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  • Sign-up now for the wait list for Governance Training – additional sessions to be added

    The following message is being forwarded on behalf of the Ministry of Health and Long Term Care:

    The high level of interest for the Effective Governance for Quality in Primary Care training sessions is an indication of the level of commitment and enthusiasm of the primary care sector. Unfortunately this means that the seven current sessions are at full capacity. The Ministry is committed to ensuring that FHTs, NPLCs, CHCs, and AHACs have access to this program, and is looking into funding additional sessions this spring. We need your help to determine the number of additional sessions needed.

    One of the goals of the program is to ensure good representation from across the province and among all models of primary care.  Ensuring all models (AHAC, CHC, NPLC, FHT) have access to this training is essential to our commitment to build capacity of governance in primary care. However, to support this, it is possible that some organizations who pre-registered will be moved to a wait list or asked to attend a different session to accommodate a diverse group. As noted, there is commitment to providing additional sessions later this spring.

    If organizations have not been able to sign up, we encourage them to sign up on the wait list as there will be a chance to be either 1) placed in one of the upcoming sessions; or 2) placed in a new session. The wait list will be used to identify the need and potential locations for these additional sessions so it is important that all organizations that have not yet been able to register for the program get on the wait list. To access the wait list, please see: https://events.r20.constantcontact.com/register/eventReg?oeidk=a07e6y7uiac83d1f49a&oseq=&c=&ch.

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    If you have any questions about the training and the upcoming sessions please contact Clarys Tirel by phone (647-234-8601) or by e-mail (clarys.tirel@afhto.ca).

    Click here to see the program description and the announcement when registration first launched.

  • QIDSS: Further advice on preparing your proposals

    AFHTO’s Recommendations on the Optimal Configuration of the Quality Improvement Decision Support Specialist (QIDSS) Role were finalized after last night’s close of the membership feedback period. This morning AFHTO ED Angie Heydon and Senior Project Lead Clarys Tirel met with FHT Unit Manager Phil Graham and Program Manager Richard Yampolsky to discuss these recommendations.

    The discussion was framed in terms of what the FHT Unit must accomplish, i.e.:

    • Invest public dollars to improve better care/better value for money
    • Make timely decisions about budget allocations (between Feb.21 – Mar.31)
    • Ensure appropriate accountability for the funds and the results
    • Optimize the capacity of the FHT sector as a whole.

    Ministry response to the recommendations was very positive. From this discussion AFHTO offers advice to increase your chance of getting approval for your proposal:

    • Priority will be given to partnerships. Find your partner(s), agree on who will be the employer and how the QIDSS will be shared, and make sure you all say this in your proposal.
    • Priority will be given to building capacity for information management among those FHTs that are committed to doing this but need help.
      • In the short-term the focus is on data standardization and cleansing, to be able to accurately identify patients in the roster and their conditions/risk factors. Over time this role will grow along the continuum of creating reports, supporting decision-making, process change and quality improvement.
      • To get some ideas of what this entails, look at presentations from Queens FHT and North York FHT on their journeys to establish data discipline. Click here to access additional presentations from the AFHTO 2012 Conference on using data to improve care.
    • For those FHTs that are more advanced, partner with FHTs that need help and describe how the QIDSS position will help spread capacity.
    • Be as specific as you can be about what you aim to achieve with this position in the next year.

    On March 31 the FHT Unit’s budget recommendations will move up through the Ministry review and approval process. Through April to June, the FHT Unit will follow up with the FHTs they’ve recommended to receive QIDSS positions, to flesh out the expectations to be specified in the final funding agreements, and to make sure there are appropriate MOUs in place among the proposed partners. Provincial level resources Once the operating plan submissions are in and the FHT-level review begins, the FHT Unit will assess the question of provincial level resources. The AFHTO report recommended 2 – 4 positions to:

    • Foster coordination and collaboration among the local QIDSS resources, including orientation of new QIDSSs, leveraging knowledge, sharing lessons learned from across the partnerships.
    • Develop deep specialization in specific EMRs in order to act as an “escalation point” for local QIDSS with challenging EMR specific questions and issues.
    • Bring strong data analytical/epidemiological skills to support local QIDSS with complex analytical problems and to support projects such as indicator development.
    • Assess the degree to which the QIDSS role has enhanced information management capacity across the FHT sector to support planning for continued capacity building.

    The Ministry’s intent is to invite a FHT to house these provincial resources. Their work would be governed on behalf of all FHTs through an AFHTO-sponsored provincial committee structure. Through AFHTO, job descriptions for these positions and terms of reference for the committee structure will be developed. Thank you for the membership input and feedback Thank you to all who gave input to create the draft recommendations and those who gave feedback on the draft to help us finalize the report.  The results of this membership consultation are summarized in the final appendix of the document. Click here to download the full report.

