Tag: Concurrent Sessions

Theme 6. The future of the regional approach to healthcare

• Date: Thursday, October 25, 2018
• Concurrent Session F
• Time: 12:00-12:45pm
• Room: Pier 4
• Style: Presentation (information provided to audience, with opportunity for audience to ask question)
• Focus: Balance between both (e.g. Presentation of a best-practice guideline that combines research evidence, policy issues and practical steps for implementation)
• Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers, Representatives of stakeholder/partner organizations

Learning Objectives

• Identify successes, commonalities, as well as barriers and challenges and obtain ideas of how to “spread and grow” the Health Link (HL) best practice approach.
• Apply an Experience Based Co-design and qualitative method approach in primary care to gather input from front line providers to move care coordination/ system navigation forward in the South East LHIN.
• Compare and contrast the results of an urban HL to a rural HL, which were both early adopters of the best practice approach.

Summary/Abstract A collaborative quality improvement project between two primary care led HL’s was an opportunity to gather perspectives and feedback directly from primary care providers as it relates to the quadruple aim.  Combined, 18 participants were interviewed across both HL’s, which included 1 large urban FHT, 3 rural FHT’s and 1 rural CHC. A validated semi-structured interview tool was used and the interviews were recorded, typed and played back for data accuracy. To eliminate bias, interviews were conducted by someone outside of the HL program. Results were analyzed using two approaches: 1)         NVivo software which generated themes that have been shared with FHT/CHC teams and quality improvement committees as well as respective HL tables and regional HL committees.   2)            Experience based Co-Design (EBD) is an emerging method used to capture the emotional content of patient/provider experiences, and can serve as the foundation for identifying opportunities for improvement. The emotions, both positive and negative plus associated processes were mapped to the HL Coordinated Care Management Framework designed by HQO.   Literature on care coordination/ system navigation in primary care was also reviewed and findings were consistent with our results. The outcomes of our project have provided the foundation for primary care organizations across our respective HL’s as well as other HL’s across the province with concepts on how to support care coordinators/ system navigators within primary care who are working with individuals living with multiple chronic conditions and/or complex needs. Presenters:

• Laura Cassidy, BComm, QIDSS, Maple FHT
• Alicia McCullum, Project Manager, Rural Hastings Health Link

Authors/Contributors:

• Laura Cassidy, BComm, QIDSS, Maple FHT
• Linda Robb Blenderman, RN, BScN, MSc. Project Manager, Kingston Health Link
• Alicia McCullum, Project Manager, Rural Hastings Health Link

Theme 5. Why hasn’t this expanded: scalable pilot programs

• Date: Thursday, October 25, 2018
• Concurrent Session F
• Time: 12:00-12:45pm
• Room: Harbour C
• Style: Presentation (information provided to audience, with opportunity for audience to ask question)
• Focus: Practical (e.g. Presentation on how to implement programs and/or practices in the team environment)
• Target Audience: Clinical providers

Learning Objectives Participants will learn:  How to select one of many ACP tools that are already available: An evidence-based approach to advance care planning (ACP)  Strategies to clearly document and track ACP in an EMR  Strategies to incorporate IHPs into ACP discussions  Strategies for educating patients about ACP, including overcoming barriers Summary/Abstract There are multiple organizations and agencies that have created tools for advance care planning, but there is little direction about scaling these interventions into primary care offices.   The goal of this presentation will be to outline the approaches to ACP and give direction about how to implement these strategies into primary care delivery within interdisciplinary care teams. The presenter will offer a back ground of the ACP approach that was implemented, including supporting literature about its efficacy. They will also provide information about how to integrate other team members into the process, including designating a specific team member for in-depth conversations as needed.   Data regarding efficacy and barriers to implementing ACP will also be reviewed based on patient feedback and clinical experience. Presenters:

• Meghan Rule, NP-PHC, Bridgepoint FHT

Authors/Contributors:

• Sheena Luck, NP-PHC, Mount Sinai FHT
• Mayura Loganathan, MD, Mount Sinai FHT

Theme 4. The “How to” stream

• Date: Thursday, October 25, 2018
• Concurrent Session F
• Time: 12:00-12:45pm
• Room: Harbour B
• Style: Workshop (session is structure for interaction and/or hands-on learning opportunities)
• Focus: Balance between both (e.g. Presentation of a best-practice guideline that combines research evidence, policy issues and practical steps for implementation)
• Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.)

