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  • AFHTO 2012 Conference: May 25 deadline for presentation submissions

    Three weeks remain to submit presentation abstracts and award nominations for AFHTO 2012 conference – Demonstrating and Celebrating the Value of Family Health Teams.

    Click on the links below to:

    This year the call for presentation abstracts may be of particular interest to Pharmacists and Mental Health/Social Workers.  Leaders from these two IHP groups have come forward to put together interdisciplinary presentations that have particular focus on, respectively, medications and mental health.

    Contributing to the AFHTO conference in any of these ways gives you the opportunity to showcase the value of FHTs and promote the conditions to build on that value. It also gives you the personal opportunity to use your leadership skills, learn more from your peers, strengthen your personal network across FHTs, and receive greater recognition across the FHT community.

    Key dates:

    • Deadline for presentation abstracts: May 25, 2012
    • Deadline for Bright Light nominations: May 25, 2012
    • Notification of acceptance for presentation: June 13, 2012
    • Conference registration opens: late June
    • Conference takes place (Toronto Hilton): Oct. 16-17, 2012
    • Bright Lights awarded: Oct. 16, 2012

  • AFHTO 2012 Conference: Call for Presentation Submissions

    Share your knowledge and experience with your peers in Family Health Teams to “Demonstrate and Celebrate the Value of Family Health Teams”.

    The conference takes place October 16 and 17, 2012 at the Toronto Hilton

    Submit an abstract

    Click here to access the online form for submission of an abstract for a workshop, oral presentation, or poster.

    Timeline:

    • Deadline for submission: May 25, 2012
    • Notification of acceptance: June 13, 2012

    NOTE: All presenters must register and pay the applicable conference fee.

    Submission Evaluation Criteria

    The poster/presentation abstracts will be evaluated in terms of the extent to which the material:

    • Is useful and/or relevant to other FHTs.
    • Can demonstrate evidence of “value” (e.g. improved quality of care, efficiency, access, etc.).
    • Offers potential to help other FHTs to improve their “value”.
    • Presents innovative ideas.
    • Reflects one or more of the conference themes.

    Presentation Format: Presentations will take place during six 45-minute breakout sessions over the 2-day conference. Presentation length can be:

    • 20 minutes (2 brief presentations will then be paired into one 45-minute time block)
    • 45 minutes (30 – 35 minute presentation plus 10 minute Q&A to fill one 45-minute time block)
    • 1 hour and 30 minutes (interactive workshop that spans two 45-minute time blocks)

    Poster Size: The maximum size for posters is 46” (vertical) x 70” (horizontal)

    If you have any questions, please contact Sal Abdolzahraei by e-mail (info@afhto.ca) or by phone (647-234-8605).

    Click here to view a PDF version of this page.

  • AFHTO 2012 Conference: Call for Program Chairs and Working Groups

    The AFHTO 2012 Conference is being developed around a set of themes that, individually and in combination, “Demonstrating and Celebrating the Value of Family Health Teams.”  Click here to see the themes and their descriptions.

    Thank you to all of our Program Working Group members who have offered their time to develop the conference program! See who is serving on the working group for each theme.

    We are still seeking AFHTO members willing to contribute to the conference planning.

    If you would like to participate on a working group, please review the program themes and e-mail info@afhto.ca indicating your working group preferences.

    Role for Program Chair and Working Group for each theme:

    • Review presentation abstracts submitted for the assigned theme (collected by AFHTO staff).
    • As needed, the group may recruit additional speakers or other related resources (e.g. facilitators, videos, interactive materials) to further develop the program for the assigned theme.
      • Ideally, the program would fill six 45-minute time slots, however some programs may end up with fewer or more sessions.
    • Review nominations for “Bright Light” awards (collected by AFHTO staff) in the assigned theme category and recommend recipients to the Awards Committee.
    • Keep the AFHTO ED apprised of information needed to coordinate communications, logistics and to answer questions from AFHTO members and other attendees.
    • Invitation to provide input on how the conference is to be evaluated.
    • If there are any budget requirements (beyond the standard AV equipment supplied for each meeting room), this is to be discussed with the AFHTO ED in advance to be presented to the AFHTO Membership Committee for review and approval.

