This document provides a list of internet resources related to primary health care. It includes the websites for organizations like the Chronic Disease Prevention Alliance of Canada, the Canadian Alliance of Community Health Centre Associations, the Canadian Health Network, and the Canadian Physiotherapy Association. For each resource, it briefly describes the organization's mission and how it relates to primary health care issues in Canada.
The document outlines an initiative by Fraser Health to promote living their organizational values of respect, caring, and trust in interactions with patients, colleagues, and the public. It details expectations for treating others in accordance with these values, such as listening, obtaining consent, and maintaining confidentiality. Managers are asked to select behaviors aligned with the values to measure and track, with the goal of submitting baseline data on progress to leadership by specific deadlines in the initiative's timetable.
This document describes a scenario where a practice administrator presents data to the managing partner, Dr. Bud Jones, showing the physician group's productivity has slipped below where it should be. Dr. Jones questions the data and resists the idea that changes are needed. At a board meeting, the physicians disagree on whether a problem exists and what should be done. The meeting ends without consensus on how to address the revenue problem.
The document then provides an overview of a change management framework to help physician organizations successfully implement changes. It identifies three foundational issues - leadership, shared vision, and culture/compact. It also outlines five levers leaders can use in the change process: align a change team, involve physicians, develop tension for
Physician performance measurement is becoming essential for quality improvement and demonstrating value to payers. However, most family medicine offices do not currently measure the care they provide. The article describes how to implement performance measurement in a way that minimizes burden by collecting data prospectively as a byproduct of patient care. Key tools for performance measurement are flow sheets and registries, which help track patients and identify those needing services. Electronic health records can also facilitate performance measurement by incorporating measures into templates.
This document discusses a new partnership between Family Health Teams (FHTs) and Public Health in Ontario. There are currently 152 approved FHTs serving over 2.75 million patients. FHTs aim to provide excellent primary health care through interdisciplinary teams of 2-25 physicians providing comprehensive care, chronic disease management, health promotion, and round-the-clock coverage with IT support. The document outlines steps for FHTs to improve quality of care through developing organizational frameworks, building interdisciplinary teams, and building links to community partners. It presents a framework involving a care model, improvement model, and learning model to guide this transition, with the goal of improving clinical, functional and population health outcomes.
The document introduces the Model for Improvement, which provides a framework for developing, testing, and implementing changes that lead to improvement. The model consists of two parts: 1) three fundamental questions to guide improvement work, and 2) Plan-Do-Study-Act (PDSA) cycles to test changes rapidly through small-scale trials. Using PDSA cycles allows improvements to be implemented systematically after building evidence of what works through consecutive tests. The Model for Improvement offers a simple, low-risk approach to achieving successful organizational change.
Cprn Implementing Primary Care Reform In Canadaprimary
This document discusses barriers and facilitators to implementing primary care reform in Canada. It analyzes the legacy of Canada's health policy culture, the structure and design of the healthcare system, and the supports required for policy implementation. Key barriers include the long history of focusing reform efforts on changing physician payment models and paying physicians fee-for-service. Facilitators include increasing physician willingness to consider alternative payment and the common elements of provincial reform plans, such as emphasis on multidisciplinary teams, rostering patients, and health promotion. However, implementation of primary care reform in Canada has been slow.
The document describes The Model for Improvement, which provides a framework for developing, testing, and implementing changes that lead to improvement. The model consists of two parts: 1) three fundamental questions to guide improvement work, and 2) Plan-Do-Study-Act cycles to test changes rapidly through small-scale trials. Using this approach can help achieve successful change by starting small, reducing risk, and learning from iterative testing to build knowledge for further improvement.
This document provides a list of internet resources related to primary health care. It includes the websites for organizations like the Chronic Disease Prevention Alliance of Canada, the Canadian Alliance of Community Health Centre Associations, the Canadian Health Network, and the Canadian Physiotherapy Association. For each resource, it briefly describes the organization's mission and how it relates to primary health care issues in Canada.
The document outlines an initiative by Fraser Health to promote living their organizational values of respect, caring, and trust in interactions with patients, colleagues, and the public. It details expectations for treating others in accordance with these values, such as listening, obtaining consent, and maintaining confidentiality. Managers are asked to select behaviors aligned with the values to measure and track, with the goal of submitting baseline data on progress to leadership by specific deadlines in the initiative's timetable.
This document describes a scenario where a practice administrator presents data to the managing partner, Dr. Bud Jones, showing the physician group's productivity has slipped below where it should be. Dr. Jones questions the data and resists the idea that changes are needed. At a board meeting, the physicians disagree on whether a problem exists and what should be done. The meeting ends without consensus on how to address the revenue problem.
The document then provides an overview of a change management framework to help physician organizations successfully implement changes. It identifies three foundational issues - leadership, shared vision, and culture/compact. It also outlines five levers leaders can use in the change process: align a change team, involve physicians, develop tension for
Physician performance measurement is becoming essential for quality improvement and demonstrating value to payers. However, most family medicine offices do not currently measure the care they provide. The article describes how to implement performance measurement in a way that minimizes burden by collecting data prospectively as a byproduct of patient care. Key tools for performance measurement are flow sheets and registries, which help track patients and identify those needing services. Electronic health records can also facilitate performance measurement by incorporating measures into templates.
This document discusses a new partnership between Family Health Teams (FHTs) and Public Health in Ontario. There are currently 152 approved FHTs serving over 2.75 million patients. FHTs aim to provide excellent primary health care through interdisciplinary teams of 2-25 physicians providing comprehensive care, chronic disease management, health promotion, and round-the-clock coverage with IT support. The document outlines steps for FHTs to improve quality of care through developing organizational frameworks, building interdisciplinary teams, and building links to community partners. It presents a framework involving a care model, improvement model, and learning model to guide this transition, with the goal of improving clinical, functional and population health outcomes.