Learning Objectives By the end of the session, the participant will:

• Understand the board’s role in operationalizing the oversight, coordination, and reporting of risk
• Know 21 questions that should be asked by healthcare boards of senior leaders
• Be familiar with related resources and tools to ensure effective oversight of integrated risk management

Summary/Abstract Drawing on strong ethical and evidence-based principles, a list of guiding questions has been developed to help boards of healthcare organizations carry out a critical governance function – the oversight of key organizational risks. There is growing awareness that in order to achieve an organization’s key mandate – that of the provision of high quality care, leaders must be aware of the risks within their organization and develop strategies to mitigate these risks through organized, integrated risk management programs. The governing body ultimately carries a fiduciary responsibility for all aspects of the healthcare organization’s business operations and clinical care. The board can create the winning conditions for change through oversight of the organization’s effective and robust risk management program. Healthcare boards often lack guidance on what they should ask senior leaders about risk.  The objective of this workshop is for the participant to be able to identify the types of questions that healthcare boards should be asking about risk. The questions ensure alignment with healthcare organizations’ strategic objectives and core business which is patient care. The questions align with a framework that looks at what can go wrong, the likelihood and impact of these risks, and the need for action. The framework incorporates the need for alignment with vision, strategy, and objectives.  While boards are responsible for oversight of risk management, senior leaders must take ownership and lead risk reporting and monitoring. Previously questions have been developed for not-for-profit sectors, this list of 21 questions is the first specific to healthcare. Presenters:

• Jordan Willcox, Enterprise Risk Management Consultant, William Osler Health System
• Lori Borovoy, Senior Healthcare Risk Management Specialist, Healthcare Insurance Reciprocal of Canada

Authors/Contributors:

• Jordan Willcox, Enterprise Risk Management Consultant, William Osler Health System
• Polly Stevens, MHSc, Vice President, Healthcare Risk Management, Healthcare Insurance Reciprocal of Canada
• Annette Down, MHSA, CHE, Senior Healthcare Risk Management Specialist, Healthcare Insurance Reciprocal of Canada

Theme 4. The “How to” stream

• Date: Thursday, October 25, 2018
• Concurrent Session F
• Time: 12:00-12:45pm
• Room: Marine
• Style: Presentation (information provided to audience, with opportunity for audience to ask question)
• Focus: Practical (e.g. Presentation on how to implement programs and/or practices in the team environment)
• Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers, Administrative staff, Representatives of stakeholder/partner organizations

Learning Objectives At the conclusion of this presentation, participants will be able to explain the advantages of FIT for colorectal cancer screening.   Learning Objective: At the conclusion of this presentation, participants will be able to identify how colorectal cancer screening in Ontario is changing.  Learning Objective: At the conclusion of this presentation, participants will be able to recognize how to make changes to their colorectal cancer screening practices. Summary/Abstract Cancer Care Ontario is changing its recommended screening test for patients at average risk of colorectal cancer (CRC) from the guaiac fecal occult blood test (gFOBT) to the fecal immunochemical test (FIT). FIT is a more sensitive screening test for CRC compared to gFOBT, and detects twice as many advanced neosplasias (including CRC and advanced adenomas).  Given FIT’s greater ease of use, it is also expected to increase participation in screening. While FIT, like gFOBT, is an at-home fecal based test, it has different stability and storage requirements, which, together with its increased performance, will require important changes in Cancer Care Ontario’s colorectal cancer screening program design. These changes will have important implications for primary care providers, including how FIT kits will be ordered for patients, how they will be distributed to eligible Ontarians, and how patients will return completed kits. This interactive presentation will provide primary care providers with an overview of the anticipated changes with FIT, and how they can prepare their practice to ensure a smooth transition to FIT. In addition to learning how to screen eligible patients for CRC with FIT, and how to order FIT, providers will also learn about how to refer patients with abnormal results for follow-up, and where to go for resources. The presentation will be given by Dr. Edward Kucharski and include FIT-specific case studies, which will reinforce the information provided in the presentation and increase participant interactivity. Presenters:

• Edward Kucharski, MD, CCFP Family Physician, South East Toronto Family Health Team, CCO Regional Primary Care Lead, Cancer Care Ontario

Authors/Contributors:

• Jill Tinmouth Provincial Scientific Lead CCO,
• Catherine Dubé Clinical Lead CCO
• Bronwen McCurdy, Group Manager ColonCancerCheck, CCO
• Jocelyn Sacco, Senior Analyst ColonCancerCheck, CCO
• Caitlin Janssen, Analyst Evidence Integration & Primary Care, CCO

Theme 3. Expanding your reach

• Date: Thursday, October 25, 2018
• Concurrent Session F
• Time: 12:00-12:45pm
• Room: Pier 9
• Style: Presentation (information provided to audience, with opportunity for audience to ask question)
• Focus: Practical (e.g. Presentation on how to implement programs and/or practices in the team environment)
• Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers

Learning Objectives 1) Participants will understand the origin of the program 2) Participants will understand the successes and challenges of the initiative to date 3) Participants will understand essential elements in overcoming the challenges of implementation Summary/Abstract As part of a province-wide trend to increase patient access to inter-professional teams in primary care, the Centre for Family Medicine FHT has launched an initiative to provide mental health services to patients of three FHOs in Kitchener-Waterloo. This program makes counselling services available to 52 additional family-physicians, serving approximately 65,000 patients. This presentation will briefly describe the origin and formation of the Partnership for Mental Health Services, and the progress on the implementation of this pilot to date, with a focus on the perspectives of the three clinical therapists supporting the FHOs. Since its inception there have been a variety of hurdles overcome, processes developed, and adaptations made. Various successes and challenges will be discussed and learnings shared that may assist others in avoiding the pitfalls of implementing a similar program. Key elements of team function will be highlighted including: formation, ingenuity, flexibility, and collaboration.  Clear and direct communication, internally and externally, have been essential in building the relationships needed for success.  Preliminary outcome data will be shared and discussed and recommendations will be reviewed for implementation of similar initiatives. Presenters:

• William Corrigan, Clinical Therapist, Centre for Family Medicine FHT
• Hendrike Isert-Bender, Clinical Therapist, Centre for Family Medicine FHT
• Carrie Greig, Clinical Therapist, Centre for Family Medicine FHT

Authors/Contributors:

• Jennifer Fillingham, Manager CFFM and KW4 Projects, Centre for Family Medicine FHT
• Sarah Harjee, Centre for Family Medicine FHT
• Patricia O”Toole, Centre for Family Medicine FHT

Theme 4. The “How to” stream

• Date: Thursday, October 25, 2018
• Concurrent Session F
• Time: 12:00-12:45pm
• Room:  Pier 7 & 8
• Style: Presentation (information provided to audience, with opportunity for audience to ask question)
• Focus: Practical (e.g. Presentation on how to implement programs and/or practices in the team environment)
• Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers, Representatives of stakeholder/partner organizations

Learning Objectives After attending this presentation participants will:

• Be able to identify gaps in knowledge and skill around MAiD assessment and provision
• Have the foundational knowledge necessary to build an interdisciplinary team, and implement processes to mount a Primary Care Response to community based requests for MAiD
• Recognize the importance of an Interprofessional and Inter-sectoral approach to MAiD provision and assessment, both for continuity of care and for continuous capacity building
• Learn to use provision debriefs as a means for continuous quality improvement

Summary/Abstract In June 2016, the Hamilton Family Health Team began collaborating with community partners to develop a comprehensive Primary Care response to community based requests for Medical Assistance in Dying (MAiD). Our Interprofessional Health Provider (IHP) support team develops and shares educational materials for clinicians, patients and families, and the broader community at large.  The clinical response team receives specific MAiD requests from across the community, and works closely with family physicians to ensure that assessors, providers, system navigators and supporting IHP are available as needed to fulfill individual requests. We are gradually increasing our team of dedicated assessors and providers through supportive mentoring opportunities, and also work closely with the LHIN, Home and Community Care, neighbouring Family Health Teams, and the Hamilton Health Sciences hospital based Assisted Dying Resource and Assessment team to ensure a seamless delivery of care across healthcare sectors.   More recently, the team has begun working with the MOHLTC Care Co-ordination Service to repatriate Hamilton MAiD requests back to our local service as appropriate. This patient-centred, capacity building model ensures not only that requests are heard and responded to efficiently and compassionately, but also that care is delivered within regulations set by legislation; in a model that respects the rights of individuals to conscientiously object to any aspect of the work and still provide an excellent patient experience. Presenters:

• Jennifer Morritt, BScN, MA, RN, CHPCN(c); Nursing Coordinator/Palliative Resource, Hamilton Family Health Team
• Noel Robb, MSW, RSW; Mental Health Counsellor, Hamilton Family Health Team

Theme 2. Healthy relationships, healthy teams

• Date: Thursday, October 25, 2018
• Concurrent Session F
• Time: 12:00-12:45pm
• Room: Pier 5
• Style: Presentation (information provided to audience, with opportunity for audience to ask question)
• Focus: Balance between both (e.g. Presentation of a best-practice guideline that combines research evidence, policy issues and practical steps for implementation)
• Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers, Representatives of stakeholder/partner organizations

