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  • 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.

  • Atikokan FHT and the Falls Prevention Team

    Atikokan — Two years in, the Atikokan Falls Prevention Team has proven its value – so much so, the team plans to stay together, and continue helping seniors maintain the quality of their lives. “There isn’t another program in the region like this,” said occupational therapist Amanda Dickson, the team leader. “It would be pretty rare to get the professionals we have to be able to work so closely together on a team. In a small town, we are able to do that.” Originally, the group was one of 33 community-based fall prevention teams funded for two years by the Northwest LHIN and St. Joseph’s Care Group. They were formed to address falls in long term care homes. But here, that model quickly expanded to include community members through in-home assessments, with the goal of helping seniors stay in their own homes as long as possible. That mobile team component, combined with the seamless approach of sharing information and resources made Atikokan unique in the NW LHIN region. When the team’s two-year funding wrapped up last month, members decided to keep it going. The team includes Cathe Hoszowski, counsellor Bob Botham, RN Keira Lacosse, dietician Kira Schan, (all from the Family Health Team), seniors’ counsellor Patricia Dunnett, Home Support coordinator Brenda Wood, pharmacist Earle Arnold, ComCare’s Phyllis Mosley, and Extended Care Wing (ECW) program coordinator Tanis Hampshire. Home visits The team looks at a broad range of health and environmental issues which can contribute to frailty and falls, with the goal of supporting independent living. That can mean relatively simple measures such as providing special footwear, eye wear, or double-sided tape to secure rugs and carpets, to improving lighting and installing hand rails. The group also addresses more complex matters: identifying balance issues caused by improper medication use, lack of balance or muscle tone, poor nutrition, or even depression. Doing all of that is fairly easy in an extended care facility, where many health professionals work in close proximity. But it has been reaching out to the community – seeing seniors in their homes, where half of all serious falls occur – that has proven valuable here. Reaching out makes sense: 50% of falls occur in the home, and seniors now make up almost a third of Atikokan’s population. Family Health Team RN Keira Lacosse said without the home visits, critical health issues may otherwise go undetected until a fall actually occurs. The visits have also been eye-opening for physicians, who may not be aware of contributing factors that can affect the overall health picture of their patient. “A lot of older people in town don’t have supports and they may have some depression or are just very isolated [and not taking proper care of their health], so it’s good for them to have someone checking in.” Adds counsellor Bob Botham: “You’re there to identify fall risks but because of your profession, you’re also noticing [other health risks], and that’s where referrals come from.” (Clients sign a form that allows the team to share information and referrals among health professionals). Lacosse will provide some preventative materials on the first visit (such as double-sided tape and nightlights) and provides information on other in-town services (such as Home Support for meals or grocery shopping services, emergency response bracelets, and blister packs to keep medications organized and easy to open). Typically, she then refers clients to Dickson, who conducts a home assessment and recommends equipment or exercises to improve safety. If necessary, the client may also be referred to a dietitian, counsellor and physician, or encouraged to sign up for home care services. Botham conducts follow-up visits to see how effectively those measures are being implemented, and if the situation is improving. These visits suggest risk factors have been reduced by 41%. Many seniors living in their homes have some fear that admitting a fall to a health professional or family member can mean ending up being put in long-term care; in fact, that is the opposite of the team’s goal, said Botham. “The goal is to keep them in their homes, and as healthy as possible,” he said. And there are many inspiring examples of seniors living in their homes in their later years, with a little help, noted Hoszowski, who cited the example of a 92-year-old friend who has used the recommendations of the team to reduce risks of falls in her home. Brenda Wood (Home Support) estimates the number of seniors using the emergency response bracelets has doubled since the team began doing assessments. Patricia Dunnett (Community Counselling) said that while some may initially feel embarrassed to need certain devices as they age, “if they see their friend [has an emergency response bracelet] then it becomes okay to do this.” The team has compiled a wealth of information on accessing services and assistive devices including coupons and reduced payment plans available for low-income seniors. Botham added that they are also working on a list of contractors who are available for home upgrades and equipment installations. Dunnett said that while seniors on fixed incomes may be reluctant to pay for certain items, it helps to realize that with an initial, and usually affordable, cost, they might be able to keep their independence much longer. With some funds from Northwest LHIN, and a donation from the seniors’ forum, the team has been able to make night lights, mats, special tape and other devices available free to clients. The team anticipates keeping their services going indefinitely; basically, communication is free, and just practical. Botham credits the “openness of our employers and the community, who realized that this would a benefit to everybody because we’re doing [these functions] anyways, so sharing our expertise and sharing the workload between us all just really made sense.” SAGES An example of pooling resources was the recent eight-week SAGES (Safe and Gentle Exercises for Seniors) program the team hosted in February which brought both ECW and community residents together four weekly sessions held each at the ECW or the Pioneer Centre. Up to a dozen seniors learned strengthening and balancing exercises from ANFC fitness instructor Shanna Brewster. (“They were doing sitting Tai Chi at the start and by the end of four weeks they were doing modified aerobics,” said Dunnett.), and heard special presentations on a range of health topics such as nutrition (by Schan) and safe medication use by Arnold. The program reunited some old friends from both ECW and the community, “and had a secondary benefit of getting them out and socializing with members of their community, especially for the higher functioning seniors,” noted Dickson. The team plans to run the SAGES program again, soon. By Jessica Smith, Atikokan Progress, May 3, 2011

