Ultimate Blogging Championship

Tag: Library

  • Practitioner Experience of an Interprofessional Integrated Primary Care-Based Programs For Seniors

    2011 AFHTO conference presentation PRESENTER (S): Dr. Ainsley Moore, MSc, MD CCFP; Joy White, RN-EC, MSN; Kalpana Nair, MSc, PhD; Maria Chacon, MD FHT/ORG: McMaster FHT & Department of Family Medicine, McMaster University ABSTRACT: Background: Multidisciplinary, integrated primary care-based programs involving multiple practitioners are recommended for frail seniors with complex concurrent conditions. This study sought to understand the perceptions and experiences of family physicians and nurses whose patients had been seen through a multidisciplinary, integrated primary care-based program for seniors, the Seniors Collaborative Care Program (SCCP). Methods: This study used a qualitative descriptive approach and took place at Stonechurch Family Health Centre (SFHC) in Hamilton, Ontario. Purposive sampling was used and each participant took part in a semi-structured, individual interview. Analysis involved a content analysis approach. Results & Conclusions: Five family physicians and 4 nurses working at SFHC took part. Main themes centred on need for clear communication and role clarity. Access to the SCCP Program was also a predominant theme, suggesting that availability of specialized geriatric services in primary care is an important step towards increasing knowledge and skills of primary care clinicians. Click here to view presentation.

  • New Innovations and Best Practices in a FHT

    2011 AFHTO conference presentation PRESENTER (S):

    Karen Y. Brooks, RN, BScN, CRE, CDM Nurse Educator; Dr. Margaret Tromp, MD, CCFP, FCFP

    FHT/ORG: Prince Edward FHT

    ABSTRACT: “Left undiagnosed or untreated, chronic disease may also exact serious health and economic consequences from patients, families, and communities” (Every, 2007, p. 70). A FHT Family Physician and CDM Nurse Educator, have implemented aspects of The Edmonton Southside Primary Care Network Chronic Disease Model. This has brought the care of chronic disease back into the family physician’s office, where FHT team members contribute, but work to improve care and coordination of service is achieved within. We have customized this approach within our family practice. Highlighted is the MOHLTC’s seven themes of priorities for FHT’s, correlated with practice management of several chronic diseases. Utilization of upstream approaches to patient preventatives and screening is addressed. A patient may see the CDM Nurse Educator, the Family Physician, or both, and spend time discussing disease management. “This team approach frees the physicians to see more patients, to concentrate on those who need them and to take satisfaction from knowing they are doing a good job” (Spooner, 2007, as cited in Every, 2007). You won’t want to miss ‘The Pork’n Beans’ of CDM. Click here to view presentation.

  • iPrep: Illness Prevention and Rehabilitation Program

    2011 AFHTO conference presentation PRESENTER (S): Dr. Lori Teeple FHT/ORG: Bluewater Area FHT ABSTRACT: To assist participants to transform their lifestyle into one of healthy eating and exercise so as to achieve and maintain a healthier body weight and waist circumference to prevent or remit disease such as diabetes, hypertension, cardiovascular and cerebrovascular events.  Target Group: Patients with BMI > 25 and Waist Circumference WC>102 cm (men) and WC> 88 cm (women). Program Objectives: 1. To help six women achieve a weight loss of 10% of their body mass in 12 months through a combination of education, mentoring and coaching utilizing advanced internet technology and weekly/bi-weekly visits.   2. The program will be evaluated on an annual basis by determining the number of females who have completed the 12 month program and reduced their weight and waist circumference, creating a healthier body and rehabilitating disease such as diabetes, hypertension and lipid disorders.  The program will give the females encouragement to continue with their ongoing lifestyle changes.  Each participant will be asked to complete and evaluation upon the completion of program. Evaluation: The iPrep program was started January 2011 and after six (6) months all participants have seen positive results and are encouraged about their lifestyle changes.  The program is looking to expand the number of participants and include men. Click here to view presentation.

  • Central Intake Triage

    2011 AFHTO conference presentation PRESENTER (S): Dr. Kathleen Brooks, M.D., FRCP (C); Mary Jane McDowell, MSW FHT/ORG: Prince Edward FHT ABSTRACT: Within the services offered by the Prince Edward Family Team nowhere is critical decision making more important than at the point of entry to our mental health system. At a time when demand for mental health services exceeds available resources, the importance of effective triage at the front door takes on increased importance. Mental health agencies can sometimes be reluctant to divert scarce clinical staff, especially the more experienced, in order to perform the role of coordination, intake and triage. The PEFHT views mental health intake as a critical decision point in serving our patients with mental health issues and as such our first hire to the program was a social worker who assumed the title of mental health program coordinator. Experienced and effective coordination and triage provides for a cohesive, accessible and equitable use of a limited resource. Click here to view presentation.

  • Tools to make your voice heard in the provincial election

    The upcoming provincial election gives each Family Health Team the perfect opportunity to build awareness about the value we deliver to our communities.  People running for office need to know (and want to know) how well their constituents are being served through their tax dollars. Why is this important?

