There is renewed commitment towards truly integrated patient-centred care and an emphasis for all sectors of the health system to work more closely together to build Ontario Health Teams (OHTs).
Creating shared leadership across participating organizations within an OHT is key to encouraging committed behaviour, optimizing collective strengths, and fostering collaboration. However, establishing a culture of shared leadership isn’t something that can be mandated overnight. Partnerships take time and must be built on the foundation of trust. How can OHTs develop an approach to shared leadership that creates a level playing field, that balances the division of powers, and that values all partners at the table?
AFHTO partnered with the Ontario Community Support Association (OCSA) and AdvantAge Ontario to develop an OHT Starter Kit and host webcasts that will help members be leaders at this time of change
This kit contains a suite of tools to support OHTs in formalizing partnerships, clarifying expectations, and identifying a shared sense of purpose. The use of tools may be leveraged by OHTs and amended to meet individual team needs. These stepping-stone documents may also evolve as OHTs develop and partnerships mature.
On September 12, the “Shift to Shared Leadership” webcast was the first of four webcasts that will help teams with these significant changes to the health care system. Stay tuned for more details on the next three webcasts!
The governance attestation requires every board have an executive director performance evaluation process in place. For guidance, a framework has been developed by Accompass to support boards in meeting this requirement. During this webcast, Accompass reviewed the Lead Executive Performance Guide. It includes the role of the board, key principles and best practices in ED performance management. One board chair also spoke to his FHT’s ED performance appraisal process and reviewed their appraisal document. Below are the materials from the webcast:
NEW and IMPROVED: The Program Performance Measures Catalogue [downloads an Excel workbook] has been refreshed and improved for 2018-2019. This spreadsheet is a list of the program measures (indicators) that your peers included as Performance Measures in Schedule A of their 2015, 2016, and 2017 Annual Operating Plans. It will help you to identify measures to consider using to evaluate your programs and to complete Step 4: Conducting a Program Evaluation of the AOP.
UPDATED: Quick Reference Guide to the Catalogue. To make the catalogue more user-friendly, we’ve created a one-page guide to walk you through the process of using it.
NEW: Choosing Better Indicators: How teams are using the PPMC [PDF]. This handout provides an overview of the PPMC and a look at the different ways your peers are using it. UPDATED: Video Walk-through of the Catalogue (below).
It’s important to remember that the catalogue is a tool, not a recipe, and there’s no “right” way to use it. Some teams use it at the brainstorming stage, to help them come up with a list of potential indicators to choose from. Others use it to narrow down their list or to refine the indicators they’re already using. Different indicators will be relevant to different teams depending on the size and structure of the team and the needs of the local population.
If you’re not sure where to start, consider reading about how other teams are using the catalogue and whether any of these approaches would work for you. The catalogue is a work in progress. The first edition was published in the spring of 2016. Based on feedback from members who used it, we made a number of improvements. The second edition, which is linked above, was published in the spring of 2017. A third, even better, edition is coming soon.
If you have feedback you would like to share about the catalogue – what works, what could be improved – or if you would like to be involved in the work of making it better, please don’t hesitate to contact us.
Program planning webinar & workshop
On March 6, 2017, AFHTO held a program planning webinar, in partnership with Public Health Ontario and the Ministry of Health and Long-Term Care. Topics covered include principles of program planning and evaluation, program planning for population-based care, and a review of the AOP submission process and timeline. We also reviewed the presented a brief demonstration of the new Catalogue. The recording and a link to the program planning slides can be found below. .
On October 24, 2017, as part of the annual AFHTO Conference, AFHTO held a 3-hour program planning workshop, Beyond Schedule A: Evidence-Based Program Planning for Community Needs. It was hosted by Allison Meserve of Ontario Public Health along with Lori Richey (Peterborough FHT) and Susan Hache (MOHLTC).
The following materials were produced to support the Program Planning & Evaluation Framework. Links to these materials are found within the document itself; they are provided here for convenient access.
