Poster Displays

Posters at the AFHTO 2023 Conference:

2023 Key Dates:

  • Hotel group rate deadline:                            October 3, 2023
  • End of early-bird registration:                       October 3, 2023
  • Date to submit PDF for online gallery:         October 10, 2023
  • AFHTO 2023 Hybrid Conference:                October 25, 2023
    •  Install poster:                                        7:00 to 7:45 AM, October 25, 2023
    •  Remove poster:                                 4:00 to 5:00 PM, October 25, 2023

 

Poster Display Guidelines:

  • The maximum size for posters is 46” (vertical) x 70” (horizontal)
  • Posters are to be put into place before 7:00 AM on Wednesday, October 25, 2023, and to removed between 4:00-5:00 PM on Wednesday October 25, 2023
  • For Virtual Posters -  PDFs should be a single page in the form of a PDF
  • Poster presenter FAQs are available here
  • Poster Information Kit

Online Poster Gallery

An online gallery of posters will be made available to attendees during the conference. In order to share your initiative with as many of your peers as possible, please email a PDF of your poster to conference@afhto.ca by October 3rd, 2023.

Posters available at the conference:

Physical posters

Poster # Theme Title Summary
  1. Using a population-based approach to provide care to the community Understanding and Addressing  Barriers to Colon Cancer Screening in Patients with Schizophrenia and Schizoaffective Disorder  People with schizophrenia have a significantly higher mortality risk from colon cancer than the general population (RR = 1.69, 95%CI 1.60 -1.80)1.    One factor contributing to this are lower colon cancer screening rates. 3456   At SJHC UFHT in July 2022, while 71.7% of the general patient population between the ages of 50-74 were up to date with colon cancer screening, in patients with schizophrenia and schizoaffective disorder this number was only 51.8%.  Too address this inequity we have embarked on a Quality Improvement Project with the West Toronto ACTT.  Our first step has been to better understand the problem by interviewing patients and holding a focus group with ACTT case managers. From those discussions we have implemented two interventions so far. We are now mailing FIT kits directly to the ACT team not the patient, and we have standardized the process to access overnight support for the necessary bowel preparation for colonoscopy.  The aim of this project is to increase the rate of colon cancer screening to 66% in patients with schizophrenia and schizoaffective disorder at SJHC UFHT by March 2024. More importantly, the goal is to develop effective processes and partnerships that address screening barriers and to spread these solutions broadly.  The hope is that eventually colon cancer screening rates could equalize across Toronto and beyond.    
 
  1. Using a population-based approach to provide care to the community Guiding Peterborough’s Tiniest Feet Toward Their Milestones The poster presented by Peterborough FHT will highlight this population of patients requiring specific routine care and who do not currently have access to primary health care. This group of patients enters the healthcare system through limited access points (mainly the hospital’s labour and delivery floor) and are supported by a few different clinics. The connections and collaboration made with the clinics supporting new babies are crucial to redirect the patients to the Well-Baby Clinic.      The Well-Baby check-ups are conducted by a nurse practitioner and a registered practical nurse working to full scope. Clinical staff provide routine visits from 2-18 months to assess growth and development and recommend immunizations for those up to 18 months of age.     There is limited access to primary healthcare, which leads to increased pressure on our local health system. The unattached patient population continues to increase yet primary healthcare cannot keep up owing to the limited amount of family physicians. This clinic is an arm of primary care, utilizing interprofessional healthcare providers to support a particular population of unattached patients.     If unattached patients cannot yet be connected to a family physician, primary care clinics focusing on different aspects of comprehensive care, such as well-baby checkups can lead to a healthier community. We are opening a door for babies to receive vaccines, for early interventions to take place should a baby requires specialized care, and for parents to know their child is reaching appropriate milestones; we’ve expanded on primary health care and team-based care. 
 
  1. Using a population-based approach to provide care to the community Team-based care by Ontario Health Teams: Where are the priority areas? The Ontario government recently implemented Ontario Health Teams (OHTs), which are nongeographic patient-provider networks. Each Ontario resident is attributed to an OHT based on care-seeking patterns. Our research team produced data on patterns of primary care attachment by OHTs, providing key information on demographics and health utilization about each OHT’s attributed population and serving as an important resource for applied health services researchers and health policy decision makers.     We created population-based, retrospective cohorts linked with health administrative data from the >14 million residents of Ontario as of March 31, 2020 and March 31, 2022. Primary care attachment was defined with our validated algorithm: Residents are considered attached if they used any community health centre (CHC), enrolled in a primary care program, or visited a primary care physician who did not have low continuity; all others were considered uncertainly attached. Team-based care is defined by residents who are enrolled in a Family Health Team (FHT) or used any CHC. Attachment data and maps are provided for the OHTs. Additional health utilization data by primary care are provided. 
 