The document introduces the Model for Improvement, which provides a framework for developing, testing, and implementing changes that lead to improvement. The model consists of two parts: 1) three fundamental questions to guide improvement work, and 2) Plan-Do-Study-Act (PDSA) cycles to test changes rapidly through small-scale trials. Using PDSA cycles allows improvements to be implemented systematically after building evidence of what works through consecutive tests. The Model for Improvement offers a simple, low-risk approach to achieving successful organizational change.
Cprn Implementing Primary Care Reform In Canadaprimary
This document discusses barriers and facilitators to implementing primary care reform in Canada. It analyzes the legacy of Canada's health policy culture, the structure and design of the healthcare system, and the supports required for policy implementation. Key barriers include the long history of focusing reform efforts on changing physician payment models and paying physicians fee-for-service. Facilitators include increasing physician willingness to consider alternative payment and the common elements of provincial reform plans, such as emphasis on multidisciplinary teams, rostering patients, and health promotion. However, implementation of primary care reform in Canada has been slow.
The document describes The Model for Improvement, which provides a framework for developing, testing, and implementing changes that lead to improvement. The model consists of two parts: 1) three fundamental questions to guide improvement work, and 2) Plan-Do-Study-Act cycles to test changes rapidly through small-scale trials. Using this approach can help achieve successful change by starting small, reducing risk, and learning from iterative testing to build knowledge for further improvement.
Regular measurement is essential to determine if changes actually improve outcomes. Teams should select measures of outcomes, processes, and balancing factors to assess the impact of changes. Run charts displayed over time help teams observe patterns and determine if improvements are real and sustained by showing the effect of changes on measured factors. Teams should collect useful, simple, minimal, and real-time data to speed improvement without slowing the process down.
A provider needs to define their patient panel size in order to effectively manage their workload and see patients when their needs arise. The current panel size can be determined using a four-cut method to assign patients who have seen multiple providers. The target panel size is calculated by dividing the total practice panel among full-time providers. The ideal panel size is calculated using an equation that considers the number of patient visits per day, number of provider days per year, and average visits per patient per year. Changing variables in this equation can alter the ideal panel size.
This document lists contact information for the registrars of various health professions in British Columbia, including their addresses, phone and fax numbers, websites, and email addresses. It includes registrars for chiropractors, dental hygienists, dental technicians, dentists, denturists, dietitians, emergency medical assistants, hearing aid dealers/audiologists, massage therapists, midwives, naturopathic physicians, nurses, occupational therapists, opticians, optometrists, pharmacists, physicians and surgeons, physical therapists, podiatrists, psychologists, and traditional Chinese medicine practitioners/acupuncturists.
Family Health Teams (FHTs) are groups of health care professionals that provide comprehensive primary care services. Patients can enroll with either an individual physician or the entire FHT group. Enrolling ensures access to care 24/7 through regular and extended office hours as well as telephone health services. Physicians in FHTs can continue existing enrollments and are encouraged to accept new patients by completing enrollment forms. The enrollment process has patients commit to using their FHT for treatment unless traveling or in an emergency and allows information sharing with the Ministry of Health.
This document discusses how health information technology (health IT) can be used to improve the quality of care in primary care settings. It provides background on projects by the Agency for Healthcare Research and Quality (AHRQ) and others to promote the adoption of health IT. The document aims to identify health IT functionality that supports quality improvement, propose strategies ("change ideas") for implementing health IT as a tool for improvement, and identify opportunities for innovation. While health IT holds promise, simply implementing current systems will not drive improvement on its own. Success requires using health IT together with robust care models and quality improvement methods.
This document provides an overview of Ontario's Chronic Disease Prevention and Management Framework. It aims to provide a common policy framework to guide efforts in effectively preventing and managing chronic diseases. It also aims to guide various ministry transformation initiatives, such as primary health care renewal and public health renewal, with a focus on chronic disease prevention and management. The framework outlines eight components that need to be addressed through a systematic approach: health care organizations, delivery system design, provider decision support, information systems, personal skills/self-management support, healthy public policy, community action, and supportive environments. It emphasizes the importance of taking a population health approach focused on prevention to reduce the burden of chronic diseases.
Consumer And Recruitment Marketing Final Bookletprimary
This document provides an overview of a series of booklets on marketing, recruitment, and retention tactics for long-term care facilities. Booklet One focuses on developing a marketing plan and HR recruitment tools and tactics. It discusses the importance of marketing to attract staff and residents. The booklet is divided into two sections: 1) developing a marketing plan through determining needs, messages, and advertising vehicles and 2) HR recruitment tactics using the internet, job fairs, and accessing the local labor market. Templates and worksheets are also provided to help facilities with their marketing and recruitment efforts.
Fraser Health is the largest and fastest growing health authority in British Columbia, serving over 1.46 million people across a large geographic area. It faces challenges in delivering equitable healthcare to both urban and rural communities given the diversity in population sizes and distances between them. The population is expected to continue growing significantly over the coming years, becoming older and more ethnically diverse on average. This will translate to increasing demand for healthcare services, particularly for chronic conditions that are more common in older populations like diabetes, arthritis, heart disease, and mental illness.
1) The National Primary Care Collaborative (NPCC) in the UK brought together over 2000 primary care practices serving 11.5 million patients to improve care through collaborative learning workshops and action periods. Significant improvements were achieved such as a 60% reduction in wait times to see a GP.
