Ultimate Blogging Championship

Category: Uncategorized

  • 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.

  • 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.

  • 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.

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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 /]

  • 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.

  • AFHTO 2016 Conference: Registration now live

    Registration now open for the AFHTO 2016 Conference! Leading primary care to strengthen a population-focuses health system October 17 & 18, 2016 – Westin Harbour Castle, Toronto, Ontario

    Ontario’s health system is on the cusp of a profound shift. Patients First has set a direction for primary care and organizing the health system to focus on local integration to meet the needs of people living in our communities. Primary care has the opportunity to become its strong foundation, delivering comprehensive care for all, over their lifetimes, by placing the health of populations in their local communities at the centre. Over 900 interprofessional primary care providers, patients and community partners will come together to explore how to set a course for primary care, drawing from the experience and views of leaders from all across the province. What will you learn from this 2016 AFHTO Conference to help you play your role in leading primary care to strengthen a population-focused health system?

    See the full Conference Schedule here. For general information you can visit our conference page. We look forward to seeing you at the AFHTO 2016 Conference!

  • 2016 Conference Themes

    Leading primary care to strengthen a population-focused health system

    The AFHTO 2016 Conference program will be built around 7 core themes.

    Concurrent Theme Descriptions

    Download a printable PDF of the theme descriptions here.

    1. Planning programs and fostering partnerships for healthier communities
    2. Optimizing access to interprofessional teams
    3. Strengthening collaboration within the interprofessional team
    4. Measuring performance to foster improvement in comprehensive care
    5. Coordinating care to create better transitions
    6. Leadership and governance in a changing environment
    7. Clinical innovations to address equity

    1. Planning programs and fostering partnerships for healthier communities

    Primary care teams are expanding their focus of care beyond rostered patient populations to the entire community. This requires new ways of planning programs and developing partnerships with the aim to care for their communities from a variety of perspectives – public health, health & social equity, LHIN & sub-LHIN regions, etc. – and identifying gaps/overlap in services with each. This stream will focus on how teams are planning for populations, improving health equity and reducing disparities, creating stronger partnerships with local health and community services, collaboration between LHIN and sub-LHIN regions and Health Links.

    2. Optimizing access to interprofessional teams

    Patients First calls to improve access to interprofessional teams for those who need it the most, focusing on equitable access across the province. Presently, only 25-30% of Ontarians can access interprofessional team-based primary care and only some other groups of physicians have access to certain IHPs for their patients. Primary care teams are trying to understand the needs in their community and their team’s capacity to adapt by asking tough questions:

    • Can the people who need care the most get it in their community?
    • How do primary care providers who don’t have access to interprofessional team resources get access for their patients?
    • How do we open the team to new patients and providers while still providing a team-based approach to care and without overwhelming existing resources?
    • What partnerships and agreements can be set up to open the door to these patients?

    This stream will focus on the steps taken so far to explore these questions and initiatives that have started to address this need.

    3. Strengthening collaboration within the interprofessional team

    Interprofessional primary care teams are designed to combine the expertise of a range of health professionals to provide comprehensive primary care. Creating a strong and high-functioning team dynamic is a challenge when teams are experiencing high turnover, new community partnerships/programs are introduced, and new team members are transitioning from solo to team practice. This stream focuses on how teams have overcome barriers to engage all team members in providing care, create a healthy team culture, manage conflict within the team, strengthen care coordination internally and in the community, and achieve optimal scope of practice for all team members.

    4. Measuring performance to foster improvement in comprehensive care

    Primary care teams have made significant progress to advance manageable and meaningful measurement for improved patient care. Early results from Data to Decisions (D2D) are showing that higher quality comprehensive, patient-centered care is related to lower healthcare costs. This stream will focus on the tools and processes teams are using to measure as well as how they are using the resulting information to improve quality.