Learning Objectives Through the application of a multidisciplinary approach, learn how we implemented the chronic disease management and prevention framework to adapt the principles of the ICCP into a plan to help improve at risk patient’s co-ordination of care and improve continuity of care.  We will illustrate how we have been able to improve first contact, and intervene before issues arise.  The inclusion of client appropriate allied health has helped to stream line the intervention so that it is designed to meet the needs of the individual client, and address any unmet social/mental health needs arising from or exacerbated by illness.  Summary/Abstract Our FHT initiated the Multi-D appointment approach to utilize the key concepts of the ICCP, but in a more efficient manner with a broader criterion including psychosocial issues.  Sullivan et al (2016) suggest that building successful professional teams includes “re-envisioning goals, promoting shared decision making, communicating effectively and interprofessionally, clarifying roles, learning from failure, and using organizational structures to support multidisciplinary teams.”   Our process is to encourage staff to use their professional judgement in initiating a referral for any “at risk” patient who might benefit from this contact.  This maximizes the coordination and comprehensiveness of care by meeting together with the patient, their significant others, and the involved primary care providers.    Our vision is to improve health outcomes and the self-efficacy necessary to manage chronic or acute conditions.  We are striving to promote a culture of client centered, safe, multidisciplinary care.  “Even in the best healthcare systems, patients most remember their individual encounters.  We must ensure that the teams we create sustain our common goal of providing high-value care for every patient, every time (Handel, 2016). Presenters:

• Mandy Weeden, CEO, Kirkland District Family Health Team
• Christina Woollings, NP-Clinical Lead, Kirkland District Family Health Team
• Julie Moody, RPN, Co-Ordinator Multi D Meetings, Kirkland District Family Health Team
• Sandra Dal Pai, NP-PHC, Kirkland District Family Health Team
• Lauren O’Connor- Byer, Pharmacist, Kirkland and District Hospital
• Christine McBean, Pharmacist, Kirkland Family Health Team

Authors/Contributors:

• Woollings, Christina NP-PHC, KDFHT
• Dal Pai, Sandra NP-PHC, KDFHT

Theme 1. Mental health and addictions

• Date: Thursday, October 25, 2018
• Concurrent Session F
• Time: 12:00-12:45pm
• Room: Harbour A
• Style: Presentation (information provided to audience, with opportunity for audience to ask question)
• Focus: Practical (e.g. Presentation on how to implement programs and/or practices in the team environment)
• Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers, Administrative staff, Representatives of stakeholder/partner organizations

Learning Objectives

• Learn about the Government of Ontario’s investment in publicly-funded psychotherapy services
• Learn about the role that BounceBack can play in addressing the service gap and supporting clients experiencing mild to moderate depression and anxiety
• Learn about BounceBack’s evidence-based benefits, eligibility criteria, referral process and how to put the service into practice at your organization

Summary/Abstract BounceBack is an evidence-based, guided self-help program designed to help adults and youth (aged 15+) manage symptoms of mild to moderate depression and anxiety. Using one-on-one telephone coaching, educational workbooks, and online videos, participants learn cognitive behavioural therapy skills to help them tackle problems such as low mood, stress, and worry. Managed by the Canadian Mental Health Association (CMHA) Ontario Division and the CMHA York and South Simcoe branch, BounceBack is free and available to clients and primary care providers across Ontario. Hear from the BounceBack program’s clinical psychologists about this new self-help psychotherapy service that is proven to reduce depressive and anxious symptoms by almost 40% at program completion. BounceBack is part of the Government of Ontario’s recent investment in publicly-funded psychotherapy services for people with mild to moderate depression and anxiety, and represents a major milestone for the mental health and addiction sector. People are in need of faster and more equitable access to mental health supports. And primary care providers need alternative and complementary solutions to offer their clients, outside of referring clients to community services with long wait lists and prescription medication. BounceBack provides rapid early intervention, in multiple languages, and no travel is required to participate. We are excited to share this innovative program with the AFHTO audience. Presenters:

• Dr. Helen Chagigiorgis, Ph.D., C. Psych, Registered Clinical & Forensic Psychologist, CMHA York and South Simcoe
• Dr. Christine Courbasson, Clinical Consultant, Clinical Psychologist, CMHA York and South Simcoe

Theme 5. Why hasn’t this expanded: scalable pilot programs

• Date: Thursday, October 25, 2018
• Concurrent Session D
• Time: 9:45-10:30am
• Room: Pier 7 & 8
• Style: Panel Discussion (in addition to providing information, panelists interact with one another to explore/debate a topic)
• Focus: Balance between both (e.g. Presentation of a best-practice guideline that combines research evidence, policy issues and practical steps for implementation)
• Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers, Administrative staff, Representatives of stakeholder/partner organizations

Learning Objectives Participants will walk away with:

1. a) An awareness of the impact of malnutrition on an individual’s quality of life, chronic disease management, risk of falls, hospitalizations and transitions to long term care
2. b) An awareness of the impact of malnutrition on the health care system and what we can do in primary care to make a difference
3. c) An appreciation of the importance of early detection and intervention to prevent and correct malnutrition
4. d) Nutrition screening tools and interprofessional clinical care pathway to use in your practice
5. e) Lessons learned from other family health teams across the province on how to launch a successful screening program.

