Ultimate Blogging Championship

Tag: Highlights

  • AFHTO 2022 Conference: just over 2 weeks to submit your abstract

    AFHTO 2022 Conference: just over 2 weeks to submit your abstract

    Reconnect and Reimagine: moving forward together

     

    Submit your abstract- deadline May 26, 2022, at 5:00 PM (EDT)

    Hourglass with green sand sits in shadow

     

    Don’t let the deadline sneak up on you. We want your insight on:

    • Reducing sources of friction in community collaboration
    • Developing the Patient Medical Neighbourhood/Ontario Health Teams (OHTs)
    • Internalising lessons learned in EDI and anti-racism journeys
    • Addressing systemic barriers
    • Supporting our own resiliency

     

    Not sure if your work is a good fit? Feel free to ask us! Email info@afhto.ca or call 647-234-8605x 1200. We’d be happy to help.

    Helpful links:

    All are welcome. Please pass this along to your peers, colleagues and network including those from other healthcare sectors, non-profits, and the academic and research communities.

    This is our first hybrid conference. This means it will be a mix of in-person sessions and on-demand. We will continue to have regularly scheduled webinars focused on primary care teams’ needs for the rest of the year so as always send in your suggestions! For this conference, we welcome speaker suggestions.

    Conference key dates:

    • May 26, 2022– Deadline for abstracts
    • June 15, 2022 – Bright Lights nominations
    • July 2022- Conference registration opens
    • September 28, 2022– Early bird registration deadline
    • October 12, 2022– AFHTO 2022 Conference

     

    For more information, you can contact us by phone (647-234-8605 x1200) or e-mail (info@afhto.ca).

  • 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:

  • AFHTO 2022 Conference: call for abstracts

    AFHTO 2022 Conference: call for abstracts

    Reconnect and Reimagine: moving forward together

    It’s time to highlight primary care.

    Present your ideas and initiatives at the AFHTO 2022 Conference:
           
    Reconnect and Reimagine: moving forward together

    We’ll be selecting sessions and posters for our 4 core themes and we need your help. We want your insight, from system and policy-level discussions to patient-focused inquiries into the ways teams can better serve their communities now as we reconnect and reimagine, moving forward together.

    What do we mean? Dive deeper into our conference theme.

    The deadline to submit for an #AFHTO2022 presentation is
    May 26, 2022, at 5:00 PM (EDT)

    Review submission guidelines

    Submit online

    Reduced registration fee for concurrent session presenters: For each approved concurrent session, up to 2 presenters will each be granted a $35 discount off the conference registration fee. Additional discounts apply for patients presenting at the conference. (Discount doesn’t apply for poster displays.)

    This is our first hybrid conference. This means it will be a mix of in-person sessions and on-demand. We will continue to have regularly scheduled webinars focused on primary care teams’ needs for the rest of the year so as always send in your suggestions! For this conference, we welcome speaker suggestions.

    Conference key dates:*

    • April 26, 2022- Call for abstracts
    • May 26, 2022– Deadline for abstracts
    • June 15, 2022 – Bright Lights nominations
    • July 2022- Conference registration opens
    • September 28, 2022– Early bird registration deadline
    • October 12, 2022– AFHTO 2022 Conference

    Do you know anyone with interesting and innovative initiatives to share? Please forward this email to your colleagues, community partners and stakeholders to make sure everyone has an opportunity to present their initiatives.

    And don’t forget, the deadline to join a working group and/or Bright Lights review committee is next Tuesday, May 3. Come behind the scenes of our first hybrid conference and be the first to learn about new developments in the field, influence conference programming and discover the latest innovators in areas directly relevant to your work. Working group members also receive a discount off their registration fee.

    For more information, you can contact us by phone (647-234-8605 x1200) or e-mail (info@afhto.ca).