  • Doctor from The Ottawa Hospital FHT uses web to cut wait-times to see specialists

    OTTAWA — An Ottawa family doctor has pioneered a simple way to bypass the lengthy delays that patients often face when they are referred to medical specialists. Using a web-based tool to make contact with high-demand specialists such as dermatologists and endocrinologists, Dr. Clare Liddy said she is able to get her patients faster access to medical advice. In many cases, her system of electronic consultations eliminates the need for patients to visit the specialist in person. In cases requiring follow-up, specialists either request more patient information, order diagnostic tests, or determine that the patient needs to be seen. Since she started using e-consultations 16 months ago, Liddy said she has cut her patients’ waits for specialists from as long as 12 months to one week. The web-based tool is secure enough to safeguard patient information and is accessible to all physicians through a website hosted by the Champlain Local Health Integration Network, eastern Ontario’s health authority. The tool is available provincewide through other regional LHINs, meaning family physicians across the province could easily set up similar e-consultation networks, said Liddy. Family physicians simply log on to the system, fill out an electronic form outlining their patients’ complaints, then send the document to a specialist who belongs to the e-consultation network. The specialists usually respond within a week. Liddy, who works at The Ottawa Hospital’s Riverside Family Health Team, described the case of a recent patient who showed up at her clinic with a mysterious rash. Instead of making a traditional referral to a dermatologist, which would have resulted in a 12-month wait, Liddy sought a specialist’s advice using e-consult. She even took a digital photo of the rash and included it in her documentation. The tool is particularly useful for patients who live in remote areas with few specialists. “Many of those patients have to make a trip to Ottawa. If you can avoid unnecessary specialist visits, that is beneficial to the patient,” Liddy told a meeting Wednesday of the Champlain LHIN. The test project was started with a $110,000 grant from The Ottawa Hospital Academic Medical Organization, which covered consultation fees for the specialists who participated. To date, 40 physicians, including some in Deep River and Winchester, have participated in Liddy’s project. She hopes that as more family physicians use the tool, changes will be made to the Ontario Health Insurance Plan to allow specialists to bill for the services they provide through e-consultations. By Pauline Tam, The Ottawa Citizen April 28, 2011 3:45 PM