    Key dates:

    • Program Working Groups in place by:               Apr. 27, 2012
    • Deadline for presentation abstracts:                  May 25, 2012
    • Deadline for “Bright Light” nominations:             May 25, 2012
    • Notification of acceptance for presentation:       June 13, 2012
    • Conference registration opens:                          late June
    • Conference takes place (Toronto Hilton):          Oct. 16-17, 2012
    • “Bright Lights” awarded:                                     Oct. 16, 2012

    Program Chair and Working Groups can rely on AFHTO staff to:

    • Assist program chairs to recruit members for working groups
    • Provide advice as needed to assist program chairs to develop program
    • Coordinate communications with AFHTO members, key stakeholders, program chairs and presenters including:
      • Calls for presentation submissions, nominees for awards, volunteers, donations, etc.
      • Consolidating relevant presentation submissions for each program chair
      • Promoting registrations
      • Preparing and posting the detailed conference agenda, presentation abstracts and room assignments
      • Collecting & consolidating responses for conference evaluation
    • Ensure all logistics come together smoothly – including:
      • Consolidating conference agenda and room assignments
      • Coordination with hotel, confirmed speakers, AV supplier and conference registrants
      • Keeping AFHTO website complete and up-to-date with information on the conference for potential and actual registrants, sponsors and exhibitors
    • Assist Membership Committee and its Chair to provide effective oversight for the overall Conference and reporting to the AFHTO board, including collecting and compiling timely reports from program working groups
    • Ensure all revenue is received and invoices are paid

  • Quality Planning – accelerating Queen’s FHT’s ability to meet targets

    The Queen’s Family Health Team (QFHT), an academic teaching clinic with 22 family physicians, 20 nursing and allied health members and 50+ family medicine residents rotating through the clinic, embarked on a quality improvement process in 2008.

    QFHT has established a Quality Plan and framework to systematically improve quality across the team.

     

    The team has met or exceeded the provincial targets set for:

    • Influenza Immunization (80% of patients over age 65)
    • Pediatric Immunization (96% completely immunized by the age of 30 months)

     

    They’re on course to achieve, by 2013, provincial targets for:

    • Cancer screening (Pap Smear, Mammogram and FOBT)

     

    They have also made significant gains in increasing the percentage of patients who have their blood drawn within 28 days and remain within therapeutic range through their:

    • Anticoagulation Management Program

     

    See the QFHT Quality Plan to read about the results they achieved and how they accomplished these improvements in preventing illness and managing care.

  • Toward a Primary Care Recruitment & Retention Strategy for Ontario

    The Association of Family Health Teams (AFHTO), the Association of Ontario Health Centres (AOHC) and the Nurse Practitioners’ Association of Ontario (NPAO) are pleased to share our joint report with our members.

    It has been a challenge for primary care organizations to recruit and retain the skilled and compassionate staff needed to deliver accessible, high quality, patient-centred primary care. Our three associations – representing all of Ontario’s interprofessional primary care organizations – teamed up in September to gather the facts and create the solid case to address the issues. About half of the 295 organizations – 10 aboriginal health access centres (AHACs), 73 community health centres (CHCs), 186 family health teams (FHTs) and 26 nurse practitioner led clinics (NPLCs) – responded to our survey.  This information, together with data from salary studies by the Hay Group, has been combined to make the compelling case. Our joint report was finalized this week and sent to the ADMs of Negotiations and Accountability Management Division and Health Human Resources Strategy Division in advance of our meeting on Feb.22.  The meeting had been scheduled for Feb.9 but was postponed due to personal circumstances. The report makes the case that:

    • The full compensation package – salaries, pensions and benefits –must be addressed to make working in primary care sufficiently attractive to recruit and retain competent staff in this sector.  Recognizing current economic constraints, it is well understood that reaching a competitive compensation level will need to be phased in over a few years.
    • As an immediate first step, the barrier to labour mobility must be removed to enable all primary care organizations to offer the HOOPP pension plan and reasonable benefit package.  This entails a 2.5% increase in compensation funding, for a total of $10.36M.
    • Since staff are required to contribute a minimum of 6.9% of gross earnings toward the pension, a matching increase of 2.5% should be added for all staff to defray their reduction in take-home earnings.  This would bring the total investment across all of primary care to $19.48M.

