Ultimate Blogging Championship

Category: Uncategorized

  • Looking beyond measurement to improvement in interprofessional care: focus groups with IHPs

    In January and February of 2016, we conducted a series of focus groups with AFHTO-member Interprofessional Health Care Providers (IHPs) about what you need in order to get better at what you do – and about how we can get better at helping you with that. We heard a lot of great information from these focus groups! Now its our turn to teach back in order to be sure we heard right from all those who were able to be a part of the focus group discussions, as well as to get input from the wider group of volunteers to help us set priorities for action. To do this, we have created an anonymous, online survey. This brief questionnaire is your opportunity to tell us what Quality Improvement (QI) means to you, whether that’s even an accurate term to describe the process of getting better at what we do, and how we can support you in doing this. The questions for this survey come out of our discussions at the focus groups. Please confirm/correct our impressions and tell us which aspects of the enablers and barriers are the highest priority for you so they can also be the highest priority for our work together. Data from the focus groups and this survey will be used internally to set priorities in supporting teams to move beyond measurement to improvement. We can’t promise we will do everything that you identify as important – but at the very least, we can commit to focusing whatever resources we have in that direction. Data from the survey will also be used externally via direct communication and broader publication to advocate for resources/tools/other supports for AFHTO members. The results will also constitute part of the data being considered in my (i.e., Carol Mulder) doctoral thesis. Rest assured that your survey data will be completely anonymous, even to us – we won’t know who has completed it The survey has been sent to everyone who signed up for the focus groups. We look forward to learning from your responses and using them to help us in improving our efforts to help you. Thanks again for taking the time to share.

    March 3, 2016

    Thanks to the more than 100 IHPs who  have signed up for focus groups!

    What’s next?

    Meeting invitations have now been sent for sessions in London (March 24), Toronto (March 29) and Kitchener (March 30). Planning for sessions in other locations is still underway.  Not all IHPs will have received a meeting invitation; they were sent to those who indicated availability for the chosen date/time.  Where there were more IHPs available than space in the focus group (maximum size of 8), a random sample of available IHPs was invited to the session. Closer to the dates of the sessions, we will send the high-level questions that will be addressed during the focus groups. There is no presentation planned as the goal of the sessions is to hear from IHPs about quality improvement, what it looks like in their teams and what it would take to better support it. All IHPs (not only those who take part in the focus groups) will be invited to comment on the guidance emerging from the focus groups and implications for AFHTO. To do that, we are hoping all IHPs who have signed up will agree to be added to the email distribution list for updates – watch your email for more information. AFHTO will work with all members to develop activities, resources and/or tools to support quality improvement within teams. These interventions will be informed by the focus group discussions and reflection on them by IHPs as well as other staff of AFHTO member organizations.

    All IHPs are invited to participate in a series of regional focus groups. AFHTO has been making progress with measurement of comprehensive, team-based primary care.  There is still more work to do with that. In the meantime, it is time to look beyond measurement to improvement in interprofessional care. IHPs are invited to complete the online survey about potential dates, times and locations as soon as possible so we can set up the sessions.  We are looking for up to 6 people for each session on a first come, first served basis. The sessions will be facilitated by Lori Chambers, a qualitative researcher and doctoral candidate from McMaster and Carol Mulder, Provincial Lead for AFHTO’s Quality Improvement and Decision Support program. There is no charge for the sessions, which are expected to be about 1.5 hours long. Date and location of groups will be decided based on response to Doodle polls. The first sessions (which we anticipate to be in late March) will be held in the locations which fill up first.  Additional options will be offered after the first sessions are set. Contact Carol Mulder for more information

  • Experiencing Aging: A Health Care Reality Check from The Change Foundation

    Health care services are created with the patients in mind, right? How would your perspective change if you had limited mobility, couldn’t hear properly and had restricted vision? That’s what many seniors experience every day. It’s time for a reality check. The Change Foundation has released two Experiencing Aging videos (also referred to as the Aging Suit videos). Through simulations informed by lived experience and using the Aging Suit to mimic the effects of aging, we’ve crafted a video series that serves as a reality check of the challenges seniors face in differently health care settings, starting with home care and primary care. You can watch a video featuring Kavita Mehta, Executive Director, South East Toronto FHT, who agreed to wear The Aging Suit and be taken through a simulation in a Primary Care setting. She was able “to walk a mile in our patient’s shoes”.