Summary/Abstract Bill is a 72 year old fellow who recently lost his wife to cancer and hasn’t been eating well. He is relying on quick meals such as tea and toast and processed foods, which has led to a 30 pound unintentional weight loss. Unfortunately, no one has noticed about his weight loss since he has always been “on the heavy side”. Bill has fallen several times at home and finally ends up in the hospital after falling on the stairs. He eventually gets discharged home. In Canada, one out of three seniors is at nutritional risk and one out of two adults is malnourished upon hospital admission.  Malnutrition in seniors is happening in our communities but often going un-noticed negatively impacting on quality of life, risk of falls and hospitalizations, longer hospital stays and  re-admissions. Despite evidence of the benefit of nutrition counselling and team support to improve health outcomes and reduce hospital admissions, an environmental scan of 184 family health teams (FHTs) in Ontario identified no active nutrition screening programs, and extremely low referrals for malnutrition nutrition counselling. The aim of 4 FHT Malnutrition Screening project is to embed nutrition screening into clinical practice and implement clinical care pathways to detect and manage senior malnutrition in family practice to reduce falls and hospitalization rates due to malnutrition. Presenters:

• Michele MacDonald Werstuck, RD MSc CDE Nutrition Program Coordinator, Assistant Professor McMaster University, Hamilton Family Health Team
• Amy Waugh, RD CDE, Upper Grand Family Health Team
• Denis Tsang RD CDE

Authors/Contributors:

• Jennifer McGregor RD CDE Niagara FHT
• Denis Tsang RD CDE

Theme 4. The “How to” stream

• Date: Wednesday, October 24, 2018
• Concurrent Session A
• Time: 2:30-3:15pm
• Room: Harbour C
• Style: Presentation (information provided to audience, with opportunity for audience to ask question)
• Focus: Balance between both (e.g. Presentation of a best-practice guideline that combines research evidence, policy issues and practical steps for implementation)
• Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers, Administrative staff, Representatives of stakeholder/partner organizations

Learning Objectives In this session, participants will:

1. Learn about the EMR Practice Enhancement Program (EPEP);
2. Understand (better) how improvements to practice-level data quality can enable quality improvement initiatives
3. Build a stronger sense, through examples, of the real impact of workflow inefficiencies on patient care and practice management
4. Have the opportunity to ask questions of a field team that has engaged with over 500 clinicians across the province, in a variety of care models, settings, and patient demographics

Summary/Abstract In the context of a busy practice, it can be challenging for clinicians and staff to find time to learn, sustain, and improve upon a new technology-based workflow.  Informed by best practices in change management, OntarioMD’s EMR Practice Enhancement Program (EPEP) deploys both assessment tools and coaching methods to help practices harness their EMR towards quality improvement goals. Since its launch in 2016, the EPEP team has engaged over 500 Ontario physicians. The EPEP team work directly with clinicians to identify knowledge gaps, analyze workflow, review EMR data quality and develop action plans with achievable tasks. Baselines are established on key measures in priority areas for the practice – for example, blood sugar levels for diabetics). These baselines and a workflow analysis help develop a diagnostic profile and generate recommended actions targeted at the practice’s goals. Generally, an EPEP engagement consists of:

• Current state assessment using the EMR Progress Assessment tool and a gap analysis to help the practice identify priority areas for improvement
• Analysis of data quality and workflow to determine root causes of data discrepancies and establish baselines for specified clinical measures, and to identify ways to improve workflow efficiency
• Customized action plan development which provides concrete, achievable tasks designed to improve data quality in identified practice priority areas and overall practice management
• Post-engagement evaluation to measure EPEP-driven improvements in EMR data quality and proficiency, at three or six months post-baseline (and at 12 months, to assess sustainability)

Presenters:

• Reza Talebi, Manager, Practice Enhancement, OntarioMD Inc.
• Mavis Jones, Senior Policy Analyst, Insight, Engagement and Transformation, OntarioMD Inc.

Authors/Contributors:

• See above