Canadian Diabetes Association. Patients First Submission. Ministry of Health and Long-Term Care. Government of Ontario.
|
|
- August Sharp
- 7 years ago
- Views:
Transcription
1 Canadian Diabetes Association Patients First Submission Ministry of Health and Long-Term Care Government of Ontario February 29,
2 The Canadian Diabetes Association (CDA) is a registered charitable organization that leads the fight against diabetes by helping those affected by diabetes to live healthy lives and by preventing the onset and consequences of diabetes while we work to find a cure. Our staff and more than 20,000 volunteers including health care professionals provide education and services to help people in their daily fight against the disease, advocate on behalf of people with diabetes for the opportunity to achieve their highest quality of life, and break ground towards a cure. 2
3 Introduction The Canadian Diabetes Association (CDA) appreciates the opportunity to respond to the Government of Ontario s Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario. Today, more than 1.6 million people in Ontario are living with diabetes, and another 2.3 million people have prediabetes. The increasing rate of diabetes and its complications pose a serious burden on the quality of life of Ontarians, the province s publicly funded health-care system and our economy. The CDA shares many of the same goals as the Government of Ontario: strengthening population and public health, improving access to quality services and primary care, and strengthening collaboration and continuity of care among health care services. This is why the CDA publishes the Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada, which are comprehensive, evidence-based recommendations for health care professionals to consider in the prevention and management of diabetes in Canada. They serve as a helpful resource and aid for anyone caring for people with diabetes and are recognized, not only in Canada but also internationally, as high-quality, evidence-based clinical practice guidelines. Within the guidelines there is an entire chapter devoted to improving the organization of diabetes care within the framework of the Chronic Care Model (CCM). Among the several recommendations to address the care gap between the clinical goals outlined in evidence-based guidelines for diabetes management and real-life clinical practice is the recommendation that diabetes care should be structured, evidence based and supported by a clinical information system that includes electronic patient registries, clinician and patient reminders, decision support, audits and feedback. These elements facilitate planning and coordination among providers while helping patients play an informed role in managing their own care. Within this submission, we propose the integration of the CDA Clinical Practice Guidelines into electronic medical records within our health care system to improve the organization of care, inter-professional collaboration and decision support for health care practitioners. 3
4 Background: Canadian Diabetes Association s 2013 Clinical Practice Guidelines Diabetes Care The 2013 Clinical Practice Guidelines support the promotion of patient self-management and recommend that diabetes care should be organized around the person living with diabetes. This person should be supported by a proactive, inter-professional team with specific training in diabetes. To improve patient self-management and outcomes, diabetes care should be delivered using evidence-based strategies including: self-management support and education and interprofessional team-based care. Inter-professional collaboration incorporates care coordination and the expansion of professional roles to include monitoring or medication adjustment and disease (case) management, in cooperation with the collaborating physician. Moreover, diabetes care should be supported by a clinical information system that includes electronic patient registries, clinician and patient reminders, decision support, audits and feedback. The Gap between Evidence-Based Clinical Goals and Clinical Practice Recent and ongoing CDA pilot projects have been designed to address some of the gaps between evidence-based guidelines and actual clinical practice by incorporating the Clinical Practice Guidelines into the health care system. Accordingly, this submission focuses primarily on interprofessional team collaboration within the delivery system, as well as decision support for health care practitioners through electronic medical records. For more information on the CDA s full set of recommendations on strengthening patientcentred care, please see the attached chapter Organization of Diabetes Care from the 2013 Clinical Practice Guidelines. RECOMMENDATION: Ensure that government policies fully support the implementation of the Canadian Diabetes Association s Clinical Practice Guidelines into clinical practice and the health care system. 4
5 Strengthening Inter-Professional Teams within LHINs The Patients First paper discusses examples of successful integration through collaborative care models, and asks the following questions: How do we support care providers in a more integrated care environment? How can we effectively identify, engage and support primary care clinician leaders? How can we support primary care providers in navigating and linking with other parts of the system? The Clinical Practice Guidelines support the chronic care model, as current evidence demonstrates the importance of a multi- and inter-professional team with specific training in diabetes within the primary care setting In adults with type 2 diabetes, this care model has been associated with improvements in A1C (i.e. blood sugar levels), blood pressure, lipids and care processes compared to care that is delivered by a specialist or primary care physician alone A reduction in preventable, diabetes-related emergency room visits also has been noted when the team includes a specifically trained nurse who follows detailed treatment algorithms for diabetes care. 6 Team membership may be extensive and should include various disciplines. Those disciplines associated with improved diabetes outcomes include nurses, nurse practitioners, dietitians, pharmacists and providers of psychological support. To help support and implement this model of collaborative inter-professional team care for managing diabetes, the