We are presenting this webinar for AFHTO members in partnership with the Cardiac Care Network of Ontario (CCN). The webinar will introduce CCN and a toolkit which is under development to support the management of Chronic Heart Failure in Primary Care Settings. Presenters will have an opportunity to provide input regarding the format, content, and mode of delivery for this tool.
A Primary Care Perspective
Tune in October 6th, 12PM ET to listen to Dr. Anthony Train (Calgary) and Dr. Kimberly Wintemute (Toronto) suggest communication strategies and practical tools that encourage the kind of shared decision-making in which patients come to understand that some tests and treatments do not add value to their care, and may potentially cause unexpected and/or unforeseen harms. The topics highlighted in this presentation will be based on the Choosing Wisely Canada Family Medicine list ‘5 Things Patients and Physicians Should Question,’ created by the College of Family Physicians of Canada and will include cases on: antibiotics, sedative hypnotics, imaging, and more.
Petrolia Topic article published on October 4, 2016. Article in full pasted below. Melissa Schlilz, Postmedia Network
Breaking down walls surrounding mental health can be difficult anywhere, but in rural areas like Lambton County, there can be different barriers that present themselves in comparison to urban areas. For youth, there can often be a lack of resources and tools at hand, or a fear of being judged by peers. But the Family Health Team in Petrolia is working to change this. Executive Director of the Central Lambton Family Health Team, Sarah Milner, has specialized in the mental health field. Since the new building opened on Glenview Road, they have taken on new projects specifically concerning youth mental health. She said that in terms of mental health services, when it comes to funding, the majority of services are where the most people are located – in larger urban centres. While she’s noticed a trend of urban services moving out to rural areas, there is a lot of work that needs to be done. “Our family health team is very dedicated to mental health and our physicians out here deal a lot with mental health issues,” Milner said. “Being rural, they see a lot in their practices, and there isn’t often a lot of resources out this way.” After seeing an ad in the Sarnia Observer regarding St. Clair Child and Youth expanding services in the county, they reached out to form a partnership. Starting this October, they will be expanding hours, coming to Petrolia for two full days rather than just a half day, working with youth up to age 17. “They would provide service and support to anyone in the community, but we offer them a space to do that here,” Milner said. “It’s wonderful for our patients because they’re here, but it also benefits the entire community.” Milner said their location, right across the street from LCCVI, is a great advantage for any students seeking help. As many kids are bussed in from Alvinston or other rural communities, this gives them an opportunity to access services while they are here. The Family Health Team has also worked directly with teachers at LCCVI, giving them the tools and knowledge to help students who may be struggling. “We’ve established some good relationships with the high school,” Milner said, noting that staff came to the centre to learn more about services offered. “So now staff would be familiar with what’s over here and be able to refer students and help make those links.” Milner said she finds that anxiety and depression are most prevalent among youth. In an age of social media and instant gratification, she said there are three trends that seem to most affect youth in terms of mental health. These are a lack of resiliency that kids don’t seem to have when it comes to hardship, a lack of a support system as well as online bullying. “It seems to be in the culture right now that everything is instant, there isn’t a lot of delay to be able to get what you want,” Milner said. “How do you deal with disappointment?” Twenty years ago, if you were bullied at school, going home meant having a safe refuge. But now, with Facebook and other social media platforms, the bullying follows kids wherever they may turn. “When those things are out on the internet, there’s no taking them back,” she said. “That can be very difficult for kids.” Milner said they are working with youth to help build resiliency, so they have the ability to weather those times of difficulty. She said there seems to be a lack of coping skills in young people, especially among girls in grade 10. In rural areas, Milner also noted that people tend to treat things a little differently, and stigma is still an issue. In smaller towns, individuals are a lot less anonymous, making it harder for some to come forward to seek help. “I still think there is a ways to go and I often find having worked in the county in mental health, sometimes it’s a little more private out here,” she said. “It’s the culture.” Despite there still being those who say there is a stigma towards mental health, there is work being done in partnership with the Suicide Prevention Committee to break this down. The Health Team co-facilitates safe talks within the community, including one which is coming up this month in Camlachie. “They teach anyone in the community skills and how to recognize someone who is suicidal, what to do and how to get help,” Milner said. “They don’t have to be the person to fix it, but they can be the person who recognizes it and help that person get the help they need.” Milner said that at this time, they are in a key position because they currently have 14,000 patients that come to them from Lambton County and beyond. While there is a desire and interest to expand mental health services out into the county, sometimes there is a lack of space to do so. Milner hopes they can continue to make connections with other organizations, linking services to people in rural areas, and working with schools to offer additional services. “Where I would like to go with things is strengthen our partnership with local high schools and elementary schools,” she said. “To provide some sort of [education]…resiliency, coping, anxiety, and being able to provide something right at those early grades.” Milner said the earlier they can lay a foundation with younger people, the easier it will be for them once they reach teenage years in dealing with depression and anxiety. She hopes to offer information sessions and tool kits for youth. “It’s slow and steady, making progress, and it hinges a lot on relationships that you have,” Milner said. “We want to help the people who have mental health issues but we also want to help the community to better understand and know where to turn.” With such a high need presenting itself in the county for mental health services, Milner has future plans for expansion in Petrolia’s services. “We’re definitely passionate and committed to mental health and trying to increase the resources out here because we know it’s a huge need,” she said. “Step by step, we’re slowly getting there to having more resources – there’s never enough – down the road we see ourselves having more robust services, it just takes time.” Click here more information about Central Lambton FHT. Click here to access the Petrolia Topic article.