2) A collaborative strategy involves bringing providers together through learning workshops separated by action periods where practices test changes, share results, and learn from each other's experiences. The goal is rapid spread of improvements to other practices.
3) An Australian Primary Care Collaborative (APCC) could help address challenges in applying evidence to patient care in Australia through skill development in quality improvement methods for primary care practitioners. Differences from the
This document provides an overview of Ontario's Chronic Disease Prevention and Management Framework. It aims to provide a common policy framework to guide efforts in effectively preventing and managing chronic diseases. It also aims to guide various ministry transformation initiatives, such as primary health care renewal and public health renewal, with a focus on chronic disease prevention and management. The framework outlines eight components that need to be addressed through a systematic approach: health care organizations, delivery system design, provider decision support, information systems, personal skills/self-management support, healthy public policy, community action, and supportive environments. It emphasizes the importance of taking a population health approach focused on prevention to reduce the burden of chronic diseases.
[1] KP HealthConnect is an integrated electronic medical record and business system that aims to improve quality, service, and affordability. [2] It includes elements such as a patient portal, secure messaging, and connectivity between clinics, hospitals, and other providers. [3] Early results show increases in online access for members, reductions in office visits and calls, and high member satisfaction with virtual care options such as telephone visits.
The document discusses the changing relationship between physicians and hospitals and the need to better engage physicians in quality improvement efforts. It notes that physicians' primary focus is their own practice and quality of care for their patients, which may not align with hospitals' system-wide quality goals. Additionally, physician culture emphasizes personal responsibility, which can conflict with a systems approach to quality. The document aims to provide a framework for hospitals to develop written plans to improve physician engagement in quality and safety initiatives. It identifies several organizations that have effectively engaged physicians and achieved results as "best-in-the-world laboratories" from which lessons can be drawn.
This document sets out a provincial charter for primary health care in British Columbia with the goal of creating a strong, sustainable, accessible, and effective primary health care system. It identifies seven priority areas for improving the system: access to primary health care, access to primary maternity care, chronic disease prevention, chronic disease management, management of co-morbidities, care for the frail elderly, and end-of-life care. The charter was developed collaboratively with stakeholders and outlines a strategic, collaborative approach focused on improving health outcomes, increasing access, and transforming the system through initiatives targeting these priority areas.
North%20 Perth%20 Bus%20 Plan %20 Sept%2006 Pdfprimary
This document provides a business and operational plan for the proposed North Perth Family Health Team (NPFHT). It outlines plans to recruit 16 allied health professionals and 4.5 administrative staff to provide expanded primary care services to over 15,000 enrolled patients. A new non-profit corporation governed by a board of directors will oversee the NPFHT. An implementation plan details activities to establish the team in an organized manner. Initial funding of $1,134,365 is requested for the first 7 months, with start-up costs of $174,200 for supplies and equipment.
This document provides a summary of a systematic literature review that examined the effectiveness of nutrition interventions for the prevention and treatment of chronic diseases in primary care settings. The review included studies on conditions such as overweight/obesity, diabetes, cardiovascular disease, and other conditions. It found that nutrition counselling and education led to beneficial outcomes for many conditions. However, it noted that the specific components and delivery methods of nutrition interventions varied widely between studies. The review concluded that nutrition services provided by dietitians can be effective in primary care, but more research is still needed, especially on the organizational aspects and implementation of such services.
This document provides an overview of a handbook for chronic disease management in Saskatchewan. It discusses three models that are used together in the collaborative - a learning model, the model for improvement, and the chronic care model. The vision is to improve care and health for those with coronary artery disease and diabetes, as well as access to physician practices. The mission is to help healthcare professionals deliver sustainable improvements in chronic disease care through quality improvement methods.
This document is a table of contents for a community action handbook that outlines a 5-step process for community-led problem solving. The steps are: 1) Initiating contact to find interested individuals; 2) Forming a community planning committee to gain commitment; 3) Gathering community information through meetings; 4) Expanding the committee to build momentum; and 5) Building a coalition to take action. The handbook provides guidance on tasks, decisions, and tracking progress at each step to form an effective community group that can work together to address local issues. It also includes examples from other communities that have used this approach.
This document discusses the evidence supporting primary care mental health collaboratives. It begins by defining common mental health problems and examining their high prevalence rates. It then reviews literature showing that collaboratives have improved mental healthcare management internationally by increasing education, encouraging organizational change, and allowing reflection. The document outlines the aims and measures of the UK's National Primary Care Mental Health Collaborative, such as consultation rates, referrals to psychiatry, and sick leave durations, which aim to improve care for patients and monitor the effects of the collaborative approach.
This document provides a map showing the locations of Family Health Teams across Northern Ontario implemented in three waves:
1) The map shows the locations of Family Health Teams in various communities across Northern Ontario, grouped into large, community, small, and rural sites.
2) The Family Health Teams were implemented in three waves, with teams in different regions of Northern Ontario launching in each wave.
3) The map identifies the regions covered by each wave and provides the number of family physicians in each type of site to characterize their size.
Family Health Teams have been established across Northern Ontario in 3 waves:
- Wave 1 included large teams of 21-30 family physicians, community teams of 11-20 physicians, and small/rural teams of 5 or fewer physicians. Teams were located in communities across central, eastern, western and Champlain regions.
- Wave 2 expanded coverage with additional large, community and small/rural teams in northeast, northwest, southeast, southwest and Toronto regions.
- Wave 3 further increased access with more large teams in central, eastern and western regions and additional community and small/rural teams across the north.
