Theme 1 – Leadership and governance for quality 1 The Role of an Interprofessional, Cross-Sectoral Planning and Priorities Committee in the Successful Function and Evolution of an FHT Theme 2 – Using data to improve care 2 Using EMR as a partner: Can an EMR system make you smarter about Diabetes care? 3 Lifting the Load: Utilizing University Students in Primary Care for Programming and Quality Improvement 4 How Quality Improvement and Decision Support Specialists (QIDSS) can help transform care 5 Laying the Foundation for Primary Care Performance Measurement in Ontario 6 The ABCs of M&M in a Family Health Team 7 Using EMR Data for Self Reflection and Facilitate Change to Enhance Patient Care (poster to follow) 8 Improving the Quality and Efficiency of Post-hospital Admission Visits to the Primary Care Provider 9 Healthy Weight Surveillance Pilot Study Theme 4 – Integration: building the team beyond the FHT 10 Standardization Committee: The Answer to Effective Utilization of Registered Nurses to Full Scope of Practice (poster to follow) 11 Evaluation of the Integration of the Physiotherapy Practitioner into the Toronto Western Hospital Family Health Team 12 Managing Systems Transitions – Integrated Hospital Transition Management Initiative – Poster Presentation 13 INR Clinics: the next step 14 The Nutrition Resource Centre as a Means for Collaboration between Family Health Teams and Public Health 15 Expanding Our QI team to Improve Patient Outcomes and Enhance Provider Engagement and Collaboration: Public Private Collaboration (PPC) (poster to follow) 16 Supporting Caregivers Through Problem Solving Therapy 17 Driving Transformation By Seeing The System Through The Eyes of Patients and Their Families Theme 5 – Advances in health promotion and chronic disease management 18 AFib Innovation Program (poster to follow) 19 Reducing CVD risk factors through Fostering Self-Management Skills using an Interprofessional Team in a Shared Medical Visit Setting 20 Smoking Cessation Program at St. Michael’s Academic Family Health Team (poster to follow) 21 Readiness – A Key Concept in Mental Health Intake Assessments 22 Colon Cancer Screening: A Family Health Team Approach to Improve Patient Awareness and Access (poster to follow) 23 EPIC: Expanding Paramedicine in the Community 24 Exploring Hand Hygiene in Primary Care (poster to follow) 25 Evaluation of a nursing led chronic disease management program 26 Group Visit Implementation and Program Evaluation: Interprofessional Well-Baby Group Visits (poster to follow) 27 Effect of’Beyond the Fork’ program on chronic disease self-management: a pilot RCT 28 Partnering with Patients in the Development of a Trauma Program (poster to follow) 29 Using a Novel Instructional Video on the Fecal Occult Blood Test to improve Rates of Colon Cancer Ccreening in Low Risk Patients: a pilot study at the Toronto Western Hospital Family Health Team 30 Meeting Parental Needs for Infant Feeding Education with Well Baby Group Visits (WBGV) (poster to follow) 31 The 4 Ps of Effective Health Promotion in Family Health Teams: Enhancing Patient Engagement in Community-based Programming. 32 Provider Education Program: Evidence-Based Asthma Knowledge Transfer into Primary Care Practice 33 Improved Cancer Screening Rates with Introduction of an EMR 34 Right Care, Right Time, Right Place: A Lung Health Collaborative in Primary Care (poster to follow) 35 Some Injuries You Can’t Kiss and Make Better: Fall Prevention in Young Children 36 Diabetes Group Visits – A Collaborative & Supportive Approach to Patient Care 37 Progress Beyond The Scale: Using Data Collection to Provide Patient and System Level Feedback in Healthy Weight Management Program 38 Health Coaching for patients with diabetes: impact on interdisciplinary teams 39 The Ontario Renal Network: Reducing the Impact of Chronic Kidney Disease through Early Detection – A Primary Care Innovation (poster to follow) 40 Bridging the Gap: Increasing cancer screening rates through quality improvement 41 Upstream Solutions for Downstream Congestion 42 See the Difference an HgbA1C Onsite Makes (poster to follow) Theme 6 – Improving care for seniors 43 Guelph Family Health Team Cooking Classes: A “Healthy Bite” closer to prevent and manage chronic disease 44 Evaluating a Health and Social Care Innovation; Findings from the Integrated Home-Based Primary Care (IHBPC) Study 45 Safe Medications And Reviews Taskforce (SMART Seniors Project) – An Interprofessional Collaboration at the St Michael’s Academic Family Health Team 46 Health Equity and Geriatric Care in a Rural Practice 47 Prescribing and Deprescribing in Frail Elderly: Use of an interdisciplinary team to enhance safe medication use in frail and homebound older adults. 