Blog

  • Temagami FHT Marks 10 Years In New Clinic HQ

     

     

    The Temiskaming Speaker article (PDF) published October 16, 2019

    TEMAGAMI (Special) — It’s been ten years since the Temagami Family Health Team moved into its new home. 
    The Temagami Medical Centre opened its doors on O’Connor Drive in the fall of 2009, at a construction cost of about $2.3 million. 
    It’s home to the family health team that has a roster of 1,450 patients. But it provides health care services to some 3,100 patients, including seasonal residents. 
    And like many families, it’s grown over the years. 
    Ten years ago, it consisted of physician Stephen Goddard, who began serving the com­munity in 1995, as well as a nurse practitioner and a receptionist. 

    Goddard, a nurse practitioner and receptionist are still there. 

    But they’ve been joined by a registered nurse, a mental health work­er, a registered dietitian-diabetes educator, a respiratory therapist, an occupational therapist, and a pharmacist. 
    There are also 4.5 administrative support professionals, including a part-time quality improvement support person and a full-time execu­tive director. 
    The team provides a long list of programs and services, including acute care, diabetes-focused visits, nutrition counselling, foot care, smoking cessation, and management of hypertension, COPD and asthma. 
    It offers grief support, anger management, and help to people cop­ing with depression, anxiety and stress. 
    Other services include falls prevention, foam rolling for chronic pain, custom splints, assistive device authorization, osteoporosis-related education and training, a memory clinic, and medication review with a pharmacist. 
    It utilizes telemedicine technology for psychiatry, dermatology and other services. 
    It works with the Timiskaming Diabetes Program and Lifelabs medic­al lab services as well as individuals providing massage therapy, chiro­practic care and physiotherapy. 
    In a news release, the team described its focus as chronic disease prevention and management, comprehensive primary care services, health and wellness promotion, communication and partnerships. 
    It recently established its first patient and family advisory council of six members of the Temagami community. 

    The council held its inaugural meeting August 8. 

    To view The Temiskaming Speaker article (PDF), click here.

     

  • Bits & Pieces: NP-led opioid prescribing, alcohol use disorder tool & more

    Bits & Pieces: NP-led opioid prescribing, alcohol use disorder tool & more

    Your Weekly News & Updates


    In this Issue:  
    • NP-led opioid prescribing

    • Alcohol use disorder tool

    • Opioids clinical primer update

    • Reminder- ED OHT mentorship program

    • Free online course on radon

    • Quality care for diabetic foot ulcers

    • Upcoming events on psychosis, sustainable eating and more


    NP-led opioid prescribing
    Mount Sinai Academic FHT has published “Improving Family Medicine Residents’ Opioid Prescribing: A Nurse Practitioner-Led Model” in the Journal for Nurse Practitioners.

    “After implementation of the model, we found a reduction in the average dose of opioids prescribed, increased use of urine drug tests and opioid treatment agreements, and fewer prescribers per patient. The nurse practitioner-led model was successfully implemented in an academic family practice with improvements in opioid prescribing and monitoring practices.”

    You can read the article here. Full access is valid until Nov. 27.


    Alcohol use disorder tool
    The Centre for Effective Practice has released the Alcohol Use Disorder (AUD) Tool, developed to walk primary care providers through screening, diagnosing, treating and communicating with patients who have, or are at risk of, developing AUD.

    The AUD Tool is one of several clinical tools developed as part of the multi-year Knowledge Translation in Primary Care Initiative.


    Opioids clinical primer update
    ‘Treating Opioid Use Disorder: Initiating Buprenorphine in Primary Care, ED and Inpatient Setting’ is the sixth and final course in the Opioids Clinical Primer program from Machealth.

    It helps clinicians address Opioid Use Disorder by providing background information and practical strategies that apply to any practice setting, including common considerations and contraindications to treatment, assessing withdrawal, and dose titration. This free course can be accessed at opioids.machealth.ca.


    Reminder- ED OHT mentorship program
    If you’re an executive director who’s part of a team that’s ‘in development’ or ‘in discovery,’ and would benefit from guidance or support from an ED who’s in full application, please complete this short survey by Friday, October 18. You’ll be connected with an ED who can offer insight on successes, challenges and lessons that they’ve been learning along the way.