  • Letter to Minister Elliott – Scheduled lifting of public health measures

    Letter to Minister Elliott – Scheduled lifting of public health measures

    AFHTO, IPHCC and Alliance logos

     

    April 21, 2022

    Hon. Christine Elliott
    Minister of Health 
    777 Bay St., College Park, 5th Floor
    Toronto, ON M7A 2J3

    Dear Minister Elliott,

    As associations representing interprofessional primary healthcare teams, we are concerned about the projected impact of what both Chief Public Health Officer of Canada, Dr. Theresa Tam, and our Chief Medical Officer of Health, Dr. Kieran Moore, have confirmed is the sixth wave of COVID-19.

    With hospitalizations related to COVID-19 surpassing the 1,600 threshold for the first time since mid-February,  we are seeing more individuals in ICUs being treated for COVID-19. While vaccinations and some immunity from  prior infection are helpful, being “fully vaccinated” (only 2 doses) or having had the virus does not stop a person’s ability to carry and transmit it to others or to become reinfected.

    We ask that you do not end any of the public health measures that are scheduled to be lifted on April 27, especially mandatory masking in all healthcare settings – including primary care clinics – and public transit.

    Please also consider reinstating masks in indoor public settings as we know masks reduce spread. At minimum, require their use in essential settings that vulnerable people must go to, such as grocery stores and pharmacies.

    We need to support healthcare providers and prioritize prevention measures. Decisions based solely on hospital capacity do not keep in mind how precarious our health human resources are – particularly in primary care, where people get care that can prevent them from being hospitalized. In addition, delayed surgeries due to healthcare providers being sick or inundated with COVID-19 cases will continue to hurt Ontarians. We have never seen as many healthcare workers off with COVID-19 as in this wave. This is putting health system capacity and the wellbeing of many Ontarians at great risk. It is critical not to lift any more prevention measures and to protect the scant HR capacity that we currently have.

    Thank you for considering our input. We wish you all the best in your future endeavors.

    Sincerely,

    Kavita Mehta, Association of Family Health Teams of Ontario

    Sarah Hobbs, Alliance for Healthier Communities

    Caroline Lidstone-Jones, Indigenous Primary Health Care Council

    
 
  • AFHTO 2022 Conference: create YOUR hybrid conference. Sign up by May 3

    AFHTO 2022 Conference: create YOUR hybrid conference. Sign up by May 3

    Reconnect and Reimagine: moving forward together

    Join a working group

    You can make an impact by joining a working group today. Come behind the scenes of our first hybrid conference and be the first to learn about new developments in the field, influence conference programming and discover the latest innovators in areas directly relevant to your work. Working group members also receive a discount off their registration fee.  

    Please extend this invitation along to your patients, colleagues, and staff. Having diverse voices, especially patients, in the working groups helps us build a varied and relevant program.

    Conference Themes

    We’re setting up working groups for concurrent sessions, posters, and the Bright Lights Awards program. We will continue to have regularly scheduled webinars focused on primary care teams’ needs for the rest of the year so as always send in your suggestions! For this conference, we welcome speaker suggestions so let us know your thoughts as the five conference themes will focus on:

    1. It takes a team: collaboration inside and out
    2. Health equity at the centre
    3. Sustainable solutions to primary care problems
    4. Mental health and addictions

    (Full descriptions here)

    Working Group Details

    Concurrent program working group members:
    The task requires a total of 4-10 hours of effort in May and June, specifically:

    • April 26 to May 26: AFHTO staff will manage the call for proposals process.
    • Week of May 9: working groups will have an initial Zoom session to brainstorm ideas on specific topics and speakers to contact/encourage to submit a presentation abstract.  
    • May 31 to June 10: each working group member individually reviews and scores abstracts for their program.
    • June 13 to 16: working groups will meet via Zoom to review scores and determine the program for this theme.

    Sign up by May 3, 2022, to confirm your participation and select your preferred conference theme.

    Bright Lights logo

    “Bright Light” Awards Review Committee:
    The task requires a total of 6-12 hours in July and August, specifically to individually review and score nominations followed by a Zoom meeting to determine the award winners. Sign up by May 3, 2022

    We may also need volunteers onsite during the conference itself. There may be other duties as we update our conference program but like other volunteers described above, onsite volunteers will receive discounted conference registration. Sign up today.