    The investigation found:

    • The biggest vacancy rates appear among the largest staff groups, e.g. 19% for Nurse Practitioners, 14% for dietitians, 10% for RNs, and 5-12% for administrative managers.  Add to this an 18% vacancy rate for pharmacists, and the result is a serious gap in skills to provide the full scope of primary care, particularly chronic disease prevention and management.
    • Factoring in turnover rates and the time needed to fill each type of position, roughly 6-7% of overall staff service capacity is lost each year due to turnover.
    • The most troubling finding is that the majority of staff who leave are then lost to the primary care sector – only 1/3 move to other primary care settings, but about 1/2 go to work in hospitals and other health care settings.
    • While Ontario’s Action Plan for Health Care calls for placing “Family Health Care at the Centre of the System,” there are barriers to attracting health providers to primary care and keeping them in this part of the health system.
    • There is overwhelming evidence that compensation packages are the root cause. Independent review found salaries to be 5 – 30% below market. Lack of the HOOPP plan makes it hard to compete with the other health sectors that do offer it.
    • Growing inequity in compensation is creating conditions for rapid expansion of unionization in this sector, beyond the 10% of PCOs who currently have staff under collective agreements.

    Please click here to read about the outcome of the joint meeting.

  • Strengthening Primary Care in Ontario: Reports are now available

    The Government of Ontario’s recently released Action Plan for Health Care puts a strong emphasis on primary care, placing “Family Health Care at the Centre of the System”. In the last week the final set of reports on Strategic Directions for Strengthening Primary Care in Ontario were also released by the Ministry to participants involved in the five working groups engaged in the process.  While these reports have no “formal” status in the Ministry, they may give some insight and ideas to government and stakeholders moving forward on this Action Plan. AFHTO has received the go-ahead to share these reports with members, please click to access:

    The Strengthening Primary Care initiative grew out of the McMaster Health Forum’s June 2010 stakeholder dialogue on “Supporting Quality Improvement in Primary Healthcare in Ontario”. It was chaired by Susan Fitzpatrick, Assistant Deputy Minister, Negotiations and Accountability Management Division and overseen by a planning group consisting of the Ontario Medical Association, Registered Nurses’ Association of Ontario, Ontario College of Family Physicians and Association of Ontario Health Centres. (PHPG was set up before AFHTO had staff in place and did not have the capacity to participate at that time.) The process involved working groups on Quality, Access, Efficiency, Accountability and Governance. AFHTO participated in 3 of these 5 groups. The synthesis report was developed thereafter. A draft was discussed with participants in the working groups in September. The final product, entitled Strategic Directions for Strengthening Primary Care in Ontario: Overview of the Recommendations of the Primary Healthcare Planning Group states, “it is not meant to be a stand-alone document, rather a high-level summary and synthesis of the recommendations of PHPG’s five Working Group reports and our joint grouping of the strategic directions for strengthening primary care in Ontario under five core themes:

    1. Integration Supported by Governance
    2. Patient Centered Approach
    3. Strategically Aligned Goals and Measures
    4. Accountability Levers and Incentives
    5. Continuous Quality Improvement.”

  • AFHTO welcomes Ontario’s focus on family and community care

    Primary care is fundamental to the health of patients and our health system. Family Health Teams have been working hard to innovate, to improve care, and from that, to improve health. For this reason, AFHTO is pleased to see the Ontario Government is placing “Family Health Care at the Centre of the System”.  Released today, Ontario’s Action Plan for Health Care calls for faster access to primary care, expanded access to house calls from health care professionals, and greater integration of primary care with all the other providers involved in the patient journey. The experience of Family Health Teams provides some guidance for moving forward. Since their first introduction in 2005, Family Health Teams have made significant strides in providing faster access to care for patients and integrating care. Some examples can be found at:

    AFHTO looks forward to working with the Ministry and primary care colleagues to share what Family Health Teams have learned, to work out the best way to implement the Action Plan, and to ensure the necessary conditions are put into place that will enable the Teams (and all of primary care) to improve quality and access to primary care for the patients of Ontario.