  • Quality update and new resources from AFHTO

    This notice to members sums up all the recent quality-related initiatives to make sure you have all the information, and to introduce new resources available through AFHTO to support your FHT’s quality journey. Quality Improvement Plans to be submitted to HQO by April 1: The Ministry’s templates and guidance materials are found at:

    For questions about completing the QIP templates, e-mail qip@hqontario.ca .  Stay tuned – information to follow in the next week or so on HQO’s webinar offerings to support the field.

    Effective Governance for Quality in Primary Care: a one-day training program: Registration opened yesterday (click here for AFHTO announcement).  At least one session is already filled – The Ministry will consider adding more sessions, based on demand. In the meantime please sign up to a session or add your name to the waiting list. Click here for the registration guidelines and link to the registration site. Proposals for Quality Improvement Decision Support Specialists (QIDSS): A week ago AFHTO circulated draft recommendations to guide FHTs in developing proposals for QIDSS positions (due Feb.20 with operating plan submissions). We are collecting member feedback (click here) until end of day tomorrow (Jan.31) to finalize the recommendations then present them to the Ministry next week. Health Quality Ontario’s development of a Primary Care Performance Measurement (PCPM) Framework: Click here to access the proceedings from the Nov. 21 PCPM Summit.  The PCPM Steering Committee has been expanded to include representatives from AFHTO, AOHC, OCFP and OMA. The ultimate aim is finalize the PCPM Framework by this summer, and by the fall of 2013, recommendations that will support the development of infrastructure, data collection, analysis and reporting. A former FHT ED joins AFHTO staff: Clarys Tirel has joined AFHTO on a three-month contract.  Clarys was ED of the North York Family Health in 2008-2011, and most recently, interim executive director of the Mount Sinai Academic Family Health Team. Her main focus will be to support FHTs as they respond to their reporting and operational requirements in the January to April time frame, namely annual operating plans and QIPs, as well as governance and leadership development. To contact Clarys, e-mail her at clarys.tirel@afhto.ca or phone 647-234-8601. AFHTO launches Members’ Discussion Forum: Go to the AFHTO members-only website and log-in using your FHT username and password, then follow the instructions to access the Members’ Forum.  (Contact Sal at info@afhto.ca if you need help.)

    You will see three discussion forums, open to all AFHTO members and intended for asking questions and sharing ideas, advice and information resources among peers. Clarys Tirel will moderate and respond.  These are:

    • FHT Governance Forum: focuses on the roles, responsibilities, structures, policies, processes and leadership that all combine to promote good governance in FHTs.
    • Quality Improvement Planning Forum: is about developing and submitting QIPs, implementing the plans, collecting and reporting data, and other factors that contribute to advancing improvement.
    • General Forum:  for any other topics affecting Family Health Teams across Ontario

    Two secure forums have also been launched, with usernames and passwords issued to participants in these forums:

    • Executive Directors Forum: enables discussion on topics that could possibly be sensitive, such as operating plans, HR issues, relations with vendors and funders, risk management, etc.
    • Health Links Forum: for FHT leaders involved as the coordinating body for one of the early adopter Health Links.  Membership in this forum is restricted at the moment as Health Links work their way through the early “growing pains”.  Access to this forum will expand over time.

    Additional forums can be set up as interest emerges.

  • PSS Users: AFHTO-MDPS Working Group is being established

    AFHTO has developed an agreement with MD Practice Software LP (MDPS), vendor of the Practice Solutions Suite (PSS) EMR, to engage in regular meetings of a joint Working Group to resolve common problems faced by FHTs using PSS, in a mutually-agreed priority order. Click here for the terms of reference for the AFHTO-MDPS Working Group. All FHTs using PSS will have the opportunity to be engaged in the process; 4 – 6 FHT representatives are needed to participate at the table on behalf of all FHT PSS users. If you would like to be considered to serve on the Working Group, please click here to submit your expression of interest.  Clarys Tirel, former ED of a PSS FHT and AFHTO’s new Senior Project Lead – FHT Governance, Quality, and Operations, will organize and facilitate communications for this group. Background: AFHTO’s March 2012 survey of FHT EMR satisfaction revealed that about one-half of FHTs use PSS. While it scored relatively well on usability, there was a strong level of dissatisfaction with support provided.  Results of a June 2012 follow-up survey of FHTs using PSS were circulated to these FHTs, and since that time AFHTO has used the results to advance a more responsive approach to solving common problems. Since FHT leaders were gathered for the AFHTO 2012 Conference in October, MDPS Assistant Vice President Andrea Holland agreed to host a customer relations session at the conference. After a number of follow-ups with MDPS, AFHTO is pleased to forward to you the two items:

