Ultimate Blogging Championship

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  • Supporting FHTs through strengthened relationships with Ministry and key associations

    In the past few days AFHTO has had meetings with the Ministry’s FHT Unit, the Ontario Hospital Association (OHA), the Ontario Medical Association (OMA) and the Association of Ontario Health Centres (AOHC). In all cases primary care is recognized as key to improving quality of care for patients and sustainability of the health system.  FHTs are recognized for their potential to significantly advance both quality and sustainability. With the FHT Unit we examined how we work together to support FHTs in achieving these ends.  In particular we focussed on how to progress in strengthening FHT governance, recruitment and retention, and capacity to get the full benefit from EMRs and data for quality care. Getting traction requires stepping forward in bite-size chunks:

    • To develop governance capacity, the FHT Unit is developing an RFP as the first step in response to AFHTO’s detailed proposal for web-based learning modules on the core set of knowledge and skills required for governance, strategic planning and risk management.
    • The framework for FHT governance is likely to be shaped by the Ministry’s “Strengthening Primary Care” initiative. AFHTO has been participating in the working groups, along with a number of other stakeholders.
    • With recruitment and retention, the next step is to understand the patterns and drivers underlying vacancy rates.  AFHTO has struck a working group that will look into questions such as time to recruit, turnover, and reasons for leaving. Working in partnership with AOHC and HOOPP, AFHTO has compiled comparative data on compensation packages.
    • Supporting use of EMRs and data is a more complex undertaking. AFHTO has exchanged ideas with some thought leaders from within the FHTs and from key organizations such as the Canadian Institute for Health Information (CIHI), the Institute for Clinical Evaluative Sciences (ICES), and Health Quality Ontario (HQO).  This may crystallize into another proposal in 6 – 9 months’ time.

    The FHT Unit continues to look to AFHTO to assemble small groups of FHT volunteers to provide feedback on implementation issues such as the revised NP-SERT program (renamed Nurse Practitioner Access Reporting or NPAR)  and the new SRI templates replacing WERS. With the OHA our focus was on what our respective associations could do to foster greater understanding and collaboration among hospitals, primary care and other key components such as CCACs. With the OMA and AFHTO we discussed a number of ideas for working together to strengthen primary care. This exploration will continue in a meeting with NPAO in a few weeks, and other associations over the course of the summer. Ideas are percolating. Some will result in highly stimulating content for the 2011 AFHTO Conference on Oct. 25-26. Other interesting collaborations are likely to emerge. Stay tuned.

  • Citizens’ Reference Panel calls for expansion of family health teams in Ontario

    Twenty-eight Ontarians who have looked at the inner-workings of the province’s health system recommend more collaboration, integration and accountability to help ensure the sustainability of high-quality, accessible and publicly-funded health care. One of these recommendations states, “We urge the Ministry of Health and Long-Term Care to accelerate the expansion of integrated family health teams throughout the province.” The report, released on June 22, 2011, was commissioned by PwC (formerly called PricewaterhouseCoopers). They invited 28 randomly-selected citizens from across the province to meet over three weekends in Toronto from April-June 2011. One male and one female panel member was selected from each of the 14 Local Health Integration Networks (LHIN) and with the age profile matching that of the population distribution of the province. This process and their discussions were facilitated by public engagement company, MASS LBP. Their recommendations can be summarized into five themes (below). Click here for links for the entire report and executive summary .

    1. Improve Accountability and Incentives. Link compensation for physicians to measurable patient outcomes and satisfaction, encourage health professionals to form interdisciplinary primary health teams, expand reporting in hospitals that measure quality and patient satisfaction.
    2. Strengthen Community Care. Requires strengthening of partnerships, mobilization of volunteers, creation of patient and community support groups, reduce cyclical funding constraints, prepare for an aging population with new resources for community services that keep people at home.
    3. Improve Access and Timeliness. Expand family health team models. Utilize nurse practitioners more widely in primary care clinics and emergency departments, and develop a centralized specialist referral system.
    4. Expedite eHealth and improve information-sharing. Communicate the importance of eHealth while addressing access and privacy issues.
    5. Step up Prevention and Promotion. Direct a share of alcohol and tobacco taxes towards health promotion. Expand nutrition and phys-ed in schools, more public education on active living, better food labeling.