  • Ontario’s Action Plan for Health Care: Highlights for primary care

    The Minister made two presentations today, an early-morning prelude for a healthcare audience and the lunchtime launch of Ontario’s Action Plan for Health Care hosted by the Board of Trade.  Below you’ll find links to the full plan and related communications pieces, as well as a bullet-point summary of the Action Plan. The general direction of the Action Plan is consistent with the content of AFHTO’s presentation to the Drummond Commission (http://www.afhto.ca/news/afhto%E2%80%99s-submission-to-drummond-commission-on-broader-public-sector-reform/ ). In particular, the Action Plan points to the critical role of primary care as the “natural anchor for patients in our health system”, a focus on quality in primary care, and the need for more formal connections between primary care organizations and other entities to coordinate care. In our Drummond submission AFHTO went further to identify the need to support the critical enablers required for primary care to play its full role in the health system: leadership, team based care, information systems and clinician involvement.  FHTs are well-positioned, and with some evolution and support, could play a key role in advancing health system transformation at the local, regional and provincial levels. Of these enablers, “information” is the one that is the least well-developed – FHTs need sufficient support to collect, manage, analyze and act on data to improve access, improve outcomes, and deliver better value for money. Details for implementing the Action Plan remain to be developed. To get a read on this, I had the opportunity to compare notes with leaders from a number of other health associations, have a follow up meeting with the primary care lead in the Minister’s Office, and exchange a few words with the Minister. Despite the Toronto Star’s report that “Matthews hopes to achieve this by placing the provinces’ 200 family health teams under the control of Ontario’s 14 local health integration networks,” the Minister’s Office confirmed that the processes, accountability and funding relationships would be developed with key stakeholders such as AFHTO, to meet the goal of creating a more seamless journey for patients through the LHINs. For the most part FHTs have developed their own LHIN-based networks – AFHTO will be tapping into these networks for advice, direction and assistance as this implementation goes forward. Other areas that AFHTO will be monitoring include the implementation plans around access, house calls, funding reform, and the concept of “Care Coordinators” for seniors recovering after hospital stays to reduce readmissions.  Having touched base with colleagues at the Ontario Association of CCACs, it’s not yet known whether the Care Coordinator is seen to be a role within a CCAC, hospital or primary care. AFHTO’s overall assessment of the Action Plan is posted at http://www.afhto.ca/news/afhto-welcomes-ontario%E2%80%99s-focus-on-family-and-community-care/ . We are pleased with the general direction, and look forward to collaborating with the Ministry and others to work out the details that will lead to sustainable improvement. Links:

    Quick summary of Action Plan (Courtesy the Minister’s Office) Faster Access and a Stronger Link to Family Health Care

    • Family Health Care at the Centre of the System:  Through the LHINs, we will hold the entire health system accountable for substantial progress towards fewer hospital readmissions.
    • Faster Access: More patients will have access to same-day and next-day appointments and after-hours care. This means better care for our patients and less strain on other areas of our health care system.
    • House Calls: We will be expanding access to house calls from health care professionals, like doctors, nurses, and occupational therapists. We will also be improving access to online and phone consultations.
    • Local Integration of Family Health Care: We will integrate family health care planning under the LHINs. Together, we will identify a model that brings planning and accountability for the full patient journey. However, the Ministry of Health and Long-Term Care will continue to have a funding role with Ontario’s doctors.
    • A Focus on Quality in Family Health Care: We will expand our focus on quality improvement to family health care, and ensure that all family health care providers are equipped to integrate the latest evidence based care into their practice.

