Ultimate Blogging Championship

Tag: Access to Care

  • QI in Action eBulletin #122: Clinically Appropriate Use of Virtual Care in Primary Care

    In this Issue:

    • Phase One Guidance for Clinically Appropriate Use of Virtual Care in Primary Care
    • Wawa FHT in the News
    • Canada-Wide Study on Health Equity and Virtual Primary Care
    • Upcoming Events

     

    Phase One Guidance for Clinically Appropriate Use of Virtual Care in Primary Care
    Content below developed by Ontario Health and edited for length

    Dr. David Kaplan, Vice President, Quality, at Ontario Health, and Co-Chair of the Primary Care Expert Panel for Guidance for Clinically Appropriate Use of Virtual Care, explains how the guidance was developed, informed and why it can be a helpful resource for primary care clinicians.

    Q: Why is Ontario Health developing guidance for clinically appropriate use of virtual care?
    A:  As we know, the COVID-19 pandemic spurred the necessity for the health care system to pivot and rapidly adopt new ways of using available technology to reach patients and deliver care. While this was an extraordinary feat and has paved the way for the innovation we are seeing within health care, there have been reports of variation in practice and clinicians and patients alike have questions about the ‘best’ uses of virtual care. To address some of the questions about virtual care and put the learnings gleaned over the pandemic into practice, we, at Ontario Health, thought it would be helpful to build on the work previously conducted by the Ontario Telehealth Network (OTN) and provide some new guidance to clinicians around virtual care.

    The Ministry of Health provided funding to Ontario Health to undertake this work and develop guidance for clinically appropriate use of virtual care. While important for all specialties, we started with developing virtual care guidance for primary care because we felt it had the potential to reach more people across Ontario and have the most impact. Over time, Ontario Health will develop tailored guidance documents that apply to other specialties.

    Q: What does the guidance include?
    A: The Phase I Guidance is expected to be released this fall. These materials are intended to be used by primary care clinicians and lays the foundation for decision-making around use of virtual care, patient-centric approaches, and respecting clinicians’ comfort with virtual care. The guidance also outlines the supports available to both clinicians and patients related to virtual care. Patient-facing ‘tools’ have been developed to complement the guidance materials and can assist clinicians to explain virtual care, the various modalities of virtual care and support patients to decide if virtual care is appropriate for their needs. We want clinicians to feel confident in their decisions related to virtual care.

    Q: How has the guidance been developed?
    The development of the guidance was modeled after related work led by Ontario Health, such as Quality Standards and Person-Centred Virtual Cancer Care Clinical Guidance. A review of statements, policies and standards set out by professional regulatory agencies, an inventory of existing guidelines and evaluation of these guidelines against a method for determining strength of this guidance, and a scoping review was conducted. We also looked at available data to determine how virtual was being used in Ontario to help inform our work.

    A primary care-specific expert panel was also established to help give direction to this work and included a mixed membership of primary care physicians, nurse practitioners and patient partners. It was important to our project team to include people from each of the six Ontario Health regions so we could be inclusive of and capture how primary care exists and is practiced across the province.

    Q: How has the use of virtual care shifted?
    A: Before March 2020, clinicians had regularly used the telephone for sharing lab results and refilling medication prescriptions. Video was being used, but primarily by specialists in Ontario and only if certain conditions were met. It was also used by primary care clinicians, though on a smaller scale. Virtual care in this context wouldn’t have been considered ‘mainstream’ until the pandemic.

    Through work we conducted with INSPIRE-PHC, a research group based out of Queen’s University, we’ve been monitoring use of telephone and video primary care delivered by clinicians. Recent data demonstrates virtual care continues to see uptake and use in primary care settings. This is a formative time for the evolution of virtual care in primary care and Ontario Health’s guidance can support primary care clinicians to take a systematic, stepwise approach to planning and delivering virtual care.

    The Guidance for Clinically Appropriate Use of Virtual Care in Primary Care is expected to be released later this Fall and we will share once they are available.  

    Wawa FHT in the News
    In a twist on the traditional rural-to-urban referrals, Wawa FHT received a request for help from a nearby urban centre. With no providers delivering medical abortions in the city or surrounding area, Wawa FHT expanded their medical abortion program to include a virtual component and provide care to this underserviced urban population. The team won a 2022 Spotlight Bright Lights Award and has been featured on CBC News.

    Canada-Wide Case Study on Health Equity and Virtual Primary Care
    Dr. Jay Shaw is leading a project with the Canadian Network for Digital Health Evaluation that aims to gain insights into how primary care organizations across Canada have successfully incorporated health equity into virtual primary care design, implementation, and delivery. The Primary Care Research Network is inviting primary care organizations across Canada to participate in a 30-to-40-minute phone interview about how equity considerations were incorporated when they implemented virtual primary care. For more information, email the research coordinator, Simone Shahid, at WCH.