  • Nomination deadlines approaching fast! Show your leadership & earn recognition in the health system

    We encourage all members to send nominations for each of the following calls for application. Please share this information with your colleagues:

    AFHTO Bright Lights Awards: Shine a light on your team’s everyday accomplishments

    Minister’s Medal nominations: Prestigious cross-sectoral healthcare award

    • Deadline to send your application to your LHIN office via e-mail is July 15, 2016
    • The awards are recognizing programs/initiatives that align with the four key objectives outlined in Patients First: Access; Connect; Inform; Protect. This year, there’s also additional emphasis on patient engagement.  
    • Given the high volume of excellent applications submitted over the past three years, the ministry is encouraging any previous applicants to reapply.
    • AFHTO members have been recognized in the past- see the 2014 awards presentations.

    AFHTO Board of Directors: Bring your experience to your association

    • Deadline to apply is July 5, 2016
    • Now is a VERY interesting time to be serving on the AFHTO board of directors! Guide primary care through system transformation.
    • Anyone who works within an AFHTO member organization is eligible. To maintain balanced representation on the board, priority consideration will be given to candidates who are:
      • Physicians (Executive Directors and Interprofessional Health Providers are also welcome to apply)
      • From AFHTO members located in the eastern and northern regions of Ontario

  • B7 Taking Care Everywhere: eConsult Progress in Ontario

    Theme 7. Clinical innovations to address equity

    Presentation Details

    • Date: 10/17/2016
    • Concurrent Session B
    • Time: 3:30pm – 4:15pm
    • Room: Harbour B
    • Style: Presentation (information provided to audience, with opportunity for audience to ask question)
    • Focus: Practical (e.g. Presentation on how to implement programs and/or practices in the team environment)
    • Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers, Administrative staff, Representatives of stakeholder/partner organizations

    Learning Objectives

    Participants will explore the development of two eConsult services in Ontario: the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service and the Provincial eConsult Initiative. Participants will receive an overview of how both services work and how interested healthcare providers can enroll. Presenters will discuss their experiences implementing eConsult services, describe what measures should be considered when planning service development (e.g. wait times for regional specialists, local access needs), and provide a look at the latest usage data.

    Participants will receive resources supporting the implementation of eConsult services in new jurisdictions.

    Summary/Abstract

    Excessive wait times for specialist appointments pose a significant barrier to patient care. Electronic consultation (eConsult) services can address this issue by improving access to specialists. This presentation discusses two eConsult services launched in Ontario: the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service and the Provincial eConsult Initiative.

    Champlain BASE has enrolled 1,040 primary care providers (PCP), including 879 family doctors and 160 nurse practitioners, and offered access to 86 specialty groups, the largest menu of specialties available from any such service worldwide. The eConsult team conducted a cross-sectional study of all eConsult cases submitted from April 2011 to March 2016 in order to describe the utilization and impact of the service. The Champlain BASE eConsult model demonstrated sustained high user uptake and impact on access to specialist advice.

    The Provincial eConsult Initiative is conducting a proof-of-concept of its service and is building on the experiences of the Champlain BASE service. Primary care teams in the pilot regions have acknowledged in a benefits evaluation and recent survey that eConsult is a welcome innovation that provides better access and equity to specialist resources.

    These innovative solutions have leveled the playing field for access to specialist advice, especially in underserved areas. Provider satisfaction with both services is high. Our lessons learned and results can be used to inform other regions interested in implementing similar systems. Ongoing research includes policy development, economic impact, education opportunities and patient perspective.