    Registration Fees for Conference Working Groups:

    • Conference working group members and presenters receive a $35 discount off their registration fee
    • We understand patients face additional financial and time pressures and do not want the registration fee to limit participation in a working group. Patients participating in full in a conference working group will be eligible for complimentary registration (to be determined once the working group task is complete).  

    AFHTO members still receive a significant discount on conference registration fees.

    Conference key dates:*

    • April 26, 2022- Call for abstracts
    • May 26, 2022– Deadline for abstracts
    • June 15, 2022 – Bright Lights nominations
    • July 2022- Conference registration opens
    • October 12, 2022– AFHTO 2022 Conference

    *All dates subject to change, except the conference dates.

    To our sponsors, the sponsorship prospectus is coming soon. For more information, you can contact us by phone (647-234-8605) or e-mail (info@afhto.ca).

  • 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

  • Election 2022: 52 days to go!

    Hi everyone,

    It’s exciting to be speaking with teams about their current advocacy and the work being planned for the coming two months as we head towards the June 2 provincial election! The election is expected to start on May 4. As you all know, though, parties are in full election mode now.

    To help make sure parties understand the importance of team-based primary care and how to address the crisis facing the healthcare sector, candidates need to hear about it – and solutions on how to fix it – from local stakeholders and voters. As healthcare leaders and providers, you are in an excellent position to do this and to encourage friends, family, and patients do as well.

    AFHTO held an advocacy webinar with our government relations firm, Enterprise Canada, last week to discuss advocacy and the tools we’ve developed to support you. The deck and recording are posted on our advocacy page.

    You’ll see the link to this at the top of the page. Underneath the webinar link, you’ll see links to the tools. They’ll be helpful in your work over the next two months.

    The following are posted:

    • Advocacy toolkit, which includes key messages, template letters, and FAQs
    • Toolkit on how to organise a townhall
    • One-pager to leave behind at meetings – or to mail or email to candidates
      • There is a standard version or a fillable version, where you can make edits to what team-based primary care is an investment in
    • Animations to use on social media
    • Social media graphics
    • Voter card with top questions to give to family, friends, team members, and patients to use either reactively when campaigns reach out, or proactively
    • Patient story map to support any patient who might join a meeting
    • Our 2022 pre-budget submission that speaks to key areas that need to be addressed

    We encourage candidate meetings by the end of April, if possible, before the election officially kicks off. It’s important that candidates know what team-based primary care is as they head into the election — and getting their time will be a bit more feasible now.

    You can find your candidates and how to reach them here:

    PC candidates
    Liberal candidates
    NDP candidates

    If no one is listed for your riding, the candidate is not yet nominated. Please keep checking these links for updates.

    Your voices are critical. And powerful. Let’s speak to our solutions together, and ensure they are heard. Elections are a great opportunity for influence and health care is a top priority for all parties, so don’t forget the influence you have.

    Please reach out to advocacy@afhto.ca if you have any questions.

    52 days to go!

    Yours in good health

    The AFHTO Team

     

  • Advocacy for Equity in Online OHIP Renewal

    AFHTO learned in fall 2021 that only people with a valid Ontario driver’s license could renew their OHIP card online. Most people who could not drive needed to go in-person to a ServiceOntario office. 

    This was particularly concerning as many people without a license are not in this position by choice. A disability that prevents some people from driving can make in-person renewal difficult at any time. And in a pandemic, going to crowded ServiceOntario offices exposes people to even further risk. 

    Along with partners, AFHTO called on the government to allow OHIP-eligible Ontarians who hold an Ontario Photo Card to be able to renew online as well. The Photo Card is identical to a driver’s license for proof of identity and residency. 

    On February 9, we were pleased to see the government publicly commit to resolving this inequity. As they need a few more months to upgrade the system, they have extended the OHIP renewal deadline to September 30, 2022.

    Their news release can be read here.

    We encourage teams make sure patients who cannot drive are aware of the Ontario Photo Card. The government introduced it over a decade ago after hearing from many people with disabilities that something similar to a driver’s license for proof of identity and residency was needed.