    Upcoming Events
    Guidance for Clinically Appropriate Use of Virtual Care
    Wednesday, November 9, 2022, 8-9 am
    Please join Dr. David Kaplan and Dr. Risa Bordman from the Primary Care Expert Panel – Guidance for Clinically Appropriate Use of Virtual Care, as they present the third of a 3-part series on the Guidance for Clinically Appropriate Use of Virtual Care.  Please register in advance.  

    Primary Care Report: Using Data for Improvement – a focus on using the opioid prescribing indicators to drive improvements in patient care
    Thursday, November 10, 2022, 12-1 pm
    Ontario Health is hosting a webinar for primary care providers on using the opioid prescribing indicators in the MyPractice: Primary Care report to drive improvements in patient care. Please REGISTER HERE to join the session. This is the fourth installment of an accredited series that will focus on using data from the MyPractice: Primary Care report for quality improvement. This 1-credit-per-hour Group Learning program has been certified by the CFPC and the Ontario Chapter for up to 1.0 Mainpro+Ⓡ credits.

    Supporting Caregivers Supports Patients- The Critical Role of Primary Care in Preventing Caregiver Burnout
    Thursday, November 24, 2022, 12-1 pm
    Primary care providers can play a key role in preventing burnout and enhancing caregiver well-being by initiating early interventions and connecting caregivers to support. Co-hosted by The Ontario Caregiver Organization and the Primary Care Collaborative, this webinar will include insights from a caregiver with lived experience, as well as examples of primary care initiatives across Ontario that are connecting caregivers to support. Click here to register.

    Highlights and Implications of the Ontario Science Table’s Brief on Primary Care
    Wednesday, November 30, 2022, 7:45-8:45 am
    On October 3, 2022, the Ontario COVID-19 Science Advisory Table (OST) released its final brief, a 3-part exploration of how primary care responded to and was affected by the pandemic, and implications for ongoing health system planning and policy. In this webinar, you will hear from a panel of primary healthcare experts who contributed to that brief, as they share some of the most significant findings and implications. To register, click here.

    Climate Conscious Inhaler Prescribing
    Thursday, December 8, 2022, 12-1 pm
    This webinar will explore the carbon footprint of healthcare systems and how inhalers contribute to it, examine two problems related to inhaler prescribing and imagine practice change that results in an immediate reduction in emissions: “high value, low carbon care”. To register, click here.

     

    In Case You Missed It: Check out eBulletin #121 or other back issues here!
    Questions? Comments? Contact us at improve@afhto.ca.

  • Bits & Pieces: social worker focus groups and more

    Bits & Pieces: social worker focus groups and more

    Your Weekly News & Updates

    In This Issue  
    • Social worker focus groups at #AFHTO2022
    • Resources needed for library refresh
    • Hamilton FHT Green Initiative
    • Member stories
    • Want to come to #AFHTO2022 for free?
    • COVID-19 vaccination for kids under 5 materials and more
    • Free online module- Management of Transient lschemic Attack (TIA) and Minor Stroke
    • ECHO Ontario Mental Health Fall 2022
    • Call for abstracts- Trillium Primary Health Care Research Day
    • Upcoming events including Wellness Check: Dealing with Transitions and Managing Stress and more

    Social worker focus groups at #AFHTO2022

    Content below provided by University of Toronto

    We want to hear your thoughts on how social work practice is organized and supported in primary care! Take part in a 60-minute focus groups with other social workers to discuss how social work practice has shifted during the pandemic. We’ll be hosting focus groups in-person at the AFHTO 2022 Conference and invite you to join the discussion. Please note the in-person focus groups are for conference attendees but we’ll also host online focus groups for social workers who are not attending the conference.

    To participate, please email Simon at sck.lam@utoronto.ca by Friday, September 9 and let us know if you will be attending the conference.

    This study from the University of Toronto is led by Dr. Rachelle Ashcroft, Associate Professor at the Factor-Inwentash Faculty of Social Work and supported by the Association of Family Health Teams of Ontario and the Ontario Association of Social Workers.

    Resources needed for library refresh

    We’re hoping you can help us update our members’ resource library! As you know, AFHTO maintains an extensive web-based library of resources for our members. This includes sample policies, agreements, and resources that have been contributed by members for members and/or developed by third-party affiliates. We’re reviewing and refining the resources to ensure the website layout is simple, intuitive, and helpful, as well as current and accurate.

    We’re asking you assist in the collection of sample documents that would be shared on our website such as:

    • Finance Policy Manuals
    • Operations Policy Manuals
    • HR Policy Manuals
    • Strategic Plans

    Please forward any sample resources to Alexander Christy at alexander.christy@afhto.ca. Members with any questions are welcome to contact Bryn Hamilton.

