| Below are relevant updates and items for AFHTO members, including free resources and tools: | |
Updates Relevant to Primary Care |
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Clinical & Patient Engagement Resources |
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Events and Learning Opportunities |
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Category: Uncategorized
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Member News: members in the media, clinical resources and free training opportunities
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Keeping healthy requires a whole team |Cochrane Times Post
Cochrane Times Post article published on March 8, 2016. Article pasted in full below. Gone are the days that family doctors show up at your door and heals all possible ailments both mental and physical. Now there is a whole team of people to offer help in what ails you. According to Cochrane Family Health Team (CFHT) coordinator Laurie Bouvier, Family Health Teams help to facilitate access to interdisciplinary professionals working collaboratively to provide coordinated, health care services to the community. Through education, health promotion and proactive interventions patients acquire the knowledge they need to make informed choices regarding their health. When these clients become empowered to take responsibility for optimizing their health and are supported in their efforts, through a coordinated health team approach healthy change occurs. The CFHT is happy to announce the addition of Lee-Ann Boucher, a Registered Social Worker (RSW). Lee-Ann has her Masters in Social Work (MSW) with 20 years of experience in the field. As a Franco-Ontarian, she is able to offer services in both English and French. Boucher is not a stranger to the community as she says she got her start in Cochrane and has had a few stints of service here over the last 20 years. She has joined the Family Health Team and is working out of the local medical clinic two days a week. Boucher is committed to filling the social work service gaps in the community by providing social work support and service navigation to registered clinic patients of the CFHT. She is currently working on four different programs to support clients with chronic disease self-management: Living Well with Diabetes, Chronic Pain Management, Memory Clinics, and Information Sessions on Grief are all available. The Living with Diabetes program is dedicated to those who suffer from diabetes and who cannot get it under control. Patients are referred to the program and are followed by the social worker, nurse practitioner, dietician and diabetes educator. The Chronic Pain Management program uses a trained facilitator from out of town, thanks to telemedicine technology, with Lee-Ann’s support to participants. The Memory Clinics offers assessment and screening to those who notice deterioration in their cognitive ability, to facilitate early detection of dementia. Patients are referred via other medical professionals. Boucher is also offering a two-part series on grief. The two information sessions are designed to assist anyone who has suffered a significant loss (death, job loss, separation/divorce, illness etc.) and those who support them. Part one of the workshop will be offered on Monday, March 14 at 4:30 at the Minto Centre boardroom, the second half will be held on March 21 at the same time and place. Those interested, in this Free program, are asked to pre-register by calling Lee-Ann at 705-272-4200 ext. 2117. The CFHT offers a range of programs to assist patients with screening, prevention and management of chronic diseases. Other programs offered are the Living Well with COPD program- which is a series of classes aimed at COPD self-management; Spirometry Clinics- which help to identify individuals at risk for airway obstructive disease; INR Program- which follows clients on blood thinners to make sure they stay in therapeutic range; Blood Pressure Clinic – which is held every Wednesday form 9-11am, to help clients manage their high blood pressure or to identify those at risk for high blood pressure and lastly the Preschool Screening Clinic- which assesses development and allows for early intervention if needed. Clients of the Cochrane Family health Teams require appointments to see the physicians and nurse practitioner. However, the Team does offer same day/next day appointments for non-emergency acute visits like ear, throat and urinary tract infections. The CFHT has been in the community since 2009 to help better serve the residents of Cochrane. Over the years they have evolved to offer different programs and services improving on chronic disease prevention and management. Click here to access the article on Cochrane Times Post website.