    Presenters

    • Clare Liddy, Clinician Investigator, C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, cliddy@bruyere.org
    • Kevin Samson, Family Physician, East Wellington Family Health Team, kevin.samson@ewfht.ca

    Authors & Contributors

    • Clare Liddy, Clinician Investigator, C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute
    • Amir Afkham, Senior Project Manager – Enabling Technologies, Champlain Local Health Integration Network
    • Erin Keely, Chief, Division of Endocrinology and Metabolism, The Ottawa Hospital
    • Darren Larsen, MD, Chief Medical Information Officer, OntarioMD
    • Elizabeth Keller, Vice-President, Product Strategy & Delivery, OntarioMD

  • Diabetes Learning Event: Improving Diabetes Care; Improving Diabetes Outcomes

    On June 16, 2016, in support of AHFTO members’ efforts to move the needle on the quality of diabetes care, we hosted a full-day learning event for interprofessional health providers (IHPs), QI staff, and patients. The day’s learnings were focused on the use of self-management as a care tool for patients affected by diabetes. Improving Diabetes Care; Improving Diabetes Outcomes was presented in partnership with the Centre for Collaboration, Motivation, and Innovation (CCMI) and five of Ontario’s Self-Management Programs. It was followed by a half-day Knowledge Translation and Exchange workshop for Quality Improvement Decision Support Specialists and other QI staff to explore ways to improve our ability to improve diabetes care. Slide decks and handouts from the presentations are available at the links below. Please feel free to contact Catherine Macdonald for more information.

    Morning Plenary Sessions

    Diabetes Care & Measurement: How fare have we come; how far do we have to go? (Carol Mulder)

    Presentation: Introduction to Self-Management (Natasha Beckles and Dona Hird)

    Afternoon Breakout sessions

    For IHPs: Brief training in developing and using Brief Action Plans (BAPs) (Carole Dove and Tammy Purdy)

    For QIDSS and QI staff: Using the EMR to facilitate and measure the use of Self-Management programs (Christina Southey)

    For patients, IHPs, and QIDSS/QI staff: Patient Tools for Self-Management (Mike Hindmarsh, Dona Hird, and Parnaz Sadighi)

     

    Want to Learn More?

    For more information about self-management as a care tool, or to find a self-management program near you, visit the following:

    AFHTO gratefully acknowledges the financial and in-kind support of Ontario’s Self-Management programs and the in-kind support of the Centre for Collaboration, Motivation, and Innovation (CCMI).

  • Canadian Pharmacists Association honours AFHTO members at annual conference

    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.

  • Patients’ experiences receiving home-based primary care (HBPC) in Ontario: Study

    Article published in Health & Social Care in the Community on June 10, 2016

    Abstract

    The lack of effective systems to appropriately manage the health and social care of frail older adults – especially among those who become homebound – is becoming all the more apparent. Home-based primary care (HBPC) is increasingly being promoted as a promising model that takes into account the accessibility needs of frail older adults, ensuring that they receive more appropriate primary and community care. There remains a paucity of literature exploring patients’ experiences with HBPC programmes. The purpose of this study was to explore the experiences of patients accessing HBPC delivered by interprofessional teams, and their perspectives on the facilitators and barriers to this model of care in Ontario, Canada. Using certain grounded theory principles, we conducted an inductive qualitative content analysis of in-depth patient interviews (n = 26) undertaken in the winter of 2013 across seven programme sites exploring the lived experiences and perspectives of participants receiving HBPC. Themes emerged in relation to patients’ perceptions regarding the preference for and necessity of HBPC, the promotion of better patient care afforded by the model in comparison to office-based care, and the benefits of and barriers to HBPC service provision. Underlying patterns also surfaced related to patients’ feelings and emotions about their quality of life and satisfaction with HBPC services. We argue that HBPC is well positioned to serve frail homebound older adults, ensuring that patients receive appropriate primary and community care – which the office-based alternative provides little guarantee – and that they will be cared for, pointing to a model that may not only lead to greater patient satisfaction but also likely contributes to bettering the quality of life of a highly vulnerable population. You can read the full article here. Authors

    • Tracy Smith-Carrier PhD RSW, School of Social Work, King’s University College at Western University
    • Samir K. Sinha MD DPhil FRCPC, Department of Family and Community Medicine, University of Toronto
    • Mark Nowaczynski PhD MD CCFP FCFC, House Calls: Interdisciplinary Healthcare for Homebound Seniors, SPRINT Senior Care
    • Sabrina Akhtar MD CCFP, Home-Based Care Program, Toronto Western FHT
    • Gayle Seddon BScN MHS RN, Toronto Central Community Care Access Centre
    • Thuy-Nga (Tia) Pham MD CCFP, South East Toronto FHT

     

  • 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

    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.

  • 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

     

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    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.

  • 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.