    Right Care, Right Time, Right Place

    • High Quality Care: Evidence will drive our decisions and it will drive our funding. IF there is evidence to support a new procedure or test, we will fund it. We will also continue to find ways to fully maximize the potential of our range of health care professionals.
    • Timely, Proactive Care: We will implement our mental health strategy starting with children and youth, including getting mental health nurses into our schools, supporting people with eating disorders, and smoothing the transitions of people between mental health care providers.
    • Seniors Strategy: We will launch a Seniors Strategy with an intense focus on supporting seniors to stay healthy and stay at home longer, reducing strain on hospitals and long-term care homes. It will include:
      • An expansion of house calls
      • More access to home care through an additional 3 million Personal Support Worker hours
      • Care Co-ordinators that will work closely with health care providers to make sure the right care is in place for seniors recovering after hospital stays to reduce readmissions.
      • The Healthy Homes Renovation Tax Credit, which will support seniors in adapting their home to meet their needs as they age, so they can live independently at home, longer.
      • Empower LHINs with greater flexibility to shift resources where the need is greatest, such as home or community care.
    • Moving Procedures into the Community: We will shift more procedures out of hospital and into non-profit community-based clinics if it will mean offering patients faster access to high-quality care at less cost. We will not compromise on quality, oversight, or accountability.
    • Funding Reform: Funding must follow the patient. We will accelerate the move to patient-based payment, as patients move through our health care system.

    Keeping Ontario Healthy

    • Childhood Obesity Strategy: We will take on the challenge to reduce childhood obesity by 20 per cent over five years. Success on this front will require partnership, so we will bring together a panel of advocates, health care leaders, non-profit organizations, and industry to develop the strategy to meet our target.
    • Online Cancer Risk Profile: All Ontarians will have access to an online Personalized Cancer Risk Profile that will us medical and family history to measure risk of cancer and then link people at higher risk to screening programs, prevention supports, or genetic testing.
    • Expanded Screening: We will expand our comprehensive screening programs for cervical, breast and colorectal cancer to notify and remind participants when they are due for their next screening.

  • Responding to staff about media speculation on public sector salaries

    Media reports on public sector salaries may be stirring up concerns among staff at your FHT.  To help you respond, this e-mail gives you a brief summary of what’s being reported, and what AFHTO is doing about concerns over inequity in compensation. Headlines on the Toronto Star and National Post websites this evening (Jan. 24, 2012) leave the impression that public sector salaries are at risk in the upcoming budget.  This is following from Premier McGuinty’s speech today to the Canadian Club. Spurred by PC Leader Tim Hudak’s comments to the press last Thursday, on Friday, CBC radio and other on-line reports fuelled speculation that the current freeze could be extended. To date government has not committed one way or the other. FHT staff and managers are very concerned about inequities in compensation across health care. This fact emerged quite clearly in last fall’s survey of interprofessional primary care organizations (FHTs, Community Health Centres, Aboriginal Health Access Centres and Nurse Practitioner-Led Clinics), conducted jointly by their representative bodies – AFHTO, the Association of Ontario Health Centres and the Nurse Practitioners Association.  Over 85% of EDs of primary care organizations identified lower compensation as one of the 3 main reasons potential candidates turn down job offers, and about half report this as being one of the 3 main reasons for staff leaving the primary care organization. Our three associations have been raising this issue at various levels in the Ministry and the Minister’s Office.  We are scheduled for a joint meeting on February 9 to review the findings from our study with the ADMs of Negotiations and Accountability Management Division and Health Human Resources Strategy Division.  Once we have reviewed the findings with the ADMs, the three associations will share the report with our respective members. While media reports are raising a lot of speculation, the key message for FHT staff is that it is only speculation at this stage.  AFHTO continues to give priority to advocate for compensation funding to recruit and retain the staff needed to deliver interprofessional primary care. The current economic situation means that achieving equity in compensation will be an incremental process.