    Hamilton FHT Green Initiative

    Screenshot of video- Hamilton FHT logo with 'Green Initiative' underneath

    The HFHT Green Initiative is an interprofessional team developing practical solutions to improve patient health care outcomes while simultaneously reducing climate change.

    The initiative provides a free and evidence-based program which includes an action-based checklist, poster orders (1148 so far delivered), a monthly newsletter (17 sent so far), a CFPC Mainpro+ accredited webinar series (212 attendees thus far), an infographic series (31 different topics), 2 waiting room videos, 2 EMR-embedded prescription templates, patient facing group education, resource kits, and project support. For more information, please contact the HFHT Green Team at green.team@hamiltonfht.ca.

    Member stories

    Essex County NPLC – calls to open more nurse practitioner-led clinics in Windsor-Essex

    Georgina NPLC – PORTRAITS OF GIVING: Beth Cowper-Fung

    Hamilton FHT – new family doctors are opening a Hamilton Mountain clinic

    Want to come for free?
    We have several openings for program hosts. These volunteers help keep our sessions on track and get complimentary registration in return. See the role description here and email paula.myers@afhto.ca if you’re interested. Deadline Aug. 31, 2022.

    COVID-19 vaccination for kids under 5 materials and more

    Recent updates include:

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

    Free online module- Management of Transient lschemic Attack (TIA) and Minor Stroke

    The West GTA Stroke Network team has developed a Free Online E-Learning Module on the Management of Transient lschemic Attack (TIA) and Minor Stroke: The Latest Best Practice! The target audience is primary care physicians. Learn more here.

    ECHO Ontario Mental Health Fall 2022
    Registration for Fall 2022 programming for ECHO Ontario Mental Health at CAMH and U of T is now open. Find out more and register here.

    Call for abstracts- Trillium Primary Health Care Research Day
    You can submit your research for presentation at the 2022 Trillium Primary Health Care Research Day, Oct. 14. Deadline Sep. 30, 2022. Find out more here.

    Wellness Check: Dealing with Transitions and Managing Stress Sep. 15

    Hosted in partnership with the Canadian Mental Health Association Ontario, participants will have the opportunity to gain insight into change processes and their impact on workplace mental health. Learn more and register here.

    Infant and Early Childhood Mental Health: A Three-Part Series, starting Sep. 15, 2022
    Hosted by ECHO Ontario Child and Youth Mental Health. Register here.

    Immunizations Across the Lifespan, Sep. 17, 2022

    Hosted by Canadian Collaborative Research Network for family physicians and pharmacists. Register here.

    OMGMA Conference 2022: Together Again, Sep. 21- 23, 2022
    In-person event in Mississauga. Register here.

    OMD Digital Health and Virtual Care Conference, Sep. 29-30, 2022
    Virtual conference hosted by OntarioMD. Find out more here.

    AFHTO 2022 Conference, Oct. 12, 2022

    Join your peers from across Ontario and beyond as we reconnect and reimagine, moving forward together.

    Members get more than 50% off registration. Register with your verification code here.

  • 2022 Conference Themes

    2022 Conference Themes

    Tectonic shifts: rebuilding primary care in a new world
    (more…)

  • Infection Control Resources and Tools

    Originally posted Mar 10, 2020. Last updated June 15, 2022 *NEW*

    We have created a list of infection prevention and control tools and resources. New and updated resources will be added to the top of each list as they become available.

     

    IPAC shareables

    Public Health Infection Prevention and Control resources

    Public Health Ontario and other organizations have provided Infection Prevention and Control (IPAC) resources to help build capacity in primary care:

    Personal Protection 

     

    Clinical Office Practices 

    For general and public-facing infection recommendations, see the COVID-19 information for Patients, Caregivers and the Public page

     

    Screening Tools  *NEW*

    Guidance
     
    EMR Screening Forms & Toolbars
    • Telus PS Toolbar | Dr. Adam Stewart, Central Hastings FHT/FHO
    • Telus PS & OSCAR | eCE, Updated April 22, 2020
    • P&P | Hamilton FHT
      • Instructions on how to import here
    • Accuro
      • The form has been published to the Accuro database; search for “Coronavirus COVID-19 Screening April22202” – created by eCE 
    Other Screening tools

     

    Testing

    Other Resources

    Research

     

    Some resources have restricted access: * Members-only resources, ** Triad-only resources

     

    Return to: Novel Coronavirus (COVID-19) Updates

    Disclaimer: The information in this resource centre represents general guidance developed by AFHTO and their partners, gathered through a rapid, non-systematic scan of relevant and valuable guidelines with an intent to support you in a timely fashion. The information reflects best knowledge at the time of writing and is subject to revision based on rapidly changing circumstances and conditions. As new best practice evidence emerges, recommendations may evolve. The resources above should be considered supplementary guidance and are not meant to replace clinical judgement or organizational directives.