Canadian Diabetes Association ran Inter-professional Collaboration (IPC) workshops in two Local Health Integrated Networks (LHINs), the Toronto Central LHIN and the Central East LHIN, in the spring of 2014 and winter of 2015 respectively. Each series of workshops ran over the span of three months to allow teams opportunities to implement quality improvement initiatives in collaborative care between sessions. The sessions were facilitated by a multidisciplinary team of diabetes and collaborative care experts including an endocrinologist, a pharmacist, a nurse and a dietitian. The workshops targeted primary care providers, Diabetes Education Program teams, other relevant health care providers (such as chiropodists, pharmacists, social workers and others) and administrators. The objectives of the IPC workshops were to: Enable comprehensive diabetes care and develop efficiencies in diabetes care by building skills and engaging a team approach Optimize inter-professional collaboration and communication Enhance diabetes management knowledge and skills through case studies Address participant-specific diabetes learning needs 5
6 Implement practical diabetes management tools immediately into practice The workshops were tailored to each LHIN through a needs assessment that engaged LHIN leadership, including primary care leads; Diabetes Education Program leadership; health care providers and administration. The needs assessment identified the current level of understanding and integration of inter-professional collaboration as well as individual learning needs for evidence based diabetes care according to the Clinical Practice Guidelines. Teams identified gaps and opportunities for inter-professional collaboration. Facilitators worked with the teams to develop quality improvement plans using action plans and techniques. Teams were expected to implement changes between sessions and report back on progress. In many cases, health care providers that were seeing the same patients for diabetes care had never met or communicated prior to the IPC workshops. The workshops provided an opportunity for providers to meet and plan in a strategic way toward improved collaboration, delineation of roles, efficiencies and communication. The results showed improvements to both individual and team comfort level in a number of areas related to diabetes management, collaborative care development of a registry and mechanisms to follow up with patients in an organized and timely manner. The inclusion of LHIN leads, primary care leads, and Diabetes Education Program leads allowed for the ability to identify areas of improvement and opportunities for Inter-professional Collaboration at a systems level, whereas individual health care providers, teams, and administrative support identified very practical solutions for improved collaboration and care. RECOMMENDATION: The Canadian Diabetes Association recommends that the Government of Ontario implement Inter-professional Collaboration workshops across the province to better facilitate team care and improve the quality of care and quality of life for people with diabetes. CDA: Electronic Medical Records Strategy Pilot Project Decision Support Over , the CDA will be running pilot projects involving electronic medical records (EMR) in Ontario and British Columbia to provide health care practitioners with best practice information at the point of care. This information will be based on the CDA s 2013 Clinical Practice Guidelines, and is intended help support decision making, leading to better access to patient-centred care and chronic disease management. 6
7 This type of decision-making support has been shown to improve outcomes for patients. In a systematic review, evidence-based guideline interventions, particularly those that used interactive computer technology to provide recommendations and immediate feedback of personally tailored information, were the most effective in improving patient outcomes. 9 For example, a randomized trial using EMR decision support in primary care found improvement in A1C (i.e. blood sugar levels). 10 A cluster randomized trial of a Quality Improvement program found that the provision of a clear treatment protocol supported by tailored postgraduate education of the primary care physician and case coaching by an endocrinologist substantially improved the overall quality of diabetes care provided, as well as major diabetes-related outcomes. 11 Incorporation of evidence-based treatment algorithms has been shown in several studies to be an integral part of diabetes case management. 1,7,12,13 Even the use of simple decision support tools, such as clinical flow sheets, has been associated with improved adherence to clinical practice guidelines for diabetes. 14 In Ontario, the CDA is identifying four Family Health Teams to run the pilot projects as well as clinical champions, such as Registered Nurses, Registered Dieticians or Pharmacists. As part of the project, the CDA will develop: practice level tools (e.g. reports, queries and audits); provider level tools (e.g. flowsheets, dashboard, widgets); and patient level tools (reports, action plans and resources). The Family Health Teams and clinical champions will first help to test the tools and then implement the program. Evaluation of the program will happen in 2017, six months after implementation. The teams will provide an EMR-generated practice report and review it with the clinician so the providers can see how the addition of EMR tools and decision support has affected their practice. This type of project has already been implemented in Saskatchewan as a collaboration between the Saskatchewan provincial government, EMR vendors and a steering committee with which CDA is engaged. This practice-level clinical registry will also give an overview of the entire practice, which could potentially assist in the delivery and monitoring of patient care in Ontario. Ideally, provincial- and national-level registries would be implemented, which are essential for benchmarking, tracking diabetes trends, determining the effect of Quality Improvement programs and resource planning. RECOMMENDATION: The Canadian Diabetes Association recommends that the Government of Ontario implement decision support making tools for diabetes management in electronic medical records systems across the province, following the results of the CDA s pilot projects in Ontario and British Columbia. 7