48 Medication Reviews for Improving Care in Elderly Family Health Team Patients on Multiple Medications (poster to follow) Theme 7 – Innovation in interprofessional collaborative team implementation 49 The Primary Care Asthma Program (PCAP): A Standardized Program Model for Evidence-based Primary Care Asthma Management in Ontario 50 An Interdisciplinary Approach to Increasing Awareness of RD’s Medical Nutrition Therapy Services 51 Making Patient Safety a Priority: Moving from a culture of blame to learning via narrative 52 Improving Patient Access to Care: Removing Barriers to Receiving Assessment and Education by Health Disciplines of the St. Michael’s Hospital Academic Family Health Team 53 The Patient Engagement Project: Lessons Learned 54 The Value of an Optometry-integrated Primary Care Model to Lowering Risk of Blindness and Augment Chronic Disease Management 55 Investigating the role of a NP and a PA in a Family Health Team 56 Strengthening the Circle of Mental Health Care: Social Work and Psychologists in Collaboration: A Panel of Physician/Social Worker and Psychologist 57 The “Missing Link”: The Integration of Registered Kinesiologists in Primary Care 58 Integrating Palliative Care into an Academic Family Health Team 59 Longitudinal Study of Mental Health Services at Summerville Family Health Team 60 “In the Wee Small Hours of the Morning”: An Insomnia Reversal Program for Primary Care 61 Primary Health Care: Chiropractic Collaboration (poster to follow) 62 A Collaborative Approach in Integrating Evidence Based Practice in Smoking Cessation- A Paradigm Shift (poster to follow) 63 Evaluation & Lessons Learned from the Interprofessional Memory Clinic: Loyalist Family Health Team – impact on the patients, care partners, health care providers and community partnerships (poster to follow) 70 PAASSPORT: Primary Care Advanced Access Study: Spreading the Practice and Optimizing interprofessional Resources and Treatment Theme 8 – Meaningful use of EMRs 64 Advanced Access – Same Day Next Day Physician Access 65 The McMaster Pain Assistant: The why, what and how of a new EMR tool that teaches. 66 Updating and Standardizing Nutrition Handouts on the EMR 67 Supporting the implementation of the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain in primary care 68 Preventing Clinically Significant Drug/Disease Interactions in Primary Care
Tag: Health Promotion & CDPM
-
AFHTO 2013 Conference – Advances in Health Promotions and Chronic Disease Management
Theme Description: Family Health Teams have been focused on health promotion, disease prevention and chronic disease management since the first teams were announced in 2005. What advances have we made? What is the new knowledge that’s emerging? What is the evidence for what works to keep people as healthy as they can be? A5 – Pulmonary Rehabilitation in the Barrie Community Family Health Team – in Primary Care A presentation of patient flow in the BCFHT will demonstrate how a PR program normally hosted in a tertiary care center; can be as effective in the primary care setting, utilizing a team approach. B5 – STOP with FHTs: Building Capacity to deliver Smoking Cessation Programming in Family Health Teams Highlighting FHTs as they integrate smoking cessation interventions into individual and organizational practices, this presentation will show how multi-stakeholder partnerships collaborate to create comprehensive smoking cessation programming in the primary care setting in Ontario. C5 – The “One Stop Shop” Diabetes program: Engaging, Aligning, and Integrating interdisciplinary team to create a patient-focused program This workshop will be divided into two components; a presentation outlining DCG’s program, followed by group discussion related to current challenges and possible solutions at DCG and other similar programs within your FHT in an effort to continue to provide exceptional interdisciplinary care to the diabetes population. D5 – Outcome Measurement: Developing a culture of Measurement, Optimization and Impact at Diabetes Care Guelph The successes and challenges related to tracking patient data in a diabetes education center are presented so other practices may benefit from the experience shared with the goal of reducing the likelihood of repeating similar time-intensive challenges and increasing process efficiency. E5 – Sustainability versus Feasibility: lessons learned from a pilot health coaching project This project titled: ‘Health Coaching in Primary care: a feasibility model” piloted health coaching for patients with diabetes in two Family Health Teams and a Community Health Centre. F5 – Exercise; The missing ingredient in the FHT recipe We will present some background data on the role of exercise therapy for chronic disease management, as well as the successes and challenges with including this type of program in a FHT, as well as a summary of outcome data and future program plans
-
Cancer Screening – Quality Improvement Toolkit
Cancer Care Ontario (CCO) has developed a Cancer Screening Toolkit to help FHTs develop cancer screening quality improvement plans. This toolkit will assist FHTs in planning, implementing, monitoring and reporting on improvements in colorectal, cervical and breast cancer screening. Tools include:
- Cancer Screening Sample Timeline,
- Instructions for developing your QIP based on the Plan, Do, Study, Act principles,
- Planning and Measurement templates
- An Appendix of additional data sources, including the ColonCancerCheck Screening Activity Report (CCC SAR).
While the toolkit provides guidelines on implementing a cancer screening QIP for all three cancer modalities, FHTs can scale back or expand their scope depending on the maturity of their cancer screening practices and other priorities. It is hoped that FHTs who choose to incorporate cancer screening into their 2013/2014 QIP will find the Cancer Screening Toolkit to be useful. Many Thanks to Dr. Suzanne Strasberg, lead physician of the Jane-Finch FHT and regional primary care lead with CCO, who shared this toolkit with AFHTO.