    Radon machealth

     

    Free online course on radon
    For non-smokers, radon is the leading cause of lung cancer in Canada. Talking to your patients about the need to test their homes is an important part of preventing radon-related cancer. McMaster University has designed a free, certified program to provide you and your colleagues with reliable, evidence-based information on radon.

    Get started here.

     

     


    Quality care for diabetic foot ulcers
    Health Quality Ontario has released their finalized quality standard and patient guide on quality care for diabetic foot ulcers. Visit their website to learn more.


    ECHO Chronic Pain/Opioids evening series, Oct. 7- Nov. 4, 2019
    A 4-part evening ECHO series on Buprenorphine/Naloxone prescribing in primary care. Register here.


    RNAO events digest, Oct – Nov 2019
    In-person workshops and webinars are now listed on the AFHTO website. Topics range from best practice guidelines, substance use, pressure injury prevention and more. Find out more here.


    CBT for Psychosis Informed Workshop, Nov 2-3, 2019
    Join this 2-day workshop held by SSO in St. Catharines. Find out more here.


    Nutrition Connections Forum: Healthy and Sustainable Eating: Leading the Shift, Nov. 14, 2019
    Learn in this cross sectoral conversation on how we can shift to a healthier and more sustainable diet. Learn more here.

  • Trent Hills FHT earns Spotlight Award

    Northumberland News article published October 9, 2019

    By John Campbell, Brighton Independent.

    TRENT HILLS — Trent Hills Family Health Team (THFHT) has been recognized for its support of families living in rural areas.

    In announcing the winner of its Spotlight Award, the Association of Family Health Teams of Ontario said nurses at Trent Hills created the Well Baby program after realizing new mothers weren’t receiving the proper support or teaching many of them needed.

    Extending beyond the post-partum period to when the children are ready for school, the program enables mothers “to learn the numerous skills that are required to be parents,” and provides them “a safe place to ask their questions.”

    Mothers and babies are seen by the same nurse for each visit and for a longer period than they would with a physician, “which allows trust to build and offers mothers a chance to discuss their concerns,” the association said.

    It also frees up more time for family physicians and nurse practitioners “to see other patients with acute and chronic conditions.”

    The nurses provide breastfeeding support as well, and “work within their full scope of practice.”

    “We were very pleased to get that award,” said Carole Robichaud, a nurse practitioner and nursing supervisor at THFHT.

    The four-year-old program “is working really well … It’s something that’s really appreciated.”

    The program’s three registered nurses — Tammy Haig, Amy Clarke and Jo-Elle Nelson — work out of Campbellford, Warkworth and Colborne, and see their patients usually every two months (less frequently as the children get older).

    Visits last about 40 minutes.

    Brighton council challenged to take part in…
    The families “quite prefer seeing a nurse (because) they get that continuity of care,” and can use us as a resource until they require a doctor, Clark said.

    “It’s a very nice interaction that we get to have with families,” Haig said.

    “There are so many topics (that) come during a visit (at) different stages (of a child’s development),” Nelson said.

    The program has resulted in an uptick in immunization rates and “early recognition of issues, problems, abnormalities,” which leads to referrals to pediatricians and other specialists sooner, Clark said.

    “It makes a big difference for a rapidly growing child,” the association said.

    Parents “trust the nurse’s opinion, with regards to vaccinations (and their) importance,” based on the relationships that develop, Haig said.

    “It’s health insurance that your child will not get that disease and not die from that disease,” Nelson said.

    “It’s nice to be recognized for the work that nurses (do) and how much we contribute to the family health team,” Haig said.

    Sarah Fields is an enthusiastic supporter of the program, which she says is “fantastic.”

    She began using it following the birth of her oldest child, Emma, five years ago, and continued with her next two — Olivia, 3, and Madelynn, two months old.

    The program offers “a fountain of information by people who are just so knowledgeable and friendly,” she said. “They just get it.”

    It isn’t just about the child, added Fields.

