Theme 5. Why hasn’t this expanded: scalable pilot programs
Family physicians often lack time, resources, and tools to address cancer and chronic disease prevention and screening (CCDPS), and to integrate the many guidelines and resources that are focused on one specific disease, organ system, or lifestyle risk. The BETTER (Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care) approach integrates evidence-based preventive care for cancer with other chronic diseases, specifically focusing on lifestyle factors. A health professional in the primary care setting is trained to take on the role of a Prevention Practitioner (PP), who then develops a tailored “Prevention Prescription” with each patient, helping them to set S.M.A.R.T. (specific, measurable, attainable, realistic, time-based) goals for their health. The St. Joseph’s Health Centre (SJHC) Urban Family Health Team (UFHT) has been implementing the BETTER approach for 2 years. It has been launched in a stepwise manner to adapt the BETTER tools and BETTER visit to their environment to account for pre-existing patient and provider expectations of what was formerly known as their “Complete General Assessment” (CGA). Appreciating the collaborative patient centred approach to the BETTER visit, it has expanded from three physicians testing the model to now include the nurse practitioner, one registered nurse and five physicians, with the plan to expand clinic wide. Challenges identified are the paper based survey, cumbersome EMR documentation and managing provider and patient expectations of the appointment. Starting with converting to an electronic survey and with further training, there are plans to address these challenges over the coming year.
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