8 Conclusion The recommendations contained in the Canadian Diabetes Association's submission represent our priorities for creating a more patient-centred health care system that will meaningfully improve the lives of people living with diabetes. For the full suite of recommendations on Organization of Diabetes Care, please see the 2013 Clinic Practice Guidelines for the Prevention and Management of Diabetes in Canada. Thank you for the opportunity to provide these recommendations. For more information, please contact: Amanda Thambirajah Director of Government Relations and Advocacy, Ontario Canadian Diabetes Association Amanda.Thambirajah@diabetes.ca 1 Shojania KG, Ranjii SR, McDonald KM, et al. Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis. JAMA 2006;296:427e40. 2 Tricco AC, Ivers NM, Grimshaw JM, et al. Effectiveness of quality improvement strategies on the management of diabetes: a systematic review and metaanalysis. Lancet; 2012:12e21. 3 Pimouguet C, Le GM, Thiebaut R, et al. Effectiveness of disease-management programs for improving diabetes care: a meta-analysis. CMAJ 2011;183: e115e27. 4 Borgermans L, Goderis G, Van Den Broeke C, et al. Interdisciplinary diabetes care teams operating on the interface between primary and specialty care are associated with improved outcomes of care: findings from the Leuven Diabetes Project. BMC Health Serv Res 2009;9: vanbruggen R, Gorter K, Stolk R, et al. Clinical inertia in general practice: widespread and related to the outcome of diabetes care. Fam Pract 2009;26: 428e36. 6 Davidson MB, Blanco-Castellanos M, Duran P. Integrating nurse-directed diabetes management into a primary care setting. Am J Manag Care 2010;16: 652e6. 7 Saxena S, Misra T, Car J, et al. Systematic review of primary healthcare interventions to improve diabetes outcomes in minority ethnic groups. J Ambul Care Manage 2007;30:218e30. 8 Willens D, Cripps R, Wilson A, et al. Interdisciplinary team care for diabetic patients by primary care physicians, advanced practice nurses and clinical Pharmacists. Clin Diabetes 2011;29:60e8. 9 de Belvis A, Pelone F, Biasco A, et al. Can primary care professionals adherence to evidence based medicine tools improve quality of care in type 2 diabetes? A systematic review. Diabetes Res Clin Pract 2009;85:119e O Connor PJ, Sperl-Hillen JM, Rush WA, et al. Impact of electronic health record clinical decision support on diabetes care: a randomized trial. Ann Fam Med 2011;9:12e Goderis G, Borgermans L, Grol R, et al. Start improving the quality of care for people with type 2 diabetes through a general practice support program: a cluster randomized trial. Diabetes Res Clin Pract 2010;88:56e Clark CE, Smith LFP, Taylor RS, et al. Nurse-led interventions used to improve control of high blood pressure in people with diabetes: a systematic review and meta-analysis. Diabet Med 2011;28:250e Katon WJ. Collaborative care for patients with depression and chronic disease. N Engl J Med 2010;363:2611e Hahn K, Ferrante C, Crosson J, et al. Diabetes flow sheet use associated with guideline adherence. Ann Fam Med 2008;6:235e8. 8
Guide to Chronic Disease Management and Prevention
Family Health Teams Advancing Primary Health Care Guide to Chronic Disease Management and Prevention September 27, 2005 Table of Contents 3 Introduction 3 Purpose 4 What is Chronic Disease Management
More informationStewart B. Harris MD, MPH, FCFP, FACPM. 2 nd Annual Congress of the Global Diabetes Alliance (GDA) October 26-29, 2010 Cairo, Egypt
SUMMIT SESSION: The challenges and applications of diabetes registries and electronic medical records (EMR's) in improving clinical care for patients with diabetes; a global perspective 2 nd Annual Congress
More informationNumber 1. Introduction to Nurse Practitioner-Led Clinics
Number 1 Introduction to Nurse Practitioner-Led Clinics April 2010 Table of Contents Introduction 3 Family Health Care for All 3 Guiding Principles 4 The Role of Nurse Practitioner-Led Clinics 5 The Vision
More informationEffectiveness of quality improvement strategies on the management of diabetes: Systematic review
Effectiveness of quality improvement strategies on the management of diabetes: Systematic review Noah Ivers MD, CCFP PhD Candidate, University of Toronto on behalf of the diabetes QI review team CAHSPR
More informationHealth System Strategies to Improve Chronic Disease Management and Prevention: What Works?
Health System Strategies to Improve Chronic Disease Management and Prevention: What Works? Michele Heisler, MD, MPA VA Center for Clinical Practice Management Research University of Michigan Department
More informationAMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY OBESITY CHRONIC CARE MODEL
ENDOCRINE PRACTICE Rapid Electronic Article in Press Rapid Electronic Articles in Press are preprinted manuscripts that have been reviewed and accepted for publication, but have yet to be edited, typeset
More informationDraft Pan-Canadian Primary Health Care Electronic Medical Record Content Standard, Version 2.0 (PHC EMR CS) Frequently Asked Questions
December 2011 Draft Pan-Canadian Primary Health Care Electronic Medical Record Content Standard, Version 2.0 (PHC EMR CS) Frequently Asked Questions Background and History What is primary health care?
More informationPrimary Health Care Measurement in Canada
Primary Health Care Measurement in Canada 2012 Accelerating Primary Care Conference / Tuesday, November 20, 2012 Greg Webster Director, Primary Health Care Information & Clinical Registries gwebster@cihi.ca
More informationDiabetes Policy Summit: Exploring Policy Options for Better Diabetes Outcomes in Ontario
Diabetes Policy Summit: Exploring Policy Options for Better Diabetes Outcomes in Ontario Summit Report November 4, 2014 Canadian Diabetes Association TABLE OF CONTENTS EXECUTIVE SUMMARY... iii 1.0 PURPOSE
More information2010- Executive Summary. Waterloo-Wellington Diabetes RCC Final Report
2010- Waterloo-Wellington Diabetes RCC Final Report Executive Summary Debbie Hollahan, Regional Director Waterloo-Wellington Diabetes Regional Coordination Centre May 31, Development of the RCC The Diabetes
More informationGuide to Completing a Nurse Practitioner-Led Clinic Wave 3 Application Form
Number 2 Guide to Completing a Nurse Practitioner-Led Clinic Wave 3 Application Form A Guide Sheet April 2010 Table of Contents Introduction 3 How will Nurse Practitioner-Led Clinic applications be evaluated?