Regular measurement is essential to determine if changes actually improve outcomes. Teams should select measures of outcomes, processes, and balancing factors to assess the impact of changes. Run charts displayed over time help teams observe patterns and determine if improvements are real and sustained by showing the effect of changes on measured factors. Teams should collect useful, simple, minimal, and real-time data to speed improvement without slowing the process down.
A provider needs to define their patient panel size in order to effectively manage their workload and see patients when their needs arise. The current panel size can be determined using a four-cut method to assign patients who have seen multiple providers. The target panel size is calculated by dividing the total practice panel among full-time providers. The ideal panel size is calculated using an equation that considers the number of patient visits per day, number of provider days per year, and average visits per patient per year. Changing variables in this equation can alter the ideal panel size.
This document lists contact information for the registrars of various health professions in British Columbia, including their addresses, phone and fax numbers, websites, and email addresses. It includes registrars for chiropractors, dental hygienists, dental technicians, dentists, denturists, dietitians, emergency medical assistants, hearing aid dealers/audiologists, massage therapists, midwives, naturopathic physicians, nurses, occupational therapists, opticians, optometrists, pharmacists, physicians and surgeons, physical therapists, podiatrists, psychologists, and traditional Chinese medicine practitioners/acupuncturists.
Family Health Teams (FHTs) are groups of health care professionals that provide comprehensive primary care services. Patients can enroll with either an individual physician or the entire FHT group. Enrolling ensures access to care 24/7 through regular and extended office hours as well as telephone health services. Physicians in FHTs can continue existing enrollments and are encouraged to accept new patients by completing enrollment forms. The enrollment process has patients commit to using their FHT for treatment unless traveling or in an emergency and allows information sharing with the Ministry of Health.
This document discusses how health information technology (health IT) can be used to improve the quality of care in primary care settings. It provides background on projects by the Agency for Healthcare Research and Quality (AHRQ) and others to promote the adoption of health IT. The document aims to identify health IT functionality that supports quality improvement, propose strategies ("change ideas") for implementing health IT as a tool for improvement, and identify opportunities for innovation. While health IT holds promise, simply implementing current systems will not drive improvement on its own. Success requires using health IT together with robust care models and quality improvement methods.
This document provides an overview of Ontario's Chronic Disease Prevention and Management Framework. It aims to provide a common policy framework to guide efforts in effectively preventing and managing chronic diseases. It also aims to guide various ministry transformation initiatives, such as primary health care renewal and public health renewal, with a focus on chronic disease prevention and management. The framework outlines eight components that need to be addressed through a systematic approach: health care organizations, delivery system design, provider decision support, information systems, personal skills/self-management support, healthy public policy, community action, and supportive environments. It emphasizes the importance of taking a population health approach focused on prevention to reduce the burden of chronic diseases.
Consumer And Recruitment Marketing Final Bookletprimary
This document provides an overview of a series of booklets on marketing, recruitment, and retention tactics for long-term care facilities. Booklet One focuses on developing a marketing plan and HR recruitment tools and tactics. It discusses the importance of marketing to attract staff and residents. The booklet is divided into two sections: 1) developing a marketing plan through determining needs, messages, and advertising vehicles and 2) HR recruitment tactics using the internet, job fairs, and accessing the local labor market. Templates and worksheets are also provided to help facilities with their marketing and recruitment efforts.
Fraser Health is the largest and fastest growing health authority in British Columbia, serving over 1.46 million people across a large geographic area. It faces challenges in delivering equitable healthcare to both urban and rural communities given the diversity in population sizes and distances between them. The population is expected to continue growing significantly over the coming years, becoming older and more ethnically diverse on average. This will translate to increasing demand for healthcare services, particularly for chronic conditions that are more common in older populations like diabetes, arthritis, heart disease, and mental illness.
1) The National Primary Care Collaborative (NPCC) in the UK brought together over 2000 primary care practices serving 11.5 million patients to improve care through collaborative learning workshops and action periods. Significant improvements were achieved such as a 60% reduction in wait times to see a GP.
2) A collaborative strategy involves bringing providers together through learning workshops separated by action periods where practices test changes, share results, and learn from each other's experiences. The goal is rapid spread of improvements to other practices.
3) An Australian Primary Care Collaborative (APCC) could help address challenges in applying evidence to patient care in Australia through skill development in quality improvement methods for primary care practitioners. Differences from the
This document provides an overview of Ontario's Chronic Disease Prevention and Management Framework. It aims to provide a common policy framework to guide efforts in effectively preventing and managing chronic diseases. It also aims to guide various ministry transformation initiatives, such as primary health care renewal and public health renewal, with a focus on chronic disease prevention and management. The framework outlines eight components that need to be addressed through a systematic approach: health care organizations, delivery system design, provider decision support, information systems, personal skills/self-management support, healthy public policy, community action, and supportive environments. It emphasizes the importance of taking a population health approach focused on prevention to reduce the burden of chronic diseases.
[1] KP HealthConnect is an integrated electronic medical record and business system that aims to improve quality, service, and affordability. [2] It includes elements such as a patient portal, secure messaging, and connectivity between clinics, hospitals, and other providers. [3] Early results show increases in online access for members, reductions in office visits and calls, and high member satisfaction with virtual care options such as telephone visits.
The document discusses the changing relationship between physicians and hospitals and the need to better engage physicians in quality improvement efforts. It notes that physicians' primary focus is their own practice and quality of care for their patients, which may not align with hospitals' system-wide quality goals. Additionally, physician culture emphasizes personal responsibility, which can conflict with a systems approach to quality. The document aims to provide a framework for hospitals to develop written plans to improve physician engagement in quality and safety initiatives. It identifies several organizations that have effectively engaged physicians and achieved results as "best-in-the-world laboratories" from which lessons can be drawn.