  • Complexity of Care study in FHTs with BSM physicians – confirm participation by July 4, 2011

    Are CFHTs different from the wider FHT sector?  Is the difference more than just the governance model?  Now you can find out. The Association of Ontario Health Centres (AOHC) and the Association of Family Health Teams of Ontario (AFHTO) invite FHTs who have physicians on the blended salary model to participate in a research project to determine the complexity of care and the individual characteristics of your patients and how it compares to other primary healthcare models across Ontario. This project is in collaboration with the Institute for Clinical Evaluative Sciences (ICES).  The objective is to describe the patients that you see and to quantify the social and medical complexity of your patients. The need to demonstrate how numerous influences make a patient more or less complex is vital for CFHTs to enable them to demonstrate the important role they play in the provision of primary health care. Why would you participate in this research study?

    • To produce a socio-demographic profile, a case-mix description, and a performance report for each CFHTs in Ontario which use the BSM payment model;
    • To understand better the patterns of health care service delivery to your patients and populations with differing needs;
    • To match health care resources more closely with health care needs;
    • To enable you to advocate for your practice and tell your CFHT story.

    How will it be completed?

    • guidelines of PHIPA will be followed and research ethics approval will be received before this project begins.
    • Data sharing agreements will be signed so that we can have access to your data.
    • AOHC will sign a data sharing agreement for all interested AOHC members
    • Individual data sharing agreements will be signed with FHTs who are not members of AOHC
    • a small data set will be required that includes the patient’s health card number, postal code, date of birth, gender, diagnoses over a two year period.
    • data will be analyzed at ICES and detailed individual reports will be prepared for each participating CFHT; Data will only be used for the intended purposes.

    What is the cost?

    • No cost for AOHC members who have paid at least half of their annual dues.
    • $1200 for non-AOHC members: this will recover the costs of data management, generating all SAS code and the production of a final report.
    • ICES provides services and charges that are established on a cost-recovery basis.

    What will each CFHT receive? Report will include:

    • tables comparing the aggregate CFHT information with the comparison models (CHCs, FHTs, FHNs, FHOs, FHGs, Not-Enrolled).
    • Socio-demographic characteristics of the individual CFHT clients including age, sex, urban-rural residence, area-level income, newcomers with OHIP registration within ten years, and those receiving medications through welfare, disability, and seniors with low income.
    • comparison comorbidity characteristics (previous acute myocardial infarction (AMI), Congestive heart failure (CHF), hypertension, asthma, COPD, mental health, mean resource utilization bands and the number of aggregate diagnostic groups (a measure of comorbidity).
    • comparison of emergency department utilization by triage level, avoidable hospital admissions and chronic disease prevention and management.

    Outcomes will be presented in relation to those expected given each CFHT’s demographics and case mix. Data for each CFHT will be made available to that CFHT. No individual-level data will be provided or reported at the level of patients. How much time will it take? June 21- September 30: June 21:               You are invited to participate in a no obligation webinar that will outline the study.  You will have an opportunity to ask questions By July 4:             We need your response as to whether you will participate; upon confirmation that you will participate, we will send data sharing agreements to sign and return July 2011:            We will require you to extract data from your clinical management software (assistance provided by Jennifer Rayner, Regional Decision Support Specialist in the Southwest region) Aug 2011:            Analysis by ICES (no time or work for you and your centre) By Sept 30:          Reports will be prepared and delivered to your CFHT Why are only CFHTs operating with a Blended Salary Model included? We are extracting data from the patient encounters because your data does not get shadow-billed through OHIP. This type of analysis is already being conducted at ICES for other models. This project will enable you to get access to this data for your centre.

  • Congratulations to 4 AFHTO members profiled in Health Quality Ontario’s 2011 Report

    Four AFHTO members are profiled in two Success Studies found in Quality Monitor 2011 Report on Ontario’s Health System, released today:

    The 2011 Report covers eight Success Studies. These four FHTs have the distinction of being the only primary care organizations that are profiled.  They join two FHTS profiled in HQO’s 2010 Report – Athens FHT (http://www.afhto.ca/news/fht-success-stories/succes-story-post/ ) and New Vision FHT (http://www.afhto.ca/news/fht-success-story-2-2/ ). This is but a sample of the excellent progress many FHTs have made in improving care for their patients. For a full copy of Quality Monitor 2011 Report on Ontario’s Health System, go to http://www.hqontario.ca/pdfs/2011_report_-_english.pdf (or for French language, go to http://www.hqontario.ca/pdfs/2011_report_-_french.pdf ).   For a summary of findings about primary care in Ontario, see pages 12-13 of the Report.