More informationEquity: Chronic Health Conditions & Primary Care. Louise Nasmith University of British Columbia
Equity: Chronic Health Conditions & Primary Care Louise Nasmith University of British Columbia 1 Fundamental Concepts 1.Horizontal and Vertical Equity People with same needs do have same access People
More informationBritish Columbia Pharmacy Association (BCPhA) Clinical Service Proposal Self-Monitoring of Blood Glucose in Type 2 Diabetes
British Columbia Pharmacy Association (BCPhA) Clinical Service Proposal Self-Monitoring of Blood Glucose in Type 2 Diabetes Introduction Self-monitoring of blood glucose (SMBG) is in widespread use among
More informationGuide to Health Promotion and Disease Prevention
Family Health Teams Advancing Primary Health Care Guide to Health Promotion and Disease Prevention January 16, 2006 Table of Contents 3 Introduction 3 Purpose 3 Background 4 Developing Health Promotion
More informationAdvanced Clinical Social Work Practice in Integrated Healthcare Module 1. Marion Becker, PhD School of Social Work University of South Florida
Advanced Clinical Social Work Practice in Integrated Healthcare Module 1 Marion Becker, PhD School of Social Work University of South Florida Introduction to Integrated Healthcare and the Culture of Health
More informationAlberta Health. Primary Health Care Evaluation Framework. Primary Health Care Branch. November 2013
Primary Health Care Evaluation Framewo Alberta Health Primary Health Care Evaluation Framework Primary Health Care Branch November 2013 Primary Health Care Evaluation Framework, Primary Health Care Branch,
More informationManaging Patients with Multiple Chronic Conditions
Best Practices Managing Patients with Multiple Chronic Conditions Advocate Medical Group Case Study Organization Profile Advocate Medical Group is part of Advocate Health Care, a large, integrated, not-for-profit
More informationmaking a difference where health matters Canadian Primary Care Sentinel Surveillance Network
making a difference where health matters Canadian Primary Care Sentinel Surveillance Network Copyright Notice January 20, 2015: Except where otherwise noted, all material contained in this publication,
More informationCanadian Diabetes Association, Diabetes Educator Section. Standards for Diabetes Education in Canada 2014
Canadian Diabetes Association, Diabetes Educator Section Standards for Diabetes Education in Canada 2014 Canadian Diabetes Association Diabetes Educator Section Belief Statements As members of the Diabetes
More informationGroup Health Centre Sault Ste. Marie, Ontario
Group Health Centre Sault Ste. Marie, Ontario Breakout Session: Thriving Models That Haven t Spread: Why Not? Picking Up the Pace Conference November 2, 2010 In 1960, a group of 50 original canvassers
More informationCombining Case and Care Management for Population Health
Combining Case and Care Management for Population Health Raena C. Akin-Deko, MHSA Assistant Vice President for Product Development, NCQA Karen Handmaker, MPP VP Population Health Strategies, Phytel August
More informationSubmission to the Standing Committee on Finance and Economic Affairs - 2015 Pre-Budget Consultations -
Submission to the Standing Committee on Finance and Economic Affairs - 2015 Pre-Budget Consultations - Presented by: James Swan, MD, F.R.C.P.(C) F.A.C.C. President Ontario Association of Cardiologists
More informationThe Cost of Diabetes in
The Cost of Diabetes in The Cost of Diabetes in Saskatchewan The Saskatchewan Diabetes Cost Model 1 In 2009, the Canadian Diabetes Association commissioned a report, An Economic Tsunami: the Cost of Diabetes
More informationAADE. American Association of Diabetes Educators 2016-2018 STRATEGIC PLAN
AADE American Association of Diabetes Educators 2016-2018 STRATEGIC PLAN Successful organizations have a well-defined mission with clear strategies and measurable goals. These elements guide the organization
More informationHypertension Best Practices Symposium
essentia health: east region 1 Hypertension Best Practices Symposium RN Hypertension Management Pilot Essentia Health: East Region Duluth, MN ORGANIZATION PROFILE Essentia Health is an integrated health
More informationMINISTRY OF HEALTH AND LONG-TERM CARE
THE ESTIMATES, 1 The Ministry provides for a health system that promotes wellness and improves health outcomes through accessible, integrated and quality services at every stage of life for all Ontarians.