This document sets out a provincial charter for primary health care in British Columbia with the goal of creating a strong, sustainable, accessible, and effective primary health care system. It identifies seven priority areas for improving the system: access to primary health care, access to primary maternity care, chronic disease prevention, chronic disease management, management of co-morbidities, care for the frail elderly, and end-of-life care. The charter was developed collaboratively with stakeholders and outlines a strategic, collaborative approach focused on improving health outcomes, increasing access, and transforming the system through initiatives targeting these priority areas.
North%20 Perth%20 Bus%20 Plan %20 Sept%2006 Pdfprimary
This document provides a business and operational plan for the proposed North Perth Family Health Team (NPFHT). It outlines plans to recruit 16 allied health professionals and 4.5 administrative staff to provide expanded primary care services to over 15,000 enrolled patients. A new non-profit corporation governed by a board of directors will oversee the NPFHT. An implementation plan details activities to establish the team in an organized manner. Initial funding of $1,134,365 is requested for the first 7 months, with start-up costs of $174,200 for supplies and equipment.
This document provides a summary of a systematic literature review that examined the effectiveness of nutrition interventions for the prevention and treatment of chronic diseases in primary care settings. The review included studies on conditions such as overweight/obesity, diabetes, cardiovascular disease, and other conditions. It found that nutrition counselling and education led to beneficial outcomes for many conditions. However, it noted that the specific components and delivery methods of nutrition interventions varied widely between studies. The review concluded that nutrition services provided by dietitians can be effective in primary care, but more research is still needed, especially on the organizational aspects and implementation of such services.
This document provides an overview of a handbook for chronic disease management in Saskatchewan. It discusses three models that are used together in the collaborative - a learning model, the model for improvement, and the chronic care model. The vision is to improve care and health for those with coronary artery disease and diabetes, as well as access to physician practices. The mission is to help healthcare professionals deliver sustainable improvements in chronic disease care through quality improvement methods.
This document is a table of contents for a community action handbook that outlines a 5-step process for community-led problem solving. The steps are: 1) Initiating contact to find interested individuals; 2) Forming a community planning committee to gain commitment; 3) Gathering community information through meetings; 4) Expanding the committee to build momentum; and 5) Building a coalition to take action. The handbook provides guidance on tasks, decisions, and tracking progress at each step to form an effective community group that can work together to address local issues. It also includes examples from other communities that have used this approach.
This document discusses the evidence supporting primary care mental health collaboratives. It begins by defining common mental health problems and examining their high prevalence rates. It then reviews literature showing that collaboratives have improved mental healthcare management internationally by increasing education, encouraging organizational change, and allowing reflection. The document outlines the aims and measures of the UK's National Primary Care Mental Health Collaborative, such as consultation rates, referrals to psychiatry, and sick leave durations, which aim to improve care for patients and monitor the effects of the collaborative approach.
This document provides a map showing the locations of Family Health Teams across Northern Ontario implemented in three waves:
1) The map shows the locations of Family Health Teams in various communities across Northern Ontario, grouped into large, community, small, and rural sites.
2) The Family Health Teams were implemented in three waves, with teams in different regions of Northern Ontario launching in each wave.
3) The map identifies the regions covered by each wave and provides the number of family physicians in each type of site to characterize their size.
Family Health Teams have been established across Northern Ontario in 3 waves:
- Wave 1 included large teams of 21-30 family physicians, community teams of 11-20 physicians, and small/rural teams of 5 or fewer physicians. Teams were located in communities across central, eastern, western and Champlain regions.
- Wave 2 expanded coverage with additional large, community and small/rural teams in northeast, northwest, southeast, southwest and Toronto regions.
- Wave 3 further increased access with more large teams in central, eastern and western regions and additional community and small/rural teams across the north.
This document provides guidance on managing waiting times in the NHS in Scotland. It outlines 10 golden rules for waiting time management that put the patient's interests first. It emphasizes the importance of appropriate referrals, adequate services, clinical prioritization of patients, and keeping patients informed of wait times. The document stresses partnership between primary and secondary care and accurate information on waiting lists. It discusses initiatives to treat backlogs versus long-term strategies to close gaps between demand and capacity. NHS Boards are asked to develop local plans that meet and exceed national targets through leadership, risk assessment, resource planning, and patient consultation.
This guidebook shares stories from nine Ontario communities that have undertaken healthy community initiatives. The stories describe their experiences and processes to raise awareness, build connections, and take action around health issues. Community members then reflected on these stories and identified "words of wisdom" from their experiences. Finally, the guidebook provides a framework and questions to help other communities document and share their own stories to guide their healthy community efforts.
The document provides tips and tools for registered dietitians working in interdisciplinary primary care settings. It outlines a proposed model for nutrition services with the RD responsible for overall management and the most in-depth nutrition counselling. It describes assessing community needs, nutrition screening, referral processes, nutrition advice and counselling. A typical nutrition counselling process is outlined including pre-screening referrals, initial visits, nutrition planning visits, follow-up visits and coordinating with the interdisciplinary team. Various tools developed in a demonstration project are also included to support RDs.
This document outlines a screening project conducted with primary care providers to identify at-risk women and incorporate screening tools for alcohol, smoking, and abuse into practice. It provided a screening and resource package, conducted academic detailing, and administered pre- and post-test questionnaires. The results showed increased screening rates for tobacco, alcohol, and abuse from pre- to post-test. While the response rate for the post-test was lower, providers reported increased use of screening tools and community referrals. The academic detailing approach was found useful by most providers.
