identify specific needs and positions to take in these consultation discussions. Members laid a foundation 18 months ago, articulated in Toward the next ministry contract: Principles and guidance for moving forward. Since then discussions with AFHTO’s board, ED Advisory Council and Physician Leadership Council has identified the following topics for deeper probing with members:
- Relationship between FHT and physicians – both those who are within the team and those outside the team who may want to collaborate in the care of high-needs patients
- Board governance requirements
- Accountability and reporting requirements
- Dispute resolution between FHT and ministry and/or LHIN
AFHTO’s member consultation will culminate with deliberations at the annual Leadership Triad Session, Oct. 17, just before the start of the AFHTO 2016 Conference. Board chairs, EDs and Lead MDs/NPs of AFHTO member organizations are welcome to register. Legal and consulting help through the consultation and implementation process will be supported by a special fund of $104,700. A huge thank you as well, to the 48 AFHTO member organizations of all sizes, waves and LHIN regions who made voluntary contributions toward this fund.
Preparation for implementing new compensation funding
We understand the letters approving increased compensation funding for each FHT, NPLC, AHAC (and through LHINs for the CHCs) are in the final stages of ministry sign-off. We don’t know how long this will take, but hopefully will be “soon”. Each primary care organization will be required to develop its own compensation plan to allocate these funds, and report back to the ministry on how the funds were used. Ministry direction is clear that this funding can only be used for compensation for approved staff positions and cannot be used for any other purposes. Meanwhile AFHTO:
- is developing support materials to help EDs and boards to develop and implement their compensation plans. These materials are generic at the moment – we won’t have any more specific details until the ministry letters have final sign-off.
- will schedule webinars soon after the ministry letters are signed.
- may enable members to get better value from their benefits dollars. On June 22 the AFHTO board approved a group benefits partnership with the Association of Ontario Health Centres and Addictions and Mental Health Ontario. More information will follow in the coming weeks.
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Data to Decisions eBulletin #37: Data Dictionary and Step-by-Step Guide released
Just released: Data Dictionary and Step-by-Step Guide to participate in D2D 4.0. Look for them on our updated planning and preparation page along with some tips on what you can do to prepare for data submission (opening August). Ensure you have the most up-to-date data: The next Primary Care Practice Team Report will be released by the end of August. Most teams have already signed up; if you haven’t, now is your last chance – deadline is June 30. IHPs: Continuing the journey from measurement to improvement. We are finalizing our summary of guidance received during our Winter/Spring 2016 focus groups with IHPs. We will soon be reaching out to all who signed up and inviting them to reflect and comment on the summary via a short survey.
D2D 4.0 Timeline
Help spread the word about D2D – invite others to sign up for the eBulletin online. Getting too many emails? Scroll to the bottom of the original email for the unsubscribe link.
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EMR queries for D2D – Follow-up after hospitalization
EMR Tools and queries for phone encounters have been developed, and will help inform the development of the queries for follow-up after hospitalization. These tips will help you support your team in recording phone encounters in your EMR. EMR queries are currently being developed by QIDSS and the EMR Communities of Practice that will help you extract data for submission to D2D. If you are interested in helping with the development of these queries, contact us.
Accuro
A team of QIDSS from the Accuro EMR CoP have developed a set of queries and an Excel tool to help extract and calculate follow-up after hospitalization data from teams connected to one of the provincial hospital report feeds (e.g., HRM, SPIRE, POI). If you have any questions about these tools please contact us.
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Time Spent Delivering Primary Care: Testing the utility of Physician FTEs as a reflection of time spent
Why measure time spent?
There is interest among AFHTO members in measuring the human resource capacity for team-based primary care. There is also concern about the effort required to capture reliable data on this and at the same time concern about the quality of data captured in less cumbersome ways. As a first step to addressing this, D2D 3.0 included an exploratory indicator, Time Spent Delivering Primary Care, in which teams were asked to submit qualitative data (stories) about their approaches to this problem.
Why count FTEs?
In D2D 4.0, we are attempting a second step: Determining the degree to which the team-level physician FTEs as reported in the addendum to the Primary Care Practice Report (PCPR) correlate with the actual time spent by physicians delivering primary care. If a robust and reliable correlation exists, we can develop an algorithm to estimate Time Spent based on reported FTEs. To do this, we are undertaking two actions in tandem: Asking teams to share the FTE data from the PCPR addendum as a part of their D2D 4.0 data submission, and recruiting physician volunteers to participate in a validation study. The estimate of FTE reported in the PCPR addendum is based on billing data extracted from EMRs and sent to the MOHLTC. This in turn is sent to the Institute for Clinical and Evaluative Sciences (ICES), who use the billing data to calculate FTEs. It is this number that we are asking teams to submit for the updated exploratory indicator Time Spent Delivering Primary Care in D2D 4.0.