More informationPriorities for Building an Integrated and Accessible Primary Care System in Ontario
Priorities for Building an Integrated and Accessible Primary Care System in Ontario October 2013 Priorities for Building an Integrated and Accessible Primary Care System in Ontario The Ontario Medical
More informationThe prescribing trends of nurse practitioners to older adults in Ontario (2000 2010)
The prescribing trends of nurse practitioners to older adults in Ontario (2000 2010) JE Tranmer, E. VanDenKerkhof, D. Edge, K. Sears, L. Levesque Queen s University Funding support: Senate Advisory Research
More informationPerson-Centered Nurse Care Management in Home Based Care: Impact on Well-Being and Cost Containment
Person-Centered Nurse Care Management in Home Based Care: Impact on Well-Being and Cost Containment Donna Zazworsky, RN, MS, CCM, FAAN Vice President: Community Health and Continuum Care Carondelet Health
More informationCanadian Diabetes Association. 2015 Pre-Budget Submission. to the House of Common Standing Committee on Finance
Canadian Diabetes Association 2015 Pre-Budget Submission to the House of Common Standing Committee on Finance August 2014 The Canadian Diabetes Association (the Association) is a registered charitable
More informationDIABETES: CANADA AT THE TIPPING POINT Charting a new path
DIABETES: CANADA AT THE TIPPING POINT Charting a new path Policy Backgrounder Issue: Canada is at a tipping point and here are the reasons why... The total population with diabetes in Canada is estimated
More informationDr. Peter Sargious Medical Director of Chronic Disease with Alberta Health Services, Calgary, AB
On September 18 th, we held our webinar, the online Chronic Disease Self- Management Program A good choice for Canada? We weren t able to answer all the questions from attendees, so we asked our panelists
More informationAnnapolis Community Health Partnership. Maryland Community Health Resources Commission April 2, 2015
Annapolis Community Health Partnership Maryland Community Health Resources Commission April 2, 2015 ACHP Collaboration between Anne Arundel Medical Center (AAMC) and Housing Authority of the City of Annapolis
More informationAcknowledgements/Disclaimer
Louise Nasmith University of British Columbia 1 Acknowledgements/Disclaimer Focus on Canadians with chronic health conditions Based on the Canadian Academy of Health Sciences panel assessment Transforming
More informationPatients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario
Ministry of Health and Long-Term Care (MOHLTC) Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario Ontario Pharmacy Research Collaboration Summit January 20, 2016 Today s Objectives
More informationAmerican Diabetes Association Education Recognition Program Overview
American Diabetes Association Education Recognition Program Overview A brief history of the National Standards for Diabetes Self-Management Education and Support and a walk through the 10 DSME/S standards
More informationRNAO Submission on Bill 178: An Act to amend the Smoke-Free Ontario Act. Speaking notes: Standing Committee on General Government.
RNAO Submission on Bill 178: An Act to amend the Smoke-Free Ontario Act Speaking notes: Standing Committee on General Government May 16, 2016 1 R N A O S p e a k i n g N o t e s B i l l 1 7 8 - M a y 1
More informationINTERPROFESSIONAL COLLABORATION
INTERPROFESSIONAL COLLABORATION CNA POSITION The Canadian Nurses Association (CNA) believes that interprofessional collaborative models for health service delivery are critical for improving access to
More informationSolutions. Health Advocate Chronic Care Management Program
Solutions Health Advocate Chronic Care Management Program Taking Control Immunizations, preventive screenings and managing chronic conditions are key to controlling costs. Yet physicians often have limited
More informationKelly Goode, PharmD, BCPS, FAPhA, FCCP and Lisa Price Stevens, MD, MPH, FACP
Kelly Goode, PharmD, BCPS, FAPhA, FCCP and Lisa Price Stevens, MD, MPH, FACP Objec&ves Describe Diabetes Awareness Program Provide Tools for Program Implementation at Other Sites Describe Shared Care Model
More informationProfile: Incorporating Routine Behavioral Health Screenings Into the Patient-Centered Medical Home
104 A LOOK TO THE FUTURE Profile: Incorporating Routine Behavioral Health Screenings Into the Patient-Centered Medical Home Background Management of chronic diseases can be challenging in primary care,
More informationHealth Care Homes Certification Assessment Tool- With Examples
Guidelines: Health Care Homes Certification Assessment Form Structure: This is the self-assessment form that HCH applicants should use to determine if they meet the requirements for HCH certification.