    If she’s “struggling with something they have lots of connections to people they can set you up with, to make sure you’re OK as well,” she said.

    “Also, if there is anything that requires next level care they are very quick to make it happen, so there’s no delays or waiting.”

    THFHT was up for two other awards: For continuous care (it helps patients manage their chronic respiratory disease through each stage of their illness) and comprehensive team-based care (it offers a nutrition program for people to prevent or reverse lifestyle disease).

     

    To read the complete Northumberland news article, click here.

  • Annual Report 2019: Health System Integration Built on the Foundation of Team-based Primary Care

    In 2017, AFHTO engaged in a strategic planning exercise that led to the development of a 3-year strategic plan with a shared vision: high quality, sustainable, team-based primary health care for all.

    It is now 2019 – the final year of our strategic plan – and there’s significant change underway in Ontario as the health care system is restructured to deliver fully integrated, patient-centred care that’s co-designed by patients, families and caregivers alongside their health care providers. 

    In our 2019 Annual Report, we show the work done by AFHTO and our members on delivering team-based primary care, which is key to providing exceptional, coordinated care, and to alleviating pressures on the health care system. It demonstrates that this is the base on which a fully integrated health care system can be built. 

  • Windsor FHT’s Team Care Centre recognized for streamlining access to care

    Windsor Star article published October 4, 2019

    By Lindsay Charlton, Windsor Star

    The Windsor Team Care Centre has received provincial recognition for its work in improving access to interdisciplinary health care.

    The Windsor Family Health Team’s Team Care Centre — in partnership with the Canadian Mental Health Association — recently won the 2019 Bright Lights Award from the Association of Family Health Teams of Ontario in the category of Access to Care: Improving Team-Based Care.

    “The Team Care Centre is all about creating connections for both people and providers, and building on existing relationships of trust, while nurturing the development of new ones when and where people need them,” Claudia den Boer, CEO of the Windsor Essex County branch of the Canadian Mental Health Association, said in a news release.

    “When the team is in with the doctor, we know people get the care they need more easily, quicker, and from a team member who is working to their strengths.” 

    The Team Care Centre — at 2475 McDougall St. — works to create a streamlined experience for patients to have various medical and social support needs met without having to retell their story and details to each provider.

    Since opening its doors in January, the centre has worked with 122 doctors and nurse practitioners, receiving more than  1,800 referrals to team-based health care — with a focus on mental health and addictions.

    The team includes a psychiatrist, a nurse practitioner, social workers and counsellors, a respiratory therapist, a registered dietitian, and various other providers.

     

    To read the complete Windsor Star article, click here.

  • Bellville NPLC holds “Pap Party” for Cervical Cancer Awareness Week

    Quinte News article published October 3, 2019

    By Amanda Smith, Quinte News

    A local health initiative aimed at women returns again later this month.

    October 21 – 25 is Cervical Cancer Awareness week and there will be five local clinics holding a “Pap Party” aimed at catching cervical cancer in the early stages.

    Dr. Piotr Oglaza told the board over 748 women in Ontario are estimated to be diagnosed this year alone and 160 will die from the disease.

    He says the goal of the clinics are to catch cervical cancer early and intervene.

    The nurse practitioner led clinic in Belleville at 15 Victoria Avenue will be open from 1 – 8 p.m. on October 21 as part of this initiative.

    The four other clinics are: Bancroft on October 21, Tyendinaga on October 22, Kingston on October 23 and Napanee on October 24 all from 5:30 – 7:30 p.m.

    Cancer Care South East is leading this program and any woman without a family doctor or nurse practitioner who is interested in booking an appointment at any of the above clinic locations is asked to call Rachel at 1-800-567-5722 extension 7809 or CancerCareSE@KingstonHSC.ca

     

    To view the complete Quinte News article, please click here.