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CORE Back Tool- now updated
In 2012, the Centre for Effective Practice (CEP) was engaged by the Ontario Ministry of Health and Long Term Care as part of their provincial Low Back Pain Strategy. To address the healthcare provider education component of this strategy, CEP developed a toolkit for primary care providers, provided in-person education sessions as well as an online education module. The Clinically Organized Relevant Exam (CORE) Back Tool was one tool included in the toolkit. It was developed in response to the needs identified by primary care providers and was designed to assist with the assessment and management of patients with low back pain in primary care settings. As a result of the overwhelmingly positive feedback received from health care providers using the tool, CEP decided to undertake an update to the tool. The purpose is to increase awareness and knowledge of evidence-based, best practice for the assessment and management of low back pain. This tool was developed under the clinical leadership of Dr. Julia Alleyne (M.D., Toronto Rehabilitation Institute) and was designed for day-to-day use in a typical primary care setting. Relevant Links
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Provincial Guidelines for Epilepsy Surgery Referrals in Ontario
Critical Care Services Ontario has recently released the Provincial Guidelines for Epilepsy Surgery Referrals in Ontario. This provides recommendations to referring physicians on appropriate evidence-based diagnostic and therapeutic referrals for patients who are determined to have medically-refractory epilepsy. It defines evidence-based indications for epilepsy surgery with careful consideration given to the paediatric population. This document was produced by Critical Care Services Ontario (CCSO), in collaboration with Provincial Neurosurgery Ontario (PNO), and the Epilepsy Implementation Task Force (EITF), a provincial initiative to implement an integrated system for epilepsy care in Ontario.
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AFHTO 2016 Conference: Join a working group to shape conference program by March 25
Announcing the theme for the AFHTO 2016 Conference Leading primary care to strengthen a population-focused health system
You can play an important role in shaping the conference by joining a working group today. Through your participation you will be among the first to learn about exciting developments in the field, influence the development of conference programming and discover the thought leaders in your chosen area. Working group members also earn a $50 discount off their registration fee. Please pass this invitation along to your patients, colleagues and staff. Having a variety of voices, especially patients, in the working groups helps us build a diverse and relevant program.
Conference Themes
Working groups are being set up for each of the seven concurrent streams and for the Bright Lights Awards program. The seven concurrent streams will focus on:
- Planning programs and fostering partnerships for healthier communities
- Optimizing access to interprofessional teams
- Strengthening collaboration within the interprofessional team
- Measuring performance to foster improvement in comprehensive care
- Coordinating care to create better transitions
- Leadership and governance in a changing environment
- Clinical innovations to address equity (Click here for descriptions)
Working Group Details
Concurrent program working group members: The task requires a total of 4-10 hours of effort between April and May, specifically:
- April 4 to May 5: AFHTO staff will manage the call for proposals process.
- Week of April 4th working groups will have an initial teleconference to brainstorm ideas on specific topics and speakers to contact/encourage to submit a presentation abstract.
- May 6 to 24: each working group member individually reviews and scores presentation abstracts for their program.
- May 25 to 31: working groups will teleconference to review scores and determine the program for this theme.
Sign up by March 25, 2016 to confirm participation and select your conference theme. “Bright Light” Awards Review Committee: The task requires a total of 6-12 hours of effort in July and August, specifically to individually review and score nominations followed by a group teleconference to determine the award winners. Sign up by March 25, 2016. Registration Fees for Conference Working Groups:
- Conference working group members and presenters receive a $50 discount off their registration fee.
- We understand patients face additional financial and time pressures and do not want the registration fee to limit participation in a working group. Patients participating in full in a conference working group will be eligible for complimentary registration (to be determined once the working group task is complete).
- AFHTO members still receive a 50% discount on conference registration fees.
Conference key dates:
- April 4, 2016: Applications for concurrent session and poster abstracts open
- May 5, 2016: Deadline to submit concurrent session and poster abstract
- Late June 2016: Conference registration opens
- October 17 & 18, 2016: AFHTO 2016 Conference
For more information you can contact us by phone (647-234-8605) or e-mail (info@afhto.ca).
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Sunset Country Family Health Team opens clinic to treat those with dementia problems
Kenora Daily Miner and News article published on March 9, 2016. Article in full pasted below. Kenora is home-base to the first memory clinic in Northwestern Ontario. The Sunset Country Family Health Team became the 78th clinic in Ontario and the first in the Northwest when it opened in February 2016 under the guidance of Dr. Linda Lee and her team from the Centre for Family Medicine Family Health Team in Kitchener-Waterloo. Lee established the first primary care memory clinic in 2006. Randy Belair, executive director of the Sunset Country Family Health Team, said the benefits of having a memory clinic in Kenora and the Lake of the Woods region are numerous. “We will increase the potential for improving diagnosis, which will have a significant impact on people’s lives,” said Belair. “Our team will provide team-based management and care throughout transitions, including system navigation.” A primary care memory clinic has a team of caregivers like nurses, social workers, pharmacists, dieticians, occupational therapists and Alzheimer Society team members working together and led by family physicians to better care for and meet the needs of persons with memory difficulties and associated conditions. Lee and her team helped set up the memory clinic for Sunset Country Family Health Team in mid-February and were back in Kenora March 7-9 to train staff on observership and mentorship, the latter of which involves interacting with patients. Once the staff at Sunset Country Family Health Team is fully trained and the program is implemented, they should be able to manage about 90 per cent of “memory loss” cases within the clinic. Lee first became interested in the idea of memory clinics when she took over an elderly practice in the late 1980s where she began to understand the needs of people with memory problems and how difficult giving them proper care was in a regular doctor’s office. “I was touched by the magnitude of suffering these people and their family members go through and very aware of the huge gaps in care for them,” said Lee. “We became a family health team in 2006 and I thought this was my opportunity to try to change the system of care and use the inter-professional health-care providers that were part of the team in the efficient, evidence-based way that would help me offer the kind of care these people need. “We were able to create a model of care that didn’t exist before — a point of access for persons living with dementia and their care partners, between the specialist and the primary care physician, but rooted in the primary care practice setting,” added Lee. “Based on our studies with this model, we can manage up to 90 per cent of the cases without relying on specialist referrals.” This frees up specialists to focus on the most complex cases of memory loss and dementia cases.
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Results of member feedback: AFHTO response to the Patients First discussion paper
Click here to read AFHTO’s response to the Ministry’s Patients First discussion paper, approved by the AFHTO board and submitted today to the Minister, Ministry and LHIN CEOs.
Response is grounded in feedback from members
In early January, AFHTO hosted 14 web meetings for FHT and NPLC leaders in each of the LHIN regions, resulting in priority action items. These provided the basis for AFHTO’s response.Member input on question of accountability and contractual relationships
The January meetings revealed this topic to be the top priority item. The driving concerns appeared to be:- Potential for misalignment since Patients First proposes to keep FHT/NPLC contracts and funding with the Ministry while accountability for planning and performance management goes to LHINs.
- Added burden and potential conflict in reporting requirements to the Ministry, LHIN and HQO.
In these meetings AFHTO members had expressed diverging views on the question of reporting to LHINs versus the Ministry, and so all FHT/NPLC leaders were invited to explore this topic more deeply. With the goal to develop with AFHTO members a position on accountability and funding relationships with the ministry and LHIN, about 30% of FHT and NPLC leaders responded via survey and/or two web meetings.
Respondents considered 10 facets of accountability and funding relationships between a FHT/NPLC and the Ministry or LHIN. Consensus emerged on the view that it’s important for performance expectations and funding decisions to be set by the same level; however, the membership was split on the ultimate question of funding relationship the Ministry versus LHIN. Click here to see the full report on the survey and web meeting results.
In assessing the responses and the response rate, the AFHTO board determined the following recommendations would best express the collective views of the membership:
- Ministry must establish minimum requirements for the LHINs’ role in planning and overseeing primary care, and hold LHINs accountable for meeting those requirements
- Ministry and LHINs must ensure that funding and performance requirements set out in contracts with primary care organizations, individual or groups of primary care providers, and other entities are aligned to achieve desired outcomes for the population and the health system
- Consistent performance measurement is critical
- Streamline multi-level reporting requirements and processes, and provide feedback to teams
- As capacity and trust are developed within each LHIN over time, evaluate whether funding and contractual relationships should remain with Ministry or shift to LHIN
Developing a unified response for primary care
AFHTO is chairing work by the Ontario Primary Care Council (OPCC) to develop a joint response to the Minister, to be finalized at its March 9 meeting. In a letter to Minister Eric Hoskins on January 25, 2016, six associations of the OPCC have provided initial feedback on the Province’s plans to strengthen our health care system. This work has been greatly informed by AFHTO’s consultation with members. -
AFHTO’s response to Patients First Discussion Paper
Click here to read AFHTO’s overall response to the ministry’s Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario discussion paper, approved by the AFHTO board and submitted on March 3rd, 2016. An initial response was issued with a statement from Dr. Sean Blaine, AFHTO President and Clinical Lead, STAR Family Health Team in Stratford. This was published in various newspapers including The Kingston Whig-Standard, Woodstock Sentinel Review and Beacon Herald.
Response is grounded in feedback from members
In early January, AFHTO hosted 14 web meetings for FHT and NPLC leaders in each of the LHIN regions, resulting in priority action items. Member input was further requested on the question of accountability and contractual relationships, summary of results available. These provided the basis for AFHTO’s response.