More informationSault Ste. Marie Group Health Centre: Big Success in a Small Community
Sault Ste. Marie Group Health Centre: Big Success in a Small Community S U C C E S S S T O R Y 1 It s Your Health Innovation in Primary Health Care in Dryden, Ontario Since 1997, all the health care providers
More informationCCNC Care Management
CCNC Care Management Community Care of North Carolina (CCNC) is a statewide population management and care coordination infrastructure founded on the primary care medical home model. CCNC incorporates
More information2014-15 Five Hills Health Region Strategic Plan
2014-15 Five Hills Health Region Strategic Plan Better Health Better Care Better Teams Better Value Introduction We are pleased to present the Five Hills Health Region s Strategic Plan for the 2014-145
More informationPIPC: Hepatitis Roundtable Summary and Recommendations on Dissemination and Implementation of Clinical Evidence
PIPC: Hepatitis Roundtable Summary and Recommendations on Dissemination and Implementation of Clinical Evidence On May 8, 2014, the Partnership to Improve Patient Care (PIPC) convened a Roundtable of experts
More informationExercise is Medicine Australia Education evaluation summary
Exercise is Medicine Australia Education evaluation summary Exercise is Medicine Australia (EIM Australia) seeks to support health care providers to become consistently effective in counselling and referring
More informationProject: TMAP Training Medical Assistants for the Patient Centered Medical Home
Project: TMAP Training Medical Assistants for the Patient Centered Medical Home Project Lead: Dana Neutze, MD PhD Team members: Mark Gwynne, DO; Steven Crane, MD; Cheryl Henderson, RN; Lakeshia Decker,
More informationQuality Improvement Plan (QIP) Narrative for Health Care Organizations in Ontario
Quality Improvement Plan (QIP) Narrative for Health Care Organizations in Ontario 3/26/2015 This document is intended to provide health care s in Ontario with guidance as to how they can develop a Quality
More informationQuality Improvement Plan (QIP) Narrative for Health Care Organizations in Ontario 3/31/2015
Quality Improvement Plan (QIP) Narrative for Health Care Organizations in Ontario 3/31/2015 This document is intended to provide health care organizations in Ontario with guidance as to how they can develop
More informationPROVINCIAL ABORIGINAL LHIN REPORT 2013/2014
1 P a g e PROVINCIAL ABORIGINAL LHIN REPORT 2013/2014 HIGHLIGHTS 1 Place Photo Here, 2 P a g e MOVING FORWARD: A COLLABORATIVE APPROACH INTRODUCTION Over the past year, the Local Health Integration Networks
More informationPhysician-Led Emergency Department Optimization Dashboard
Physician-Led Emergency Department Optimization Dashboard Enhancing Efficiencies in the ED and Beyond ehealth 2015: Making Connections June 1, 2015 Dr. Tony Meriano, Chief Medical Information Officer TransForm
More informationDiabetes Care 2011-2012
Clinical Innovations in the Patient Centered Medical Home to Improve Diabetes Care Robert A. Gabbay, MD, PhD, FACP Chief Medical Officer & Senior Vice President Joslin Diabetes Center Harvard Medical School
More informationCLINICAL NURSE SPECIALIST
CLINICAL NURSE SPECIALIST CNA POSITION The Canadian Nurses Association (CNA) believes that clinical nurse specialists (CNSs) make a significant contribution to the health of Canadians within a primary
More informationITAC HEALTH BREAKFAST ROUND TABLE
ITAC HEALTH BREAKFAST ROUND TABLE An update on ehealth Ontario Presented by Greg Reed, President and CEO February 27, 2013 Increasing Access in the Community Today ehealth Ontario is working with community
More informationPreventing and Managing Chronic Disease: Ontario s Framework
Preventing and Managing Chronic Disease: Ontario s Framework "This document has been developed to inform planning for chronic disease prevention and management (CDPM) in Ontario. It provides the evidence
More informationManaging Care for Adults With Long-term Medical Illnesses. A Review of the Research
Managing Care for Adults With Long-term Medical Illnesses A Review of the Research Is This Information Right for Me? If you meet all of the following, this information is for you: You or someone you care
More informationPATIENRTS FIRST P OPOSAL T O STRENGTHEN PATIENT-CENTRED HEALTH CARE IN ONTARIO. DISCUSSION PAPER December 17, 2015 BLEED
PATIENRTS FIRST A P OPOSAL T O STRENGTHEN PATIENT-CENTRED HEALTH CARE IN ONTARIO DISCUSSION PAPER December 17, 2015 BLEED PATIENTS FIRST Message from the Minister of Health and Long-Term Care Over the
More informationCanada s Healthcare Procurement Services Organization
Canada s Healthcare Procurement Services Organization Table of Contents 1 2 3 4 About HealthPRO 3 Our Contract Services 4 How We Work 10 We Lead Issues That Matter 19 2 HealthPRO Across Canada We often
More informationHome Care Nursing in Ontario
Home Care Nursing in Ontario March 2011 Home Care Nursing in Ontario Nurses play an integral role in the delivery of quality care in the home. Home nursing care is the promotion of health, assessment,
More informationCentraCare Health System Creates New Tools to Treat Tobacco Dependence
CentraCare Health System Creates New Tools to Treat Tobacco Dependence Between October 2010 and June 2012, ClearWay Minnesota SM provided the CentraCare Health Foundation with funding and technical assistance
More informationOntario s Enhanced 18-Month Well-Baby Visit Electronic Medical Record (EMR) Integration and Repository Project
Ontario s Enhanced 18-Month Well-Baby Visit Electronic Medical Record (EMR) Integration and Repository Project Ministry of Children and Youth Services (MCYS)/Better Outcomes Registry & Network (BORN) Ontario/eHealth
More informationCanadian Nurse Practitioner Core Competency Framework
Canadian Nurse Practitioner Core Competency Framework January 2005 Table of Contents Preface... 1 Acknowledgments... 2 Introduction... 3 Assumptions... 4 Competencies... 5 I. Health Assessment and Diagnosis...