  • AFHTO 2011 Conference – Workshop submissions due July 15

    Family Health Teams are a unique innovation in primary care – there is so much for all of us to learn and to celebrate. Whether you have been a FHT for 5 years or 5 months, you have valuable experiences to share with other FHTs. We invite FHTs to submit abstracts for workshops, oral presentations, or posters you would like to present to your peers on Day 2 of the conference, October 26, 2011. The 2011 Conference starts at noon Tuesday, October 25 and ends at 4:00 PM Wednesday, October 26 at the Westin Prince Hotel, 900 York Mills Road, Toronto. Day 1 is focused on FHT leadership – the skills, tools, policy challenges and action planning needed to strengthen leadership within FHTs – followed by AFHTO’s Annual General Meeting and board elections at 4:30 and a celebration dinner at 6:30.  Day 2 focuses on innovation and best practice – featuring keynote presentations, concurrent workshops and posters and displays on key themes (see below). Abstracts for Day 2 should be focused on one or more of the following key themes: 1. Achieving Patient Access: Quality and Targets 2. Implementing Health Promotion and Chronic Disease Management 3. Building Team Collaboration 4. Optimizing EMR/Information Technology 5. Reducing Hospitalizations 6. Planning, Measuring and Governing for Quality Improvement 7. Building Community Linkages and Partnerships To submit an abstract for a workshop, oral presentation, or poster you would like to deliver on Day 2, October 26, please click here. PLEASE NOTE:

    • Deadline for submission:              July 15, 2011
    • Notification of acceptance:           August 31, 2011
    • All presenters must register and pay the conference fee.

    Fees are as follows:

    • Day 2 – Innovation & Best Practice:  Members $275 / Non-members $550
    • Day 1 – Leadership Retreat (for AFHTO Members only): $150
    • 2-Day Conference (AFHTO Members only): $325
    • Dinner and Celebration of FHTs:  Members $50 / Non-members $80

    Click here to register for the conference. Click here to access the Westin Prince Hotel to book, modify or cancel hotel reservations.

  • Credit Valley FHT to be expanded to serve local Francophone population

    TORONTO/CNW/ – The Office of the French Language Services Commissioner is pleased to report that the Ministry of Health and Long-Term Care will be implementing concrete measures to ensure the development of primary French-language health care services in the Peel-Halton region. After carefully considering various potential delivery models, the Ministry has determined that the expansion of the Credit Valley Family Health Team is the best option to respond to the needs of the local Francophone population. This family health team will work in collaboration with the Centre de services de santé Peel et Halton — the organization that had initially turned to the Commissioner’s Office for help. QUOTE “This good news allows us to look toward the future with renewed confidence, knowing that Francophones in the Peel-Halton region will soon have access to health services in French,” said Commissioner François Boileau. “This positive outcome would not have been possible without the tireless efforts of our complainants and the Ministry of Health and Long-Term Care’s commitment to achieving results.” QUICK FACTS

    • In March 2010, the Commissioner’s Office presented an investigation report requesting concrete measures from the Ministry of Health and Long-Term Care to address the lack of French-language health services in the Peel-Halton region.
    • As a first response to this investigation, the Ministry acknowledged that it was ultimately responsible for the provision of equivalent French-language health services; the Ministry then proceeded to modify the criteria used to select family health teams to reflect the specific situation of the Francophone community.
    • The Centre de services de santé Peel et Halton has received $125,000 from the Ministry to help with the recruitment of health professionals and help set up these new services.
    • The Credit Valley Family Health Team hopes to welcome its first Francophone patients by March 31, 2012.

    LEARN MORE Read the French Language Services Commissioner’s investigation report at www.flsc.gov.on.ca in the PUBLICATIONS section.