-
AFHTO 2012 Conference – Improving the Patient’s Experience of Care
The following presentations were made at the conference under this theme: Seniors Serving Seniors – Using Focus Groups to Inform Programming Respecting our Patients and Each Other – a Customer Service Approach Champagne Club – Assessing Excellence in Customer Service at an Academic Family Health Team Evaluating the impact of two different forms of diabetes self-management education on knowledge, attitude and behaviours of patients with Type 2 diabetes mellitus Holistic Palliative and Wellness Support for the Whole Family Gaps & Patient Perspectives on the Organization of Health Services for Post-Gestational Diabetes The Role of Elder Mediation in the Interdisciplinary Care of Elderly Patients – What Have We Learned
-
AFHTO 2012 Conference – The Triple Aim in FHTs – Better Care, Better Health, Better Value
The following presentations were made at the conference under this theme: Improving Processes Together: Co-design with Seniors, Caregivers, and Clinicians Building a House Calls Practice: The Key Features and Processes of an Integrated Home-Based Primary Care Model Implementation of the Asthma Action Plan to improve asthma control, quality of life and reduce hospital visits Medical directives & policies – how to get started and how they can support your quality and patient safety In-Home Primary Care Program for Frail Seniors: A Guelph Family Health Team Aging At Home Initiative
-
AFHTO 2012 Conference – Meeting Needs of Special Populations
The following presentations were made at the conference under this theme: Caring for patients with severe physical challenges “Speak Freely”: Counselling Drop in Clinic for Teens Developing a Patient-centred Primary Care Model for Vulnerable Older Adults How can Family Health Teams promote the health of people with developmental disabilities?: Practical steps that Teams can implement and extend to other special populations Introduction to Traditional Healing Practitioners/Knowledge and Methods: working with the Aboriginal Patient The Rural Geriatric Glue How the Enhanced 18-month Well-Baby Visit Has Led to Primary Care-Public Health Partnerships
-
Links on Health Promotion and Illness Prevention
The following is a selection of the many sites that contain information and resources for patients:
General Health Information
Canadian Living Fraser Health Health Canada Healthy Ontario Take Heart Algoma Heart and Stroke Foundation of Ontario Medline Plus – Interactive Health Tutorials NHS Scotland Northern Health Ontario Ministry of Health Promotion Public Health Agency of Canada Vancouver Coastal Health
Women’s Health
The Canadian Women’s Health Network Women’s Health Matters
Children’s Health
Asthma Society of Canada Caring for Kids Child & Family Research Institute Physical Activity Kids Health Ontario Early Years Centres also offers many resources and programs for parents with young children (0-6).
Healthy Eating
5 to 10 a Day for Better Health Dietitians of Canada Eat Right Ontario Health Canada Interior Health – Nutrition Over the Life Cycle Your Digestive Health
Physical Activity
Active 2010 Government of Canada Health Canada Public Health Agency of Canada
Healthy Living
ActNowBC BC Health Guide Healthy People Living in Healthy Communities Healthy U Prevention Trails for Health
Smoking Cessation
The Lung Association Ontario Ministry of Health Promotion Smokers Help Line Tobacco Free RNAO Smoking and Pregnancy
Persons with Disabilities
-
Smoking cessation – online tool to support patients
The Break It Off Mobile Application – a behaviour modification tool to help smokers kick the habit – allows patients to identify triggers, deal with cravings, track their progress, and call a Smokers’ Helpline Quit Coach directly through the application. It can be downloaded onto Apple and Android devices.
This is part of the Canadian Cancer Society’s “Break It Off” digital campaign to promote tobacco cessation using the metaphor of ending a personal relationship. The website also offers a resource hub for patients to learn about proven quit methods, such as phone counselling, patches, gums, and inhalers.
-
Using Spirometry in Clinical Practice
2011 AFHTO conference presentation PRESENTER (S): Angie Shaw, RRT,CRE Respiratory Educator; Amy Massie, RRT, CRE Respiratory Educator FHT/ORG: New Vision FHT ABSTRACT: This workshop will assist Family Health Team members in utilizing spirometry as a valuable tool in various clinical settings. Case studies will be presented, worked and reviewed. There will be a brief review of spirometry interpretation principles. Participants will then have the opportunity to practice interpretations, and consider recommendations based on the case presentations. Upon completion of the workshop participants will be better able to use spirometry results as a valuable tool in diagnosis and treatment of obstructive/restrictive lung conditions, and have an improved understanding of what recommendations to make based on results from spirometry testing. Click here to view presentation.
-
Self Management for Chronic Pain Patients
2011 AFHTO conference presentation PRESENTER (S): Shellie Buckley, RN FHT/ORG: Stratford FHT ABSTRACT: Self management is a fairly new, vogue term used in healthcare but does it really work for patients with chronic pain? The data collected at the Stratford Family Health Team over the past two years shows chronic pain patients will attend six week group sessions and will benefit not only at the time but continue to demonstrate positive effects weeks and months later. Following the standardized model of the Stanford Chronic Pain Self Management Program patients are supported and guided through a six week structured program. Each week patients learn and develop skills or tools to help them be competent and successful self managers. A collection of real patient case studies will be reviewed to demonstrate the benefit of self management for the patient with chronic pain. Click here to view presentation.