    5. Coordinating care to create better transitions

    Primary care is an anchor for patients and families, providing comprehensive care throughout their lives and guiding them through the health system. Primary care providers offer patients and families a single point of contact to help them manage their own care and access programs and services. This stream highlights how primary care teams are managing care coordination for their patients whether through Health Links, supporting better integration through shared care models, implementing strategies for specific populations such as seniors or individuals who need access to mental health and addiction programs, or better management of chronic diseases.

    6. Leadership and governance in a changing environment

    Patients First describes the need for clinical leadership to deliver the system transformation expected in primary care in the coming months and years. The role of a “clinical leader” from a system standpoint denotes a clinician who looks up and out from their individual clinical setting to their wider community and the health system to effect change. Leaders, clinicians and governors in primary care teams will be challenged to fulfill this role. This stream will focus on sharing resources to strengthen individual leadership competencies, the role of clinical and administrative leaders in primary care teams, and the governance structures needed to foster change.

    7. Clinical innovations to address equity

    Primary care teams are resourced to care for patients with chronic and complex conditions by offering diverse professional expertise and access to the resources and skills required to manage the “whole patient”. This stream will focus on how teams are leveraging their resources and organizing care to address gaps, reach special populations and provide better access to care where and when its needed. Specific topics of interest include improving access and outcomes in mental health, palliative care, and diabetes.

  • Invitation to join focus groups to inform Ontario ehealth strategy

    Dear members,

    We are sharing the invitation below for clinicians and administrators in family health teams and nurse practitioner-led clinics to participate in focus groups to inform the next ehealth strategy for Ontario.

    This consultation is being led by MD+A Health Solutions, a technology consulting firm engaged by the Ministry of Health and Long Term Care.

    Members have clearly indicated in previous surveys related to Data to Decisions (D2D) that there are outstanding needs related to EMRs. You have also demonstrated tremendous capacity for getting value out of existing tools and thus are well-positioned to share your learnings and suggestions for systemic solutions.

    See the email and information sheet below to learn more about the consultation process, and to confirm your interest in participation.

    ________________________________________________________________________________________________

    Hello,

    The Ontario Ministry of Health and Long Term Care (the ministry) is currently refreshing their Clinician eHealth Strategy and is interested in gathering information on how Family Health Teams and Nurse Practitioner Led Clinics currently use Electronic Medical Records (EMRs) and other ehealth tools to support their practice. The ministry has engaged us, MD+A Health Solutions, a health information and technology consulting firm, to support this work.

    MD+A is currently in the process of reaching out to key stakeholders in the health sector to solicit input on a variety of topics related to the current and future state of clinician ehealth in Ontario. As part of this, MD+A is interested in holding three 60-minute focus group sessions with clinicians and administrators from FHTs and NPLCs to discuss:

    • Current use of EMRs and other digital health tools
    • Effectiveness of EMRs in supporting interdisciplinary care
    • Shared services and support models
    • Implementation and adoption supports and challenges

    MD+A would ask that you or a member of your FHT or NPLC participate in one of the focus groups. By participating, you will have an opportunity to inform the future of EMR use and health information technology in Ontario.

    MD+A anticipates holding sessions by webinar during the last week of June or first week of July. If you or someone in your organization is interested in participating in a session, please provide your availability as soon as possible but no later than Monday, June 27 at http://fluidsurveys.com/s/fhtfocusgroup/.  Focus groups will begin as early as June 28.

    More detailed information on the topics to be discussed and the dial-in information will be provided in advance of the session. In addition, a document that provides additional background on the project and FAQs has been attached to this email. If you have other questions or comments, feel free to email Lynsey Turchet at lynsey@mdahealth.ca.

    Thank you in advance for your participating in this process. Your feedback will be a key input in to the development of the clinician ehealth strategy.

    Sincerely,
    MD+A Health Solutions

    Relevant Link:

  • Learning Event – Improving Diabetes Care; Improving Diabetes Outcomes

    Registration is now open:

    Space is limited and will be available on a first come, first served basis. Participation is free, and meals and refreshments will be provided. Please share this learning opportunity with IHPs and QIDSS in your teams and encourage them to invite their patients.