The Annual Meeting will be held just before the official opening of the AFHTO 2016 Conference. The Meeting takes place:
Monday October 17, 2016 at 8:30 AM
Harbour Ballroom A+B, Westin Harbour Castle
One Harbour Square, Toronto, Ontario
Each eligible FHT or NPLC is entitled to designate one voting representative for the meeting. The FHT or NPLC board chair has the right to appoint ANY one person associated with their FHT or NPLC to this role.
Please reply to Sombo.Saviye@afhto.ca to indicate who will be the voting representative. Voting delegates will be required to register before the meeting to receive their electronic voting package and keypad.
All who work within an AFHTO member organization or serve on its board are welcome to attend as well.
The agenda and all the reports for the Annual Meeting are attached. The AFHTO board will present:
There will be an opportunity for AFHTO members to ask questions and present opinions. You are also most welcome to send me your comments and questions in advance.
On behalf of the AFHTO board, we look forward to seeing you at the meeting.
AFHTO’s vision is that all Ontarians will have timely access to high-quality and comprehensive primary care – care that is informed by the social determinants of health, delivered by collaborative teams, and anchored in an integrated, equitable and sustainable health system. Our 2016 Annual Report, Equity, Integration and Access: Shaping a Population-Focused Health System chronicles the work of AFHTO and its members to move Ontario toward that vision. In this report you’ll read about:
Around the world, cost-effective and high-performing health systems are based on a solid foundation of comprehensive primary care. We hope you enjoy reading what AFHTO members are doing to strengthen that foundation, and we look forward to continuing to work with you toward this vision.
Key themes that have emerged so far in AFHTO consultation with members – team culture, the relationship between physicians and the FHT, and how that relationship is influenced by the Ministry-FHT contract, Ministry-FHO contracts, and the formal or “unwritten” contract between FHT and FHO. This discussion document summarizes the background and issues in these and other topics arising from Ministry-FHT contracts. With indications that primary care contracts for FHTs, NPLCs, CHCs and AHACs will likely become standardized over the next few years, the content of the next FHT contract is important for all. AFHTO’s consultation process so far has involved the AFHTO board, Physician Leadership Council and Executive Director Advisory Council. Next step is discussion in the annual AFHTO Leadership Session, Monday, October 17, 10 AM – 12 noon, Westin Harbour Castle, Toronto. There are 175 leaders from AFHTO member FHTs and NPLCs registered so far, and room for up to 50 more. There is no charge to attend this session, but you MUST BE REGISTERED – click here to do so. FHT and NPLC board members are particularly encouraged to register to ensure the governance perspective is heard.
These are complex topics. Hopefully you will find this discussion guide a helpful digest to inform and guide you and the leaders of your FHT or NPLC through these issues.
AFHTO staff will compile the results into a meeting report to share with members and the AFHTO board. AFHTO will continue to inform and consult with members to develop positions as issues emerge. These results will form the basis for what AFHTO will advocate for the next FHT contract template. Click here to access the discussion document.
This section provides tools, resources and updates for Health Link leaders to support knowledge translation and promote a culture of continuous learning. Materials to support the members of the Health Link Community of Practice (CoP) will be posted here.
AFHTO is currently facing a number of priorities. In particular, we are focused on advocacy, education, and support regarding the implementation of Patients First and the implications for our member teams in terms of governance, accountability, and relationships with their LHINs. Given this, and given that Health Quality Ontario (HQO) has established a robust Health Links Community of Practice, we have made the decision to wind down ours. This will allow us to maintain our focus while mitigating the duplication of effort between AFHTO and HQO. Members of this CoP are invited to join HQO’s Health Links Community of Practice and participate in their webinar series Transitions between Hospital to Home. Part 1 of this series will take place on Friday, October 14 from 12:00-1:00pm; Part 2 will take place on Wednesday, November 16 at the same time. The attached flyer contains information about the topics and guest speakers. Register for the webinars here, or email HQO for more information. Going forward, AFHTO will continue to monitor Health Links developments for potential relevance to primary care, and we will work with HQO to ensure that the role of primary care organizations as leaders and sponsors of Health Links is recognized and supported. We will also maintain the resources on this page, so please check back here for updates related to primary care. In future, we may re-assess the need for a Health Links Community of Practice specifically for FHTs and NPLCs, and if we determine that one is needed, we will reconvene it at that time. In the meantime, we encourage you to get involved with HQO’s Health Links Community of Practice and make sure that your voice – the voice of team-based primary care – is heard.
