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Family Health Teams and Family Health Teams and Public Health: Public Health: A new partnership A new partnership
Nick KatesNick KatesLead : Quality Management CollaborativeLead : Quality Management Collaborative
Family Health Teams
152 approved146 business plans approved126 hired some or all staff2.75 million patients
50 more proposed
Vision for Family Health Teams
Excellent Primary Health Care for Ontarians
Family Health Teams
2-25 physicians (some larger)Comprehensive primary health careInterdisciplinary teamsChronic disease prevention and managementHealth promotion and disease preventionSelf-management supportRound the clock coverageIT support
Escaping“The Tyranny of the Urgent”
Thomas Bodenheimer 2002
“Here is Edward Bear,comingdownstairs now, bump, bump, bump,on the back of his head, behindChristopher Robin. It is, as far ashe knows, the only way of comingdownstairs, but sometimes he feelsthat there really is another way, if onlyhe could stop bumping for a momentand think of it”
A.A. Milne 1926
Illustration E.H.Shepard 192614
“Insanity is doing things the way we’ve always done them, and expecting different results”
CHANGING THE PARADIGM
Focus on populationsFocus on longitudinal care / closing the loop (a system of care)Care co-ordinationPatients as partnersAddress all determinants of healthWell-linked with community partners
Everyone is working hard but in isolation
Address quality as well as quantity
Creating a culture of improvement and innovation
Breaking out of our traditional ways of doing things
Take the leap…. we will build our own wings on the
way down.Donald Berwick
Like trying to cross a bridge while we’re still building it
Role of the Quality Management Collaborative
To assist FHTs with
developing and evaluating programsintegrating additional health professionals and building teamsbuilding links with community partnerscreating organisational frameworks to support theseThe Improvement and Innovation agenda
Negotiating the transition to a new model of care
3 Steps for FHTs
Foundation tasksHR / RecruitmentOrganisational frameworks / governanceITSpace
Building teams
Improving the quality of care we provide
How to get there : The approach
A framework / model
Processes and supports to make it work
How will we get there : The Framework / Model
The Care Model
The Improvement Model
The Learning Model (Collaboratives)
INDIVIDUALS AND FAMILIES
Improved clinical, functionaland population health outcomes
HEALTH CAREORGANIZATIONS
Informed,activated
individuals& families
Prepared, proactivepracticeteams
Activated communities &
prepared, proactivecommunity
partners
HealthyPublicPolicy
SupportiveEnvironments
CommunityAction
DeliverySystemDesign
ProviderDecisionSupport
InformationSystems
Ontario’s CDPM Framework
Productive interactions and relationships
PersonalSkills & Self-Management
Support
How will we get there : The Framework / Model
The Care Model
The Improvement Model
The Learning Model (Collaboratives)
How to get there : The Processes
Set up a Quality Improvement Team
Get to know your FHT
Improve access and office efficiencies
On site support
Health promotion and illness prevention in FHTs
Mission
Ontario’s CDPM Model – role of community, populations
Traditional activities
Self management support
Enhanced 18 month baby visit
A community resource
Collaboratives
How to encourage it
Gradual
Change the culture
1 clinician vs all
3 steps
Risk factors (ie obesity)
Antecedents (ie adverse childhood events)
Pre-natal / early cohort
Link with community partners
IT
Incremental
Links with public health
Personal contacts
Presence in FHTs
Formal links
Collaborative programs
Sharing community data
Joint needs assessments
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