Tag: Concurrent Sessions

Theme 6. Leadership and governance for accountable care

Presentation Materials (Members only)

Presentation Slides: Quality Improvement Leadership Team (QuILT): Hearing Everyone’s Voice

Learning Objectives

Participants will gain the knowledge of the benefits of bringing together a passionate group of individuals whose main objective is to improve the quality of care for patients of the TVFHT. Other FHT will see the benefits to their organization by having a committee comprised of each profession, administrative staff, and a family physician. The presentation will touch on why TVFHT believes that this group is integral to its operations, and why other FHT may find a similar committee beneficial to their organization.

Summary

The TVFHT Quality Improvement Leadership Team (QuILT) works to better understand the responsibilities TVFHT as an organization holds to the Ministry of Health and Long-Term Care (Ministry) and Health Quality Ontario (HQO), and has worked towards creating plans and processes to meet those responsibilities from various clinical perspectives to make these efforts meaningful. QuILT also works to assure the TVFHT Board that processes are in place to continuously improve the care, health and well-being of the population we serve. This will include processes to demonstrate outcomes of a high performing organization as defined by HQO’s attributes of a high-performing health system: Accessible, Effective, Safe, Patient-Centered, Equitable, Efficient, Appropriately Resourced, Integrated and Focused on Population Health. Membership includes interdisciplinary team representation recruited through an expression-of-interest invitation. QuILT will ensure an organization-wide approach to:

1. Annual quality improvement plan (QIP) submission to Health Quality Ontario (HQO) that aligns with the organizational Strategic Directions and the Ministry of Health and Long Term Care (MOHLTC) health care strategic priorities.
2. A coordinated quality improvement work plan to achieve QIP deliverables.
3. Consistent application of evidence informed practices.
4. Timely access to information by providers and team members for informed decision making.
5. Building a culture of, and capacity for, a collaborative, integrated and systematic approach to quality improvement that include standardized data collection tools.
6. Ongoing accountability and reporting timelines.
7. Ongoing advising related to professional practice such as policies and implementation of evidence informed practice.

Presenters

• Thames Valley FHT:
  • Natalie Clark, Program Administrator
  • Jill Strong, QIDSS
  • Tim McDonald, Physician

Authors and Contributors

• Michael Oates, Director-Operations and Quality, Quality Improvement Leadership Team, Thames Valley FHT

Theme 6. Leadership and governance for accountable care

Presentation Materials (Members only)

Presentation Slides: Quality Improvement Leadership Team (QuILT): Hearing Everyone’s Voice

Learning Objectives

Participants will gain the knowledge of the benefits of bringing together a passionate group of individuals whose main objective is to improve the quality of care for patients of the TVFHT. Other FHT will see the benefits to their organization by having a committee comprised of each profession, administrative staff, and a family physician. The presentation will touch on why TVFHT believes that this group is integral to its operations, and why other FHT may find a similar committee beneficial to their organization.

Summary

The TVFHT Quality Improvement Leadership Team (QuILT) works to better understand the responsibilities TVFHT as an organization holds to the Ministry of Health and Long-Term Care (Ministry) and Health Quality Ontario (HQO), and has worked towards creating plans and processes to meet those responsibilities from various clinical perspectives to make these efforts meaningful. QuILT also works to assure the TVFHT Board that processes are in place to continuously improve the care, health and well-being of the population we serve. This will include processes to demonstrate outcomes of a high performing organization as defined by HQO’s attributes of a high-performing health system: Accessible, Effective, Safe, Patient-Centered, Equitable, Efficient, Appropriately Resourced, Integrated and Focused on Population Health. Membership includes interdisciplinary team representation recruited through an expression-of-interest invitation. QuILT will ensure an organization-wide approach to:

1. Annual quality improvement plan (QIP) submission to Health Quality Ontario (HQO) that aligns with the organizational Strategic Directions and the Ministry of Health and Long Term Care (MOHLTC) health care strategic priorities.
2. A coordinated quality improvement work plan to achieve QIP deliverables.
3. Consistent application of evidence informed practices.
4. Timely access to information by providers and team members for informed decision making.
5. Building a culture of, and capacity for, a collaborative, integrated and systematic approach to quality improvement that include standardized data collection tools.
6. Ongoing accountability and reporting timelines.
7. Ongoing advising related to professional practice such as policies and implementation of evidence informed practice.