  • AFHTO’s Response to Ontario’s 2022 Spring Budget

    TORONTO, April 29, 2022 /CNW/ – On behalf of the Association of Family Health Teams of Ontario (AFHTO) members across the province, AFHTO welcomes the investments in home care, mental health care, and health human resources in the 2022 Ontario Budget, Ontario’s Plan to Build.

    The investments will help strengthen the critical areas of home care and mental health care in our health system and expand access to care. AFHTO also recognizes that the government understands the need to invest in the health care workforce, while building the health human resources workforce of the future, specifically in underserviced communities. However, the challenges in primary and community care remain significant given lower funding and salary limits. AFHTO continues to urge the Ontario government to expand access and funding to team-based primary care to provide comprehensive care for Ontarians.

    “Home care and mental health need substantial rebuilding, and we commend the government for these investments,” said Kavita Mehta, Chief Executive Officer, AFHTO. “But seniors managing multiple conditions and medicines, people suffering from mental health challenges, and parents caring for children with chronic conditions need an integrated primary care team that can work hand-in-hand with patients to provide comprehensive and coordinated care. It is time to ensure every Ontarian who needs it has access to team-based primary care.”

    Only one in four Ontarians have access to team-based primary care, which offers more timely access to care, better coordination of care, and cost savings for the health system. An investment in team-based primary care – something the government has not committed to in recent years – is an investment in better seniors’ care, improving access to mental health care, and improving health outcomes.

    AFHTO is calling on the government to invest an additional $75 million per year for the next 10 years in team-based primary care. The healthcare system is complex, each patient’s needs are unique, and a team approach meets these needs. Without access to team-based primary care when needed, too many people fall through the cracks, negatively impacting their health and increasing costs to our healthcare system.

    “Evidence shows it can cost the province three times more to care for a patient who is unable to access high-quality team-based care. Yet only one in four Ontarians have access to an interprofessional care team,” said Clarys Tirel, President & Chair, AFHTO. “Interprofessional primary care teams are there for populations that need support the most – regardless of where they live – such as seniors, those dealing with mental health challenges, and people with chronic illnesses. When it comes to better access to care, it takes a team. We need further investments in team-based primary care.”

    Along with our partners in primary and community care, AFHTO will continue to work with the Ontario government, and all political parties heading into the 2022 Ontario election, to ensure that our health system provides access to team-based primary care for every person who needs it.

    For further information: kavita.mehta@afhto.ca

    Relevant Links:

  • Paxlovid Prescription Forms

    Dear Members,

    Partnering For Quality and the eHealth Centre of Excellence have developed resources for PS Suite, Oscar and Accuro to help with Paxlovid prescriptions and referrals. See below for prescription forms and additional resources. 

     

    PS Suite: (Designed by Partnering For Quality)

    1. Download the package: Click here
    2. Unzip the .cfm file to your Desktop
    3. Import the .cfm file into PS Suite

    Oscar: (Developed by eHealth Centre of Excellence)

    1. Download the package: Click here

    2. Import the full .zip package into Oscar

    Accuro: (Designed by Partnering For Quality)

    Found in the global forms list

    Name: Paxlovid Prescription- 04122022- DC

    Publisher: wejerrett

    Date: April 13, 2022

    PDF version: Click here

    For more clinical guidance on prescribing Paxlovid, click here. 

     

    Yours in Good Health,

    The AFHTO Team

  • Prescribing Paxlovid, Fourth Doses and Additional Resources

    Dear Members,

    As COVID-19 hospitalizations and cases continue to rise across the province, the reality of this sixth wave of the pandemic is taking hold with this highly transmissible BA.2 sub-variant of Omicron. Ontario approved fourth doses of the COVID-19 vaccine for those eligible and has now made it possible for physicians and Nurse Practitioners to prescribe Paxlovid that can be dispensed in community pharmacies. As we head into what will be a difficult spring, please see below for some additional resources and updates you may find helpful.

    Prescribing Paxlovid
    An individual with a valid prescription for Paxlovid is eligible to receive publicly funded Paxlovid if they live, work, or study in Ontario or are here for an extended stay. They also need to meet the applicable clinical criteria outlined in the Ontario Health Guidance for providers on access to COVID-19 antiviral treatment.

    An individual is not required to have a valid Ontario health card or be an Ontario Drug Benefit Program recipient to receive publicly funded Paxlovid. Community pharmacies across the province are still onboarding to dispense Paxlovid and you can find which locations already have the antivirals on the Ministry site. Paxlovid is also available at all provincial Clinical Assessment Centres.

    Below are some resources you may find helpful:

    In their President’s Message yesterday, the Ontario College of Family Physicians highlighted key details to keep in mind with the rollout of Paxlovid prescribing, including additional clinical tools that would be helpful in determining patient eligibility for the antivirals.