  • Governing for Quality in Primary Care, a free one-day training program

    Registration for Effective Governance for Quality in Primary Care is now closed. Click here to go to the waiting list. The site also lists the objectives and full agenda for the day-long program.  The program has been approved for 3.25 credits for certified Canadian College of Health Leaders members. A corresponding application for CME credits has been submitted to the Ontario College of Family Physicians. If organizations have not been able to sign up for a session, sign up on the wait list as there will be a chance to be either 1) placed in one of the upcoming sessions; or 2) placed in a new session. Click here for the ministry’s message regarding the waiting list and possible additional training sessions.

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    This is a free one-day training program to be held in seven locations across the province, for boards of family health teams, community health centres, aboriginal health access centres and nurse practitioner-led clinics.

    To provide a common, evidence-based platform of governance training to support the quality agenda, the Ministry has partnered with the Association of Family Health Teams of Ontario (AFHTO), the Association of Ontario Health Centres (AOHC), the Nurse Practitioner’s Association of Ontario (NPAO) and the Canadian Patient Safety Institute (CPSI) to develop and deliver the Effective Governance for Quality in Primary Care program.

    It is recommended that each organization send three participants including the Board Chair, Chair of the Board Quality Committee (or other board representatives) and the executive director or clinical lead.

    Click here for more information about the program and dates/locations for the one-day training sessions. To see this document in French, click here.

    Watch for the registration announcement next week. Space is limited – register early to avoid disappointment.

     

  • Added support for FHT EDs at year end: new AFHTO staff and re-launched ED discussion forum

    AFHTO is pleased to announce two new resources to support you through the crunch of operating plan and quality improvement plan submissions – a former FHT ED joins AFHTO staff and a new secure discussion forum to facilitate communication among FHT EDs.

    New staff:

    On Monday, Jan. 28, Clarys Tirel joins AFHTO on a three-month contract.  Clarys was ED of the North York Family Health in 2008-2011, and most recently, interim executive director of the Mount Sinai Academic Family Health Team. In between she managed a primary care project for the Toronto Central CCAC on integration issues for non-FHT family physicians.

    Her main focus will be to support FHTs as they respond to their reporting and operational requirements in the January to April time frame, namely development of annual operating plans, formal quality improvement plans, and participation in planning and development of Health Links. She will also be gauging opportunities to support and augment the Ministry-sponsored “Governing for Quality in Primary Care” training program.

    To contact Clarys, e-mail her at clarys.tirel@afhto.ca or phone 647-234-8601.

    Executive Director Discussion Forum:

    One of Clarys’s support roles will as moderator for our newly re-launched Executive Director Discussion Forum.  This is a secure forum, accessible to only FHT EDs via username and password, to enable you to freely discuss topics that could possibly be sensitive, such as operating plans, HR issues, relations with vendors and funders, risk management, etc.

    To access the AFHTO Members Discussion Forums:

    1. Login to AFHTO’s Members Only website, using your FHT’s Members Only username and password.
    2. Click on the Connect to Member’s Forum link on the bottom left corner of the webpage.
    3. Enter your Member’s Forum username and password to log-in.  (HINT: If you click on “log me on automatically each visit”, you can skip this step in future.)
    4. Click on Board index to see the discussion forums. The Executive Director Discussion Forum is visible only to those who have been authorized to use it, i.e. FHT EDs.
    5. You are now able to post topics and reply to discussions. Click here if you need instructions on how to post and reply.
    6. If you need assistance, contact Sal at info@afhto.ca.

    You will see three (or four) additional discussion forums that are open to all AFHTO members. All of these forums are intended for asking questions and sharing ideas, advice and information resources among peers.

    • FHT Governance Forum: focuses on the roles, responsibilities, structures, policies, processes and leadership that all combine to promote good governance in FHTs.
    • Quality Improvement Planning Forum: is about developing and submitting QIPs, implementing the plans, collecting and reporting data, and other factors that contribute to advancing improvement.
    • General Forum:  for any other topics affecting Family Health Teams across Ontario
    • If your FHT is involved as the coordinating body for one of the early adopter Health Links, you will also see the Health Links Forum.  Membership in this forum is restricted at the moment as Health Links work their way through the early “growing pains”.  Access to this forum will expand over time.

