Tag: Highlights

  • Interprofessional Medication Management in Patients With Multiple Morbidities

    Published in Deutsch Aerzteblatt-International, November 2016 [English version]

    Abstract

    Background: Medication reviews and medication management are being used more and more around the world to improve medication safety. Both of these tools were originally conceived as pharmaceutical care activities and have recently been developed into interdisciplinary approaches. We studied the efficacy of interprofessional medication management for multimorbid patients that takes their medical conditions, but also their general living situation into account. Methods: A comprehensive medication management was performed, which involved the collection of information on the drugs each patient took, the way they were stored, the patient’s drug intake and handling, and any problems that arose with pharmacotherapy. The interventional approach was evaluated over a period of 15 months in a cluster-randomized controlled trial with a stepped wedge design.  The primary endpoint was the quality of pharmacotherapy, as assessed with the Medication Appropriateness Index (MAI). A mixed model was used to analyze efficacy. Results: 162 patients were enrolled in the study; 142 were included in the intention-to-treat analysis (53.3% women, mean age 76.8 ± 6.3 years). The mean total MAI score decreased significantly (p ≤ 0.001) from the control phase (29.21, 95% CI [26.09; 32.33]) to the intervention phase (22.27 [19.00; 25.54]), with an effect strength (Cohen’s d) of –0.24 [–0.36; –0.13]. The number of drug-related problems declined as well. Conclusion: In this study, interprofessional collaboration increased medication safety. Working across disciplinary boundaries allowed for a decrease in drugrelated problems and brought up aspects outside the purview of the primary care physician.

    Authorship & Citation

    Corresponding Author: J. Köberlein-Neu (corresponding Author: koeberlein@wiwi.uni-wuppertal.de) English Citation: Köberlein-Neu J, Mennemann H, Hamacher S, Waltering I, Jaehde U, Schaffert C, Rose O: Interprofessional medication management in patients with multiple morbidities—a cluster-randomized trial (the WestGem study). Dtsch Arztebl Int 2016; 113: 741–8. DOI: 10.3238/arztebl.2016.0741 Translated from the original German by Birte Twisselmann, PhD.  Original German Version available here.

  • Brighton-Quinte, Trent Hills, and Northumberland FHTs Receive Provincial Investment

    Inside Belleville article published November 10, 2017. Article in full pasted below.

    Sarah Hyatt, Brighton Independent

    Brighton — Ontario’s 2017 investments in interprofessional care were in the spotlight last week, as Northumberland-Quinte West MPP Lou Rinaldi made a stop at the Brighton Health Services Centre on Tuesday, Nov. 7. The province has committed more funds for local health care, hoping to enhance quality of care and access to services, those in attendance last Tuesday heard.

    During his stop, Rinaldi highlighted an additional new base funding of $270,154 for the Brighton-Quinte West Family Health Team (BQWFHT). The team will also receive an extra $28,300 in one-time support to improve health care services. “I’m very proud to have been at the forefront of family health teams in Ontario,” said Rinaldi. “This investment continues to support a ‘full-circle’ approach to health care and will increase access to services for the entire community.” The BQWFHT currently provides care to almost 13,000 patients.

    “As part of the 2017 budget, Ontario is helping more people across the province access teams of health care professionals, to ensure patients can receive comprehensive and personalized health care where they need it,” a statement on behalf of the province reads. There are currently 294 interprofessional care teams within Ontario that provide care to more than four million patients. The province has committed a total of $248.4 million in the next three years to support those existing teams and so new care teams can be created.

    “The Brighton-Quinte West Family Health Team remains a significant asset within this community and these additional funds will help with various staffing needs,” said Mayor Mark Walas, following Rinaldi’s visit to the Brighton Health Services Centre and happy to hear the province has committed additional funds for health care teams. Support for existing teams may include recruitment of new staff or funds may also be used to retain current workers. Ontario wants every region to have at least one health team in coming years.

    Of that $248.4 million, about $102 million is dedicated for expansion of care teams and about $145 million for the recruitment and retention of health care professionals. About $15 million will be invested for 2017-18. These investments, in addition to Ontario’s announcement that prescription medications will be free for all kids and youth 24 years old and younger, are said to be part of a provincial plan to increase access to care and will improve patient experience, as well as reduce wait times. (More information on the Patients First Action Plan for Health Care and OHIP+: Children and Youth Pharmacare Program is available via the web.)