More informationSection C Implement One (1) Clinical Decision Support Rule
Office of the National Coordinator for Health Information Technology c/o Joshua Seidman Mary Switzer Building 330 C Street, SW, Suite 1200 Washington, DC 20201 Dear Mr. Seidman: On behalf of the American
More informationPerceptions of Adding Nurse Practitioners to Primary Care Teams
Quality in Primary Care (2015) 23 (2): 122-126 2015 Insight Medical Publishing Group Short Communication Interprofessional Research Article Collaboration: Co-workers' Perceptions of Adding Nurse Practitioners
More informationWebinar outline. Case management definitions 5/27/2015. Case Management in Diverse Settings
Case Management in Diverse Settings Webinar outline Overview of Case Management Corrine Truman (AHS) Cherie deboer (Leduc Beaumont PCN) Jennifer Day (Canadian Armed Forces) Questions and Discussion Case
More informationImproving Diabetes Care for All New Yorkers
Improving Diabetes Care for All New Yorkers Lynn D. Silver, MD, MPH Assistant Commissioner Bureau of Chronic Disease Prevention and Control Diana K. Berger, MD, MSc Medical Director Diabetes Prevention
More informationACTIVELY MANAGED DRUG SOLUTIONS. for maintenance and specialty medication. Actively Managed Drug Solutions is not available in the province of Quebec
ACTIVELY MANAGED DRUG SOLUTIONS for maintenance and specialty medication Actively Managed Drug Solutions is not available in the province of Quebec ARE YOU UNDERESTIMATING THE IMPACT OF CHRONIC DISEASE?
More informationONTARIO NURSES ASSOCIATION
ONTARIO NURSES ASSOCIATION Submission to Consultations on Regulation of Physician Assistants (PAs) under the Regulated Health Professions Act, 1991 Health Professions Regulatory Advisory Council (HPRAC)
More informationChapter 8 - General Discussion
Chapter 8 - General Discussion 101 As stated in the introduction, the goal of type 2 diabetes care is to offer patients an integrated set of interventions in relation to life style, blood pressure regulation,
More informationExamples of Quality Improvement Projects in Adult Immunization
Examples of Quality Improvement Projects in Adult Immunization The following activities are provided to prompt your thinking about what works best for your practice. When designing a project, consider
More informationFor the Record: The Truth About Electronic Charting in Home Care
For the Record: The Truth About Electronic Charting in Home Care Athena Lu Kreiser, MHA Senior Project Manager Jewish Home Lifecare akreiser@jhha.org Healthcare Unbound June 23, 2009 Seattle, WA Jewish
More informationMRI Process Improvement
The Ontario Provincial MRI Process Improvement Project Phase 3: Sustaining Continuous Improvement and Accountability for Better Access to Medical Imaging By: The Joint Department of Medical Imaging Toronto,
More informationMinistry of Health and Long Term Care (MOHLTC) Patients First: A Proposal to Strengthen Patient Centred Health Care in Ontario
Ministry of Health and Long Term Care (MOHLTC) Patients First: A Proposal to Strengthen Patient Centred Health Care in Ontario Objectives 1 Provide an overview of the MOHLTC s proposal to strengthen patient
More informationLessons on the Integration of Medicine and Psychiatry
Lessons on the Integration of Medicine and Psychiatry Edward Post, MD, PhD Associate Professor of Internal Medicine, University of Michigan VA Health Services Research & Development Center of Excellence,
More informationALBERTA MEDICAL ASSOCIATION PRIMARY CARE SUMMIT WHAT WE HEARD
ALBERTA MEDICAL ASSOCIATION PRIMARY CARE SUMMIT WHAT WE HEARD Corinne Saad February 8, 2013 CONTENTS Introduction... 2 Primary health care: What s working... 2 Physician/patient relationship... 2 Team
More informationImplementing CDSMP in an integrated health care system
Implementing CDSMP in an integrated health care system The Group Health experience October 2, 2009 Kimberly Wicklund, MPH Group Health Overview Consumer-governed, non-profit financing and care delivery
More informationStrategic Plan. Ambulatory Care 2013-2016. Exemplary Patient-Centred Ambulatory Care Experiences
Ambulatory Care Strategic Plan 2013-2016 Exemplary Patient-Centred Ambulatory Care Experiences Table of Contents 1.0 Executive Summary 3 2.0 Background and Context 4 3.0 The Ambulatory Care Model at Princess
More informationElectronic Health. North Simcoe Muskoka Overcoming the Challenge!
