North York Family Health Team

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1 North York Family Health Team Inside this issue: Newsletter July 2014 Remembering Susan Langford 1 Charting Tips 1 NYFHT at AFHTO Conference 2 Remembering Susan Langford Susan Langford was a well respected and liked colleague at the North York Family Health Team. Susan began working with us in August 2008 to organize and support the central clinic, even before the offices were complete! She started downstairs in suite 301, before she transitioned to 707, rolling with the punches of a new organization that was continually growing. Eye See...Eye Learn QI Corner 7-day Follow-up Resident QI Projects NYGH Family Medicine Leadership Changes In suite 707, Susan established systems and routines for supporting our clinical staff and for smooth operations of the central clinic. She was a point person for so many of us. She efficiently and reliably organized and arranged our time to meet the needs of the patients. She treated everyone respect and kindness. With Susan s passing, our hearts go out to her family and friends. As dedicated as she was to the work at the North York Family Health Team, we can only imagine the heartfelt love she must have given as a grandma, mom, partner and friend. There is a real void in the North York Family Health Team, especially the clinic as we all miss her welcoming smile and kind heart. Sun Safety 5 Safety Notice 6 Charting Tips: Third Party Requests for Information There are many reasons for charting. Creating a permanent record for legal purposes is one reason. It is good for us to remember this when we write notes. Anything (or everything) you record may be requested by a third party, and it is the patient s decision whether this information is suitable to be shared. Remember that the patient legally owns the content of their own chart, and can view it if they request to do so. The family physician is legally the guardian who keeps the chart safe. Please consider each word that you record and its appropriateness for all potential audiences.

2 Page 2 North York Family Health Team North York Family Health Team Well Represented at AFHTO Conference Six posters and teaching sessions have been accepted for presentation at the AFHTO conference, which will be held in October Jasmine Montreuil and Christine Truong will present their poster on the Impact of curriculum design on patient -centred care: integrating adult learning theory and constructivism into diabetes group education and its effects on patient satisfaction, confidence and learning outcomes. This poster presentation will review NYFHT s transformative journey toward improved patient-centred care through the integration of adult education theory and constructivism into our diabetes education program. Dr. Kimberly Wintemute, Karen Rothschild, Dr. Michelle Greiver, Sue Griffis, Dr. Marla Ash, Dr. Maria Muraca, Marjan Moeinedin and Suja Arackal will present a 45-minute concurrent session about preventive services. Their presentation, No one left behind: going beyond reminder mailings and EMR alerts for preventive services explains the processes developed to target difficult to reach patients when implementing a FHTwide reminder and EMR alert program for preventive services. The underlying elements for this initiative includes strong leadership and organized FHT-level data governance, analytics and privacy infrastructure. This presentation will detail the programs, processes used and outcomes achieved. Dr. Kimberly Wintemute and Danuta Southgate will present a 45-minute concurrent session about NYFHT s End-of-Life initiative. Their presentation, Optimizing End-of-Life Planning for Medically Complex Patients will address research demonstrating the importance of end-of-life planning and will showcase an innovative way to support patient decision-making. This presentation will highlight how optimizing end-of -life planning will provide patients with a more timely transition from active treatment to palliative care. Dr. Michelle Greiver, Sue Griffis and Danuta Southgate will present a 45-minute concurrent session about Transitioning between EMR Systems. Their presentation will describe the process of moving from a Multiple-EMR/Multiple Server-System to a Single EMR/Single Server System. They will present about outcome measures obtained from this process including how many NYFHT physicians and staff are ready to adopt a new EMR system and how many are satisfied with their current EMR system. The presentation will include findings that having physician and provider champions increased engagement, and as a result, we obtained comprehensive information for future vendor procurement. Marjan Moeinedin will present a 45-minute concurrent session about Optimizing Quality of EMR Data to Improve Care: Leading the Human Side of Change. Marjan s presentation will describe successful change management strategies used in regard to EMR data entry. She will discuss findings of the differences in the quality of EMR data entry prior to and after the change management strategies were implemented. These strategies support NYFHT in improving patient care by ensuring EMR data is collected and coded properly. Dr. Michelle Greiver and Marjan Moeinedin are co-authors in partnership with another FHT for a presentation on accessing and using EMR data. Their 45-minute presentation, Mining for data gold: how to recycle imperfect EMR data into useful information will address how to work with imperfect data, what additional tools and resources are available, how to access these tools and resources, what can be done today to improve EMR data, and potential issues and problems to avoid. They will discuss the experiences and approaches of different FHTs and the structures, processes and outcomes for data use.