    © Copyright (c) The Ottawa Citizen

  • FHT Funding Agreements: MOHLTC to distribute revised documents this week

    AFHTO has been working with the Ministry of Health and Long-Term Care and the Ontario Medical Association (OMA) to address concerns regarding the new FHT Funding Agreement templates. FHT Leads should be receiving from the Ministry, prior to the April 29 sign-back date, a revised agreement that addresses our key concerns with these templates. For those FHTs that requested an exemption to the requirement that “all positions funded pursuant to this Agreement shall be employees of the Recipient unless the Ministry has provided its written consent”, you will receive a separate exemption agreement. The Ministry continues to encourage all FHTs to strive to meet this goal; however, the exemption agreement gives greater flexibility regarding FHT staffing arrangements while upholding the Government of Ontario’s risk management needs. Note that the exemption agreement lists a few “as applicable” requirements. If your FHT has a concern with any of these “as applicable” requirements, you may wish to seek clarification from your Ministry consultant to determine whether they are in fact “applicable” in your case. The template agreements for all Physician-Sponsored and Mixed Governance FHTs have been revised to address the concerns regarding governance, liability and communications. AFHTO and the OMA would like to recognize the Ministry’s willingness to make these revisions to address the concerns raised by FHTs. As with any contract, each FHT is advised to carefully review the new agreement and to discuss any ongoing concerns with appropriate legal counsel and their Ministry consultant.

  • FHT Funding Agreements: deadline extended to April 29, 2011

    Ministry staff are distributing today (April 15) a memo from Phil Graham announcing the sign-back deadline is extended to April 29, 2011.   The memo reads:
     
    I would like to thank all those Family Health Teams who have reviewed the new FA and articulated their issues and concerns to the ministry and those who have signed back. The ministry has reviewed the issues raised and is working with the Ontario Medical Association (OMA), Association of Family Health Teams of Ontario (AFHTO) and the Association of Ontario Health Centres (AOHC) in an effort to address the issues that are common across FHTs.
    In light of this on-going work and in an effort to arrive at optimal solutions to the issues identified, the ministry is extending the deadline for sign-back from the previous extension date of April 15, 2011 to April 29, 2011. Although the ministry will consider a further extension should further review and discussion be required, all FHTs are encouraged to expedite the process of review and sign-back once the ministry provides responses to the issues identified, expected shortly. Any changes or amendments made will also be shared with FHTs that have already signed back their FA.
    Thank you for your attention to this and I look forward to addressing these issues cooperatively so we can continue to support the delivery of quality, interdisciplinary care to Ontarians.

  • FHT Funding Agreements: update on the “employee requirement”

    AFHTO has learned the Ministry is working on a framework for granting exceptions to the “employee requirement” that appears in all Funding Agreements. They expect the draft to be completed in the next few weeks. AFHTO was told that, at minimum, we would get advance notice of the content of this framework. AFHTO continues to request the opportunity to review and give feedback on the draft framework for exceptions so that problems can be identified and solved before the Agreements move into implementation. AFHTO has a very successful track record in this regard, given past work in pulling together working groups from member FHTs to give constructive feedback and attempt to solve problems with the Ministry on such issues as the move to 5-year funding, NP-SERT and the new smoking cessation program. AFHTO first notified FHTs about the potential problem with the “employee requirement” clause on March 25, and survey results indicated this would pose significant implementation challenges for many FHTs. As noted in that March 25 e-mail, the “employee requirement” was introduced with the intent to meet a government-wide directive from Ministry of Government Services (MGS) implemented last September for all transfer payment agencies. In the last few days AFHTO has discussed these concerns with the Minister’s Office (MO) and the Ontario Medical Association (OMA). We welcomed news that the MO is working with the FHT Unit and MGS to find reasonable and workable solutions to fulfil the intended purpose of the directive while minimizing the risk of destabilizing staffing arrangements and service delivery in FHTs. The OMA shares AFHTO’s concerns, and our two organizations are working collaboratively in seeking solutions. In the meantime AFHTO has learned that some FHTs have yet to receive an extension date for signing their Agreement.  Other FHTs have received a response to their specific problems in implementing the “employee requirement” with a message that says, “The Ministry realizes that there may be isolated circumstances where exemptions will require consideration. … The ministry is not encouraging exceptions and very rarely will approve unless extreme circumstances.” AFHTO continues to recommend to those FHTs who have not yet signed the Agreement:

    • Do not rush into signing the Agreement until your FHT is comfortable with the requirements and the timeframe for implementation.
    • If the “employee requirement” poses problems for your FHT, wait to see the Ministry’s framework for granting exceptions.
    • Continue to work with your Ministry consultant to seek clarification on other issues affecting your FHT.
    • Seek legal advice as needed to deal with your FHT’s unique situation.
    • Please continue to keep AFHTO in the loop. AFHTO remains ready to gather FHT opinions, coordinate discussion, and facilitate resolution of issues that are common among FHTs.