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  • Tilbury District FHT takes on the COVID-19 Vaccine Rollout

    Chatham Daily News published April 14, 2021

    By Mark Malone

    The Tilbury District Family Health Team began giving the AstraZeneca-made vaccine for COVID-19 to its 55-and-older patients this week.

    Its health team is one of two primary-care providers in Chatham-Kent administering doses as an extension of the province’s pharmacy vaccination program.

    More are scheduled to be added this week and next, said Jeff Moco, spokesperson for the Chatham-Kent public health unit.

    “The thinking is that primary care would be a good outlet to help support and reach those with chronic health conditions,” Moco said.

    The Tilbury District Family Health Team has locations in Tilbury and Chatham. Patients from both sites can make appointments, but the vaccine has been given only in Tilbury since the program began Monday.

    “We’re starting small and growing,” executive director Kelly Griffiths said.

    Approximately 30 doses had been administered as of Wednesday morning.

    “We have a limited supply and we’re going to be working with the public health unit when more supply comes in,” Griffiths said.

    “We’re really proud to be able to work with public health with the vaccination efforts in our community,” she added. “It’s pretty exciting.”

    Patients with the Tilbury District Family Health Team can call 519-682-2307 ext. 303 to book an appointment.

    “It’s going really well,” Griffiths said. “Patients are happy to be able to receive their vaccine in our office. … They have that comfort with being able to come to a primary-care provider’s office to receive it. They said they really appreciate that.”

    The public health unit provides the family health team with vaccine doses and will do the same with more doctors’ offices as the rollout expands.

    “Our role is in the receiving, distribution and education/support aspects of vaccine for those primary-care groups interested,” Moco said. “This has been the case for all of the other vaccines that one would normally get through their primary-care provider as we’ve been doing this for years.”

    A complete list of groups now eligible to receive the vaccine is available at https://ckphu.com/covid-19-vaccine/.

    Go to getyourshotck.ca to make an appointment at the mass vaccination clinic at the John D. Bradley Convention Centre in Chatham or at any future mobile clinics.

     

    Read the full article here

  • COVID@Home

    Shared by the Ministry of Health

    Last updated June 2, 2021

    COVID-19 pandemic has led to unexpected surges in demand on the provincial healthcare system, and healthcare settings across the province face patient capacity constraints, potentially affecting care for all patients. In an effort to ease these constraints on the healthcare system, Ontario Health is providing tools and resources for COVID@Home to help primary care providers who wish to remotely monitor people who have mild to moderate COVID-19 in the community.

    As part of the COVID@Home initiative, the Ministry of Health has procured a stockpile of oxygen saturation monitors to be distributed to primary care professionals and teams who wish to provide enhanced monitoring of their COVID-19 positive patients at home. 

    Resources

     

    Looking for more COVID-19 related resources?

  • Team-based primary care improved health behaviors among patients with multimorbidity

    Scaling Up Patient-Centered Interdisciplinary Care for Multimorbidity: A Pragmatic Mixed-Methods Randomized Controlled Trial, The Annals of Family Medicine March 2021, 19 (2) 126-134

    Abstract

    PURPOSE

    To measure the effectiveness of a 4-month interdisciplinary multifaceted intervention based on a change in care delivery for patients with multimorbidity in primary care practices.

    METHODS

    A pragmatic randomized controlled trial with a mixed-methods design in patients aged 18 to 80 years with 3 or more chronic conditions from 7 family medicine groups (FMGs) in Quebec, Canada. Health care professionals (nurses, nutritionists, kinesiologists) from the FMGs were trained to deliver the patient-centered intervention based on a motivational approach and self-management support. Primary outcomes: self-management (Health Education Impact Questionnaire); and self-efficacy. Secondary outcomes: health status, quality of life, and health behaviors. Quantitative analyses used multi-level mixed effects and generalized linear mixed models controlling for clustering within FMGs. We also conducted in-depth interviews with patients, family members, and health care professionals.