Program Planning and Quality Improvement: Introducing the SAPD* Cycle
In June 2017, over 50 Quality Improvement Professionals – including QIDS Specialists, interprofessional health care providers, and partners from Health Quality Ontario and OntarioMD — gathered for a day of networking and learning. The theme for this Knowledge Translation Exchange (KTE) day was Program Planning and the SAPD* cycle. You may already be familiar with the Plan-Do-Study-Act (PDSA) cycle. SAPD is the same cycle – it just starts at “Study” or measurement, instead of at “Plan,” to build on the momentum in measurement that AFHTO members have achieved.
Note: The Woolwich CHC has offered their privacy policy for use on our website as a sample only. Due to differing governance systems, this example should only be used as a reference on how an agency might construct its own privacy policy.
AFHTO’s Executive Director Mentorship Program connects experienced EDs with new EDs who feel they would benefit from the support of a mentor.
Executive directors and admin leads play a key role as leaders, facilitators, and links within their teams and across their communities, with their peers, staff, physicians, boards, patients, and other system leaders. Mentoring is about supporting people to develop into their role, and this mentorship program is in place to help leaders in primary care teams excel.
ED Mentorship Program Overview
New executive directors tell AFHTO when they would benefit from this program and if there are specific areas in which they need guidance or support. This helps with mentor-mentee matching. We also make every effort to match EDs whose teams work in similar environments, taking into consideration geography, size, governance structure, academic or Francophone status, and other characteristics that reflect the diversity of teams.
EDs then decide frequency of meetings and communication. While there is no timeline on a mentorship program, EDs tend to work together for six months to a year. While formal mentorship rarely goes longer, the EDs tend to stay in touch from the relationships they build.
Benefits of the ED Mentorship Program
Benefits to Mentors
Benefits to Mentees
Being part of a solution to build capacity for leadership in primary care
Pleasure of giving back and passing on skills, knowledge and wisdom
Satisfaction of enhancing a mentee’s understanding of the primary care team workplace
Heightened profile within their workplace
Coaching practice and leadership skills
Heightened self-awareness
Access to wisdom and expertise in a confidential safe relationship
Opportunities for self-assessment
Greater understanding of current business practices
Introduction to business networks and related supports
What we have heard is a testament to the strong leaders in our membership. Mentees agree that their mentors are knowledgeable and able to provide needed support and guidance. Mentors tell us that their mentees are happy to receive input and guidance; willing to self-evaluate; and open to applying a mentor’s insights to their own situation.
Here is a sample of what the participants have said:
“My mentor is awesome, very helpful! She provides amazing support.”
“My mentor is very knowledgeable and easy to work with. She always makes time to answer questions and provide guidance when required.”
“I would suggest having a mentor work with all new EDs when they come onboard.”
“I can learn as much from my mentee as she can from me. Seems to be working for both of us.”
Resources for ED mentors and mentees
The materials are available to assist our ED mentors and mentees in defining and developing the mentoring relationship.
The program launched in February 2016 with an orientation webinar for ED mentors, presented in partnership with the Centre for Effective Practice (CEP).
Executive Director Resource Toolkit [PDF] (Updated in 2019) In collaboration with The Osborne Group, members of the former Executive Director Advisory Committee, and work group, AFHTO has developed this very thorough toolkit to orient new EDs of teams to their role and provide all EDs with easy access to a comprehensive collection of tools, resources and templates that will help you manage the organization effectively. The Toolkit can be used:
As an orientation guide for new Executive Directors
As a support for current Executive Directors
As an educational tool to help explain the scope of the Executive Director role
As a resource for team boards as they hire, orient and oversee the ED role.
The material is organized as follows:
Introduction to Family Health Teams and Nurse Practitioner-led Clinics
Explore topics like physician practice models and relationships to FHTs, Medical consultants to NPLCs
Key information about the role of the Executive Director
Learn your role with your Board and the Ministry
Understand: financial planning; operational planning; legislative compliance; program planning & QI; Human resources; community relationships; Risk Management
Resources, tools, templates and sample documents
Hyperlinks in the text will take you to relevant sample tools, suggested references and related information. In addition, AFHTO is committed to building a robust repository of resources for EDs on the website as part of an ongoing area of work. We encourage all EDs to share existing tools/policies/templates by adding them to our existing repository of sample organization policies and procedures.