     

  • Ten FHTs sustain blood pressure reduction through Hypertension Management Program

    (New York, N.Y.): A ground-breaking Canadian blood pressure education program will be a powerful tool in fight to reduce stroke around the world. This morning, Dr. Sheldon Tobe, Chair of the Canadian Hypertension Education Program (CHEP) and a long-standing Heart and Stroke Foundation researcher, unveiled a new and powerful tool in the management of hypertension at the American Society of Hypertension (ASH) Scientific Meeting —The Heart&Stroke Hypertension Management Program.

    “Diagnosing high blood pressure (hypertension) and lowering it in one patient is relatively simple,” says Dr. Tobe. “But keeping the pressure down in hypertensives across the entire country has proven to be a formidable challenge for patients and healthcare systems.” To test and quantify the efficacy of the Hypertension Management Program, a three-year demonstration phase was launched in 11 primary care sites (10 family health teams and one community health centre) in communities across Ontario, including Beamsville, Brighton, Deep River, Dryden, Kitchener, Mount Forest, North Bay, Shelburne, Toronto, Vermillion Bay, and Windsor. The Hypertension Management Program consists of healthcare provider education and tools as well as patient specific tools to facilitate blood pressure management and control by providers and self-management by patients. After the initial intervention at the start of the study, the Family Health Teams continued delivering the program on their own. “More than 3,600 patients participated in the Canadian study and blood pressure fell quickly. Remarkably after three years, patients with a diagnosis of hypertension had sustained average blood pressure reductions of 6.4/3.8 mmHg,” said Dr. Tobe. The Heart&Stroke Hypertension Management Program has resulted in 41% more people in these 11 primary-care centres across Ontario keeping their high blood pressure under control. Even modest reductions in blood pressure can dramatically decrease the incidence of cardiovascular disease.

    • A reduction of 5 mm Hg in systolic in blood pressure translates into:
    • A 14% drop in stroke mortality
    • A 9% drop in coronary heart disease and
    • A 7% reduction in overall mortality
    • It has been shown that effective blood pressure control can reduce the incidence of stroke by up to 40%!

    “This study is showing us that in hypertension, a simple inexpensive education intervention can lead to the sustained achievement of blood pressure control for at least three years,” Dr. Tobe says. Dr. Mel Cescon of the New Vision Family Health Team in Kitchener says, “Our team was able to transfer and adapt this protocol to the diagnosis and early treatment of other chronic conditions such as diabetes.” The Canadian program will assist family physicians and healthcare providers in achieving those elusive, sustained, reductions in hypertension. Supported in large part by the Ontario government, the Heart and Stroke Foundation of Ontario collaborated with the Ontario College of Family Physicians, the Registered Nurses’ Association of Ontario and the Ontario Pharmacists’ Association to create the program. FINANCIAL BENEFITS In 2005, cardiovascular disease cost Canada more than $21 billion a year in healthcare and lost productivity. That number is expected to climb to more than $28 billion by 2020. The U.S. Agency for Healthcare Quality and Research has reported that Americans spent $29 billion for prescription cardiovascular drugs alone in 2008. “Getting hypertension under control is one way of greatly reducing the hemorrhage of taxpayers’ money,” said Dr. Tobe. “For patients in the Canadian and American healthcare systems, for care-givers and administrators alike, the implementation of the Heart&Stroke Hypertension Management Program will prove beneficial financially and in terms of public health. It is imperative that we get guideline-based programs like this into everyday primary care practice right across North America.” BEST EVIDENCE POINTS THE WAY The new protocol is guided by best practice principles. The Heart&Stroke Hypertension Management Program demonstrates that an evidence-informed inter-professional primary healthcare provider educational intervention can successfully integrate into the practice of primary care clinicians to improve the management and control of hypertension in their patients. A GLOBAL PERSPECTIVE According to the World Health Organization, hypertension is a major cause of disability and is the leading risk factor for premature death, causing an estimated 7.5 million deaths per year globally. More than one third of the world’s population suffers from high blood pressure and cardiovascular disease. The number of baby boomers headed for the high risk years for cardiovascular disease is expected to create unique stress on healthcare systems all over the world. “These made-in-Canada results should give healthcare professionals, healthcare economists and everyone with high blood pressure cause to rejoice,” said David Sculthorpe, CEO of the Heart and Stroke Foundation of Ontario. Want to find out more about hypertension and global health? Visit: www.heartandstroke.ca BACKGROUND For healthcare providers, the support system includes:

    • Hypertension Flowsheet charting tool in both paper and electronic formats, with built in prompts to guide the healthcare provider during the patient’s visit and to record the patient’s progress and care plan;
    • Confidential practice reports, produced through a secure web-based data repository that enable providers to know how well their patients are doing over time and compared with other participating sites;
    • Tape measures with waist circumference risk markers.