    While the system will soon be equal to people who drive and those who do not, AFHTO will continue advocacy for people who will still struggle with renewal despite this fix.

     

    AFHTO’s advocacy

    We were pleased to see the Ontario Human Rights Commission write to the ministers soon after our public statement. 

    We also spoke with the ARCH Disability Law Centre in January, and were pleased with their letter to the ministers the following week.

    Thank you to our partners for agreeing to join us in this advocacy, particularly the Alliance for Healthier Communities, the Indigenous Primary Health Care Council (IPHCC), and the Nurse Practitioner-led Clinic Association (NPLCA). And thank you to the Canadian National Institute for the Blind (CNIB) who we later learned had raised this with government before and who partnered with us upon AFHTO’s outreach. 

  • COVID-19 Outpatient Therapies, Vaccination Updates and Other Updates

    Dear members,

    January has been an incredibly difficult month, and we want to thank you and your teams for all that you have done, and continue to do, for your patients. Encouragingly, the latest update on COVID-19 projections from the Science Table indicates that while hospital and ICU admissions continues to be high, Ontario data shows that vaccination (including third doses) is providing strong protection against serious illness.

    The Ministry of Health issued a memo on the gradual resumption of selected clinical activities on February 1st, in addition to updated COVID-19 Directive #2 for Healthcare Providers and accompanying Q&A. The Ministry notes that latest modelling for hospitalizations and new admissions indicates that we have likely reached the peak of the current wave and will see a gradual decline in new hospitalizations in the coming weeks, and the revised Directive #2 allows the cautious and gradual resumption of diagnostic imaging, cancer screening and scheduled ambulatory clinics, and non-urgent and nonemergent surgeries as operationally feasible.

    See the Ministry of Health’s Provincial testing guidance and the implementation of antivirals in Ontario slide deck, released February 2nd, for an overview of Ontario’s COVID-19 testing strategy, expanded use of Rapid Antigen Tests (RATs), antiviral pathway within 5 days of symptom onset, and other important information.

    Please find below for additional resources to aid your teams as we look forward with cautious optimism to the end of the Omicron wave.

    COVID-19 Outpatient Therapies

    This template patient script from the OCFP, updating on available COVID-19 treatments, can be adapted for community-based practices. The OCFP has also updated their Considerations for Balancing Demands, including more info on caring for symptomatic and COVID +ve patients.

    Referral forms in Telus PS, Accuro and OSCAR
    The North York Family Health Team has kindly digitized the referral form and made it available for all Telus PS and Accuro users in the province. Special thanks to Suja Arackal, Data Manager at the North York FHT.

    • For Accuro users:
      • Both the forms (“Ontario COVID-19 Monoclonal Antibody(mAb) EUA Treatment Referral” & “List of sites distributing Paxlovid”) are available in Accuro cloud.
      • Please follow this link for instructions on how to download a form from Accuro cloud.
    • For PSS users:
      • Please download the custom form “Ontario COVID-19 Monoclonal Antibody(mAb) EUA Treatment Referral” and the handout “List of sites distributing Paxlovid” using this link.
      • Instructions on how to import a handout in PSS: Click here
      • Instructions on how to import a custom form in PSS: Click here

    Thank you to Lisa Hawkins, QIDSS with the Champlain Region FHTs and Dr. Kevin Lai in North York for their assistance in developing the form for OSCA users.

    • For OSCAR users:
      • There are two options for you to choose from depending on your EMR compatibility. Please click here for more details.

    You can also find the OCFP summary of the OH Guidance for Primary Care Providers – Access to Sotrovimab and Paxlovid for outpatient therapies for COVID-19 here.

    COVID-19 Vaccination

    All about RATs
    The provincial stock of Rapid Antigen Tests (RATs) is now in good supply and can be used for staff and patients. Primary care will see their backordered RATs from provincial stockpile in the next week or two and can also order additional tests from the provincial stockpile. ConfusedAboutCOVID.ca has a good fact sheet on “When should I use Rapid Antigen Test?” you can share with your patients. You can order the RATs here.

    *NEW: note that symptomatic household members of patient-facing healthcare workers (includes primary care) are now eligible for PCR testing.
     