  • Bits & Pieces: Focus on City of Lakes FHT, members in the media & more

    Bits & Pieces: Focus on City of Lakes FHT, members in the media & more

    Your Weekly News & Updates


    In this Issue:  
    • Focus on City of Lakes FHT
    • Youth Opportunities Fund registration deadline Oct. 9
    • Executive Director OHT Mentorship Program
    • Members in the media
    • Collaborative Governance workshop slides
    • Ontario Health Team digital supports
    • Call to create transition fund to support patient medical homes in primary care
    • Call for applications – TUTOR-PHC 2020
    • ECHO Concussion pilot
    • Upcoming events focused on physiotherapists, social workers and more

    Focus on City of Lakes FHT

    City of Lakes video

     

    City of Lakes FHT has shared a video that covers their mission, vision and introduces their interdisciplinary healthcare team and services. Watch it on our site.

     

     

     


    Youth Opportunities Fund registration deadline Oct. 9
    Ontario Trillium Foundation’s (OTF) Youth Opportunities Fund (YOF) announced the deadlines for three grant streams.

    AFHTO members may be eligible for the System Innovations Stream, which supports collaboratives that are strengthening the quality and responsiveness of systems so they work better for youth facing systemic barriers.

    Organization Registration Deadline: Oct. 9, 2019
    Grant Application Deadline: Nov. 6, 2019
    Up to $250,000 per year
    2 to 6 years


    Executive Director OHT Mentorship Program
    Many changes are happening across the health care sector, and teams are at varying levels of planning and participation in the development of an OHT.

    If you’re an executive director who’s part of a team that’s ‘in development’ or ‘in discovery,’ and would benefit from guidance or support from an ED who’s in full application, please complete this short survey by Friday, October 18. You’ll be connected with an ED who can offer insight on successes, challenges and lessons that they’ve been learning along the way!


    Members in the media

    Belleville NPLC: holding a “Pap Party” during Cervical Cancer Awareness week

    East Wellington and Guelph FHTs: feature on the Guelph and Area OHT

    Minto Mapleton, Mount Forest and Upper Grand FHTs: Minto council receives report on Rural Wellington Ontario Health Team

    North Durham FHT: Durham continues to push for an Ontario Health Team

    Windsor FHT: feature on their Bright Lights award-winning team care centre


    Collaborative governance workshop

     

    Collaborative Governance workshop slides

    The slides from this Sep. 17 preconference workshop, Collaborative Governance: Moving at the Speed of Trust, which explored different ways of approaching the initial governance structure of an OHT, are now available on our site.

     

     


    Ontario Health Team digital supports
    The eHealth Centre of Excellence (eCE) is committed to supporting the OHTs throughout the application and selection process. To understand exactly how the eCE can support OHTs with the digital health components outlined in the full application, read eCE’s Role in the Full OHT Application.  


    Call to create transition fund to support patient medical homes in primary care

    On Oct. 3 leaders from the Canadian Association of Social Workers, the Canadian Medical Association, the Canadian Nurses Association and the College of Family Physicians of Canada called on federal party leaders to commit to establishing a targeted $1.2 billion Primary Health Care Transition Fund. Read the news release here.


    Call for applications – TUTOR-PHC 2020
    Transdisciplinary Understandings and Training on Research – Primary Health Care, is a one-year, pan-Canadian interdisciplinary research capacity building program that has been training primary and integrated health care researchers and decision-makers from family medicine, nursing, psychology, epidemiology, social work, occupational therapy, education, policy and many other disciplines since 2003.

    The call for applications is open to graduate students, post-doctoral fellows, mid-career clinicians, and decision makers in primary health care. For more information, please go to the website. Please contact Project Coordinator, Rob Van Hoorn (tutor@uwo.ca) if you’re interested in applying. Deadline is Dec. 2, 2019.


    ECHO Concussion pilot
    Starting Nov. 13, ECHO at UHN will be launching a NEW 10-session pilot on Concussion. The series will focus on diagnosing and managing patients with concussions and applying the current guidelines.

    This is online interactive case-based learning fully funded by the Ministry, where you will connect with an inter-professional team of experts including physiatry, neurology, neuropsychiatry and family medicine. To register or find out more, visit their site.


    Essential Skills For Social Work With Groups, Oct. 14- Dec. 10, 2019
    A 4-part modular course to expand existing social work knowledge and refine group work skills, held by the OASW. Learn more here.


