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Panel Ph Nick Kates


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  • 1. Family Health Teams and Public Health: A new partnership Nick Kates Lead : Quality Management Collaborative
  • 2. Family Health Teams 152 approved 146 business plans approved 126 hired some or all staff 2.75 million patients 50 more proposed
  • 3. Vision for Family Health Teams Excellent Primary Health Care for Ontarians
  • 4. Family Health Teams 2-25 physicians (some larger) Comprehensive primary health care Interdisciplinary teams Chronic disease prevention and management Health promotion and disease prevention Self-management support Round the clock coverage IT support
  • 5. Escaping “The Tyranny of the Urgent” Thomas Bodenheimer 2002
  • 6. “Here is Edward Bear,coming downstairs now, bump, bump, bump, on the back of his head, behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there really is another way, if only he could stop bumping for a moment and think of it” A.A. Milne 1926 Illustration E.H.Shepard 192614
  • 7. “Insanity is doing things the way we’ve always done them, and expecting different results”
  • 8. CHANGING THE PARADIGM Focus on populations Focus on longitudinal care / closing the loop (a system of care) Care co-ordination Patients as partners Address all determinants of health Well-linked with community partners
  • 9. Everyone is working hard but in isolation
  • 10. Address quality as well as quantity
  • 11. Creating a culture of improvement and innovation
  • 12. Breaking out of our traditional ways of doing things
  • 13. Take the leap…. we will build our own wings on the way down. Donald Berwick
  • 14. Like trying to cross a bridge while we’re still building it
  • 15. Role of the Quality Management Collaborative To assist FHTs with developing and evaluating programs integrating additional health professionals and building teams building links with community partners creating organisational frameworks to support these The Improvement and Innovation agenda Negotiating the transition to a new model of care
  • 16. 3 Steps for FHTs Foundation tasks HR / Recruitment Organisational frameworks / governance IT Space Building teams Improving the quality of care we provide
  • 17. How to get there : The approach A framework / model Processes and supports to make it work
  • 18. How will we get there : The Framework / Model The Care Model The Improvement Model The Learning Model (Collaboratives)
  • 19. Ontario’s CDPM Framework INDIVIDUALS AND FAMILIES Healthy Public Personal Policy Skills & Self- Management HEALTH CARE Supportive Support Environments ORGANIZATIONS Delivery Information Community System Provider Systems Action Design Decision Support Productive interactions and relationships Informed, Activated Prepared, activated communities & proactive individuals prepared, proactive practice & families community teams partners Improved clinical, functional and population health outcomes
  • 20. How will we get there : The Framework / Model The Care Model The Improvement Model The Learning Model (Collaboratives)
  • 21. How to get there : The Processes Set up a Quality Improvement Team Get to know your FHT Improve access and office efficiencies On site support
  • 22. Health promotion and illness prevention in FHTs Mission Ontario’s CDPM Model – role of community, populations Traditional activities Self management support Enhanced 18 month baby visit A community resource Collaboratives
  • 23. How to encourage it Gradual Change the culture 1 clinician vs all 3 steps Risk factors (ie obesity) Antecedents (ie adverse childhood events) Pre-natal / early cohort Link with community partners IT Incremental
  • 24. Links with public health Personal contacts Presence in FHTs Formal links Collaborative programs Sharing community data Joint needs assessments