    For BQWFHT staffers, the investment is important for a number of reasons. “The past few years have seen significant growth in our patient population, as well as the recruitment of new physicians to the area,” said Wendy Parker, executive director. “The annual funding acknowledges the provision of high-quality primary care to our patients and families, and responds to our need for increased programs and services in the Brighton, Colborne and Quinte West communities.”

    The purpose of health care teams is to bring together a diverse group of professionals to help meet the individual and often-complex needs of patients. Teams include professionals from all fields of health care, including doctors, social workers, nurses, dietitians, physiotherapists and more. Since its inception with the first wave of family health teams in Ontario, the BQWFHT has worked hard to bring high-quality health care to its patient base and the organization has seen continuous growth, said Dr. Richard Wiginton, the lead physician with the team.

    “We have excellent governance and numerous clinical programs run by our dedicated and professional staff,” he said. “We are an increasingly utilized teaching site for undergraduate, medical resident and nurse practitioner training.” And it’s the quality of the team which has helped with successful recruitment of new physicians to the area, Wiginton insists. The doctor said the team is “very pleased to be recognized” by the province and “with our new and significantly increased funding. We are careful and responsible stewards of Ontario taxpayer dollars and we look forward to the stability and opportunities for growth that our new funding will provide.”

    As warden for the county, Walas was also pleased to hear both the Trent Hills and Northumberland family health teams are seeing an increase in funding support. To support recruitment and retention, $79,600 in additional base funding has been dedicated for Trent Hills. The Northumberland team will receive a boost of $107,000 for recruitment and retention, $51,134 in additional base funding and $8,000 in one-time support to enhance quality and access to health care services.

    Click here to access the Inside Belleville article.

    Relevant Link

  • AFHTO members to be recognised in 2017 OCFP Awards

    AFHTO congratulates Sherbourne Health Centre FHT and physicians in our member family health teams who will be recognized on Thursday, November 23, 2017 at the Ontario College of Family Physicians (OCFP) 2017 Awards Ceremony.

    Congratulations to all those recognized this year:

    Dr.  Michael Lee-Poy of The Centre for Family Medicine FHT, named 2017 Reg. L Perkin Ontario Family Physician of the Year as well as Regional Family Physician of the Year. Sherbourne Health Centre FHT, named 2017 Family Practice of the Year. Regional Family Physicians of the Year

    And the following Award of Excellence recipients:

    Relevant Links:

  • The Centre for Family Medicine FHT Awarded REACH Funding

    Congratulations to The Centre for Family Medicine Family Health Team eHealth Centre for Excellence, one of six successful public healthcare service provider organizations receiving the second round of REACH funding. REACH is a grant funding program delivered by the Ontario Centres of Excellence (OCE) on behalf of Ontario’s Ministry of Government and Consumer Services. The program’s goal is to support Ontario healthcare provider organizations to adopt healthcare technology solutions to meet their high-priority needs. For this round, OCE is supporting these projects with a $4.3 million program investment from the province. See this link for further details.

  • Niagara North FHT Supports Intergenerational Community Cooking Classes

    Niagara Advance article published November 3, 2017. Article in full pasted below. Penny Coles, Niagara Advance Cooking classes at the Niagara-on-the-Lake community centre are bringing youth and seniors together to learn about healthy meals. Let’s Cook Together is a continuation of a successful program that took place last year at the community centre, paid for by a provincial grant for seniors. It’s being repeated this year, free of charge thanks to funding by the Healthy Kids Community Challenge, with an inter-generational component. The program offers four weeks of cooking classes, Thursdays from 4 to 6 p.m. The theme of the current program, which wraps up next week, is Boost your Fruits and Vegetables, which teaches and encourages participants to include produce as part of their daily meal plan, says Nicole McDougall, program facilitator and dietician with the local family health team. A new session begins Nov. 16 and runs until Dec. 7. Dan Maksenuk, community centre co-ordinator, says the class has 18 regulars registered this session, pretty evenly divided but with a few more young people that seniors. “It’s been very successful,” he said. “With the combination of kids and seniors, you can see them learning from each other. The seniors help the young people cut and prepare food, and the kids help the seniors with technology.” The recipes contain lots of whole grains, legumes and lean protein sources for a balanced meal, McDougall says, and any leftovers from the class are taken home by participants, along with copies of the recipes. Support is provided by the family health team and Niagara Region Public Health community food advisors. To register call 905-468-4386 or visit www.notl.org. Click here to access the Niagara Advance article.