    • To make sure all candidates running in your riding know you exist, what you do, and what your work means for the people in their riding. As many FHTs have experienced, the person who becomes your MPP can be a valuable resource for the FHT.
    • To build confidence in the added value generated by this model of care. AFHTO has met with the Health Minister and Health Critics for the three major parties.  All three acknowledged that FHTs are popular with their colleagues and constituents, but many politicians remain skeptical as to whether the results are “worth” the extra investment. The July 23 Petrolia Topic recently reported, “(NDP leader Andrea) Horwath said the NDP hopes the provincial auditor-general looks at the FHT model ‘…to make sure it’s value for money.’”

    Many FHTs are very involved with their political representatives already. To help all AFHTO members become more active, AFHTO has developed the following tools:

    • Three 3 key messages that can have stronger impact the more consistently they are used.  Family Health Teams are Ontario’s innovation in team-based care that:
      • Improves access to health care.
      • Promotes health and reduces the impact of chronic disease.
      • Has the potential to reduce the total cost of care.
    • A brochure in English (click here) and French (click here), which:
      • Delivers these three messages and provides some evidence for each.
      • Contains one page for FHTs to enter their own information.
      • Allows you to print out copies as needed to hand out to candidates and campaign workers in your riding, and leave in your waiting areas.
    • A list of candidates in each provincial riding and their contact information (click here).

    AFHTO sent out e-mails to members by riding on Aug.31/Sept.1 and on Aug.5/6, to enable coordination within ridings. AFHTO encourages you to meet your candidates and spread the good news about your FHT and the FHT model. We hope you will find these resources helpful in your communications. As always, your feedback is welcome.

  • Supporting FHTs through strengthened relationships with Ministry and key associations

    In the past few days AFHTO has had meetings with the Ministry’s FHT Unit, the Ontario Hospital Association (OHA), the Ontario Medical Association (OMA) and the Association of Ontario Health Centres (AOHC). In all cases primary care is recognized as key to improving quality of care for patients and sustainability of the health system.  FHTs are recognized for their potential to significantly advance both quality and sustainability. With the FHT Unit we examined how we work together to support FHTs in achieving these ends.  In particular we focussed on how to progress in strengthening FHT governance, recruitment and retention, and capacity to get the full benefit from EMRs and data for quality care. Getting traction requires stepping forward in bite-size chunks:

    • To develop governance capacity, the FHT Unit is developing an RFP as the first step in response to AFHTO’s detailed proposal for web-based learning modules on the core set of knowledge and skills required for governance, strategic planning and risk management.
    • The framework for FHT governance is likely to be shaped by the Ministry’s “Strengthening Primary Care” initiative. AFHTO has been participating in the working groups, along with a number of other stakeholders.
    • With recruitment and retention, the next step is to understand the patterns and drivers underlying vacancy rates.  AFHTO has struck a working group that will look into questions such as time to recruit, turnover, and reasons for leaving. Working in partnership with AOHC and HOOPP, AFHTO has compiled comparative data on compensation packages.
    • Supporting use of EMRs and data is a more complex undertaking. AFHTO has exchanged ideas with some thought leaders from within the FHTs and from key organizations such as the Canadian Institute for Health Information (CIHI), the Institute for Clinical Evaluative Sciences (ICES), and Health Quality Ontario (HQO).  This may crystallize into another proposal in 6 – 9 months’ time.

    The FHT Unit continues to look to AFHTO to assemble small groups of FHT volunteers to provide feedback on implementation issues such as the revised NP-SERT program (renamed Nurse Practitioner Access Reporting or NPAR)  and the new SRI templates replacing WERS. With the OHA our focus was on what our respective associations could do to foster greater understanding and collaboration among hospitals, primary care and other key components such as CCACs. With the OMA and AFHTO we discussed a number of ideas for working together to strengthen primary care. This exploration will continue in a meeting with NPAO in a few weeks, and other associations over the course of the summer. Ideas are percolating. Some will result in highly stimulating content for the 2011 AFHTO Conference on Oct. 25-26. Other interesting collaborations are likely to emerge. Stay tuned.

  • FHT Funding Agreements: MOHLTC to distribute revised documents this week

    AFHTO has been working with the Ministry of Health and Long-Term Care and the Ontario Medical Association (OMA) to address concerns regarding the new FHT Funding Agreement templates. FHT Leads should be receiving from the Ministry, prior to the April 29 sign-back date, a revised agreement that addresses our key concerns with these templates. For those FHTs that requested an exemption to the requirement that “all positions funded pursuant to this Agreement shall be employees of the Recipient unless the Ministry has provided its written consent”, you will receive a separate exemption agreement. The Ministry continues to encourage all FHTs to strive to meet this goal; however, the exemption agreement gives greater flexibility regarding FHT staffing arrangements while upholding the Government of Ontario’s risk management needs. Note that the exemption agreement lists a few “as applicable” requirements. If your FHT has a concern with any of these “as applicable” requirements, you may wish to seek clarification from your Ministry consultant to determine whether they are in fact “applicable” in your case. The template agreements for all Physician-Sponsored and Mixed Governance FHTs have been revised to address the concerns regarding governance, liability and communications. AFHTO and the OMA would like to recognize the Ministry’s willingness to make these revisions to address the concerns raised by FHTs. As with any contract, each FHT is advised to carefully review the new agreement and to discuss any ongoing concerns with appropriate legal counsel and their Ministry consultant.