    Long COVID

    COVID-19 Clinical Assessment Centres
    A reminder that clinical assessment centres have been stood up to support assessment, diagnosis, and disposition planning for people whose symptoms cannot be safely self-monitored at home but are also not experiencing severe symptoms that would require emergency care.
    See:

     
    Events
    Ontario Health Community of Practice

    • Primary Care and COVID-19 Support Community of Practice January 12th Ontario Health CoP meeting recording can be accessed online. In this recording you will hear Dr. Chris Simpson speak about COVID Clinical Assessment Centres and Dr. Mangin provides updates to the COVID Monitoring pathways for primary care.
    • The next CoP meeting is on February 9th from 8:00 a.m. to 9:00 a.m. and will focus on further discussions on monitoring and Post COVID-19 Condition clinical guidance for primary care. Katie Hogue, NPLCA President, will speak to her experience up in Parry Sound. Register here.

    Ontario College of Family Physicians Community of Practice

    • The OCFP COVID-19 CoP February 4th session on Responding to the Omicron Surge – Part 2 can be accessed here. The slide deck from the session is also available here.  
    • The next CoP session will be Friday, February 18th from 7:55 a.m. to 9:15 a.m. and registration details coming soon.

    Ontario Medical Association and OCFP Town Hall

    • On February 3rd the OMA and OCFP hosted a Town Hall on COVID-19 and children with Dr. Kieran Moore, Ontario’s chief medical officer of health, and other experts. Watch the recording here.

    In the next week we are expecting the updated Primary Care Guidance document which will provide updated guidance on how to manage in-person care with updated IPAC, screening and testing guidance. We will ensure we share that as soon as it is available.

    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.

    Yours in Good Health,

    The AFHTO Team
    (in collaboration with the Primary Care Collaborative)

  • Impact of Team-Based Care on Emergency Department Use

    Research article published in The Annals of Family Medicine January 2022, 20 (1) 24-31

    Impact of Team-Based Care on Emergency Department Use

    Abstract

    PURPOSE We sought to assess the impact of team-based care on emergency department (ED) use in the context of physicians transitioning from fee-for-service payment to capitation payment in Ontario, Canada.

    METHODS We conducted an interrupted time series analysis to assess annual ED visit rates before and after transition from an enhanced fee-for-service model to either a team capitation model or a nonteam capitation model. We included Ontario residents aged 19 years and older who had at least 3 years of outcome data both pretransition and post-transition (N = 2,524,124). We adjusted for age, sex, income quintile, immigration status, comorbidity, and morbidity, and we stratified by rurality. A sensitivity analysis compared outcomes for team vs nonteam patients matched on year of transition, age, sex, rurality, and health region.

    RESULTS We compared 387,607 team and 1,399,103 nonteam patients in big cities, 213,394 team and 380,009 nonteam patients in small towns, and 65,289 team and 78,722 nonteam patients in rural areas. In big cities, after adjustment, the ED visit rate increased by 2.4% (95% CI, 2.2% to 2.6%) per year for team patients and 5.2% (95% CI, 5.1% to 5.3%) per year for nonteam patients in the years after transition (P <.001). Similarly, there was a slower increase in ED visits for team relative to nonteam patients in small towns (0.9% [95% CI, 0.7% to 1.1%] vs 2.9% [95% CI, 2.8% to 3.1%], P <.001) and rural areas (‒0.5% [95% CI, –0.8% to 0.2%] vs 1.3% [95% CI, 1.0% to 1.6%], P <.001). Results were much the same in the matched analysis.

    CONCLUSIONS Adoption of team-based primary care may reduce ED use. Further research is needed to understand optimal team composition and roles.

    Authors:

    • Dr. Tara Kiran, St. Michael’s Hospital Academic FHT
    • Dr. Rahim Moineddin, Department of Family and Community Medicine, Faculty of Medicine, University of Toronto
    • Alexander Kopp, ICES
    • Dr. Richard H. Glazier, Institute of Health Policy, Management and Evaluation, University of Toronto

    Relevant Links: