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  • Member news: MAID, transgender primary care guide, funding opportunities and more

    Below are relevant updates and items for AFHTO members, some with fast approaching deadlines:

    AFHTO News
    • AFHTO to present on Patients First Act: AFHTO has been selected to present on Bill 41 to Standing Committee on the Legislative Assembly on Nov. 21. AFHTO’s submission will be posted on our website after the presentation.

    Quality and Value
    • Survey sent to teams in STOP Program regarding depression and smoking cessation: AFHTO is collaborating with the Centre for Addiction and Mental Health (CAMH) in their CIHR-funded QI initiative. This is to manage depression and depressive symptoms as they relate to smoking cessation in the STOP Program. An invitation to complete a preliminary survey has been sent to teams in the program. Deadline Nov. 25.

    Requests for Proposals

    Resources

    Health Quality Ontario (HQO) News & Tools:

    o   Under Pressure: Emergency Department Performance in Ontario was just released. Key findings include 47% of adult Ontarians reported going to emergency for a condition they thought could have been treated by their primary care provider.

    Knowledge Translation in Primary Care Initiative (developed by Centre for Effective Practice):

    o  Medical Assistance in Dying (MAID) Resource: just released to help clinicians better understand the process to be undertaken for the provision of MAID.
     o  Guide to Patient Engagement in Quality Improvement: just released, the guide outlines how patients can be engaged in quality improvement initiatives, with a focus on the QIPs. o  Ontario poverty tool updated: originally developed for Ontario, it’s now been adapted for use across Canada.
    • Trans Primary Care Guide: online interactive tool for primary and transition-related care to trans and gender-diverse patients from Sherbourne Health Centre and Rainbow Health Ontario in collaboration with University of Toronto’s Biomedical Communications program.
     

    Conferences and Events

     

  • Medical Assistance in Dying (MAID) Resource

    On June 17, 2016, the federal government passed legislation to amend the criminal code to allow access to Medical Assistance in Dying (MAID) for those who are eligible. To support physicians and nurse practitioners (clinicians), the Ministry of Health and Long-Term Care engaged the Centre for Effective Practice to develop a resource to help clinicians better understand the process to be undertaken for the provision of MAID. Developed as part of Knowledge Translation in Primary Care Initiative under the clinical leadership of Dr. Sandy Buchman, the goal of this resource is to support clinicians (physicians and nurse practitioners) with the provision of MAID and to implement a consistent approach to the process within Ontario. This resource also highlights key considerations and recommends processes for the provision of MAID by medical and nurse practitioners based on extensive consultations with key stakeholder organizations and regulatory bodies. It is intended to supplement, not circumvent, existing regulatory body requirements or institutional processes that have been implemented. The Knowledge Translation in Primary Care Initiative is aimed at developing and disseminating health information and clinical tools to support primary care providers. Its purpose is to improve engagement and enhance communication with primary care providers across Ontario and is a collaboration of the Ontario College of Family Physicians (OCFP) and the Nurse Practitioners’ Association of Ontario (NPAO) and the Centre for Effective Practice (CEP). Relevant Links:

  • Webinar: Financial Literacy for FHT and NPLC Leaders

    AFHTO, in partnership with BDO Canada, presented this FREE webinar on financial reporting for board members, executive directors, and finance managers of AFHTO-member FHTs and NPLCs.

    This 90-minute webinar presentation touched on the following topics:

    • Financial reporting and the budget process
    • Accounting for and tracking in-year budget reallocations — tools and tips
    • Financial reporting and the ASRER
    • Financial reporting and “One-time expenses”
    • Understanding accounting for and reporting the HST rebate

    Resources from the webinar:

    View a recording of the webinar here.

    Presenters:

    • Liz Chirico (CPA, CA), Senior Manager, Assurance and Accounting, BDO Canada.
    • Dean Decaire (CPA, CA), Assurance Partner, BDO Canada.

    This webinar discusses:

    • Financial reporting: Issues for FHTs; budgeting & oversight; Responsibilities of FHT Directors; Legislative requirements; FHT Funding agreement; Controls;
    • Budgeting: Managing your Budget; One-time expenses
    • Financial Reporting: ASRER
    • HST Rebate: Accounting for the HST Rebate; Rebate Rates
    • Not-for-profit Corporations Act (ONCA): Considerations; Steps to take
    • Board of Directors

  • Patients not attached to new primary care practices receive lower quality care, research suggests

    Article published in Annals of Family Medicine on November 14, 2016 The accompanying news release and abstract are shown below. One in six patients in Ontario does not belong to an organized primary care practice, new research suggests. These patients receive lower quality care and are more likely to be poor, urban and new immigrants, the study says. The Ontario government has invested millions of dollars in reforming the primary care system to improve access and quality of care. Fifteen years ago, most doctors practiced alone and were paid by the visit (fee-for-service). Now, most doctors are part of groups where they formally enroll patients, provide after-hours care, and get some lump-sum payment per year for looking after their enrolled patients (capitation). Joining these new groups was voluntary for doctors and their patients. When reforms are voluntary, there is a risk the most vulnerable in society will be left behind, said Dr. Tara Kiran, a family physician at St. Michael’s Hospital, an adjunct scientist at the Institute for Clinical Evaluative Sciences (ICES) and lead author of the study. In the study, published today in Annals of Family Medicine, Dr. Kiran and colleagues analyzed Ontario data from 2001 to 2011. They found that patients who didn’t belong to these new primary care practices were more likely to reside in an urban area, live in a low-income neighbourhood and have immigrated to Canada in the last 10 years. The study also found that patients left out of new primary care practices were less likely than those who were included to be screened for cervical, breast, and colorectal cancer (52 per cent vs. 66 per cent, 58 per cent vs. 73 per cent and 44 per cent vs. 62 per cent, respectively), and were less likely to receive recommended tests for diabetes (25 per cent vs. 34 per cent). In 2011, 2, 376, 248 (18 per cent of) Ontarians did not belong to these new primary care practices. “Some of these people that have been left behind are seeing traditional fee-for-service doctors,” said Dr. Kiran, “but others might not want a regular primary care doctor or perhaps couldn’t find one and are getting care from walk-in clinics.” Dr. Kiran said that patients left behind from these new groups had poorer quality of care even before reforms were introduced and the gaps in quality of care seem to have widened over time. The report follows the Ontario government’s introduction of the Patients First Act, a goal of which is to improve access to primary care. Dr. Kiran said there are lessons to be learned from what worked and what didn’t during the last round of reforms. She said that new reforms need to specifically reach out to more vulnerable groups of patients to connect them with a primary care provider. “We need to educate new Canadians about what good primary care looks like and how they can access it,” said Dr. Kiran. Dr. Kiran said health care leaders should also be reaching out to doctors who still practice alone and finding ways to support them and their patients. “To improve care for all Ontarians, there needs to be specific strategies to reach out to both patients and physicians who are not currently part of an organized primary care practice,” she said. Abstract Those left behind from voluntary medical home reforms in Ontario, Canada Kiran T, Kopp A, Glazier RH. Ann Fam Med. 2016; Nov 14 [Epub ahead of print]. Purpose — Health systems are transitioning patients to medical homes to improve health outcomes and reduce cost. We sought to understand the characteristics and quality of care for patients who did and did not participate in the voluntary transition to medical homes. Methods — We used administrative data to compare diabetes monitoring and cancer screening for patients attached to a medical home (N=10,785,687) versus a fee-for-service physician (N=1,321,800) in Ontario, Canada on March 31, 2011. We used Poisson regression to examine associations in 2011 after adjustment for patient factors and also assessed changes in outcomes between 2001 and 2011. Results — Patients attached to a fee-for-service physician were more likely to be immigrants and live in a low-income neighbourhood, and urban area. They were less likely to receive recommended testing for diabetes (25% vs. 34%; adjusted relative risk [RR] 0.74, 95% confidence interval [CI] 0.73 to 0.75) and less likely to receive screening for cervical (52% vs. 66%; adjusted RR 0.79, 95% CI 0.79 to 0.79), breast (58% vs. 73%; adjusted RR 0.80, 95% CI 0.80 to 0.81), and colorectal cancer (44% vs. 62%; adjusted RR 0.72, 95% CI 0.71 to 0.72) compared to patients attached to a medical home physician in 2011. These differences in quality of care preceded medical home reforms. Conclusion — Patients left behind from medical home reforms are more likely to be poor, urban, and new immigrants and receive lower quality care. Strategies are needed to reach out to these patients and their physicians to reduce gaps in care. You can read the full article here. Authors

    • Tara Kiran, MD, MSc, CCFP, St. Michael’s Hospital Academic Family Health Team
    • Alexander Kopp, BA, Institute for Clinical Evaluative Sciences
    • Richard H. Glazier, MD, MPH, CCFP, St. Michael’s Hospital Academic Family Health Team; Institute for Clinical Evaluative Sciences; Institute for Health Policy, Management and Evaluation, University of Toronto

    Relevant Links:

  • Manitoulin Central FHT Physician named Regional Physician of the Year

    The Manitoulin Expositor article published November 9, 2016. Article in full pasted below. Expositor Staff, The Manitoulin Expositor

    MINDEMOYA—Dr. Maurianne Reade, a physician at the Manitoulin Central Family Health Team in Mindemoya, is this year’s Northeast and Northwest Ontario 2016 Regional Physician of the Year as awarded by the Ontario College of Family Physicians (OCFP) Awards.

    The OCFP’s Annual Awards program celebrates the outstanding skill, knowledge and dedication of family doctors across Ontario, a press release from the association states. The awards recognize excellence in community and medical leadership, outstanding contributions in teaching and exceptional teamwork.

    The Regional Family Physician of the Year Award recognizes the outstanding contributions of seven Ontario family doctors who provide exemplary care to their patients and are passionately involved in activities that contribute to excellence in family medicine.

    Dr. Reade has practiced as a rural physician in Mindemoya since 2001. She is an associate professor at the Northern Ontario School of Medicine, a board member of the Physician Clinical Teachers Association and an executive member of the OMA Academic Medicine Forum and Rural Expert Panel.

    Described by peers as someone who views health holistically, her dedication to family medicine shines through in her daily routine where she can be found caring for patients in their homes, in the family health team clinic or First Nations Health Centre, the local emergency room and hospital ward.

    “Good for Dr. Reade,” said Dr. Cooper, MHC chief of staff when contacted by The Expositor. “She certainly deserves some credit for all she does. Dr. Reade is an inspiration to her colleagues, a pleasure to work with, a tireless educator and an excellent clinician.”

    The awards will be handed out at a gala event later this month at the Fairmont Royal York.

    Click here to access The Manitoulin Expositor article 

  • Statutory Obligations in the Workplace

    Beginning September 1, 2017, the Ontario Ministry of Labour will undertake safety inspections at Family Health Teams to ensure compliance with the Occupational Health and Safety Act (OSHA). The three priority areas of focus are for these inspections are: Internal responsibility systems, workplace violence, and needle safety.

    Statutory Compliance Toolkit

    AFHTO’s Statutory Compliance Toolkit [PDF] ensures that boards and Executive Directors are well informed about their legal obligations and have access to the basic tools and resources to ensure compliance and/or risk mitigation. This resource is customized for FHT and NPLCs and highlights the key laws that boards need to know and the impact that those laws have on the organization and on the board members personally. The Statutory Compliance Toolkit was developed by legal experts from DDO Health Law and overseen by AFHTO staff. If you have any questions please contact info@afhto.ca

    Occupational Health & Safety Act (1990)

    Among other things, the Occupational Health and Safety Act (OHSA) regulates practices relating to material and environmental hazards and to workplace violence and harassment.

    To support healthcare workplaces in voluntary compliance with the OHSA, the Ministry works closely with the Public Services Health and Safety Association (PSHSA) who provide health and safety information, products and services.

    Resources from the Public Services Health & Safety Association (PSHSA)

    AFHTO has partnered with the Public Services Health & Safety Association (PSHSA) to provide our members with a selection of tools and resources, and we continue to work with them to develop more.

    Other resources for OHSA compliance

    Help us build our library: Consider sharing your human resources policies and tools with fellow AHFTO members.

    Employment Standards Act (2000)

    Among other things, the Employment Standards Act (ESA) regulates practices relating to salaries, payment of wages, hours of work, overtime, leave, and termination.

    Other resources for ESA compliance

    Please see Human Resources: Compensation, Benefits, and Pay Equity  and Human Resources: Employment Policies and Procedures in our Library of Organizational Policies and Procedures. Help us build our library: Consider sharing your human resources policies and tools with fellow AHFTO members.

    Accessibility for Ontarians with Disabilities Act (2005)

    The Accessibility for Ontarians with Disabilities Act (AODA) regulates accessibility standards for businesses, non-profits, public sector organizations, municipalities, producers of educational materials, and library boards. It applies to you both as a service provider and as an employer.

     

    Other resources for AODA compliance

    Summary of new regulations effective January 2017, from Macmillan LLP [PDF]. All organizations with 20 or more employees must confirm their compliance with these new requirements as well as all previous ones by December 31, 2017. Accessibility Ontario provides training and development to help nonprofits and businesses in Ontario comply with the AODA. Help us build our library: Consider sharing your human resources policies and tools with fellow AHFTO members.    

  • Data to Decisions eBulletin #46: Using D2D for annual reporting

    Consider using D2D data for your QIP and annual operating plan: D2D 4.1 will be released in early 2017. You’ll be able to incorporate refreshed data from your new Primary Care Practice Report and use your updated results in your annual program and quality improvement plans. Keep an eye on this page for updates. Speaking of program planning, an updated Program Indicator Catalogue will be coming in January to help you select indicators for your Schedule A report that are more in line with evidence and what your peers are using. Check out the Catalogue and other resources here. Help for your patients with depression: Now that you can identify patients with depression in your EMR (thanks to the standardized query for depression), you may want to be part of a CAMH project to better manage depression and depressive symptoms. It builds on the STOP smoking cessation program that most AFHTO members are already part of. Check out what other teams are doing to get even better at all kinds of things. The AFHTO 2016 Bright Lights winners, poster and concurrent-session presentations are now posted, as are the abstracts from Health Quality Ontario’s 2016 Health Quality Transformation conference, and the winners of the 2016 Minister’s Medals and Honour Roll. There’s a good chance somebody was doing something that might work for you!

    Help spread the word about D2D – invite others to sign up for the eBulletin. 

  • RNAO funding Tobacco and Nicotine Intervention

    Request for Proposal: TNI Implementation Site Application 2016-2017

    The Registered Nurses’ Association of Ontario (RNAO) is requesting applications from interested and eligible health care organizations to become Tobacco and Nicotine Intervention (TNI) Implementation Sites. A letter of intent to apply is due on Nov 30th, 2016. Applications must be received by the RNAO before 4:00 pm EDT on Dec 16th, 2016. RNAO’s TNI Initiative builds on RNAO’s expertise in developing and supporting uptake of clinical best practice guidelines, a program launched in 1999 that has gained wide international adoption. The RNAO TNI Best Practice Initiative has been funded by the Ministry of Health and Long-Term Care since 2007. The purpose of the initiative is to build capacity among nurses and other health care professionals in Ontario to integrate TNI best practices into daily practice. The initiative’s multi-prong system approach recognizes the importance of the leadership role of health organizations, nurses and TNI Champions in supporting individuals and organizations to integrate TNI best practices at the individual, organizational and system levels. To learn more, please visit RNAO’s site.

  • Family Practice Nurse – West Durham FHT (Pickering)

    Job Summary

    The Family Practice Nurse will work in close collaboration with physicians and other interdisciplinary health professionals including Nurses, Nurse Practitioners, Social Workers, Dietitian and Pharmacist.  As a vital member of the team, the Registered Nurse is responsible for delivering quality nursing care to patients with a focus on assessment, health education, disease prevention, as well as the early identification and support for chronic health conditions.

    Education:

    • Certificate of Competence  and current membership with the College of Nurses of Ontario (CNO)
    • BScN preferred
    • Current CPR or basic Cardiac Life Support (BCLS) registration

    Experience:

    •  Minimum of 3-5 years experience providing patient care to patients of all ages in a comprehensive Family Practice or relevant Ambulatory care setting.
    • 3-5 years experience providing patient care across the spectrum of problems encountered in Family Medicine/Primary Care
    • Demonstrated achievement of good working relationships with colleagues, professional staff and the interprofessional team
    • Previous experience with an electronic medical record (EMR) program or willingness to learn electronic record keeping using a clinical management system (CMS)
    • Highly developed ability to organize time and set priorities effectively
    • Ability to work independently with minimal supervision
    • Ability to make clinical decisions within professional domain

    Qualifications:

    •  Demonstrated leadership and strong interpersonal skills
    • Effective verbal and written communication skills
    • Excellent decision making, problem recognition, problem solving skills, negotiation and conflict resolution skills
    • Ability to work in an inter-professional team environment and implement best practices in patient care
    • Ability to prioritize, manage time effectively and be flexible in a very active work environment

     Roles and Responsibilities:

     This is not intended as an all-inclusive list, but rather a sample of the duties and responsibilities required of the position.  Duties and responsibilities may vary over time.

    Direct Care:

    • Systematically assess patients’ physical and psychosocial needs
    • Assist patients and their families in identifying resources to maximize the patient’s health
    • Perform direct clinical care to patients including procedures such as: immunizations, throat swabs, TB skin test, suture removal, wound dressing, ear syringing, blood pressure monitoring, etc.
    • Assist other team members with clinical procedures, etc.
    • Perform telephone patient triage and monitoring within the clinic setting as required
    • Provide appropriate and accurate telephone assessment advice and follow-up (eg. Discuss test results, test preparations, medications, etc) as necessary
    • Provide health education, health promotion, counseling to patients and their families across the continuum of care including immunization, chronic disease management, well baby and family care
    • Report and record accurately and appropriately, using electronic charting

    Coordination:

    • Initiate appropriate action in response to changing patient needs and collaborate with the interprofessional team to assist patients
    • Arrange appropriate follow-up, referrals, appointments and investigations according to established procedures.
    • Collaborate on the design and delivery of chronic disease prevention and management programs.  Assist in monitoring and evaluating the success in achieving CDM program objectives.
    • Assist in coordinating programs and arranging follow-up care

    Administration:

    • Collect accurate and comprehensive patient-related information and document this information in the electronic clinic management system.
    • Prepare monthly/quarterly reports for the Ministry of Health and Long Term Care (MOHLTC)
    • Willingness to routinely participate in staff meetings

    Education/Advocacy:

    • Help patients to identify and use health resources
    • Support team health care programs including Diabetes, Smoking Cessation, COPD, etc. and deliver health education programs for patients
    • Participate in the educational process of other health team members and students of all disciplines
    • Participate in the orientation of new staff members and students
    • Actively seeks out formal and informal opportunities to enhance knowledge and expertise.

     

    Teamwork:

    • Work with the team to develop collaborative approaches to family practice for the management of clinical problems in primary care
    • Establish, promote and maintain good relations with patients and staff
    • Support and maintain the goals and objectives of the West Durham Family Health Team
    • Communicate effectively with patients, team members and external agencies involved in the patient circle of care

     If you enjoy working in a team and collaborative environment providing patient care and health promotion education, please e-mail your resume and cover letter by November 30, 2016 to:

     Andrea Petroff, Executive Director, West Durham Family Health Team

     apetroff@westdurhamfht.com .