Presenters

• Thames Valley FHT:
  • Natalie Clark, Program Administrator
  • Jill Strong, QIDSS
  • Tim McDonald, Physician

Authors and Contributors

• Michael Oates, Director-Operations and Quality, Quality Improvement Leadership Team, Thames Valley FHT

Theme 4. Building the rural health care team: making the most of available resources

Presentation Materials (Members only)

Presentation Slides: Community Quilt – The Story of How Our FHT has been Woven into the Fabric of the Community

Learning Objectives

Feeling overwhelmed by your rural residents’ needs for accessible, team-based programs? Is it practical to creatively tap into existing community resources to offer programs in the rural areas with fewer resources? Minto-Mapleton FHT is a multi-sited, rural team that services 15,000 patients in a geographical area of close to 850 square kilometres. Learn about our unique partnerships that have allowed us to do more with less. Explore the possibilities of potential community partners and how to foster productive relationships to meet some of your harder to reach patients. Understand the role/importance of program ownership and champion development for program sustainability.

Summary

In 2011, Canada’s Health Minister quoted: “3 of 5 Canadians, older than 20 years of age, have a chronic disease and 4 out of 5 people are at risk”. In total, chronic diseases cost the Canadian economy at least $190 billion a year. The Minister noted that commitment to collaboration is a cornerstone of Canada’s approach to chronic disease prevention and control. Despite considerable effort, FHTs working in solo, find it impossible to meet the needs of all patients and their health conditions. This presentation will cover the journey our rural FHT has taken to secure sustainable community partnerships and viable programming while maintaining integrity of program objectives. MMFHT reached out to community partners, assessed existing programs and identified gaps that could easily be met by creating strong, symbiotic relationships. From humble beginnings, to the successes of today, and plans for tomorrow, we will share innovative approaches aimed at cost sharing, avoiding duplication, seeking out additional venues, staffing and programming.   Partnerships have spread current, evidence-based information, to patients that normally do not access FHT services at our typical venues. Clear, specified navigation guidelines have resulted in the right patients now being seen by the right practitioners at the right time. By including telemedicine, we have expanded our reach while decreasing patient costs of transportation, parking and extended work absences. The power point presentation will include patient and community partnership testimonials. In conclusion, we will discuss the importance of well-defined roles within the partnerships and the need to identify individual responsibilities.

Presenters

• Minto-Mapleton FHT
  • Vicky LaForge, Chronic Disease Prevention and Management Nurse
  • Jenny Harrison, Registered Dietitian
  • Sandy Turner, Health Promoter

Authors and Contributors

• Helen Edwards, Seniors’ Centre for Excellence
• Marg Stevens, North Wellington Health Care
• Patient and partnership testimonials

Theme 3. Transforming patients’ and caregivers’ experience and health

Presentation Materials (members only)

Presentation Slides: Patient Councils: Experiences within the GTA

(I) Community Engagement – Mississauga Halton Share CCAC Share Care Council

Learning Objectives

1. Define the key elements of a Patient and Caregiver Bill of Rights
2. Identify benefit of forming a Share Care Council and how it benefits families and caregivers
3. Describe how a patient and family advisory forum provides a direct voice to inform service development and funding priorities
4. Learn how to develop strong relationships with families and caregivers in the circle of care
5. Identify best practices of a family patient advisory forum – watch a video interview with a Share Care Council member as she explains the importance of having a patient voice in the development of new programs/services.