  • FHT Funding Agreements: deadline extended to April 29, 2011

    Ministry staff are distributing today (April 15) a memo from Phil Graham announcing the sign-back deadline is extended to April 29, 2011.   The memo reads:
     
    I would like to thank all those Family Health Teams who have reviewed the new FA and articulated their issues and concerns to the ministry and those who have signed back. The ministry has reviewed the issues raised and is working with the Ontario Medical Association (OMA), Association of Family Health Teams of Ontario (AFHTO) and the Association of Ontario Health Centres (AOHC) in an effort to address the issues that are common across FHTs.
    In light of this on-going work and in an effort to arrive at optimal solutions to the issues identified, the ministry is extending the deadline for sign-back from the previous extension date of April 15, 2011 to April 29, 2011. Although the ministry will consider a further extension should further review and discussion be required, all FHTs are encouraged to expedite the process of review and sign-back once the ministry provides responses to the issues identified, expected shortly. Any changes or amendments made will also be shared with FHTs that have already signed back their FA.
    Thank you for your attention to this and I look forward to addressing these issues cooperatively so we can continue to support the delivery of quality, interdisciplinary care to Ontarians.

  • FHT Funding Agreements: update on the “employee requirement”

    AFHTO has learned the Ministry is working on a framework for granting exceptions to the “employee requirement” that appears in all Funding Agreements. They expect the draft to be completed in the next few weeks. AFHTO was told that, at minimum, we would get advance notice of the content of this framework. AFHTO continues to request the opportunity to review and give feedback on the draft framework for exceptions so that problems can be identified and solved before the Agreements move into implementation. AFHTO has a very successful track record in this regard, given past work in pulling together working groups from member FHTs to give constructive feedback and attempt to solve problems with the Ministry on such issues as the move to 5-year funding, NP-SERT and the new smoking cessation program. AFHTO first notified FHTs about the potential problem with the “employee requirement” clause on March 25, and survey results indicated this would pose significant implementation challenges for many FHTs. As noted in that March 25 e-mail, the “employee requirement” was introduced with the intent to meet a government-wide directive from Ministry of Government Services (MGS) implemented last September for all transfer payment agencies. In the last few days AFHTO has discussed these concerns with the Minister’s Office (MO) and the Ontario Medical Association (OMA). We welcomed news that the MO is working with the FHT Unit and MGS to find reasonable and workable solutions to fulfil the intended purpose of the directive while minimizing the risk of destabilizing staffing arrangements and service delivery in FHTs. The OMA shares AFHTO’s concerns, and our two organizations are working collaboratively in seeking solutions. In the meantime AFHTO has learned that some FHTs have yet to receive an extension date for signing their Agreement.  Other FHTs have received a response to their specific problems in implementing the “employee requirement” with a message that says, “The Ministry realizes that there may be isolated circumstances where exemptions will require consideration. … The ministry is not encouraging exceptions and very rarely will approve unless extreme circumstances.” AFHTO continues to recommend to those FHTs who have not yet signed the Agreement:

    • Do not rush into signing the Agreement until your FHT is comfortable with the requirements and the timeframe for implementation.
    • If the “employee requirement” poses problems for your FHT, wait to see the Ministry’s framework for granting exceptions.
    • Continue to work with your Ministry consultant to seek clarification on other issues affecting your FHT.
    • Seek legal advice as needed to deal with your FHT’s unique situation.
    • Please continue to keep AFHTO in the loop. AFHTO remains ready to gather FHT opinions, coordinate discussion, and facilitate resolution of issues that are common among FHTs.

  • FHT Funding Agreements: update on Ministry’s new deadline

    AFHTO has learned that all FHTs who requested an extended deadline to sign their Funding Agreement have received it. For some FHTs the new deadline is Friday, April 8, and others have until Friday, April 15. The FHT Unit has told AFHTO it will work with each FHT individually to resolve the issues the FHT has raised.  While the common issues were reiterated, the Ministry’s view is that each FHT’s needs and issues are unique, and each FHT has been given funding in their budget for legal assistance to help them with this. Each FHT does have unique circumstances. Some are sufficiently satisfied and have signed the agreement. Others have copied AFHTO on their letters to the Ministry specifying their FHT’s concerns. For those FHTs who have not yet signed, AFHTO suggests you:

    • Continue to work with your Ministry consultant to seek clarification.
    • Do not rush into signing the Agreement until your FHT is comfortable with the requirements and the timeframe for implementation.
    • Seek legal advice as needed to deal with your FHT’s unique situation.

    AFHTO is continuing to monitor progress and to seek advice on the unresolved issues. We sincerely hope that all FHTs will find workable solutions; however, if your FHT should find itself reaching an impasse, please keep us informed. AFHTO remains ready to gather FHT opinions, coordinate discussion, and facilitate resolution of issues that are common among FHTs.