Electronic Health North Simcoe Muskoka LHIN North Simcoe Muskoka Overcoming the Challenge! When the North Simcoe Muskoka Local Health Integration Network first opened its doors, it was recognized that
More informationLevel 1 Level 2 Level 3 Level 4 Level 5. At least one physician champion referring to Navigation Program
Definitions: Key Stakeholders: Those people that you feel are essential to making a program work. Include Administration, s, Staff, Physicians (both employed and private practice). Specialty areas include
More informationEMR Lessons Learned from Ontario and British Columbia Demonstration Projects and the PHC Voluntary Reporting System (PHC VRS)
EMR Lessons Learned from Ontario and British Columbia Demonstration Projects and the PHC Voluntary Reporting System (PHC VRS) Patricia Sullivan-Taylor, CIHI Trillium Primary Care Research Day June 19,
More informationSelf-Management Support
Education & Training Curriculum on Multiple Chronic Conditions (MCC) Strategies & tools to support healthcare professionals caring for people living with MCC. Module 2 Self-Management Support Full citations
More informationRecommendations and Next Steps: Reform Health Care Practice
Incorporate into routine medical practice screening and intervention for risky substance use and diagnosis, treatment and disease management for addiction Develop core competencies for physicians in understanding
More informationLEADING THE WAY: CALIFORNIA S DELIVERY SYSTEM REFORM INCENTIVE PROGRAM (DSRIP)
September 2014 LEADING THE WAY: CALIFORNIA S DELIVERY SYSTEM REFORM INCENTIVE PROGRAM (DSRIP) 7 0 W A S H I N G T O N S T R E E T, S U I T E 2 1 5 O A K L A N D, CA 9 4 6 0 7 P H O N E : ( 5 1 0 ) 8 7
More informationEMR Outcomes Self-Assessment Contents
Contents Introduction... How does it work?... Select Purpose... Patient Care Processes... Registration and Attachment... Scheduler... Referral/Consult... 4 Assessment and Treatment... 5 Assessment-Ordering
More informationAlameda County s Health Care Coverage Initiative Network Structure: Interim Findings
Alameda County s Health Care Coverage Initiative Network Structure: Interim Findings Introduction The Health Care Coverage Initiative (HCCI) Program in Alameda County is called Alameda County Excellence
More informationWhat is Palliative Care
What is Palliative Care Maine Quality Counts Portland Regional Forum Isabella N. Stumpf, DO Division Director, Palliative Medicine, Maine Medical Center Medical Director, Palliative Care, MaineHealth Disclosure
More informationTORONTO STROKE FLOW INITIATIVE - Outpatient Rehabilitation Best Practice Recommendations Guide (updated July 26, 2013)
Objective: To enhance system-wide performance and outcomes for persons with stroke in Toronto. Goals: Timely access to geographically located acute stroke unit care with a dedicated interprofessional team
More informationPromoting the Health of Community-Living Older Adults with Multiple Chronic Conditions through Nurse-Led Interventions: A Program of Research
Promoting the Health of Community-Living Older Adults with Multiple Chronic Conditions through Nurse-Led Interventions: A Program of Research Maureen Markle - R eid, Associate Professor, Canada R esearch
More informationThe Commission on the Reform of Ontario's Public Services
Submission to The Commission on the Reform of Ontario's Public Services For discussion Thursday, November 10, 2011 Association of Family Health Teams of Ontario Page 2 of 11 Contents 1 Introduction...
More informationAllied health professionals are critical to good health outcomes for the community. Labor s National Platform commits us to:
25 June 2016 Lin Oke Executive Officer Allied Health Professions Australia PO Box 38 Flinders Lane MELBOURNE VIC 8009 Dear Ms Oke Thank you for your letter presenting the Allied Health Professions Australia
More informationWestern Canada Chronic Disease Management Infostructure Initiative
Western Health Information Collaborative (WHIC) Western Canada Chronic Disease Management Infostructure Initiative CDM Data Standards Introduction - 10/24/2005 1:55 PM Prepared by Western Health Information
More informationTHE ROLE OF HEALTH INFORMATION TECHNOLOGY IN PATIENT-CENTERED CARE COLLABORATION. 2012 Louisiana HIPAA & EHR Conference Presenter: Chris Williams
THE ROLE OF HEALTH INFORMATION TECHNOLOGY IN PATIENT-CENTERED CARE COLLABORATION 2012 Louisiana HIPAA & EHR Conference Presenter: Chris Williams Agenda Overview Impact of HIT on Patient-Centered Care (PCC)
More informationCanada Health Infoway Update
Canada Health Infoway Update Presentation to North East LHIN ehealth Advisory Committee May 9, 2013 Terry Moore, Executive Regional Director, Canada Health Infoway Canada Health Infoway Created in 2001
More informationOperational Guide. for Family Health Teams
Operational Guide for Family Health Teams Vision Better health and better care with engaged individuals and communities The Primary Health Care Framework for New Brunswick Operational Guide for Family
More informationHealth and Medical Billing Requirements in Minnesota
Improving Access to Preventive Services Emerging Practices from Community Transformation Grant projects Kala Shipley Iowa Department of Public Health Cherylee Sherry Minnesota Department of Health Robert
More informationThe Information Management Strategy Cascade: Strategy-Based Performance Management of a Flu Recall Practice
The Information Management Strategy Cascade: Strategy-Based Performance Management of a Flu Recall Practice Juliana Jackson, Karen Born, Jamie Read and Adalsteinn Brown Abstract The Health Results Team
More informationHealth Innovation Challenge - Chronic Disease Management. Haley Augustine & Rakesh Gupta Dalhousie University: Medical School
Haley Augustine & Rakesh Gupta 1 Health Innovation Challenge - Chronic Disease Management Haley Augustine & Rakesh Gupta Dalhousie University: Medical School Professor: Lynette Reid, lynette.reid@dal.ca
More informationThe Patient-Centered Medical Home How Does Managed Care Pharmacy Add Value?
The Patient-Centered Medical Home How Does Managed Care Pharmacy Add Value? With heath care reform now being implemented, it is important that managed care pharmacy understand how to provide value for
More informationPopulation Health Management & the Medical Neighborhood. Patient Centered Primary Care Collaborative Monthly National Briefing September 26, 2013
Population Health Management & the Medical Neighborhood Patient Centered Primary Care Collaborative Monthly National Briefing September 26, 2013 Outline What is Population Health Management? Registries
More information