  • Rapids FHT and Partners Form Lambton County Drug Strategy

    The Sarnia Journal article published October 29, 2017. Article in full pasted below. Troy Shantz, The Sarnia Journal The numbers are staggering. Last year, 1,326 residents of Sarnia-Lambton were prescribed an opioid for pain. That’s one in six. Another 1,326 people — one in every 93 people living in Sarnia-Lambton — were treated for an addiction to opiates with prescribed methadone or suboxone. Forty-seven people were hospitalized for opioid poisoning, five died, and 48 babies were hospitalized for maternal drug addiction in 2016, according to Lambton Public Health. “Some of the stats were just amazing,” said Lynn Laidler, the executive director of Rapids Family Health Team. “We didn’t realize how high they were.” In response, a committee began looking at ways the community could reduce drug abuse this summer. It had people from Rapids, Bluewater Health, Lambton Public Health, the city and Sarnia Police. A couple of weeks ago, representatives from more than 20 agencies met in a brainstorming session to discuss the creation of a Lambton County Drug Strategy. Laidler said better communication between agencies and with the wider community was identified as one priority. Social media will be used, and some agencies are willing to combine budgets and staff to make it happen, she said. At Bluewater Health, addiction treatment staff have seen a 300% increase in demand for service since 2014. The hospital recently announced it is getting $445,000 to create an eight-bed addiction treatment unit, which could be open as soon as January. The unit is regarded as a stopgap measure until a 24-bed facility with fully integrated drug treatment program can be opened in Sarnia. “We have a lot of good things, but we can always do more,” said Laidlaw. The group of agencies plans to meet again Nov. 23 with the goal of announcing at least two directives. Click here to access the The Sarnia Journal article. Relevant link:

  • Announcing the Bright Lights 2017 Award Winners

    AFHTO has named the winners of our annual Bright Lights Awards. These innovators have improved primary care by making the most of their resources, strengthening interprofessional collaboration, and building strong partnerships beyond their walls. This has resulted in better patient outcomes, better access, and better experience of care. Review committees made up of AFHTO members selected the winners from more than 70 nominations. In addition to the awards in our seven conference themes, the AFHTO board presented a special award for Leadership in Public Health and Primary Care Collaboration to Windsor-Essex County Health Unit. They demonstrate a strong commitment to health promotion, working with FHTs, NPLCs and CHCs in their community to design coordinated, evidence-based programs and services.

    The seven Bright Lights Award recipients are listed below. Click on the links to read a summary of each of their achievements.

    1. West Durham FHT

    Award category: Effective Leadership and Governance for System Transformation

    Achievement: Leadership is not a title –Taking a proactive approach to change, adopting processes to ensure their leadership is skills-based, patient-centred and inclusive.

    2. Belleville Nurse Practitioner-Led Clinic

    Award category: Planning Programs for Equitable Access to Care

    Achievement: Primary Care Low Back Pain Pilot – Successfully implementing a new interprofessional approach to managing low back pain. This improved patient outcomes with less reliance on medications and fewer ER visits, and fortified collaboration both within the team and with other organizations

    3. Leamington and Area Family Health Team

    Award category: Employing and Empowering the Patient and Caregiver Perspective

    Achievement: Changing the Culture Around Advance Care Planning – Breaking taboos through an education program for patients, caregivers, families and the community, destigmatizing conversations around end-of-life care.

    4. St. Michael’s Hospital Academic Family Health Team

    Award category: Strengthening Partnerships

    Achievement: Health Justice Initiative– Implemented a multilevel program to address legal issues that present a barrier to better health, including providing onsite legal assistance for patients, educating staff and undertaking advocacy at the system level.

    5. eHealth Centre of Excellence, Centre for Family Medicine Family Health Team

    Award category:  Optimizing Use of Resources

    Achievement:  Coordinated Access to All Services – Demonstrating leadership in digital health through the development and spread of a systemwide coordinated approach to access to a wide variety of care and services.

    6. Thamesview, Tilbury District and Chatham Kent Family Health Teams

    Award category: Using Data to Demonstrate Value and Improve Quality of Care

    Achievement:  Primary Care Impact on an Integrated Case Management Model for the Frequent User – Adopted an integrated case management model that improved the healthcare experience of individual patients with complex needs, simultaneously reducing ER visits and hospital admissions.

    7. North York Family Team

    Award category: Clinical Innovations for Specific Populations

    Achievement: Multidisciplinary Approach To Deprescribe Sedative Hypnotics In The Elderly – Introduced a two-stage, interprofessional insomnia reduction program for older adults, resulting in improved mood and sleep quality, reduced anxiety and lower drug use.

    The call for nominations for the 2018 Bright Light Awards will go out in June 2018. All AFHTO members are welcome and encouraged to participate. For additional event photos, please contact info@afhto.ca. [envira-gallery id=”30971″]    

  • Manitoulin Central FHT Physician Awarded Associated Medical Services (AMS) Phoenix Fellowship

    The Manitoulin Expositor article published October 20, 2017. Article in full pasted below. Expositor Staff, The Manitoulin Expositor MINDEMOYA—A Northern Ontario School of Medicine (NOSM) faculty member who works at the Manitoulin Central Family Health Team and Manitoulin Health Centre in Mindemoya, Dr. Frances Kilbertus, is among six distinguished educators to receive a 2017 Associated Medical Services (AMS) Phoenix Fellowship. Dr. Kilbertus, NOSM associate professor, and Dr. James Goertzen, NOSM assistant dean, continuing education and professional development, are among six distinguished educators to receive the award. Dr. Kilbertus is focusing her Fellowship on projects that explore how the community, the workplace, health professionals and learners are interwoven in a process of learning and practicing palliative care in the culturally diverse rural community on Manitoulin Island. “The focus for the first year of the fellowship will be exploring community involvement, creating opportunities for engagement and dialogue around death and dying, and developing learning tools for palliative care that are inclusive of an Indigenous perspective,” Dr. Kilbertus says. “The second year will focus on the rural clinical workplace; how learners and practitioners understand and appreciate palliative care and how compassionate learning environments are created and sustained.” The Fellowship from AMS Healthcare is awarded each year and specifically targets individuals with strong leadership abilities who are committed to nurturing and sustaining the learning and practice of compassionate care. The intent of the Fellowship is to provide support (the equivalent of $50,000) to individuals to allow them to devote time to engage in leadership activities, building capacity in their home institution and across Ontario. “The Northern Ontario School of Medicine was founded on a strong social accountability mandate,” says Roger Strasser, NOSM Dean and CEO. “These fellowships, which advance compassionate care within the health-care community and sustain compassion in the environments on which health professionals learn and work, fit perfectly with the Schools’ distributed, community-engaged, learning-centred model of education and research.” Click here to access The Manitoulin Expositor article.