    Rolling out fourth doses of COVID-19 vaccines
    On April 7th, the Ministry expanded eligibility for fourth doses (second booster dose) of the COVID-19 vaccine to include individuals aged 60 years and over as well as First Nation, Inuit and Métis individuals and their non-Indigenous household members aged 18 and over. Additional considerations include:

    • A fourth dose should be offered to those who received their third dose (first booster dose) five months (140 days) prior. The minimum interval for the fourth dose (second booster dose) is three months (84 days).
    • To maximize the immune response of the vaccine after a COVID-19 infection, it is recommended that individuals wait three months (84 days) after they tested positive, or their symptoms started.
    • At this time, it is not recommended to administer a fifth dose (second booster dose) to immunocompromised people.

    As a reminder, if  you would like to administer vaccines in your clinic so please connect with your PHU operational lead for information if you haven’t yet done so.

    Events
    IPAC Strategies To Ensure A Safe Environment In Primary Care Clinics
    The Primary Care Collaborative has partnered with Public Health Ontario to provide an infection prevention and control (IPAC) information webinar to those working in clinical office settings. In this webinar, practical IPAC strategies for ensuring a safe environment for patients, clinicians, and staff will be reviewed and evidence-based resources will be introduced to support the ongoing development of a complete IPAC program for this practice setting. Such an IPAC program will be responsive to current concerns related to the COVID-19 pandemic, as well as routine infection risks in the clinical office environment.
    Date & Time: Thursday April 14, 2022 12:00 p.m. to 1:00 p.m.
    Speaker: Dr. Jeya Nadarajah, IPAC Physician, Science and Public Health, Public Health Ontario

    Please register here.

    COVID-19 Community of Practice: All About Paxlovid
    The next OCFP/UofT DFCM CoP will be all about Paxlovid.
    Date & Time: Friday, April 22, 2022 from 7:55 a.m. to 9:15 a.m.
    Speakers: Dr. Sohal Goyal, Family Physician, West Mississauga Medical, Dr. Kelly Grindrod, Pharmacist and Associate Professor, University of Waterloo School of Pharmacy and Dr. Andrew Morris, Medical Director, Antimicrobial Stewardship Program, Sinai Health System/University Health Network.

    Please register here.

    Ontario Health Primary Care and COVID-19 Support CoP
    Ontario Health has a monthly series that will run every second Wednesday April to December. Its objectives are:

    • Provide updates on new guidance and initiatives affecting primary care.
    • View presentations and ask questions related to COVID-19 response and recovery initiatives within primary care.
    • Learn from and connect with your peers.

    Please register here.

    Alliance for Healthier Communities
    On April 5, 2022, the Alliance held a webinar on COVID-19 and indoor air quality – how community spaces can reduce transmission using ventilation, filtration, and ultra-violet disinfection. Click here to access the recording.

    New and Updated Resources

    Last week, the Ontario government announced the launching of a suite of supports for Ukrainian families arriving under the Canada-Ukraine Authorization for Emergency Travel. The supports available include Ontario Health Insurance Plan (OHIP) coverage. Please find the news release here and additional information on coming to Ontario from Ukraine here.

    The Ministry has developed the guidance document Ukrainians Fleeing War: Early Assessment Considerations for Primary Care Providers. This document is intended to support primary health care providers in their early assessments and care of individuals arriving in Ontario who have been displaced due to the war in Ukraine.

    There is a lot going on and we know you are exhausted. Heading into these ongoing waves is a constant reminder that this virus has no timetable around an end date, and we need to continue to remain vigilant to reduce its spread. Once again thank you for all you are doing to keep your patients and the community safe. If you need any assistance or have any questions, please do not hesitate to contact us. Stay safe.
     
    Yours in Good Health,
    The AFHTO Team

  • Bits & Pieces: Happy Nutrition Month and more

    Bits & Pieces: Happy Nutrition Month and more

    Your Weekly News & Updates

    In This Issue  
    • Happy Nutrition Month
    • Where do we go from here? Understanding the impact of preventive screening backlogs video
    • Implications for primary care with the lifting of COVID measures and more
    • Transitions from youth to adult health care services quality standard
    • OCFP Awards – call for nominations extended to Mar. 20
    • Upcoming events including Ontario Health and Primary Care, MHA CoE, and HCNS, and more

    Unlock the potential of food Ingredients fora healthier tomorrow

     

     

    Happy Nutrition Month

    March is Nutrition Month, and today is Dietitian’s Day. We appreciate our teams’ registered dietitians, their ongoing commitment to teamwork and helping patients create a healthier future. #YourFutureIsHealthy

     

     

     

    Where do we go from here? Understanding the impact of preventive screening backlogs video

    On March 9 Choosing Wisely hosted a talk focused on the impact of screening delays in primary care related to the pandemic as part of their monthly conversation series. You can watch the recording with Drs. David Kaplan and Guylène Thériault here.