This document outlines Saskatchewan's Action Plan for Primary Health Care, which aims to strengthen primary health care services in the province. It describes the vision for an integrated primary health care system delivered through networks of health care providers. The plan establishes defined roles for Regional Health Authorities and the government in managing, operating and funding primary health care. It also outlines characteristics of the new system and a phased implementation approach over 10 years to establish primary health care teams accessible to all residents.
The Role And Value Of Primary Care Practiceprimary
This document summarizes discussions from a 2002 conference on building consensus for healthcare reform in Canada. It includes summaries of two presentations:
1. Marie-Dominique Beaulieu's presentation on the role and value of primary care. She defines primary care and argues for strengthening it in Canada. She calls for changes like developing primary care teams with nurses and better information systems.
2. Howard Bergman's presentation in which he argues for strengthening and transforming primary care as the foundation of the healthcare system. He calls for an evidence-based approach and investing in primary care to improve health outcomes. Both agree comprehensive reform is needed, not just changes to primary care itself.
The document describes The Model for Improvement, which provides a framework for developing, testing, and implementing changes that lead to improvement. The model consists of two parts: 1) three fundamental questions to guide improvement work, and 2) Plan-Do-Study-Act cycles to test changes rapidly through small-scale trials. Using this approach can help achieve successful, low-risk change through a simple and effective process of continuous learning and adaptation.
This document summarizes the final report from the Forum on Teamworking in Primary Healthcare. The forum was convened by several national healthcare organizations to examine teamworking in primary care. The report found evidence that effective teamwork occurs when roles are clearly defined and rewarding, communication is good, and there are shared goals. It identified barriers like competing demands, status differences, and lack of resources. The report provides recommendations to improve teamworking at both the organizational and team member levels. It also highlights several examples of successful teamworking initiatives in UK primary care settings.
The document discusses strategies for improving patient flow and reducing cycle times in medical practices. It describes how mapping patient flows, measuring cycle times, and identifying interruptions can help practices pinpoint bottlenecks. Practices have found that small tests of change focused on areas like visit planning, co-locating staff, efficient office design, exam room standardization, documentation shortcuts, and streamlined check-in/out processes can uncover hidden capacity and increase revenue. The key is developing a deep understanding of the current process from the patient's perspective before envisioning an ideal flow and implementing changes while monitoring for unintended consequences. Physician leadership and a team effort are essential to successfully redirecting patient flow.
Snap%2 B Framework%2 Bfor%2 B General%2 B Practiceprimary
This document presents the Smoking, Nutrition, Alcohol and Physical Activity (SNAP) Risk Factor Framework for General Practice. The framework was developed to provide integrated approaches for general practitioners to support behavioral risk factor management for smoking, nutrition, alcohol and physical activity.
It identifies these four risk factors as major contributors to disease burden and outlines seven outcomes areas for action: organizational structures, financing, workforce development, information systems, communication, partnerships and referral networks, and research. The framework is intended to streamline support for general practices and encourage collaboration across different organizations and levels of care.
The document is the first annual report from the Health Results Team, which was created by the Minister of Health and Long-Term Care to improve patient access to healthcare in Ontario. The report details progress made in the first year to transform the healthcare system through initiatives like establishing Local Health Integration Networks, reducing wait times, implementing Family Health Teams, and improving information management. The Health Results Team worked across the healthcare community and achieved many milestones to deliver on the vision of creating a more integrated, sustainable, and patient-centered healthcare system.
This document provides updates on chronic disease management initiatives including the Chronic Disease Management Collaborative (CDMC). Key information includes:
1. An explanation of delivery system design which involves defining roles, using planned interactions, providing case management, and ensuring regular follow-up to effectively manage chronic illnesses.
2. Details on upcoming training for the Clinical Practice Redesign program and information sessions on a new diabetes education program using group visits.
3. Announcements of learning workshops and conferences on chronic disease management and diabetes.
The document discusses the role of registered dietitians in primary health care. It begins by explaining that primary health care focuses on wellness promotion rather than just illness treatment. It also notes that nutrition is important for health but access to nutrition services is limited. The document then describes key elements of primary health care, including using a population health approach, comprehensive services, coordination of care, interdisciplinary teams, and cost-effectiveness. It outlines the practice of registered dietitians in primary health care, including their skills in health promotion, education, and working with communities. Examples are provided of how dietitians contribute to quality of life, health outcomes, and cost containment through various strategies and actions.
Rg0035 A Guideto Service Improvement Nhs Scotlandprimary
This document provides a guide to using various tools and techniques for improving health care services. It focuses on using process mapping to analyze patient journeys through the health care system. Process mapping involves capturing each step of a patient's experience in a visual map to identify issues like bottlenecks, unnecessary steps, or handoffs between staff. Preparing for process mapping by defining the scope and goals and involving relevant staff and patients is important. Once complete, process maps can reveal problems and opportunities for improving efficiency and patient experience.
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1. MARCH 2005
INSIDE THIS ISSUE Primary Care Transformation Strategy
At the February 21st Hospital eHealth Council meeting, Council received an
update on the Primary Care Transformation Strategy in Ontario from Dr. Jim
PRIMARY CARE UPDATE
MacLean, Lead, Primary Health Care Reform, Ministry of Health and
Family Health Teams &
Long Term Care (MOHLTC), and Harley Rodin, VP, Business
Ontario MD
Development, OntarioMD.