3 Page 3 Eye See...Eye Learn Eye See Eye Learn is a not-for-profit program designed to detect, diagnose and treat children with vision problems when they begin junior kindergarten. The program is currently active in 15 districts in Ontario, and will be launching in Toronto this month. The eye exams are covered under OHIP There is no cost to participate in the program, nor any fee associated with the purchase of glasses The program will be available to junior kindergarten students who will start school in September Ontario Association of Optometry has met with members of our team. We provided input on program roll-out and helped to imagine how primary care and optometry can collaborate to support pediatric eye care. One of the realizations from the meeting was that many children do not have their eyes checked before starting school (despite there being a strong evidence base for this recommendation). As we know, there are also children who miss their 4-year-old visit, hence missing both vaccines and counseling around optometry care. Is anyone interested in using the EMR to help identify kids who have fallen between the cracks? Please Kimberly at kwintemute@nyfht.com QI Corner 7-day Follow-Up Post-Hospital Discharge for High-Risk Patients Please continue to strive to see high-risk patients within 7-days of hospital discharge. If you need a list of high-risk diagnoses, let Kimberly know by and she will send it to you again (kwintemute@nyfht.com). Posters have recently been distributed to NYFHT offices, to let patients know which conditions require an office visit within 7 days. This information is also on our website. Please consider adding to the bottom of your office signature, if you patients. For nurses, dietitians and pharmacists who run group programs (e.g. Healthy Heart or DEP classes), please consider reviewing this concept with patients in class. There are now two wards at NYGH who are piloting the practice of ward clerks calling our offices to secure a follow-up appointment before the patient is discharged. We will watch this to see if it makes a difference.

4 Page 4 North York Family Health Team Cont d Although 7-day Follow-Up is technically the integration measure for our QI Plan, it may in fact be a proxy measure for access. With changes in the fee schedule (especially diminished requirements for preventive care visits), perhaps we can re-purpose our time, opening up more potential for same day / next day care? If the offices have better access and patients have increased awareness, I wonder if we can move this measure? Resident QI Projects The first year family medicine residents at NYGH each do a QI Project. Several of these residents are embedded in NYFHT offices. Thank-you so much to these NYFHT staff and physician office staff who have helped the residents with their QI projects in the and academic years: Shari Fein, administrative assistant in the office of Dr. s Browne and Griffin, helped residents Sarah Park and Kristen Farn with their project on Mammogram Report Follow-Up and resident Sarah Ramzan on her project Increasing Abdominal Aortic Aneurysm Screening Erika North, Physician Assistant in the office of Dr. s White and Laine-Gossin, helped Rowan Henry with his project on End of Life Planning Lana Rusinek, nurse in the office of Dr. s Somerville, Topp and Zoudis, helped Kenneth Bonah on his project to enhance smoking cessation interventions NYGH Family Medicine Leadership Position Changes There have been recent changes in leadership roles in our department at NYGH, involving NYFHT physicians. Here are the changes: Dr. David Eisen is now Chief, Department of Family and Community Medicine Dr. Allyson Merbaum is now Interim Director, Postgraduate Medical Education, Department of Family and Community Medicine Dr. Rebecca Stoller is now Professional Development Representative, Department of Family and Community Medicine.

5 Page 5 Sun safety from head to toe with Dr. Kimberly Wintemute: It's beginning to feel a lot more like summer as the temperature rises. While you may remember to apply sunscreen to protect you from the sun's harmful UV rays, are you reaching all the right areas? Dr. Kimberly Wintemute, Medical Director of the North York Family Health Team, reminds us of five important areas not to miss when applying sunscreen to stay safe under the sun. This article was published by North York General Hospital. 1) Scalp Even if you aren't sporting the Bruce Willis bald headed look, your scalp is still at risk of getting sunburned if you have fine or thin hair. Powdered sunscreen is the best way to protect your scalp. Simply part your hair in several places and brush it on. These products are available with tint, which makes them great to use on your face too. They won't leave a shine like other sunscreens. 2) Ears Ears are often forgotten when it comes to sun protection. If you have short hair, wear baseball caps or wear your hair up, your ears are at risk of getting sunburned. They definitely need sunscreen. 3) Lips We don't typically put creams on our lips, so it's easy to see why people forget to apply sunscreen on this area. The lips are a common place for skin cancers that are caused by the sun. Use a lip balm with SPF or put the sunscreen right over your lips. 4) Back of shoulders and upper back The back of your shoulders and upper back are often missed because they are hard to reach on your own. Ask a friend to help apply sunscreen to this area to make sure you are protected. 5) Tops of feet If you love wearing flip flops or sandals, make sure you apply sunscreen on the tops of your feet before putting on your footwear. This part of the body is frequently exposed to the sun and needs protection. No one is completely safe from the sun. In Canada, sunlight is strong enough to cause skin cancer. Do all you can now to help reduce the risk of cancer later in life. In family medicine, we often see the effects of long-term sun exposure. Malignant melanoma, a type of skin cancer, is an aggressive disease related to sun exposure. It can spread throughout the body and it can take a person's life. When you are outdoors, protect yourself by remembering to cover-up, wear sunglasses and a hat, and use sunscreen from head to toe.

6 Newsletter Page 6 Safety Notice In case of an Elevator incident, at 240 Duncan Mill Road, please report the incident to both the Landlord and the Technical Standard & Safety Authority (TSSA) as soon as possible: The Landlord/Owner Phone: The Technical Standard & Safety Authority (TSSA) Phone: Website: North York Family Health Team Management Office 240 Duncan Mill Road, Suite 301 Toronto ON M3B 3S6 Tel: Fax: