3. Comprehensive team-based care
- Date: Friday, September 20, 2019
- Concurrent Session F
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Time: 12:00pm-12:45pm
- Room: Harbour C
- Style: Presentation (information provided to audience, with opportunity for audience to ask question)
- Focus: Practical (e.g. Presentation on how to implement programs and/or practices in the team environment)
- Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers
Learning Objectives
Many of our patients who are recommended to participate in an evidence based cardiac rehabilitation program have issues in accessing this service due to travel, distance, time, cost, among other barriers. In order to meet and support these patient’s needs our team developed a local primary care program using the Cardiac Care Network of Ontario Standards. Interested conference attendees can gain knowledge of how to create their own cardiac rehab program by learning from our experiences and adapting from our processes and templates to meet their own local needs.
Summary/Abstract
Based on good evidence, individuals with cardiovascular disease would benefit from a cardiac rehabilitation program to support improvement in quality of life along with positive long term health outcomes. However, despite evidence and supports available, we have found that many of our local patients who could benefit do not have the right access to participate in such a program. Time, distance, weather, driving, and cost are all contributing factors to low compliance and uptake to nearby larger city programs we typically refer too. Family Health Teams have the unique benefit to be able to provide seamless, patient and family centred, team-based care. By utilizing pre-existing programs and providers along with establishing community partnerships, developing a cardiac rehabilitation program is realistic and feasible within a Family Health Team located in a smaller community setting. Based on these factors, we developed an accessible, local program that is guideline complaint for our patients to access. The free community based program has a developed patient care pathway which aids in patient transition, goal setting and outcomes. This presentation will review our developed care pathway, along with discussing key learnings and challenges in developing and implementing such a program. The presentation will emphasize the potential for spread of similar programs within other small community Family Health Teams.
Presenter
- Jenny Harvey, RN, Stratford Family Health Team
- Brittany McLeod, RN, Stratford Family Health Team
- Dr. Jason Bandey MD, Stratford Family Health Team
Authors/Contributors
- Dr. Jason Bandey MD, Stratford Family Health Team