    Implications for primary care with the lifting of COVID measures and more

    Recent updates include:

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

    Transitions from youth to adult health care services quality standard

    Ontario Health (Quality) has released the Transitions From Youth to Adult Health Care Services Quality Standard, developed in partnership with the Provincial Council for Maternal and Child Health (PCMCH). If you have any questions, please contact qualitystandards@ontariohealth.ca.

    OCFP Awards – call for nominations extended to Mar. 20
    Nominate your colleagues for an OCFP award. Multiple categories ae open, including regional Family Physician of the Year. New for 2022 – Ontario family physicians can self nominate in any OCFP Award category. Deadline now Mar. 20, 2022.

    Vaccine Hesitancy for People who are Pregnant, Lactating or Planning to Become Pregnant, Mar. 17, 2022

    Public Health Agency of Canada (PHAC) is collaborating with the Canadian Vaccination Evidence Resource and Exchange Centre (CANVax) for this webinar. Register here.

    COVID Recovery, Mar. 25, 2022

    41st in the series ‘Changing the way we work’ for OCFP’s COVID-19 CoP for Family Physicians. Register here.

    Ontario Health and Primary Care, MHA CoE, and HCNS, April 1

    AFHTO has arranged for an update and conversation with Ontario Health on its role in supporting primary care, the work being led through the Mental Health and Addictions Centre of Excellence (MHA CoE), and the vision for OH’s Healthcare Navigation Service (HCNS). Register here.

    COVID-19 and indoor air quality – how community spaces can reduce transmission using ventilation, filtration, and ultra-violet disinfection

    Hosted by the Alliance and IPHCC, this April 5 webinar features two experts in indoor air quality from the University of Toronto. Want to get started now? Dr. Siegel and Dr. Li have shared five great things you can do to improve air quality and reduce airborne transmission of COVID-19.

    Your Voice is Important: Election Campaign Training with Enterprise Canada, Apr. 6, 2022

    The provincial election is just over three months away. Now is the time for local candidates to hear from you!

    If you have any questions or need support, please email advocacy@afhto.ca.

    Diabetes Care: Tools and Resources to Support Mental Health Needs, Apr. 8, 2022
    Hosted by Ontario Health and moderated by Dr. David Kaplan. Find out more here.

  • Living with and Managing COVID-19, Updated Guidance and Events & Webinars

    Dear Members,

    On Wednesday Dr. Kieran Moore, Ontario’s Chief Medical Officer of Health, held a press conference where he announced the removal of the mandatory masking requirement for most settings on March 21, with the eventual lifting in most settings by April 27.  As part of the Living with and Managing COVID-19 (FR) strategy, a number of public health measures are being lifted including masking, isolation and testing requirements.

    Like many of you, we share a lot of the same concerns that our partners like the OHA, Children’s Health Coalition and RNAO have articulated that the removal of masks may be too soon, especially as we are still in a pandemic and high risk settings like schools have large groups of children not yet vaccinated. Now more than ever, getting as many children vaccinated and third shots to those over 18+ is critical. If you would like to administer vaccines in your clinic please connect with your PHU operational lead for information if you haven’t yet done so.

    Living with and Managing COVID-19

    Highlights from the  Living with and Managing COVID-19 (FR) strategy:

    CMOH Directives & Letters of Instructions:

    • A process is currently underway to gradually revoke all CMOH Directives and instructions by the end of April, which will be replaced with operational guidance or recommendations from the CMOH and relevant Ministry.
    • The first Directive to be revoked (FR) is Directive #6 (first issued on August 17, 2021), which required regarding the COVID-19 vaccination or and testing policies for public hospitals, home care and community services providers organizations, Home and Community Care Support Services organizations and ambulance services with respect to paramedics. Directive #6 will be revoked effective March 14, 2022, after which time organizations may retain their own policies.
    • On March 21, 2022, masking requirements will end in most places including schools but will remain in public transit, LTC, retirement homes, other healthcare settings and congregate settings like shelters and jails. Also, businesses will no longer have to conduct passive screening to require patients to self-identify recent exposure to a COVID-19 case. Other measures in schools are to also be lifted including removing cohorts and daily on-site screening.
    • On April 27, 2022 all remaining measures, directives and orders end including removing masking requirements in all remaining settings and revoking Directives 1, 2.1, 3, 4 and 5. Operational guidance post-April 27 will include a requirement for masking in all healthcare settings, though we are still seeking clarity on that.  