    Learning & KTE Event Program

    Studies have shown that interprofessional care teams outperform other models in caring for patients with diabetes. Nevertheless, we still have a long way to go. AFHTO members have thus identified diabetes care as a priority for collectively advancing improvement in primary care. To support our members in this, AFHTO, in partnership with the Centre for Collaboration, Motivation, and Innovation(CCMI), and with the support of Ontario’s LHINs, is presenting a full-day learning event for QIDSS, IHPs, and patients with diabetes. Educators from the Ontario’s LHINs and CCMI will introduce attendees to self-management as a care tool and lead a discussion of how it can be used to address gaps in diabetes care. This will be followed the next day by a knowledge translation workshop for QIDS Specialists on creating concrete action plans for moving from measuring to improving diabetes (and other outcomes) in their own teams.

    • Thursday, June 16 – full day for IHPs, QIDS Specialists, and patients: How to use self-management techniques to move from measuring to improving care for patients with diabetes.
    • Friday, June 17 – half-day for QIDS Specialists: Developing collective action plans to improve diabetes (and other) outcomes.

    For more information, please consult the Program Agenda and FAQ or contact Carol Mulder.

    Location

    The workshop will be held in the Sala Caboto Ballroom of the Columbus Event Centre, located at 40 Playfair Avenue in Toronto.

    Accommodation / Hotel Discount

    The nearest hotel is the Holiday Inn Yorkdale, located at 3450 Dufferin Street. A special rate of $139.00/night is available on June 15 and 16. Register at this link or call 1-866-568-0046 and request the Association of Family Health Teams of Ontario group rate.  

  • C4 Because you care: Using your EMR data to save lives

    Theme 4. Measuring performance to foster improvement in comprehensive care

    Presentation Details

    • Date: 10/17/2016
    • Concurrent Session C
    • Time: 4:30pm – 5:15pm
    • Room: Metropolitan Ballroom Centre
    • 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

    Learning Objectives

    1. Describe what difference EMR data quality makes to patients: it saves lives
    2. Describe the ideal focus for improving EMR data quality: something that matters to you!
    3. Describe the ideal person to start improving EMR data quality: you, whoever you are!
    4. Describe the team characteristics needed to improve EMR data quality: any team, any time, any where”

    Summary/Abstract

    There is more in our EMRs than you might think!  We have each found key issues for our patient populations that relate directly to patient safety and health.  We worked to resolve them by strengthening our EMR data and processes.  We will be sharing our learnings about how we are protecting patient health through data clean up.  One important learning is that you can start with whatever matters most to you – and anyone can do it! You just need to look at your situation and your data with a critical eye. Another learning is that paying attention to the details matters. Having the right data in the right place at the right time in the right way can save lives! Conversely not having it causes risk to our patients.

    The data in our EMRs has incredible implications for individual patients as well as population health. We found out that it is not as hard as we might have thought to make a difference. Join us to hear how we are making patient’s lives better by improving data quality.

    Specifically, we will tell you about how participation in D2D 3.0 EMR data quality measure for preventative care helped us to identify and correct a serious issue in our colorectal cancer screening data.  We will also tell you about how the use of clinical and demographic data captured in EMR enhanced the rate of diabetes-related complication screening and immunization uptake in our Chinese and South Asian patient population.

    Presenters

    • Denis Tsang, Registered Dietitian, Carefirst Family Health Team
    • Anna Gibson-Olajos, Executive Director, Powassan & Area Family Health Team
    • Amy Choy, Registered Nurse, Carefirst Family Health Team
    • Meghan Peters, Quality Improvement Decision Support Specialist, City of Lakes Family Health Team

    Authors & Contributors

    • Myrtle Robichaud
    • Anuradha Srinivasan
    • Jennifer Mulligan, Administration, Powassan & Area FHT
    • Kerri Smith, Clinical Assistant, Powassan & Area FHT