Summary

Mississauga Halton CCAC established the Share Care Council to give patients and caregivers an authentic engagement forum and direct voice in service development and funding priorities. Mississauga Halton CCAC recognizes the most important partners in caring for patients are patients and their informal caregivers. It recognizes that an inclusive approach to the circle of care will improve quality of care and outcomes. Authentic engagement is not a strategy; it is part of care. The Patient and Caregiver Bill of Rights is an important milestone as Mississauga Halton CCAC and service providers along with patients and caregivers as it articulates how they will work together to attain an exceptional patient experience. Launched in 2014, the Council meets quarterly. Members of the Council proactively identified the need to articulate patients and caregivers priorities to ensure consistent care guidelines. In a truly collaborative approach, the Mississauga Halton CCAC engaged front-line staff and contracted service providers to determine how these priorities could be realized with the intention of creating a single charter for patients, caregiver and care providers across the region. The Council is a patient and caregiver forum that gives them a direct voice to inform service development and funding priorities. This Council strengthens that partnership between Mississauga Halton CCAC and its patients and caregivers. The forum’s name also recognizes the role of primary care and other health service providers, and reflects Mississauga Halton CCAC’s inclusive approach to developing programs and services that deliver an exceptional patient experience.

Presenters

• Nancy Gale, Associate Vice-President, Strategic Communications and Partnership Advancement, Mississauga Halton CCAC

(II) Patients’ Perspectives: Getting Patients Involved and Engaged to Participate in PAC (Patient Advisory Council)

Presentation Materials (members only)

• Materials will be posted following the 2015 Conference.

Learning Objectives

• How to get patients involved in PAC
• Relevant recruiting methods and process to recruit and select patients to be on PAC
• Patients’ experiences with the recruitment and selection process
• What to look for/qualifications in patients that should or want to be on PAC
• Types of patients who get involved/volunteer
• Patient motivations/hot buttons to get them involved
• What patients want to get out of being on PAC
• Benefits/expectations/outcomes/improvements

Summary

• Will discuss how to get patients involved and the recruiting methods and selection process used to establish a PAC
• Patients’ experiences with the recruitment and selection processes
• Key attributes/qualifications to look for in patients that should or want to be on PAC
• Types of patients who get involved and why – Key motivations/hot buttons for patients to get involved in PAC
• Patient Expectations/ Benefits/ Outcomes/ Improvements of being on PAC
• Key impact of presentation: to help FHT’s across Ontario implement a PAC in their centre by providing some patient insights that could help them recruit patients

Presenters

• Sonia Mastroianni, Patient, South East FHT

Authors and Contributors

• South East FHT
  • Maureen Gans, M. Ed., Director, Interprofessional Practice & Quality Improvement
  • Edwin MacNevin, Patient
  • John Lakich, Patient
  • Samantha Hartlen, Patient

Theme 2. Optimizing capacity of interprofessional teams

Learning Objectives

By the end of the presentation, participants will:

1. Reflect upon the four principles of family medicine and its relevance within Ontario’s FHT’s.
2. Consider the meaning of Shared Accountability and its impact on team-based care.
3. Re-evaluate personal perspectives on willingness to provide collaborative patient-centred care.

Presenters

• Dr. Ivy Oandasan, Professor, Department of Family and Community Medicine, University of Toronto

Presentation Materials (Members only)

• Materials will be posted following the 2015 Conference.

Theme 1. Population-based primary health care: planning and integration for the community

Presentation Materials (members only)

Presentation Slides: Nutrition Education at your Local Coffee Shop

Learning Objectives

Participants will:

• Understand the barriers preventing connection with marginalized individuals who lack food security.
• Learn how to connect with and equip individuals to use food bank items together with cheap local produce to prepare nutritious meals and snacks.
• Learn how to start from the home setting and work with individuals at their own pace.
• Learn how useful printed materials are for this population.
• Learn how to effectively provide nutrition advice outside a health care setting.