    Case and Contact Management and Isolation:

    • Non-household close contacts no longer need to isolate but for 10 days after exposure should self-monitor for symptoms, wear a mask, avoid activities that require removal of mask, not visit anyone who is at higher risk for illness (i.e., seniors) and not visit or attend work in highest risk settings (unless they have previously tested positive in past 90 days).
    • Household close contacts no longer need to self-isolate but should follow the above precautions for 10 days if: they have previously tested positive for COVID-19 in past 90 days or are household members over age 18+ and that have been vaccinated and received their including booster dose or are household members under 18 years old and are fully vaccinated (two doses). If household members do not meet the above criteria they must self-isolate per current requirements.

    You can find additional information about COVID-19 data reporting in the Living With and Managing COVID-19 briefing deck.

    N95 Respirators

    With the recent changes to Directives 1, 4 and 5, the use of N95 respirators has increased across the province’s health system. Please see this memo (FR) from Alison Blair, Associate Deputy Minister, Pandemic Response and Recovery and Melanie Frasier, Associate Deputy Minister, Health Services, on more information on the N95 Respirators that have been secured by the Ontario government over the next five years. Also included in the memo are instructions for health services providers on how to access N95 1870+ respirators and Fit Testing Supports. A reminder that health service provider organizations can request N95 1870+ respirators through Ontario Health’s Critical PPE Intake Form.

    Additional Ministry Updated Information

    In addition, the guidance for PCR testing has been updated and the eligibility has been expanded. The updated eligibility now includes: an outpatient who requires a diagnostic test for clinical management. This category gives primary care providers the flexibility to get PCR tests for their patients based on their clinical judgment.

    Events and Webinars

    Vaccine Hesitancy for People who are Pregnant, Lactating or Planning to Become Pregnant
    Public Health Agency of Canada (PHAC) is collaborating with the Canadian Vaccination Evidence Resource and Exchange Centre (CANVax) to produce a webinar to inform health care providers on vaccine hesitancy and strategies to build vaccine confidence in people who are pregnant, lactating or planning to become pregnant.
     
    At the end of this webinar, participants will be able to: 

    • Discuss the challenges to vaccine confidence for individuals and families who are pregnant, considering pregnancy or lactating  
    • Identify strategies for building vaccine confidence among pregnant families, new parents, and those who intend to become pregnant  

     
    Event Information:
     
    English Presentation  
    Thursday, March 17, 2022
    3:30pm – 4:30pm EST
    Register: Click here
     
    Presenters:
    Dr. Ève Dubé, PhD, Medical anthropologist, Quebec National Institute of Public Health, Laval University
    Dr. Isabelle Boucoiran, M.D., M. Sc., Obstetrician-gynecologist, maternofetal medicine and reproductive infectious diseases specialist, clinical associate professor, Université de Montréal
     
    Moderator:
    Stephanie Elliott, MPH, CPH, Public Health Agency of Canada

    Improving your indoor air quality is essential to curbing the spread of COVID and protecting the health of your staff, clients, and community.

    Join the Alliance for Healthier Communities at noon on Tuesday, April 5 for a special Lunch ‘n’ Learn Webinar. Dr. Jeffrey Siegel and Dr. Amy (Tianyuan) Li will share practical advice about simple-low-cost measures you can take now to monitor and improve air quality in your facilities. These include portable filtration, bathroom fans that exhaust outdoor, strategically use of UV disinfection, and ways to clear air in rooms between uses.

    Register now, and be sure to mention any questions you’d like to see addressed. Want to get started right away? Check out these five great things non-profits can do with their year-end surpluses (or any time) to improve air quality and reduce airborne transmission of COVID-19 and other pathogens. This event is co-sponsored by our partners at the MAP Centre for Urban Health Solutions and the Indigenous Primary Health Care Council.

    We know you have a lot of questions around how to manage patient care as we look at living with and managing COVID in this next phase of the pandemic, including IPAC and masking for in-person care. We’re working with Public Health Ontario and our primary care partners to get some guidance and hope to have some information shortly. In the meantime, please continue to stay safe and thank you for all that you do. As always, please contact us if you have any questions.

    Yours in Good Health,

    The AFHTO Team

  • Updated primary care guidance document, revocation of Directive #2 and other supports

    Dear Members,

    With the announcement on February 14th that the government is moving to the next phase of reopening on February 17th, now more than ever it’s important to keep the pressure on ensuring more Ontarians get vaccinated. Thank you again for all your hard work in supporting your patients and community in all aspects of the pandemic efforts, while also managing the critical work of keeping your doors open for primary care.

    In addition to the reopening, as of 8:00 a.m. on Friday, February 18, 2022, Ontario is expanding booster dose eligibility to youth aged 12 to 17. Appointments can be booked through the provincial booking system and the Provincial Vaccine Contact Centre, as well as at primary care clinics and select pharmacies administering the Pfizer vaccine.

    Appointments are to be booked approximately six months (168 days) after a second dose and individuals must be 12 years old at the time of appointment. If you would like to administer vaccines in your clinic please connect with your PHU operational lead for information if you haven’t yet done so.