  • AFHTO response to Globe and Mail comment about FHTs

    On January 17, Globe and Mail columnist Adam Radwanski wrote about the upcoming MOHLTC-OMA negotiations, focusing on costs and value for money (echoing the Auditor General of Ontario’s report). Unfortunately he used the term “family health team” when he was refering to physicians in capitated models in his statement, “The province will continue trying to get more family doctors away from fee-for-service. But that won’t do much good if it doesn’t get better value out of ‘family health teams,’ which a majority of doctors have already moved toward because the Liberals provided financial incentives to do so.” AFHTO’s response appears below. To read the Globe column, go to:   http://www.theglobeandmail.com/news/politics/adam-radwanski/ontario-sets-out-to-change-the-way-doctors-work/article2304673/ Dear Mr. Radwanski, Thank you for your article this morning on the upcoming OMA-MOHLTC negotiations. You’ve hit on a number of key issues, including the need to know what value is being received from increased investment in primary care. As pointed out in Auditor General of Ontario’s press release regarding his chapter on Funding Alternatives for Family Physicians,  “What concerned me about this was not that these doctors were making more money but rather that the Ministry of Health and Long-Term Care has not analyzed whether this has actually resulted in Ontarians getting better access to a doctor.” I’m writing to you for two reasons — One is to clarify and correct the terminology and concepts you used in your column.  This is the challenge of the alphabet soup of Ontario’s primary care system!  There is an important distinction between Family Health TEAMS (the term used in your column)and the methods for paying family physicians, i.e. Family Health Groups (FHG), Family Health Organizations (FHO), and Family Health Networks (FHN).  The Auditor General’s report was focused on the latter (i.e. FHG, FHN, FHO). He reported that in the 2010/11 fiscal year, these three types of arrangements accounted for over 90% of family physicians (7,739) participating in an alternate funding arrangement and over 90% of enrolled patients (9.6 million enrolled Ontario residents). Just over 2000 of these family physicians also participate in Family Health Teams (FHTs), and over 2.6 million Ontarians are enrolled. FHTs are organizations that bring together a group of physicians (FHO or FHN or salaried physicians) with other health care professionals (e.g. nurse practitioners, pharmacists, dietitians, social workers) to provide comprehensive primary care and health promotion for their patients. In addition to reporting on FHG, FHN and FHO arrangements, the Auditor General’s report made a few brief comments to explain what FHTs are, and offered the following observation:

    In December 2008, the Ministry commis­sioned the Conference Board of Canada to conduct a five-year study on Family Health Teams to identify their successes and short­comings. Each year, the Ministry has been receiving interim study results, which focus on areas such as team functioning, patient access, and chronic disease management. The Ministry indicated that it will use the final report—expected in 2013—to assist it in determining whether any changes should be made regarding Family Health Teams. …  We also noted that interim results of the Min­istry-commissioned study on Family Health Teams have indicated that enrolled patients were generally satisfied with their access to health services.

    We reiterate that the key issue, as pointed out by the Auditor General, is the need for a plan for on-going collection and reporting of data to monitor and improve on the value being delivered for Ontario’s investment in primary care.  The only data from FHTs that is currently available is from the Conference Board study; the Association of Family Health Teams of Ontario (AFHTO) continues to encourage the Ministry to release the results to enable FHTs to learn from it and improve. This brings me to point #2. FHTs have been committed to improving quality, and the interprofessional model has enabled a number of interesting innovations. I draw your attention to one example – Dorval Medical Associates Family Health Team – which monitors the quality, capacity and cost of their operation, together with a unique method for engaging patients in determining priorities, and uses the results to continually improve in all three of these domains. Over the past 3 years, Dorval has evidence of that accomplishment. A report on Dorval’s method and results is posted at – http://www.dorvalmedical.ca/about-us/the-dorval-model/ If you’d like to pursue any of this further, I’d be pleased to speak to you further about Family Health Teams and connect you to leaders and thinkers in this area. FYI —  AFHTO’s ideas for improving value in the delivery of health care services are outlined in our presentation to the Drummond commission, posted at http://www.afhto.ca/news/afhto%E2%80%99s-submission-to-drummond-commission-on-broader-public-sector-reform/ . Thanks again for your interest in bringing these issues to the public. Sincerely, Angie Heydon Executive Director Association of Family Health Teams of Ontario (AFHTO)