    RESULTS

    The trial randomized 284 patients (144 in intervention group, 140 in control group). The groups were comparable. After 4 months, the intervention showed a neutral effect for the primary outcomes. There was significant improvement in 2 health behaviors (healthy eating with odds ratios [OR] 4.36; P = .006, and physical activity with OR 3.43; P = .023). The descriptive qualitative evaluation revealed that the patients reinforced their self-efficacy and improved their self-management which was divergent from the quantitative results.

    CONCLUSIONS

    Quantitatively, this intervention showed a neutral effect on the primary outcomes and substantial improvement in 2 health behaviors as secondary outcomes. Qualitatively, the intervention was evaluated as positive. The combination of qualitative and quantitative designs proved to be a good design for evaluating this complex intervention.

    Authors– Martin Fortin, Moira Stewart, Patrice Ngangue, José Almirall, Mathieu Bélanger, Judith Belle Brown, Martine Couture, Frances Gallagher, Alan Katz, Christine Loignon, Bridget L. Ryan, Tara Sampalli, Sabrina T. Wong, Merrick Zwarenstei

    Relevant Links

     

  • Bits & Pieces: respiratory care during COVID-19, Stay-at-Home order and more

    Bits & Pieces: respiratory care during COVID-19, Stay-at-Home order and more

    Your Weekly News & Updates

    In This Issue  
    • Member stories
    • Reminder – Your role in improving the population health of people at risk or living with diabetic foot complications
    • Register now! A webinar on EMR/EHR auditing obligations
    • Revised Phase 2 vaccination plan, identifying vaccine-eligible patients and more
    • Data governance framework for health data collected from Black communities in Ontario
    • Resources for injectable opioid agonist treatment
    • Team-based primary care improved health behaviors among patients with multimorbidity
    • Insulin therapy and managing At-Risk Drinking and Alcohol Use Disorder (AUD) during COVID-19
    • Upcoming events including respiratory care during COVID-19and more

     

     

    Member stories
    Bancroft Community FHT – Bancroft Community FHT physician raises awareness about COVID-19

    Temagami FHT – Temagami FHT hosts successful COVID-19 vaccine clinic

    Haliburton Highlands FHT– vaccination clinic provides relief to elders

    You can share your own vaccination stories with our member initiative webform. If you have any questions, please email us at info@afhto.ca.

    Reminder – Your role in improving the population health of people at risk or living with diabetic foot complications, April 15, 2021

    Co-hosted with Wounds Canada, this interactive webinar on Thursday, April 15 will provide an overview of your role to improve the population health of people at risk or living with diabetic foot complications across the full continuum of care settings to improve patient experience, outcomes and costs. Register here.

    Register now! A webinar on EMR/EHR auditing obligations

    Teams are invited to join AFHTO and Kate Dewhirst (Kate Dewhirst Health Law) on Friday, May 7, from 12 PM to 1:30 PM to better understand obligations to audit electronic medical records (EMR) and electronic health records (EHR). Topics discussed will include why you have an audit, how often you should audit, and how to audit. More information and registration are here.

    Revised Phase 2 vaccination plan, identifying vaccine-eligible patients and more

    Recent updates include:

    We continue to update several pages on our site with resources and news:

    Framework with black women- one in wheelchair and anotheer holding a black girl in her arms

     

    Data governance framework for health data collected from Black communities in Ontario

    The Black Health Equity Working Group has released the latest version of the Engagement, Governance, Access and Protection Framework (E-GAP), which is designed to guide the implementation of race and socio-demographic data collection strategies at the local and provincial levels in Ontario.

    • Download the report in English or French
    • Download the Consultation Summary Report in English or French

    You can contact the working group at info@blackhealthequity.ca

     

     

    Resources for injectable opioid agonist treatment
    Addictions and Mental Health Ontario (AMHO) has new resources to support increased access to injectable opioid agonist treatment (iOAT). iOAT is an evidence based and cost-effective medical intervention that is recommended for people with severe opioid dependence who have not responded to oral opioid agonist treatment or for whom oral opioid agonist treatment is not appropriate. More information and resources are here.

    Team-based primary care improved health behaviors among patients with multimorbidity
    Recently published in The Annals of Family Medicine, this research highlighted results when health care professionals (nurses, nutritionists, kinesiologists) were trained to deliver patient-centered intervention based on a motivational approach and self-management support. Read more here.

    Insulin therapy and managing At-Risk Drinking and Alcohol Use Disorder (AUD) during COVID-19

    Centre for Effective Practice recently launched new tools:

    Respiratory Care During COVID-19: What Have We Learned One Year Later, April 21, 2021

    Reflect on best practices & considerations for diagnosing and managing lung diseases during the pandemic. Co-hosted with the Lung Health Foundation
    Find out more here.

    Project ECHO (UHN), Starting April 2021
    Join ECHO Ontario (UHN) for their newly released programs starting this spring.
    For more information:

    To register, click here.

    COVID-19 CoP: Vaccination in primary care, evolving vaccine evidence, and more, April 23, 2021
    The OCFP & University of Toronto DFCM will be discussing evolving vaccine evidence and experience delivering vaccines as part of primary care pilots.
    Learn more here.

    Primary Care Vaccine QI Support Group Webinar Series, April 22- May 13, 2021

    Join Ontario Health to learn valuable lessons from pilot sites, gain access to resources, information and quality improvement tips to assist you in moving forward with your vaccine plans.

    Register here

    A Deep Dive into Co-Designing Care Models for your Priority Populations, May 6, 2021
    The RISE OHT webcasts will show how your OHT can re-design care for patients in your priority populations, and help every patient in those populations experience coordinated transitions between providers.
    Learn more here.

  • Mobilizing Primary Care to Support Hospitals with COVID@Home and Ramping up COVID-19 Vaccinations

    Dear triad members,

    Last night we received a memo from Matt Anderson, President and CEO of Ontario Health, that outlines the severity of the situation in hospitals due to the increase in COVID-19 cases.

    Ontario is facing a severe crisis with hospital capacity due to the surging number of cases. The positive COVID-19 cases announced today was over 4,200 – the second highest number since the pandemic began. The pressure on hospitals’ critical care capacity is extreme. As a result, Ontario Health has instructed hospitals to ramp down all elective surgeries and non-emergent/non-urgent activities to preserve critical care and human resource capacity as of Monday, April 12, at 12:01 AM. This does not currently apply to hospitals in the Northern Ontario Health Region or pediatric specialty hospitals.

    In the ADM memo we shared yesterday with the EDs and administrative leads, PHUs have been asked by the Ministry to utilise primary care to their full capacity in the mobile team vaccination efforts and in contacting eligible patients to encourage they vaccinate. This includes anyone aged 18 and older in high-risk communities, as announced on April 7.

    There will be pop-up and mobile clinics for those aged 18 and older in high-risk communities at essential workplaces, in community centres, and in public spaces. At this time, people aged 18 to 49 cannot book online; mass vaccination sites will be adhering to older age cut-offs and other eligibility criteria, as noted on the online booking page. Communication about this to patients will be critical.

    Teams are encouraged by the Ministry to work with their PHU to be clear on eligible patients and to optimise the use of primary care in delivering the vaccines.

    You will also soon receive a memo from the Ministry requesting that teams who are in identified hot spots (about 30+), where hospital capacity has reached its limits, help support the care of mild to moderate COVID-19 patients in their homes with the COVID@Home program. You may hear from your Senior Program Consultant, who will check to see what kind of capacity you have for this initiative, including extending support to patients of non-affiliated physicians in your community.

    As part of the COVID@Home initiative, the Ministry of Health has procured a stockpile of oxygen saturation monitors to be distributed to primary care professionals and teams to provide enhanced monitoring of their COVID-19 positive patients at home. To learn more, the Ontario College of Family Physicians has shared a webcast explaining COVID@Home with Dr. Dee Mangin from their most recent Family Medicine Summit.

    We have requested a meeting for teams early next week with the Ministry and/or Ontario Health to support teams who have questions. We will share that information as soon as we have it.

    For today, please reach out to your public health unit, if you have not already, to help support community-wide vaccination efforts. All needed care for your patients remains critical. However, as this is a dire situation that Ontario is facing, we encourage you assess your ability to support the vaccination efforts and to help relieve strain on the hospitals to the best of your capacity.

    We will continue to keep you posted as we learn more. These are incredibly challenging times, and primary care will be critical in ensuring we get through them.

    Thank you for the work you are doing. If you have any questions, please contact us at info@afhto.ca.

    Yours in good health,

    The AFHTO team

  • Ontario stay-at-home order and the Phase 2 COVID-19 vaccine distribution plan

    Dear Executive Directors and Administrative Leads,

    The third province-wide stay-at-home order took effect today at 12:01 AM.

    Under the stay-at-home order, primary care teams are encouraged to continue virtual care wherever possible but do not stop or delay in-person care. It remains at a clinician’s discretion to determine if a patient needs to be seen in person.
    While all teams have continued to deliver virtual care since the pandemic began, a reminder that the following are available as support tools in determining virtual vs. in-person care:

    In yesterday’s announcement, the provincial government did not address some of what we consider important to help control the spread, such as paid sick days. However, the pivot to go into high-risk communities and to vaccinate anyone there aged 18 and older is a step in the right direction.   

    These mobile teams – part of Phase Two in the COVID-19 vaccine distribution plan – are starting in the regions with the highest rates of transmission (ex. Toronto, Peel). This will expand to other hot spot regions based on established patterns of transmission, severe illness, and mortality. The news release can be read here.

    We received this memo today from ADM Patrick Dicerni regarding vaccination. On a related note, we encourage teams to work with public health regarding the mobile teams that will go to high-risk congregate settings, residential buildings, faith-based locations, and locations occupied by large employers in high-risk communities. Vaccinating is something primary care does best, and no one knows their communities better! If your team has the capacity, reach out to your public health unit as primary care can play a key role in getting these shots in arms.

    This is hopefully the final time we’ll see a stay-at-home order issued in Ontario for COVID-19.

    If you have any questions, please contact us at info@afhto.ca.

    Stay well,
    AFHTO

    Relevant Link:

  • Temagami FHT hosts successful COVID-19 vaccine clinic

    The Star article published April 7, 2021

    By Jamie Mountain, Local Journalism Initiative Reporter

    TEMAGAMI – Temagami’s seniors aged 70 and up and priority healthcare workers were some of the latest to receive their first Moderna COVID-19 immunizations.

    The Temagami Family Health Team, in conjunction with the Timiskaming Health Unit, hosted a one-day vaccine clinic on March 31 at the Temagami arena.

    “The word is it went well,” said Temagami Emergency Control Group member and councillor Barret Leudke.

    “The municipality has taken direction from the (Timiskaming) Health Unit. So they’ve asked us to provide a venue and that’s what we did,” he noted in a telephone interview.

    Municipalities, he noted, have been “hosting the clinics in arenas, so that worked out well that we had that type of facility. It went relatively smooth from a tactical standpoint.”

    Leudke noted that the arena had the space, the floor plan from the health unit “on how to lay everything out,” and Temagami did its best to make certain that everything was in place to host the clinic.

    Read the full article here

  • Haliburton Highlands FHT vaccination clinic provides relief to elders: ‘overwhelmed and so thankful’

    Minden Times article published April 7, 2021

    By Sue Tiffin

    In just eight days, over about 40 hours, a team of people made up of physicians, nurses, paramedics, administrators, roads crew, volunteers and spouses of those team members vaccinated 1,946 people in Haliburton County.

    “It was a very successful few days,” said Kimberley Robinson, executive director and manager, Haliburton Highlands Family Health Team/Haliburton Family Medical Centre.

    The last clinic at the Haliburton Family Medical Centre was held March 30, as mass vaccination clinics are prepared to open in the upcoming weeks.
    The site was one that occasionally saw tears – not for the jab of the needle, but for the relief felt by our community’s older population – some born in the early 1930s – as some of the first Ontario residents to receive the COVID-19 vaccine one year into the pandemic.
    “They were simply overwhelmed and so thankful to be receiving the vaccine,” said Robinson. “Many people were relieved and excited. We heard from so many, how they are now one step closer to seeing their grandchildren, children, sister/brother. People commented that the clinic was not only efficient, but that every person they had contact with was so pleasant and kind. There were many kudos to the team.”

    To manage distributing leftover shots – vials of vaccine must be used in full or risk being wasted – Robinson said if leftovers were likely, the team first called patients who were booked the next day in the clinic to see if they might be able to come a day early; then searched the HFMC database to see if patients born in 1946 or earlier had been booked for a vaccination or had already received one and call them in if not; and if additional older residents could not be found, health care workers supporting the vaccination clinic who hadn’t received their first dose were vaccinated.

    The clinic required much support to run as efficiently as it did, and Robinson said that came together right from the entrance, with Dysart et al municipality supporting the event by providing paid parking passes for those attending the clinics, and members of the roads crew and park and rec directing traffic and handing out consent forms as people arrived.
    “All participants that I spoke with were honoured to be part of the COVID vaccine roll-out locally – including me,” said Robinson.

    Volunteers from Lakeside Church, spouses of other team members and county administrators screened and greeted patients, who were then coordinated by nurses. Medics in the observation area assisted with the checkout process and an administrator or clinician stood by in case of an adverse event. Staff from Haliburton Family Medical Centre, Haliburton Highlands Family Health Team and the Haliburton Highlands Health Services covered check-in, check-out, immunizing and observation. A nurse with Haliburton Highlands Health Services immunized each person – almost 2,000 participants, most people who were born prior to 1946.

    “I was overwhelmed by the gratitude,” said Robinson. “I was also overwhelmed by the support of my colleagues, our community partners, and others. Team members of the HHFHT and HFMC put aside their daily roles and responsibilities to work in the vaccination clinics, which meant long days and late nights. We had administrators with the County of Haliburton, roads crew, Haliburton County Paramedic Service medics and administrators, retired physicians, spouses of our team members, members of the Lakeside Church community, HHHS and Community Support Services. They just got it done. I am so proud to be part of such a spectacular team.”

    Locally, mass vaccination clinics will be held at the S.G. Nesbitt arena in Minden beginning April 6, and the A.J. LaRue arena in Haliburton beginning April 12.

    Read the full article here

  • Stay-At-Home Order Welcome But More Needed

    Stay-At-Home Order Welcome But More Needed

    Shared by the Primary Care Collaborative

    Primary Care Collaborative logos

    April 7, 2021 – The Primary Care Collaborative welcomes the Ontario Government’s announcement of new provincial measures to stop the alarming spread of COVID-19. While the vaccine rollout continues across the province, we are in a race against the variants, and bold action was needed to protect all Ontarians, particularly those most marginalized. We recognize the collective exhaustion with COVID-19 restrictions, including among primary care providers, yet the stay-at-home order is necessary if we are to turn the tide on the pandemic.

    A further step needed to slow the spread and halt the devastation of COVID-19 is provincial support for paid sick days, which would support staying home when ill. As well, we echo the Ontario Medical Association in urging those who are able to support their local restaurants and other small businesses by ordering food and other goods through delivery or curbside pickup. 
     
    This pandemic has shown time and again that COVID-19 will affect the most vulnerable among us. Primary care will continue to step up by providing care, staffing assessment centres, and now integrally involved in the vaccine rollout. We will do our part to ensure equity is front and centre in our response and we will work together with the Ontario Government and Public Health to end COVID-19. 

    Relevant links:

     

    About the Primary Care Collaborative (PCC):
    We are a coalition of primary care organizations collectively representing 14,000 family doctors, 1,000+ primary care nurse practitioners, 286 primary care teams, 28 Indigenous primary care teams, including northern, rural, and remote teams. This alliance of comprehensive primary care organizations joined together by common purpose to build on the collaborative work during the COVID-19 pandemic as we move towards recovery in a time of health system transformation. The PCC provides a collective and cohesive voice with the purpose of advancing equitable person-centred primary care in Ontario and is focused on influencing policy by creating a unified voice towards resolving barriers or challenges that prevent comprehensive primary care from being the foundation of the health system.