    Primary Care Guidance Document
    The Ministry has issued the COVID-19 Guidance: Primary Care Providers in a Community Setting (FR) (Version 10.0, Feb. 14, 2022). In this document see:

    • Updated in-person care guidance (page 3)
    • Updated active screening recommendations (page 6)
    • Updated PPE requirements when caring for patients with suspected or confirmed COVID-19 (page 9 and 14)
    • New testing guidance (page 11)
    • Updated case management (page 13)  
    • Updated HCW self-isolation and return to work guidance (page 17)

    Also the Ministry has updated COVID-19 Interim Guidance: Omicron Surge Management of Critical Staffing Shortages in Highest Risk Settings (Version 3.0, Feb 11, 2022) which you can find here (FR).

    Revocation of Directive #2 and Revised Directive #2.1
    On Thursday, February 10th, the CMOH revoked Directive #2 to allow for the resumption of non-urgent and non-emergent surgeries and procedures in hospitals. Until there is a return to normal hospital capacity, Dr. Moore also issued an updated Directive #2.1 to ensure that hospitals resource share across the system. For more details:

    To support the cautious and phased resumption of these clinical services, Ontario Health has provided operational guidance to the hospital and health care system in the Operational Direction for Optimizing Care: Wave 5 (FR) document. Of particular note was a specific request for primary care in supporting the response.

    Primary Care and Community Support Services:

    • Continue to focus on urgent and emergent care to avoid unnecessary emergency visits
    • Continue to optimize capacity to support flow and provide care at home, as appropriate
    • Resume or continue preventative care (e.g., cancer screening)
    • Undertake early identification and referral of patients who would benefit from covid therapeutics
    • Continue to support vaccinations and remote monitoring of covid patients
    • Ensure community support service organizations continue to participate and collaborate on regional response and recovery efforts

    Importance of Vaccinating Children 5-11
    As of February 9th, nearly 55% of all Ontarian children aged 5-11 have received their first dose of a COVID-19 vaccine, of which nearly 25% are fully vaccinated with two doses. The government has requested that there be a renewed focused on vaccinating children 5 to 11 years old. To support these efforts, please see:

    Update on RATs
    The Ontario COVID-19 Science Advisory Table has released a new review on Use of Rapid Antigen Tests during the Omicron Wave. Some key notes:

    • Combined oral-nasal sampling that involves swabbing both cheeks, the back of the tongue or throat, then both nostrils, should be implemented for rapid antigen tests
    • a single negative rapid antigen test result should not be used to rule out a case of COVID-19 at this time
    • a single positive rapid test result can be used to confirm COVID-19
    • there are multiple ways in which serial testing can be applied to assess the likelihood of COVID-19, depending on the case rate, risk tolerance, and setting.  

    Just a reminder that the provincial stockpile has received additional RATs and all backlogged orders should have been fulfilled. Additional orders can be made here.

    Also a reminder that primary care can refer patients for PCR testing using the PHO developed form when the diagnostic test is required for clinical management, at the discretion of the referring clinician. The form is being embedded in the 3 major EMRs (Telus PSS, Accuro and OSCAR) and updated guidance will soon be available.

    Other vaccination resources

    • VaxFacts is partnering with the Black Physicians’ Association of Ontario to provide a dedicated, free telephone service for members of Black communities to receive vaccine information. No OHIP required. Visit shn.ca/VaxFacts or call 416-438-2911 ext. 5738.
    • GO-VAXX Mobile Vaccine Clinics are now accepting walk-in. Check the GO-VAXX schedule for times and locations. If your organization is interested in having the GO-VAXX bus visit your community, please contact GOVAXX@ontario.ca.
    • OCSA’s Accessible Drive-to-Vaccine program has been extended and provides door-to-door rides to vaccination sites for people with disabilities, including seniors with mobility issues.
    • The Rehabilitative Care Alliance has compiled this list of outpatient rehab programs which may be helpful for patients experiencing ongoing symptoms of COVID-19.

    Upcoming Events:
    Ontario College of Family Physicians/University of Toronto Department of Family & Community Medicine

    • The next CoP session will be Friday, February 18th from 7:55 a.m. to 9:15 a.m. on The Omicron Aftermath: Post-acute COVID and Physician Wellness. Register here.

    Choosing Wisely Canada

    • Laboratory medicine is under strain from COVID-19, with critical shortages in blood tubes, devices, and lab staffing. Learn primary care recommendations to conserve – register for the Five Recommendations for Using Labs Wisely During Global Blood Tube and Other Resource Shortages talk on February 24th at 12:00 p.m.

    As we start slowly reopening the province again, we want to thank you once again for all you are doing to keep your patients and the community safe. If you need any assistance or have any questions, please do not hesitate to contact us.

     Yours in Good Health,

     The AFHTO Team

    (in collaboration with the Primary Care Collaborative)