    For patients, the self-management resources offered by healthcare providers include:

    • An education booklet
    • A log book
    • Information fact sheets
    • Consumer e-tools such as “My Heart&Stroke Blood Pressure Action Plan” and ”My Heart&Stroke Risk Assessment” – which provide confidential risk assessment, an opt-in program for email support and the ability to track/monitor blood pressure and progress.

    Contact info: Diane Hargrave Public Relations, 416-467-9954 x104 cell 416-826-5911 dhprbks@interlog.com

  • Study on interprofessional teamwork in FHTs finds link to strong leadership & EMR use

    The May 2011 edition of Canadian Family Physician reports on a study of team members in Ontario’s FHTs, by Dr. Michelle Howard and others from McMaster University. Click here to access the full report.

    Key findings are:

    • Interprofessional teamwork, by way of family health teams (FHTs), shows promise as a strategy to facilitate optimal primary health care.

    • This study aimed to understand how organizational factors influenced team climate and to determine whether there were modifiable factors that predicted a better team climate in the FHT setting.

    • Team climate is positively predicted by strong leadership, group or developmental culture, and use of electronic medical records within the FHT.

    • The lack of relationships found between most organizational factors, such as governance or mix of health professionals, and team climate suggests that interpersonal aspects of teamwork override organizational aspects, and that individuals who commit to working in this environment will engage in teamwork regardless of other factors in the environment.

  • Progress of Family Health Teams showcased in Annals of Family Medicine

    A number of leading experts from Canada and abroad comment on Ontario’s experience in setting up Family Health Teams.  The Annals of Family Medicine has published these responses to an article on FHTs in the March 2011 edition of this American journal. The original article had been written for the benefit of Americans trying to come up with models of their own, by a team led by Walter Rosser of Queen’s University. This publication was reported by Canadian Press, and the story picked up in a number of Ontario newspapers. Click here to read the journal article. Click here to read the commentary. Click here to read the Canadian Press story as it appeared in the Globe and Mail, March 16, 2011.

  • Accessibility for Ontarians with Disabilities Act, 2005 (AODA)

    Resources to assist FHTs in meeting requirements of the Accessibility for Ontarians with Disabilities Act, 2005 (AODA)

    The purpose of the AODA legislation is to create an accessible Ontario for persons with disabilities by 2025 through provincial accessibility standards which improve access by identifying, removing, improving and preventing barriers. Under this act, the following Standards have been or will be enacted:

    • Customer Service (in effect as of Jan.1, 2012)
    • Employment + Information and Communication + Transportation (each are waiting for enactment)
    • Built Environment (has not had 3rd reading).

      All businesses, including non-profits with 1 or more employees must be compliant with the ‘Customer Service Standard’ by January 1, 2012. The focus is on flexible service that meets individual needs which put the person first, not the disability.  Core principles are independence, dignity, integration and equality.

    Fines for non-compliance:

    Fines may be up to $155,000. Liability for conviction per Director or Senior Manager is $50,000/day and for an organization is $100,000/day.  

    Requirements of Customer Service Standard:

    1. Establish policies, practices and procedures to provide accessible service to people with disabilities.
    2. Allow for assistive devices, support persons and service animals appropriately.
    3. Provide alternative and accommodating communication formats, on request.
    4. Post notices when access to facilities or services are interrupted.
    5. Train all employees and others who represent the organization and maintain training records.
    6. Establish and make available a public document for this accessibility standard.
    7. Report organizational compliance and progress related to this standard to the provincial government.

    Resources to help FHTs meet mandatory requirements:

    AccessON website offers compliance information and standards for all accessibility challenges within Ontario. Primary Care Accessibility Checklist is a self-assessment tool for the primary care setting meant to increase awareness of the needs of patients with disabilities, and to enhance accessibility in the practice. The Guelph Family Health Team (GFHT) is sharing their templates with AFHTO Members. Documents may be edited to match individual FHT branding and accessibility requirements.

    Other templates and resources shared by member teams can be found here.