    We will announce these forums more broadly next week when the Ministry is ready to launch the Quality Improvement Plan templates and guidance documents, and registration opens for the “Governing for Quality in Primary Care” training program. New forums can be added as needs and interests evolve. Member participation and feedback is always welcome. Please use the Member’s Forum to share your comments, questions and ideas.

  • Renewing AFHTO’s strategic vision and priorities: link to survey and webinar presentation

    If you missed the AFHTO membership webinars this past week, click here to access the full presentation. It gives you an overview and update on the current environment for FHTs and action underway by AFHTO to support its members. AFHTO is striving to ensure your association continues to reflect the aspirations and respond to the priority needs of the AFHTO membership.  The two webinars, held on Jan. 22 and 24, provided context and gave members the opportunity to contribute to AFHTO’s strategic vision and priorities going forward. We are also collecting feedback via membership survey; if you haven’t done so already, please click here to respond to the survey, by Feb. 5 please. The AFHTO board will review all input received via the webinars, survey and e-mails. This will provide guidance to finalize the AFHTO strategic plan and 2013-14 operating plan. The plans along with the survey/webinar results will be communicated to members around mid-March. During the call members also asked questions about the additional $2,000 the Ministry provided to FHTs last August, specifically earmarked for FHT membership in AFHTO (and/or AOHC for 28 community-governed FHTs).  Click below to access:

    Friendly reminder:  AFHTO sent out invoices for voluntary contributions to enable each FHT to make full use of the funding they have received, but not yet used, within this 2012-13 fiscal year. If your FHT has not yet used its full $2000 for membership, please consider investing it in the work of your association.

     

  • Minister releases Seniors Strategy for Ontario

    The full report, Living Longer, Living Well is now available in both English and French on the Ministry’s website at: English: http://www.health.gov.on.ca/en/common/ministry/publications/reports/seniors_strategy/ French: http://www.health.gov.on.ca/fr/common/ministry/publications/reports/seniors_strategy/default.aspx ************************************************************ January 8, 2013 – Living Longer, Living Well – Highlights and key recommendations from the report of Dr. Samir K. Sinha, Provincial Lead, Ontario’s Seniors Strategy – was released on Tuesday, January 8, 2013. Government committed to developing such a strategy in Ontario’s Action Plan for Health Care. The full 200 page report, containing 169 recommendations, is not yet released and is in the process of being translated. With the release, the Minister committed to moving ahead immediately with two of the recommendations:

    • Match every older Ontarian who wants one with a primary care provider through Health Links and new physician incentives to care for high-needs patients. (These incentives were included in the most recent Physician Services Agreement.)
    • Improve access to home care by expanding personal support worker services through community support agencies for low-needs patients.

    The Seniors Strategy is built on five principles:  Access, Equity, Choice, Value, Quality. Its recommendations cover a comprehensive range of topics: promoting health and wellness, primary/community/acute/long-term care, caring for caregivers, developing elder-friendly communities, addressing ageism and elder abuse, medications, and addressing unique needs of older aboriginal peoples and others with diverse needs, such as those from LGBTQ and ethnocultural communities and those with limited abilities. The section on primary care is reproduced below.  Implementation details have not been announced – the Minister stated that Dr. Sinha is developing the detailed implementation plan. —————– Excerpt from Living Longer, Living Well : Strengthening Primary Care for Older Ontarians Through our consultations, we learned that strengthening the provision of primary care will be essential to securing the health of older Ontarians. As they are likely to have more complex and often inter-related health and social care issues, they will often benefit from a team-based approach to primary care that prioritizes continuous quality improvement. We also learned through our consultations that communication among primary care providers, hospitals, and community care co-ordinators in particular, is not currently required. This often can create care gaps that everyone agrees should not exist. We also learned that there still are older Ontarians who cannot easily find a primary care provider. This is especially the case for those who are homebound and would benefit from house calls. We need to do more to improve primary care for older Ontarians by building models of care that deliver high quality care and best serve their needs, while ensuring that every older Ontarian who wants a primary care provider can get one. Key Recommendations:

    • The Ministry of Health and Long-Term Care should promote and develop mechanisms in accordance with legislative/regulatory frameworks to advance the goal that all older Ontarians who want a primary care provider will have one.
    • The Ministry of Health and Long-Term Care should ensure that its development of Quality Improvement Plans in Primary Care and Health Links support a core focus around the care of older Ontarians – with an emphasis on supporting primary care access for older adults and focusing attention on areas of care that influence the health and well-being of older adults.
    • The Ministry of Health and Long-Term Care should mandate that care co-ordinators from Community Care Access Centres (CCACs), Community Support Services (CSS), and community mental health agencies providing care or service co-ordination support must identify and notify a patient’s primary care provider of their name, their role, their contact details, and the services being co-ordinated for the patient/client.
    • The Ministry of Health and Long-Term Care should maintain and improve funding levels to support the provision of house calls by primary care providers.

  • Inviting input on AFHTO’s strategic direction/Maximizing value from Ministry funding for FHT memberships

    Thanks to our FHT members, AFHTO has built a strong foundation to serve family health teams. We are reaching out to FHTs to move to the next stage in your association’s development: 1.      As FHTs and AFHTO have matured, it’s time to renew the strategic vision and priorities for this association. You are each invited to give input on AFHTO’s strategic direction, to ensure your association continues to reflect the aspirations and respond to the priority needs of the AFHTO membership.  Responses are requested by February 5, 2013. 2.      A key platform for expanding AFHTO’s capacity to serve its members is the $2000 funding increment for FHTs last August – an increment the Ministry has indicated can only be used for membership in AFHTO (and/or AOHC for the 28 FHTs that are community-governed). At the October 16 Annual Meeting, AFHTO members approved a plan to request a voluntary contribution to enable each FHT to make full use of the funding they have received, but not yet used, within this 2012-13 fiscal year. AFHTO board members will conduct webinars to provide additional background and answer member questions. Click here to register for one of these sessions:

    • Tuesday, January 22, 2013, from 4:30 to 5:30 pm
    • Thursday, January 24, 2013, from 12:00 to 1:00 pm

      Why should FHTs make a voluntary contribution to their association? FHTs are facing immediate pressures and opportunities – delivering operating plans by February 20, making the case for new Quality Improvement Decision Support Specialist positions, delivering the first Quality Improvement Plans by April 1, and some are leading or participating in development of Health Links. With the addition of contract staff and consultant assistance, AFHTO is immediately adding to our capacity to help you navigate these uncharted waters. This expansion of service is made possible by the Ministry’s $2000 funding increment for FHT membership fees in AFHTO (and/or AOHC). The Ministry has indicated these funds are specifically earmarked for this purpose. For AFHTO members who paid 2012-13 fees that were less than this, or those who expensed their membership fees in the previous fiscal year, you are invited to calculate a voluntary amount based on your own unique budgetary circumstances. Please note that 2013-14 membership renewal notices will go out after April 1. Auditors have advised that membership fees should be expensed in the year in which the benefit is received. Since the AFHTO membership year runs from April 1 to March 31, AFHTO is adopting the practice of issuing renewal invoices at the start of the membership year. FYI – One hard copy of this package has been mailed to each FHT. This invitation is also being e-mailed to the addresses we have on file for the board chair, lead physician and executive director for all member FHTs. If you have any comments, questions or concerns please don’t hesitate to contact AFHTO’s Executive Director (angie.heydon@afhto.ca or 647-234-8503) or Membership Coordinator, Sal Abdolzahraei (info@afhto.ca or 647-234-8605). AFHTO looks forward to continuing to support FHT success in improving and delivering optimal, sustainable interprofessional care.

  • FHT Annual Operating Plans / AFHTO help will be available in January

    Executive Directors: You have received your Family Health Team 2013/14 Annual Operating Plan Submission Package at some point today.  Plans must be submitted to the Ministry by February 20. To support FHTs in this submission process, AFHTO will re-launch a Peer-to-Peer discussion forum in early January.  This facility will help you seek and share advice with your peers as you develop your plans. The 2013/14 package offers FHTs the opportunity to propose implementation of a new role – the Quality Improvement Decision Support Specialist (QIDSS). The package states, “The ministry strongly encourages and will give preference to requests for this resource that are shared among a collection of FHTs, where appropriate. … This new position is meant to assist FHTs in moving forward with their use of data to guide clinical decision-making, develop patient-centred programs and other improvement activities. With the assignment of these resources, the ministry expects demonstrated improvements in these and other areas.” To help FHTs with their proposals for the new QIDSS position, AFHTO is preparing an advice document for FHTs. With the view to gaining the greatest value from these new positions, AFHTO is looking into various ways FHTs could structure and frame their proposals for shared use of this resource. We are aiming to complete this advice document for members no later than January 23. With the many new initiatives FHTs will be responding to over the next few months – e.g. the first Quality Improvement Plans by April 1, development of Health Links – AFHTO is enhancing its ability to support FHTs in these common needs by recruiting a contract position, Senior Project Lead- FHT Governance, Quality, Operations.  We expect to have this additional assistance in place before the end of January. We look forward to continuing to support FHT success in improving and delivering optimal, sustainable interprofessional care.