    Liver Disease in Primary Care: Approach to Fatty Liver, Oct. 17, 2019
    Part of ECHO Liver quarterly evening series. Find out more here.


    PHC Connect, Nov. 8, 2019
    Physiotherapists working in primary health care organizations across Ontario are invited for an interactive day of networking, professional development, and discussion hosted by the Ontario Physiotherapy Association at Burlington FHT. Attendees will hear from guest speakers about the changing health environment, the impact, and opportunities for primary health care and physiotherapists working in this sector. Click here for more information and to register. For any questions, please contact Maryam Ahmed at mahmed@opa.on.ca.


    Annual Toronto Geriatrics Update Course, November 1 & 2, 2019
    Learn about topics such as osteoporosis updates, capacity assessments, managing dementia and reducing falls among older patients. Hosted by the Sinai Health System and UHN. Coupon code available here.

  • Focus on City of Lakes FHT

    City of Lakes FHT is pleased to share a video that covers their mission, vision and introduces their interdisciplinary healthcare team and services.

    Whether or not you’re their patient, you may not be aware of all the things they do. From services to programs to digital health, they’re constantly working to create a better healthcare experience for their patients.

     

    For more information on City of Lakes FHT, please visit their website.

  • QI in Action eBulletin #91: Breast Cancer Screening

    In this issue

    • What is Breast Cancer?
    • Recommendations on Breast Cancer Screening
    • Initiatives by Teams
    • Resources and Research
    • Support Services for Patients and Caregivers
    • Upcoming QI Events
    • Other Resources

    What is Breast Cancer?

    • Breast cancer starts in the cells of the breast and be described in two ways1:
      • Invasive: breast cancers that grow past the walls of the milk duct and into the surrounding tissues1
      • Non-Invasive: breast cancers that remains contained within the walls of the milk duct1

    Recommendations for Breast Cancer Screening

    • Canadian Task Force on Preventive Health Care recommends:
      • The Task Force recommends against screening women aged 40 to 49 years old
      • The Task Force recommends in favour of screening women aged 50 to 74 years with mammography every 2-3 years
    • HQO recommends magnetic resonance imaging as an adjunct to mammography for breast cancer screening in women at less than high risk for breast cancer  
    • HQO recommends ultrasound as an adjunct to mammography for breast cancer screening

    Initiatives by Teams
    Our teams are doing some great work with breast cancer screening. Below are some initiatives that your team can implement if you’re looking to enhance cancer screening.

    • Quarterly Reconciliation between the EMR and SAR reports
    • EMR queries to search for patients overdue for their screening
      • With EMRs teams are also documenting whether breast cancer screening was offered and if the patient declined
    • Using flags within EMRs generated via queries
    • Broadcasting a message via HealthMyself or OCEAN to patients
    • Integrating cancer screening promotion into flu shot clinics while patients wait for 10-15 minutes post immunizations

    Resources and Research

    Support Services for Patients and Caregivers

    Upcoming QI Events:

    Other Resources:

    • The eHealth Centre of Excellence (eCE) is committed to supporting the OHTs throughout the application and selection process. To understand exactly how the eCE can support OHTs with the digital health components outlined in the full application, read eCE’s Role in the Full OHT Application.  
    • Speak to a drug information pharmacist for any questions about opioid tapering, switching, interactions and withdrawal through the Opioid Prescribing Hotline.

    References

    1. Breast Cancer. (2019, June 11). Retrieved from https://www.cancercareontario.ca/en/types-of-cancer/breast-cancer .

    In Case You Missed It: Check out eBulletin #90 or other back issues here!
    Questions? Comments? Contact us at improve@afhto.ca.

  • Virtual Clinic coming to Elliot Lake Family Health Team

    Elliot Lake Today article published September 17, 2019

    By Brent Sleightholm, Elliot Lake Today

     

    Family Health Team responds to crush of patients without doctors in Elliot Lake

    Elliot Lake’s Family Health Team representing 10 family physicians along with two nurse practitioners and a cadre of other health care providers, allied staff who work with them, is looking for $72,000 from the City to set up a virtual health clinic at their downtown facilities, next year.