A unified response for primary care
AFHTO chaired work by the Ontario Primary Care Council (OPCC) to develop a joint response to the Minister on the Province’s plans to strengthen our health care system. The six associations of the OPCC provided initial feedback in a letter to Minister Eric Hoskins on January 25, 2016. Finalized at its March 9 meeting, the joint response was submitted on March 24. It offered advice on the following key areas:
- Ministry stewardship and LHIN mandate
- Access to interprofessional health providers and access to teams
- Embedding care co-ordination in primary care and the next steps to support implementation
- The interface between primary care, mental health and addictions
- Clinical leadership
- Governance, performance and accountability
- Critical enabler: data and information management
This work has been greatly informed by AFHTO’s consultation with members.
What’s happening in each region?
AFHTO members are meeting with their LHINs and working together to strengthen the primary care voice within the LHIN. See below for resources to further support this engagement:
LHIN # LHIN Implementation Plan (Oct. 9th submission) Results from Regional Consultations 9 Central East Link Online 11 Champlain Link Online 8 Central Link Online 4 Hamilton Niagara Haldimand Brant Link Online 6 Mississauga Halton Link Online 13 North East Link Online 12 North Simcoe Muskoka Link Online 14 North West Link Online 10 South East Link Online 2 South West Link Online 3 Waterloo Wellington Link Not currently available 1 Erie St Clair Not currently available Online 7 Toronto Central Not currently available Online 5 Central West Not currently available Online -
Data to Decisions eBulletin #30: Higher quality and lower cost
News Flash: Patients of higher quality teams have lower healthcare costs! From D2D 3.0 comes concrete evidence that the work you put into quality does make a difference! Early notice that D2D 4.0 is now scheduled for Fall 2016. Watch this space for emerging details. Focus Groups with IHPs – looking beyond measurement to improvement in interprofessional care: IHPs will be sharing their clinical perspectives on how AFHTO can help teams move from measurement to improvement. Some focus groups have already been scheduled, and we are still seeking participants for others. How is D2D working for you? We are currently scheduling interviews between Dan Wagner (MSc student) and EDs/Admin Leads to find out what teams have to say about D2D. Contact Carol Mulder for more information. Quality Improvement Toolkits from Cancer Care Ontario: Toolkits are now available for advance care planning and improving cancer screening for quality improvement planning. Program Planning Tools available online: Program Planning & Evaluation Tools and a newly developed Indicator Catalogue are now available to support teams in completing Schedule A requirements.
Help spread the word about D2D – invite others to sign up for the e-Bulletin online. Getting too many emails? Scroll to the bottom of the original email for the unsubscribe link.
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Higher quality care linked to lower healthcare costs
The biggest news coming out of D2D 3.0 is the concrete data that higher quality comprehensive, patient-centered care is related to lower healthcare costs.
Data to Decisions (D2D) is making an impact well beyond what it means to individual teams.
In addition to showing teams how they compare to their peers, D2D is making it easier for AFHTO to advocate for how team-based primary care could be measured across the province. With all the data submitted by members, we can show that measuring in a way that is meaningful and manageable for front-line providers makes a difference.
What difference does this make to your team?
Perhaps you and your team will be encouraged to hear the good news that high quality care is related to lower health system costs. The work you put into quality improvement does make a difference. You may also be encouraged by the early evidence from D2D (consistent with other published literature[1] ) that AFHTO members deliver better quality than the rest of the province on average. The comparison is not totally valid (because of differences in data sources and patient demographics) but it IS a comparison that many are interested in making. AFHTO is using D2D data to support arguments for a provincial solution for consistent capture of patient experience data as well as easier, more timely access to other important data sources. Finally, you and your team may also be encouraged that AFHTO now has an even more compelling argument for aligning performance in primary care with what really matters to patients and primary care teams. In the meantime, you may find the quality roll-up indicator useful at the local level (select the “Roll-up” tab at the top of the display). We have put together some tips for using your results to focus improvement efforts. And if you’d like to spread the good news around, consider sharing this handout with your colleagues. [1] Kiran, T., Victor, J., Kopp, A., Shah, B., & Glazier, R. 2014. The Relationship between Primary Care Models and Processes of Diabetes Care in Ontario. Canadian Journal Of Diabetes, 38(3), 172-178.