AFHTO Events

Get Moving! Physical Activity for Better Quality Care

Tuesday, March 7, 2017 YMCA Toronto Central 20 Grosvenor Street, Toronto ON  

On March 7th, 2017, nearly 100 interdisciplinary health-care providers from across Ontario came together to share and learn about the role of physical activity in primary care. We were reminded that exercise is medicine, and physical activity is a vital sign. By incorporating physical activity promotion into primary care, we can improve the quality of care we deliver and get better outcomes for our patients.

Several themes emerged across presentations and groups. These included:

  • Using EMR tools to screening patients, track their progress, and measure program outcomes.
  • Leveraging partnerships with other providers, stakeholders, and community groups/programs to make the most of limited physical activity resources and keep programs free and accessible to patients.
  • Involving the whole interprofessional team to ensure that programs and patients are supported by the people best equipped to do so.
  • Meeting diverse patient needs through individualized goals, external resources, and multicomponent programs that can be tailored to meet each patient’s needs, even in a group.
  • Using Motivational Interviewing and similar techniques to help patients choose to Get Moving.

Read on and follow the links to learn more about programs that are currently in place and ready for spread. One (or more) of them may be a perfect fit for your team!

Physical activity for general health and wellness Physical activity for mental health Physical activity to prevent falls and promote health in seniors Physical activity for patients with chronic illness
Wisdom from the field: AFHTO member stories Barriers and Enablers to incorporating physical activities Supporters

Physical activity for general health and wellness

Researchers from University of Waterloo, the Research Institute for Aging, and GERAS Centre demonstrated that Exercise is Medicine, and they presented a series of practice tips to help refine exercise programs for patients with a variety of chronic conditions, to both maximize benefit and reduce risk. They reminded us that exercise is a vital sign and that primary care providers, because of their existing relationships with patients, are in a good position to counsel patients on physical exercise and refer them to exercise professionals.

Physical activity for mental health

Researchers from the Faculty of Kinesiology & Physical Education (KPE) at the University of Toronto and the Mental Health and Physical Activity Research Centre (MPARC) presented evidence showing that physical activity can increase mental wellness and is effective for both preventing and managing clinical depression. They also shared tips for supporting patients’ motivational autonomy in order to help them become more active.

Physical Activity to prevent falls and promote health in seniors

Healthcare professionals and leaders from the North East LHIN region presented Stay on Your Feet (SOYF), a regional falls-prevention strategy that supports healthy, active aging. This strategy is rooted in partnerships, fostering collaboration across interprofessional health teams and with community partners. This initiative, in partnership with local Public Health units and six Family Health Teams, was recognized with a 2015 Alumni Achievement award by IDEAS (Improving & Driving Excellence Across Sectors) and a 2016 Bright Lights Award. It includes a suite of EMR tools to screen for falls risk, as well as support for coordinated planning and delivery of exercise classes in the community. We heard from one such program, From Soup to Tomatoes This armchair-based exercise program has spread to communities throughout the North East an is ready for your team to adopt.

Physical Activity for patients with chronic illness

Health professionals from Metabolic Syndrome Canada  (MetSC) presented a nutrition- and exercise-based treatment program shown to improve outcomes related to cardiovascular and metabolic health. It was designed for implementation in interprofessional health teams with access to nutrition and exercise specialists (such as registered dietitians and kinesiologists). MetSC provides training as well as materials and connections for peer support. The program uses patient-developed goals and measurement tools to evaluate progress.

Wisdom from the Field: AFHTO member stories about their physical activity initiatives

In addition to the above presentations, we heard from three teams who are currently using physical activity programs to improve patient outcomes.

Barriers and Enablers for incorporating physical activity into team-based primary care

Barriers

Enablers

  • We have no funding for physical activity programs, and grants to support this are scarce.
  • Create partnerships with local organizations to share resources – consider contacting the Get Moving! Presenters as a starting place.
  • Get help from your peers and others to make the case that your program relates to specific conditions/goals for which program funding is available (e.g. chronic disease management, falls prevention).
  • We have no space to do physical activity – and what we have is difficult for patients to access.
  • Find local organizations and programs to partner with or refer patients to.
  • Talk to your peers and the Get Moving! Presenters for ideas.
  • We don’t have a kinesiologist or other expert in physical activity.
  • Look for community programs or organizations that have access to kinesiologists or other experts, and partner with them.
  • Connect with the Ontario Kinesiology Association or the AFHTO Communities of Practice for health promoters or physiotherapists for help finding professionals and/or students nearby.
  • Consider adopting a program that can be run by a volunteer.
  • We don’t know who to talk to at various organizations to build partnerships – and it takes a lot of time to get a partnership in place.
  • Consider contacting the Get Moving! Presenters to get started.
  • Consider contacting anyone you know at public health units, LHINs, existing community programs or academic institutions.
  • Consider contacting the Ontario Kinesiology Association or the AFHTO Communities of Practice for health promoters or physiotherapists.
  • Bad weather affects outdoor programs.
  • Explore tools that patients can use in their homes, such as Soup to Tomatoes DVDs (coming soon).
  • Consider adapting programs so that they can be run regardless of weather, such as Team Unbreakable (above).
  • Find local organizations or programs with indoor space to share.
  • Our patients are not always motivated to exercise, especially if they have diverse/complex needs.
  • Use Motivational Interviewing to help patients set their own goals.
  • Gradually increase exercise.
  • Use individualized and multi-component programs rather than a standard physical activity prescription.
  • Keep programs free for participants by accessing funding or leveraging community partnerships.
  • We have trouble using our EMRs to support and track progress with our physical activity programs.
  • Treat physical activity like other vital signs that are routinely measured and recorded in EMR during appointments.
  • Screen patients while they wait, using OCEAN tablets.
  • Reach out to organizations which support EMR development (e.g., AFHTO EMR Communities of Practice, Ontario MD.
  • Ask your QIDS Specialist for help with implementing EMR tools that have been developed and shared with other teams: eg custom EMR forms, encounter assistants, or similar tools.

Supporters

  • Support for Get Moving! has been provided by:
  • Metabolic Syndrome Canada, founder of the CHANGE Program
  • The Ontario Kinesiology Association
  • The North East Local Health Integration Network (NE LHIN) and the Government of Ontario
  • Change_Horizontald      OKA logo         NE LHIN Logo - EN