2005 READINESS Understanding Primary Care Reform and Family Health Teams
SURVEYS - eHR Readiness Dr. MacLean offered insight into the description and plans for the
& Technical Network development of Family Health Teams (FHT) in Ontario. FHTs propose a
Readiness comprehensive range of primary care services provided by an interdisciplinary
team made up of a mix of family physicians, nurse practitioners, nurses,
Client Registry/EMPI pharmacists, social workers, dieticians and others. FHTs will improve access
Demonstration to primary care by providing patients with after-hours care through extended
office hours as well as offering telephone health advisory service (THAS).
UPDATE ON LOCKBOX
FHTs will receive funding through an approved budget with the MOHLTC that
Announcing Technical will cover all approved services, including administrative costs, and may be
issues Learning (TILE) offset by community or other contributions. Funding levels for other healthcare
professionals will be consistent across the province but the specific
NEW ADVISORY GROUP compensation models will be determined by the FHTs themselves. Support for
Hospital Lab Information information technology will be provided in combination through OntarioMD
Systems and the MOHLTC.
CASE STUDIES LAUNCH Recognizing the diversity of communities and health-related needs across
Ontario, the MOHLTC has developed a number of guiding principles to ensure
optimal development and implementation of FHTs.
CALL TO ACTION • Flexibility and Choice – Respecting local requirements for size, scope and
focus.
Share your eHealth • Community and Provider Partnerships – Encouraging collaboration
success story with us! across sectors and institutions to meet the unique needs of local
See Page 4 for more details. populations.
• Team Based Care - Interdisciplinary approach.
• Build on Existing Models and Successes – Aimed to build upon existing
strengths and leverage prior learning.
Further reinforcing the Ministry’s commitment to support the unique needs of
FHTs, three governance models are proposed:
• Community groups - Must be registered as non-profit organizations with a
board of directors that includes community representation.
• Provider groups - May be established as partnerships or professional
associations.
• Mix of provider groups and community groups - Will combine a non-
profit/community-based organization with a form of provider group.
A series of toolkits and guides are being finalized to assist primary care
groups in their establishment of an FHT.
2. Primary Care Transformation (cont’d)
FHT InfoKits, intended to help guide potential FHT proponents, have been provided to over 800
communities/providers. Within this package, an Information Request Form (IRF) was included to allow interested
groups to apply for consideration for Wave 1 funding for FHT establishment. By Feb 15th the MoHLTC received 213
completed applications from across Ontario, representing all geographic areas and practice sizes. An inter-divisional
Ministry team is in the process of evaluating these applications and will announce their recommendations to the
Minister in March 2005.
Ontario MD
Harley Rodin highlighted the OntarioMD strategy and development plan. Owned by the Ontario Medical
Association (OMA), with sponsorship from the MOHLTC and utilizing SSHA infrastructure, OntarioMD will operate
as the physicians’ advisor on e-Health. OntarioMD helps physicians use information technology to increase
efficiency, reduce costs, and enrich patient care. OntarioMD will deliver this by connecting physicians to other
healthcare providers and the private sector, including certified Clinical Management System vendors, professional
services, the MOHLTC and its associated programs. Interconnectivity, best practices and practical tools will be
available for physicians via the OntarioMD.ca portal. Aligning with and connecting to existing information networks
and pre-built tools will drive the most value through the OntarioMD system.
OntarioMD will offer numerous benefits for physicians, including consolidation of prescription renewal requests,
sending and receiving patient referral and consult information, Clinical Management System remote access, access
to MOHLTC-sponsored and private sector e-services, as well as clinical productivity content and tools. Health service
providers will benefit from enhanced access to physicians, and efficiencies gained in practice. Ultimately, patients
will benefit from an overall improvement in the speed and quality of patient care and services.
OntarioMD is on its way to achieving its development goals. The 2005 fiscal year was earmarked for provincially
launching the OntarioMD.ca portal, establishing funding and further delivering the transition support program. In
2005, OntarioMD will focus on earning users, building support structures, delivering clinical productivity tools, and
developing revenue opportunities. In 2006 and beyond OntarioMD intends to lead the market by establishing a
sustainable competitive advantage, wider electronic medical record deployment, and the delivery of advanced clinical
tools. For more information, contact Harley Rodin at 416-623-1248 (harley.rodin@ontariomd.com).
2005 Readiness Surveys
The Ontario Hospital eHealth Council is proud to update readers on the status of the two Readiness Surveys it is
sponsoring among Ontario Hospitals in the spring of 2005.
The 2005 EHR Readiness Survey was launched with great excitement on March 7th. Survey Coordinators in
hospitals across Ontario received their invitations to complete their electronic surveys, with a deadline to complete
by April 4th, 2005. Pilot testing indicated that this web-based survey is intuitive and easy to complete, requiring less
than one hour for an IT-savvy Hospital Information Officer. To support Survey Coordinators in completing the
assessment, the eHealth Team held a web cast presentation of “How to complete the 2005 EHR Readiness
Survey in 5 Easy Steps” on March 10th, 2005.
Following one week behind the EHR Readiness Survey, the 2005 Technical Network Readiness Survey was
launched on March 14th, with a deadline for completion of April 11th, 2005. This short web-based survey assesses
the way networks are currently engaged with Smart Systems for Health Network (SSHA) and / or other external
networks.
Survey results should be available in Summer 2005. Results of these two surveys will be used for provincial eHealth
strategy planning and advocacy purposes, as well as informing participants about their own eHealth status among
their peers. For more information, or to access an archived copy of the web cast presentation, contact Martha
Murray at 416-205-1312, or by email at mmurray@oha.com.
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3. Hospital eHealth Council Establishes A New Working Group
In its continuing efforts to advocate for Ontario health system change, the Hospital eHealth Council has established a
Hospital Lab Information Systems Advisory Group (HLIS AG). HLIS AG brings together representatives of
hospital laboratories from different regions of Ontario with clinical and lab interface expertise.