    The clinic, said health team Executive Director Nancy Ewen, would operate five days a week, weekdays, with Dr. Maria Celia Raquel Lopez interacting with Elliot Lake non-rostered patients on a video link.

    Ewen said Lopez has previously served as a locum (a person who stands in for an absent doctor) in their clinic. Non-rostered patients are patients who do not have a family doctor.

    The health team’s initial ask is $300 a day, two days a week, to fund the trial project which will run from the last week in September through the end of December, this year. As well, the health team wants City Council to approve spending $72,000 in 2020 which Ewen said it would cover their operating expenses for the five-day-a-week program next year.

    The virtual clinic concept was raised at Monday afternoon’s meeting of the Elliot Lake Finance and Administration Committee.

    The Committee voted unanimously in favour of a $3,900 trial for the rest of this year and a priority spot on the 2020 city budget roster for $72,000 for all of next year. Two members of the standing committee, Mayor Dan Marchisella and Councillor Chris Patrie, were absent from the meeting. The recommendation will go on to City Council. The City’s budget process is expected to get started in October.

    “They (virtual clinics) are temporary solutions to deliver care to non-rostered patients,” Ewen told the committee. “Virtual clinics are popping up all over Ontario.”

    “A couple of cases I have heard of, New Liskeard has had a successful virtual clinic,” she said.

    Once a doctor was recruited there the virtual patients were absorbed into the new practice and the New Liskeard virtual clinic was disbanded, Ewen added.

    “Peterborough still has a virtual clinic in place, looking after non-rostered patients and Kapuskasing has something called a locum clinic, where they actually bring in locums, so it’s not virtual,” she said.

    “At the Family Health Team, we were established in 2007. We have 10 family physicians on site right now. Three of these are over the age of 65. Three are between 55 and 65 so they are starting to wind down, starting to look at retirement.” She added that the health team has some 10,000 rostered patients who come through their doors every month.

    The elephant in the room, though, was the crush to the system from the estimated 1,300 non-rostered patients who live in Elliot Lake.

    Ewen provided that figure which she said was derived from the Ontario Ministry of Health and Long Term Care, “As well as conversations with our physicians.”

    The virtual clinic will be operated on the second floor of the health team’s downtown headquarters.

    Later in the meeting, during the public question period, Elliot Lake resident Mike Thomas told the committee he had been an advocate of the clinic idea for years. He said, “I think that would be great.” But at the same time, he wondered if the virtual clinic would be effective.

    He added that he has seen both sides of the Elliot Lake healthcare system, as a non-rostered patient and one who is rostered with a doctor. In Mr. Thomas’ words, “As you know, I was in an accident in 2017. Some of the forms, prescriptions, referrals, they’re pretty tough.” 

    Thomas went on, “I don’t see that changing, with the transfer to a rostered patient.” Regarding the virtual clinic platform from ELFHT, Mr. Thomas said, ” I wish we could bring more of their services forward. We need to know how much of their services they’re going to roll over.” He also said he believes the Health Ministry’s estimate of 1,300 non-rostered patients in Elliot Lake is low.

    “We have had a non-opioid policy as long as I’ve been here,” Thompson said.

    He wondered how family health team physicians would be able to carry out prescription requisitions for senior retirees, many of whom have been prescribed opioids elsewhere, in light of the family health team’s strictures.

    “So are you going to get into the details of that when it goes forward to Council?” he asked the committee.

    “For any of those people, those seniors, who come to Elliot Lake, are you going to have them write their prescriptions? Because most of their prescriptions are opioids,” said Thomas.

    Committee Chair Councillor Norman Mann responded. 

    “On an operational level, it is up to the Elliot Lake Family Health Team Directors to decide how to proceed,” Mann said. “So I would suggest their Board of Directors will decide on the clinic and what form of mandate it will have. That is not something I can discuss.”

    “But (The City) as a funder of the Elliot Lake Family Health Team, we would ask them for their consideration of your concerns.”

    Ewen said she needs an answer from the city on the Elliot Lake Family Health Team clinic funding proposal by November.

    To read the complete Elliot Lake Today article, click here.