  • Premier Kathleen Wynne Grants Georgina’s NPLC $1.63 million

    York Region article published October 18, 2017. Article in full pasted below. Heidi Riedner, Georgina Advocate Dressed appropriately in a liberal swath of red, Premier Kathleen Wynne paid a visit to Georgina’s nurse practitioner-led clinic to deliver a $1.63 million grant that will help meet the demand for local health care. “Everyone here supports and believes in the notion that we should be able to provide high-quality, patient-centred care for people as close to their homes as possible,” Wynne said during the announcement of the provincial funding at the Dalton Road clinic Oct. 11. “That’s what this clinic is about (and) our investment will help more people get the care they need faster and closer to home.” The long-awaited and much-anticipated funding is the result of a comprehensive application put together by the clinic’s director, Beth Cowper-Fung, finally making its way through the bureaucratic process. It will go toward the clinic’s new location on the vacant Lake Drive lot, just east of the town parkette, in Jackson’s Point. “Thanks to the generosity of the Georgina Community Health Care Council, we’ve been able to stay here while we’ve been waiting for this great news, however the current building no longer meets code for a medical facility,” Cowper-Fung said. More functional space to offer confidential programs to the clinic’s current 3,000 patients, as well as the opportunity to provide services to more people who do not have a primary health care provider are two key benefits of the new location, Cowper-Fung added. It is the next step not only in the evolution of the nurse-practitioner model of health care, but also what Wynne called a “transformation of health care in Ontario” built on an interdisciplinary approach “that we know works so well.” “To be fair, we’re just figuring that out again as a society,” Wynne said, adding offering an amalgam of services in one location is a “good idea” and counteracts the “silo” effect of care created during the past few decades. Wynne added Georgina’s clinic is “ahead of the curve” in that respect. Indeed, 15 applications were received from across the province this year, according to the executive director of the Nurse Practitioners’ Association of Ontario, Theresa Agnew. Nurse practitioners (NPs) started out as registered nurses (RNs) who went back to university to “learn how to do more for their patients”, Cowper-Fung said. Thanks to recent regulatory changes, the scope of nurse practitioners has expanded to include writing prescription medications and ordering diagnostic imaging. Georgina’s one and only NP-led clinic — one of 25 clinics serving 60,000 people in the province — has come a long way since NP Anne Hughes worked alongside Dr. Burrows almost a decade ago. Its current team offers primary care, as well as access to specialty services from social workers, a dietician, registered practical nurse, physiotherapist and lab technicians. Combined, they provide a gamut of services from mental health care, to service co-ordination and referral to community health care providers and agencies, chronic disease management programs, patient education, health promotion and disease prevention programs and palliative care. Services also include off-site house calls to the Chippewas of Georgina Island, local youth and women’s shelters and two area group homes. “We provide primary care and services to all ages at all stages,” Cowper-Fung said. “From the first prenatal visit when we get to hear that first heartbeat, which is so exciting, to the very last of palliative care when we hear the very last.” While the province is investing in family health teams and nurse practitioner-led clinics to advance the interdisciplinary care that people need, it also puts more money into hospitals, increasing funding for home care and mental health programs in schools, Wynne said. “We understand that we have to work on all fronts,” she said. Ontario’s health care budget for 2017-18 is $53.8 billion, which represents a 3.8 per cent increase from the previous year. The Central East LHIN’s annual budget, which includes York Region, is $2 billion. Breaking ground on the clinic’s new location is expected in 2018. Click here to access the York Region article.

  • AFHTO 2017 Conference: Tips for your arrival and stay

    Planning your Conference Experience Sharing your Conference Experience Hotel Registration & Directions

    It’s now less than one week to the AFHTO 2017 Conference on October 17 & 18! We look forward to seeing you all as we welcome over 800 delegates from around the province. To ensure a smooth experience, please see below for some helpful tips for planning your arrival and stay at the conference:

    Planning your Conference Experience

    • Today is the deadline to pick your sessions and ensure your personalized schedule will be printed on your name badge. Click on the “change or update your registration” link in your confirmation email to do so.
    • The conference program is available online and a printed kit will be handed out on arrival.
    • Displays at the Conference: Feel free to visit our poster and exhibit displays during your breaks.
    • Wi-Fi will be available to conference attendees for 1 device per person (smartphone, tablet, computer or other electronic device).
    • For information on our Concurrent Sessions, Opening and Closing Plenaries, Bright Lights Awards Dinner, and all other conference sessions click here .

    Conference On-site Registration opens at 8:00 AM on both Oct. 17 and 18

    • Conference registration is in Convention Centre North, Second Floor. For a map of the convention centre see page 4 of the registration kit.
    • If you can no longer attend the conference and someone else is taking your place, please forward your registration confirmation e-mail to him/her to show it at the registration desk

    Sharing your AFHTO experience

    • The official AFHTO hashtag is #afhto2016 – be sure to follow @afhto on twitter and “like” AFHTO on Facebook for regular updates at the conference.

    Hotel Registration & Directions

    Note: Blue Jays play home playoff games on Monday, October 17 at 8:00pm and Tuesday, October 18, at 4:00pm. The conference winds up at 2:30, well in advance of the game, but traffic in the Toronto waterfront area is likely to be heavier.  Allow for longer travel times, or perhaps plan to extend your stay by a few hours to enjoy the excitement! Hotel room registration is in the main building.

    Attendance at this program entitles certified Canadian College of Health Leaders members (CHE / Fellow) to 7.5 Category II credits toward their maintenance of certification requirement. This program has been certified by the College of Family Physicians of Canada and the Ontario office for up to 16.25 Group Learning credits.