Chaired by Dr. Sherry Perkins of the Ottawa Hospital, the HLIS AG is strategic in nature, tasked to examine a
variety of key issues that pertain to the effective electronic sharing of laboratory information. The team also
collaborates with the OLIS project team to provide input into OLIS’ adoption and change management strategy.
A kick-off meeting was held on February 15th, with a second meeting on March 23rd, 2005. The Group is interested in
defining models for the exchange of laboratory data, advocating for Quality Assurance in lab data and advising on
Nomenclature and Messaging Standards.
The principle aim of the group in the near term is to determine the ongoing work plan and to define the deliverable
products. Meetings take place every four to six weeks.
For more information, please contact Carol McFarlane at 416-205-1438, or by email at cmcfarlane@oha.com
Client Registry/EMPI Demonstration
On March 2nd, 2005, the Regional Registries Working Group (RRWG) was fortunate to receive an invitation to a
Canada Health Infoway (CHI) sponsored presentation of Capital Health’s Client Registry and NetCare EHR.
With most of the working group in attendance, Corinne Blair, Team Leader, Data Management & Integration at
Capital Health Authority (CHA) in Edmonton, provided education on CHA’s EHR Strategic Plan and the critical
importance of an effective EMPI to enable the plan. Topics covered included the implementation approach and
schedule, build requirements, technical requirements, and infrastructure architecture. Once the technical grounding
was conveyed and all questions answered, Corinne demonstrated the EMPI live, punctuated with first-hand
anecdotes outlining CHA’s challenges, solutions, and lessons learned. The RRWG formally thanks CHI for creating
an exceptional knowledge transfer opportunity and forging links between inter-jurisdictional registry builders.
For more information on the session, or a copy of Corinne Blair’s presentation, please contact Stella Skerlec at CHI,
at (416) 979-4606 ext. 3021 or by email sskerlec@infoway-inforoute.ca
Lockbox Update
In late January, the Information Privacy Commissioner’s Office of Ontario (IPC) issued an RFP for the development
of a transition strategy for hospitals and their vendors to comply with the lockbox provisions of Ontario’s Personal
Health Information Privacy Act (PHIPA). The project was awarded to Accenture, who is now looking for hospital
experts to provide input and advice regarding the business and technical requirements.
Accenture held an initial information meeting on Monday, March 21. With the help of stakeholder experts, the
project plans to:
Identify major issues to consider in developing technological solutions to the lockbox.
Develop technology options with select vendors.
Gain feedback from hospital representatives and seek input on developing the final product, which includes:
A Migration Strategy document (which can form part of a toolkit for hospitals transitioning to comply with the
lockbox provisions of PHIPA [in effect November 1, 2005]); and
A set of requirements for vendor software to comply with lockbox / PHIPA provisions.
For more information, please contact Lan Djang at 416-205-1497, or by email at ldjang@oha.com
3
4. Announcing Technical Issues LEarning (TILE)
A best practice approach for sharing knowledge about information technology issues
The Ontario Hospital eHealth Council, through the activities of its Network Operations Working Group (NOWG), is
pleased to announce the upcoming launch of the Technical Issues Learning (TILE) online application. Beginning in
April, those in the hospital and other healthcare sectors will be able to submit their own learning experiences to share
with others. TILE Reports allow online entry of information and technical experiences by any users of externally
networked hospital systems (e.g. SSHA, health care providers, etc.) and enables them to share reports with
colleagues in a user-friendly electronic format.
We’re interested in hearing about any issues or experiences of an information technology nature that you may have
encountered in the course of connecting to other healthcare providers, and what solutions, if any, you have come up
with to resolve issues. An invitation to TILE will be sent out in April. The TILE Reports are designed to be used by
information systems personnel at any Ontario hospital.
For more information please contact Lan Djang at ldjang@oha.com, or call 416-205-1497.
Case Studies Portfolio Launch
In the spirit of sharing, supporting, learning, and connecting, the Hospital eHealth Council is pleased to announce the
launch of our new eHealth Case Study Portfolio, an initiative to profile and communicate eHealth achievements
within our membership.
The Hospital eHealth Council enthusiastically supports our membership in advancing and sharing their eHealth
successes across the broader health sector. Assembling, summarizing, and promoting our members’ journeys
through eHealth development and implementation has the potential to educate and empower stakeholders across
the healthcare system. With these tools, we can leverage our understanding of our contemporaries’ achievements
and learning, as well as use this information to identify opportunities for resource sharing and optimization. Even
more, sharing contact information offers the opportunity for knowledge transfer and project support.
A traditional Case Study illustrates the history, context, strategy, structure, implementation, and outcomes of real life
project examples. At the Ontario Hospital eHealth Council, we have been working to ensure that our Case Studies
contain enough pertinent information to be useful, without being burdensome to read. Limiting each study to a
maximum of 2 pages, we consistently report on: Background / Context; Solutions; Challenges; and Lessons Learned.
These cases reveal a wide range of strategies, options and lessons to support the Ontario hospital sector, and
beyond to broader health stakeholders.
To date, we have three Case Studies ready for circulation. These studies document the following initiatives:
• The Grand River Hospital: My CARE Source Patient Portal
• The Thames Valley Hospital Planning Partnership Experience: Reaching a Memorandum of
Understanding
• The Scarborough Hospital: Automation of Medical Systems for Patient Safety
We welcome your ideas for new Case Studies to add to our portfolio. Please contact Nancy Gabor at 416-205-1601,
or by email at ngabor@oha.com, for more information.
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