The Barrie Community Health Links and the Barrie and Community Family Health Team are producing a series of patient story videos entitled Health Links in Action. The first in the series is called Evelyn. The Barrie Community Health Link are in their third year, and they have seen significant success in terms of cost savings and systems impact, providing evidence of the need for continued investment in Health Links. However, perhaps the greatest testimonial for the incredible work that is being done is from patients and their families. Please feel free to share the link to this video.
You can access a number of resources on Coordinated Care Planning, Patient & Community Engagement, Quality Improvement, Privacy, and other interesting articles by clicking on the link below. These have been created by the Hamilton Health Link and are posted for information and use by other AFHTO members: http://hchealthlink.ca/.
Resources developed by East Toronto Health Link on Advanced Care Planning (ACP):
Integrated Care in Norway – this article discusses the mandatory multidisciplinary plan for individual care, the “Individual Care Plan” introduced by law in Norway. The regulation was established to meet the need for improved efficiency and quality of health and social services, and to increase patient involvement. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107091/)
The Longwoods Ways & Means to Enable Health Links conference was held on February 26th. Click here for the Longwoods summary of the day and Ontario Health Links Infographic. The presentation slides from the conference are available online here.
A series of 3 reports published by the Health System Performance Research Network to assess the value that Ontario’s Health Links add to the system.
If you have any questions or wish to submit additional resources, please contact Bryn Hamilton, Provincial Lead Governance & Leadership: bryn.hamilton@afhto.ca
The D2D 4.0 Interactive Report is now live. Launch webinars were held on September 29 at 8:30 am and 3:30 pm providing a summary of the results. It was recorded for the benefit of those who were unable to attend or wish to review it – see below.
An Orientation webinar has also been recorded to help you use and navigate the interactive report – see below. Once you’ve watched the webinar and checked out your results, use the links below to help you contextualize and apply this information:
Need help? Contact us.
| Presenters putting the final touches on their slides, chefs prepping their menus, and your peers printing their posters – we’re gearing up for the AFHTO 2016 Conference and all we need is you. There is still time for you and your team to register for energizing discussions, forward-looking plenaries, and networking with your colleagues. If you’ve already registered, don’t forget to pick your sessions if you haven’t already done so as some of them have limited space available. Just click the “change or update your registration” link in your confirmation email titled “Confirmation of Registration”. | ||
Attendees at the AFHTO 2016 Conference will focus on Leading primary care to strengthen a population-focused health system, spending two session-packed days studying innovations in primary care, strengthening partnerships and learning how to navigate significant changes ahead. Highlights include diverse and relevant topics across 7 core themes: |
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| Concurrent Sessions | Posters | IHP Profession-Based Networking Sessions |
| Effective Governance for Quality in Primary Care | Leadership Triad Session: Tackling the big issues: relationship and accountability questions in Ministry contracts | EMR Communities of Practice Meetings (vendors included) |
| Seeking volunteers Would you like to come to the conference at a reduced rate? Volunteer at our registration desk on either or both days and you’ll be eligible for a discount on registration. Email info@afhto.ca for details.This program has been reviewed by the College of Family Physicians of Canada and is awaiting final certification by the College’s Ontario Chapter. Attendance at this program entitles certified Canadian College of Health Leaders members (CHE / Fellow) to 7.5 Category II credits toward their maintenance of certification requirement. | ||
Through this exploratory indicator, teams were asked to report the percentage of patients for whom timely (within 48 hours) discharge notification was received who were subsequently followed up within 7 days of discharge via any mode, by any clinician. Teams shared stories about how they are approaching follow-up after hospitalization and how they track their progress with that. It is clear there is still a wide range of approaches to both providing and tracking follow-up after hospitalization.
| Providing follow-up after hospitalization | |
| What makes it easy? | What makes it difficult? |
| Access to hospital, including hospital privileges, having staff in hospital or access to hospital records | Lack of timely discharge reports |
| Signing up for Hospital Report Manager (automated feed of hospital information to EMR). | Paper-based reporting |
| Proximity to the hospital, such as co-located teams and hospitals. | Lack of human resources available to support follow-up after hospitalization. |
| Participating in pilot projects with their local hospital or Health Links. | |
| Use of EMRs, to identify patients requiring follow-up, prompt a provider to follow-up, or to identify when follow-up has occurred. | |
Click the image below to download an interactive graph of follow-up after hospitalization. This will allow you to hover over the individual bars and see the stories that each team provided about how they tracked follow-up after hospitalization. NOTE: This will not work in all web browsers; if you cannot see the stories, download (save) the PDF and open it in a PDF viewer, such as the Adobe Acrobat Viewer for full functionality. If you have any problems please contact improve@afhto.ca.. 
To access all of these stories in a PDF, click here.