  • Bits & Pieces: respiratory care during COVID-19, Stay-at-Home order and more

    Bits & Pieces: respiratory care during COVID-19, Stay-at-Home order and more

    Your Weekly News & Updates

    In This Issue  
    • Respiratory care during COVID-19: what have we learned one year later, Apr. 21
    • Ontario needs a Stay-at-Home order
    • Member stories
    • Lessons learned from KFLA Moderna community vaccination clinics and more
    • UpToDate discount reminder
    • Evaluation and performance improvement for OHTs CoP and webinar
    • Upcoming events including improving the population health of people at risk or living with diabetic foot complications and more

     

    Respiratory care during COVID-19: what have we learned one year later, Apr. 21

    The COVID-19 pandemic has required healthcare professionals to change the way care is delivered and has allowed for the development of innovative practices and partnerships for the continued provision of quality care.

    On April 21 this webinar, co-hosted with the Lung Health Foundation, will highlight practice changes and considerations for the diagnosis and management of chronic lung diseases such as COPD. This includes highlighting the challenges of respiratory diagnostics such as spirometry testing and policies and changes that were needed to provide a safe testing environment.

    Find out more and register here.

    Ontario needs a Stay-at-Home order

    Ontario needs a Stay-at-Home order, community vaccination plans, and paid sick leave for ALL workers to stop spread of COVID-19 variants, reduce the burden on health care.

    Today the Primary Care Collaborative (PCC) issued a statement urging the government to do more to suppress the transmission of COVID-19, including these 5 vital actions:

    1. Move the province from a shutdown to a stay-at-home order
    2. Ensure vaccines are reaching those who are most at risk for infection and who need them the most
    3. Prioritize vaccination of teachers, educators and school staff
    4. Create a broad education and communications campaign to address vaccine hesitancy
    5. Implement paid sick leave for all essential workers now.

    Read the full statement here.

    Member stories

    Dr. Allan Grill on CTV

    Markham FHT– our president and chair Dr. Allan Grill on CTV on protecting schools from outbreaks and more

    Multiple members- our Twitter thread highlighting members’ vaccine efforts. One tweet already has nearly 20,000 views!

    Lessons learned from KFLA Moderna community vaccination clinics and more

    Recent updates include:

    We continue to update several pages on our site with resources and news:

    UpToDate discount reminder

    Thanks to our partnership with Wolters Kluwer, AFHTO members have access to special benefits on UpToDate®. Physicians, residents, NPs, pharmacists, and PAs are all eligible.  For more details, please contact your ED or Admin Lead.

    EDs and Admin Leads, if you have any questions, please email us at info@afhto.ca.

    Evaluation and performance improvement for OHTs CoP and webinar

    HSPN is hosting a new community for those working on evaluation and performance improvement in OHTs. You can join here.

    The next OHT Evaluation Webinar will be OHT Improvement Measures for Focus Populations on April 27. Register here

    Your role in improving the population health of people at risk or living with diabetic foot complications, April 15, 2021
    Co-hosted with Wounds Canada, this interactive webinar will provide an overview of your role to improve the population health of people at risk or living with diabetic foot complications across the full continuum of care settings to improve patient experience, outcomes and costs. Register here.

    Together We Care Virtual Conference, April 20-22, 2021
    Join the OLTCA & ORCA as they connect the LTC and retirement community sector to help shape the future of senior’s care.
    Find out more here.

    Building vaccine confidence in the Black community, evolving guidance, and more, Apr. 9, 2021

    The OCFP’s COVID-19 COP will focus on building vaccine confidence in the Black community.
    Find out more here.

    A Deep Dive into Co-Designing Care Models for your Priority Populations, May 6, 2021
    The RISE OHT webcasts will show how your OHT can re-design care for patients in your priority populations, and help every patient in those populations experience coordinated transitions between providers.
    Learn more here.