     Thank you in advance for your interest.  Please note that only candidates selected for interviews will be contacted.

     

     

     

     

  • Member news: Members in the media, continuing education, and more

    Below are relevant updates and items for AFHTO members:

    Congratulations to AFHTO Members
    Congratulations to Anna Gibson-Olajos of Powassan FHT and QIDS Specialist Meghan Peters on being awarded Poster of Distinction at Health Quality Transformation. Congratulations to Carefirst FHT,  Clare Liddy of Ottawa Hospital Academic FHT, and Suzanne Singh of Mount Sinai Academic FHT on being named to the 2016 Minister’s Medals Honour Roll.
    Congratulations to this year’s AFHTO Bright Lights Awards winners. Bright Lights awards are presented at the annual AFHTO conference to recognize member innovations that are making a positive impact. Congratulations to AFHTO QIDS program staff Carol Mulder and Greg Mitchell for being awarded Abstract of Distinction for their presentation, Moving the Needle on Diabetes Care at Health Quality Transformation 2016.

    Members in the Media
    Queen’s FHT and Belleville NPLC were featured in Inside Belleville for Prescription to Exercise, an initiative they undertook in partnership with the YMCA and a local CHC.

    Resources
    Help Starts Here: Ontario 211 telephone/online service for information and referrals to community, social, health and related government services. Learn more. Ontario Health System Action Plan: Syrian Refugees: Phase 2 released. Email for more information.
    Measuring Up 2016 was released by Health Quality Ontario (HQO) in October. The Primary Care chapter addresses access, patient involvement in decisions, and screening – indicators also used in D2D. Plain language checklist for Health Care Professionals developed by HQO to help you communicate clearly with patients and caregivers.

    Send Your Input to Help Develop Policy and Resources
    Health Technology: HQO is seeking professional and public comment on draft guideline recommendations. Currently: hyperbaric oxygen therapy for treatment of diabetic foot ulcers. Email for information. Quality Standards: HQO is seeking professional and public comment on draft guideline recommendations. Currently: heavy menstrual bleeding. Email for information.

    AFHTO Conference
    Many thanks to all who contributed to the success of AFHTO 2016! Conference materials, evaluation forms, and application for certificate of attendance available here. Our 2016 conference marks the beginning of the term for our new Board of Directors. Special congratulations to our incoming president and chair, Marg Alfieri from the Centre for Family Medicine FHT.
    Mark your calendars: AFHTO 2017 will take place on October 25-26, 2017 at the Westin Harbour Castle, Toronto.  

    Upcoming Web Events

    Webinar: Financial Literacy for FHT/NPLC Leaders. November 15, 12:00-1:30, presented by AFHTO and BDO Canada, for board members and EDs/Admin Leads. Register here. Coming up from Choosing Wisely Talks monthly webcast: Deprescribing inappropriate sedative hypnotics. November 3. Join here.
    FREE Webcast Series on Perinatal mental health from Mount Sinai Hospital. Episode 3 airs November 24. Email for information. Upcoming Long-Term Care Webinars from Centre for Effective Practice: Managing dementia with antipsychotics; falls prevention and mobility enhancement.

    Conferences
    Health Achieve – OHA Annual Conference. November 7-9, Toronto. Register online.

    Children’s Mental Health Ontario 2016 Conference. November 20-22, Toronto. Register online or download conference program.

     
    OCFP 54th Annual Scientific Assembly. November 24-26, Toronto. Download program, or email for more information. Addressing Substance Use Institute  – November 14-18, North York. From RNAO & Canadian Centre on Substance Abuse.   Register online, view agenda, or email for more information.
    Respiratory Health Forum. January 25-26, 2017, Toronto. More information here.