Summary

541 Eatery and Exchange is a for-benefit, not-for-profit business that provides affordable nutritious homemade food in an area of Hamilton where this is not otherwise available. Using volunteers and very few paid staff keeps costs low and encourages community participation. There is a pay it forward system that uses buttons, and the café is full of all kinds of people. It has become a focus for the resilience and strengths in the neighbourhood. Using a grant from the Learning by Giving Foundation – McMaster University, we will describe hiring a Registered Dietitian to work with participants from our community, beginning with home visits to each participant to ensure the program meets their needs. Using existing resources as much as possible she will develop a simple illustrated text that accompanies each of the six sessions per series. Food is available but not always accessible or usable for our neighbors. It is easier to rely on fast food rather than deal with the contents of a food bank box. We will unpack a typical box and make meals from it, adding simple fresh ingredients. We will look at what a store cupboard should contain. We will visit the local farmers market together. This presentation will demonstrate how collaboration with local organizations and businesses enhances access to nutrition advice for hard to reach populations, and offers health care in an unexpected setting.

Presenters

• Michele MacDonald-Werstuck, Registered Dietitian, DFM McMaster University; McMaster FHT; Stonechurch FHC
• Rev. Sue Carr BSc MTS, Executive Director 541 Eatery and Exchange, DFM McMaster University, Stonechurch FHC
• Marika Smit, Registered Dietitian (pending July 2015), 541 Eatery and Exchange

Presentation Materials (Members only)

• Materials will be posted following the 2015 Conference.

Theme 1. Population-based primary health care: planning and integration for the community

Presentation Materials (Members only)

Presentation Slides: Taking Collaboration to the Next Level…Dealing with the Social Determinants of Health

Learning Objectives

The purpose of this presentation is to share the knowledge we have gained through our Medically Complex Patient Pilot Program and the changes in practices that have resulted in reaching out to more patients and their caregivers.

1. How to identify patients.
2. How to determine which partnerships can best serve the patients.
3. How to provide health care when those most in need don’t show up.
4. How Mental Health, addictions, physical health and crime can be tackled together with success.

Summary

The Family Health Team interdisciplinary model has increased accessibility and revolutionized primary care. However, complex patients with significant medical and social problems require a different approach to providing care. During our Medically Complex Patient Pilot Program (MCPPP) some of the most complex patients identified by our partners did not come to appointments and were frequently unreachable. These were often folks with no phone, no fixed address or had mental health and addiction problems which made travelling to appointments and or making appointments near impossible for them. The Innovation Centre is an organization in Sault Ste Marie which uses data to drive innovation. They identified an area of the city where a significant number of residents are marginalized and economically and socially disadvantaged. It indicates that this area of the Sault has the highest poor academic performance and poor health, the highest crime rates and mental health and addiction issues. The police had already initiated a Neighbourhood Resource Centre (NRC) located in the heart of the identified region where frontline Mental Health workers work side by side with police officers to serve the population in a better way. We identified a lack of primary care through a community engagement survey funded by NELHIN and with support from Police Services, the Resource Centre was equipped with an examination room and a weekly drop in clinic was started. Through our MCPPP and the NRC, we have forged collaborations with various agencies to identify and address a broad spectrum of concerns, including medical and social issues. Regular case conferencing that may include the patient keeps everyone involved connected. Thus far there have been plenty of anecdotal reports of better chronic disease management and emergency room diversion and these stats will be followed.

Presenters

• Dr. Alan McLean, MD, CCFP; Physician Lead, Superior FHT

Authors and Contributors

• Superior FHT
  • Dr. Alan McLean, MD, CCFP, Physician Lead Superior FHT
  • Michelle Brisbois, Interim Executive Director, Superior FHT
  • Susan McLean, RN; Director, Clinical Services and Program Development, Superior FHT