Testing FTEs as a reflection of time spent
The corresponding validation study will involve direct observation of a sample of physician volunteers for a short period of time (e.g., 1 week), tracking how much time they spend on primary care activities. Activities outside the office will be tracked by daily self-report from the physicians. Observation will be conducted by trained research associates, not physicians themselves. The process of observation has been tested and refined through a nurse practitioner study and was reportedly well received and non-disruptive. Processes for establishing provider and patient consent were developed to the mutual satisfaction of patients, providers and the Research Ethics Board. Total time spent on primary care by each physician in the study will be compared to ICES’ FTE estimates for these physicians in search of a correlation.
Expanding the indicator to include the entire primary care team
Even if Physician FTEs turn out to be a robust reflection of the time spent by physicians in delivering primary care, this is not a reflection of the work done by the entire team. AFHTO is continuing to explore strategies for measuring the time spent by all clinicians in order to better measure capacity and the contribution of all team members to the delivery of care.
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Primary Care input needed on interface with child and youth mental health services
Many families first attempt to access child and youth mental health care through you; their family doctor, pediatrician, walk-in clinic or hospital emergency department. Primary care professionals often report feeling ill-equipped to manage child and youth mental health concerns. To further complicate matters, community-based child and youth mental health services typically have limited funding and long waitlists. Children, youth and families need a more efficient and effective system of mental health care with more collaborative, coordinated partnerships across primary care and child and youth mental health sectors. The Ontario Centre of Excellence for Child and Youth Mental Health’s latest policy-ready paper will summarize the latest knowledge on evidence-informed approaches to ensuring a seamless interface between Ontario’s primary care system and community-based child and youth mental health service systems. A key step in this process is to ask community-based service providers, primary care physicians and professionals, families and youth what they think: What’s working, what’s not, and how things can be improved? They’re looking to engage primary care professionals in a one-hour telephone conversation about your insights and experiences on the intersection of Ontario’s primary care and child and youth mental health services. Say what worked, what didn’t and how things can be improved. By participating, you’re helping to shape how child and youth mental health services are delivered in Ontario and identify priorities for change. Interested individuals will be contacted throughout July and early August to schedule a one-hour telephone interview. They can also host a telephone focus group with multiple participants. If you have an existing group meeting they could call into, let them know. This document provides additional details on the project and process. For more information on this policy-ready paper and to RSVP, please contact Veronica Hoch at vhoch@cheo.on.ca or by phone at 613-737-2297 ext. 3478.
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2016 Concurrent Sessions
Our concurrent session presentations are organized into six 45-minute timeslots (3 per day) and seven themes. To help you plan your conference schedule, we have arranged the sessions by date, concurrent session, time, theme, and title.
Concurrent Session Selection
Concurrent session presentations were chosen by working groups consisting of AFHTO members across Ontario, representing the full breadth of professions within collaborative primary care. Submissions were chosen for reflecting the conference theme, usefulness/applicability to interprofessional primary care teams, innovativeness, evidence of impact, and clear learning objectives.
[table id=35 /]
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2016 Concurrent Sessions
Our concurrent session presentations are organized into six 45-minute timeslots (3 per day) and seven themes. To help you plan your conference schedule, we have arranged the sessions by date, concurrent session, time, theme, and title.
Concurrent Session Selection
Concurrent session presentations were chosen by working groups consisting of AFHTO members across Ontario, representing the full breadth of professions within collaborative primary care. Submissions were chosen for reflecting the conference theme, usefulness/applicability to interprofessional primary care teams, innovativeness, evidence of impact, and clear learning objectives. [table id=35 /]
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Diabetes Management Outcome Tools webinar
Come see new Diabetes Outcome tools for Practice Solutions which the Diabetes Community of Practice have created. The tools were created primarily for Registered Dietitians, but during this webinar we are looking for suggestions to modify these for a wide variety of interprofessional health providers. For a recording of this webinar please register to view the video here: https://attendee.gotowebinar.com/register/1324413807695060483 For more information on this session, please contact Denis Tsang, Lead of the Diabetes Community of Practice at denistsangrd@gmail.com. Members, for more information on the Diabetes Community of Practice, please visit our Diabetes Care page.