  1. Using a population-based approach to provide care to the community An audit of Family Health Team websites: Information on palliative care services Support for those with a life-limiting illness is an increasingly emphasized aspect of comprehensive primary care, and many Family Health Teams provide a range of palliative care services to their own patients. Patients seeking to learn about services and resources offered by their FHT may encounter limited information online, which can impact their understanding of palliative care options. The objective of this study was to describe the proportion of FHT websites mentioning “palliative care,” the proportion of FHT websites with information about their own palliative care services or patient resources, and the extent of palliative care services offered by FHT. Using a programmed script, all 185 FHT websites were reviewed in March 2023 to determine what information on palliative care services was publicly available and whether FHT websites offered palliative care resources for patients. Reviewers noted whether the FHT offered their own palliative care, referred to an external organization for palliative care, or both provided and referred. Overall, one fourth of FHT websites contained the phrase “palliative care.” Of these, 66% described their own palliative care services, 17% directed patients to external palliative care services, and 17% both provided and referred. Of all 185 FHT websites, 15% offered palliative care resources. Although a website is only one communication tool in a FHT, patients may benefit from increased access to web-based information about palliative care services offered by their FHT and from online palliative care resources.  
 
  1. Using a population-based approach to provide care to the community Promoting Health Equity through Community-based Preventative Healthcare Initiatives During the pandemic the Carefirst FHT worked closely with the High Priorities Communities Strategy (HPCS), a critical part of the government’s strategy to improve health equity for those communities that are more vulnerable as reflected by the impact of COVID-19 pandemic. This partnership of 30+ service partner organizations continued post-pandemic to focus on health system recovery.  In consultation with the partners, Carefirst and the Collaborative identified women’s health literacy and preventative cancer screening as a critical service gap for immigrant women from both East Asian and South Asian women. Over the summer of 2022, the HPCS and the Carefirst FHT worked collaboratively to develop several women's health focused education sessions and deliver them in their community, in languages they understood and by industry experts. Sessions focused on cervical cancer, postpartum depression and endometriosis. In the Fall of 2022, the mobile pap clinic was launched offering women convenient access to cervical cancer screening. The services and programs delivered in partnership highlights the power of leveraging expertise and relationships. By combining the strength of clinical expertise and knowledge of primary care in the Carefirst FHT with the partnerships and relationships of the HPCS, together we were able to improve the health literacy and cancer screening rates of a marginalized and vulnerable patient population.
 
  1. Using a population-based approach to provide care to the community Elder Care Registered nurse  supporting aging complexities With a growing aging population and human health care staffing constraints, the often time consuming and avoided conversations are promoted, initiated and documented for better patient outcomes with allocation of an RN champion. This then allows for focused visits between provider and patient with much of the trust building, navigation and system linkages having been facilitated by the RN lead. With early identification of elder care needs we can help patients avoid unnecessary hospital visits, better support aging at home well, and ensure early palliative care planning.  
 
  1. Using a population-based approach to provide care to the community Optimizing Early Detection Lung Cancer Screening

"The presentation will provide an overview of the program, “Optimizing Early Detection in Lung Cancer Screening”.  Two participating pilot sites used EMR searches to identify at risk patients and were electronically sent lung cancer risk questionnaires that calculated their score of having lung cancer in 6 years, using a validated tool.  Patients with a score of >= 2% were then brought in for appointments with their GP to discuss about referral to the ON lung cancer screening program.    There are several innovative aspects of the program that include:  

1. Reducing the number of ineligible patients referred to the program.  Based on the ON pilot program, about ~ 35% of patients referred did not meet the eligibility criteria.  By pre-screening patients with the questionnaire, our goal was to reduce the number of ineligible referrals to less than 5%  

2.Patients often do not discuss smoking and lung cancer related issues.  Also, it can be difficult for clinicians to remember about programs.  By using EMR tools and digital questionnaires, we can take a proactive approach to identifying patients at high risk.  

3.There was some uncertainty about having patients complete lung cancer questions remotely but generally there were positive responses from patients that will be shared.
  1. Using a population-based approach to provide care to the community Facilitating Transitions in Care and Services: Interprofessional Best Practices A significant point in the provision of health care is when a person’s information and care needs are being transferred between health and social service providers, interprofessional teams and settings. To this end, the Transitions in Care and Services best practice guideline was released in June 2023 to provide evidence-based recommendations for interprofessional teams, organizations and the health system to support safe and effective transitions in care. It was developed by an expert panel of interprofessional practitioners, researchers and policy makers and included persons with lived experience and representatives from Ontario Health Teams. The guideline addresses transitions in care for pediatric and adult persons and their support networks. This interactive workshop will highlight the guideline development process and key recommendations. Dynamic discussions will ensure that attendees learn how to best tailor implementation strategies and mobilize seismic change in their organizations. Participants will engage in hands-on learning activities, using an equity, diversity and population health lens, and social movement actions. This will include sharing approaches to create magnetic engagement and collective identity, as well as rigorous monitoring and evaluation of effective transitions in care between primary care and other health sectors. 
 
  1. Using a population-based approach to provide care to the community Developing and Disseminating Clinical Guidelines for Social Isolation and Loneliness in Older Adults    An Angus Reid survey found that 48% of Canadians reported themselves as being socially isolated, lonely or both (Reid,2019). Social isolation among older adults is associated with increased chance of premature death, depression, dementia, disability from chronic disease, increased use of health and support services and increased number of falls. (National Academies of Sciences, Engineering and Medicine (2020). In 2023, the US Surgeon General published an advisory on the related growing health crisis and the importance of social connection.      In response to this growing health issue, The Canadian Coalition for Seniors’ Mental Health (CCSHM) is developing Canadian guidelines for health and social service providers to support them in their professional roles with respect to the prevention, screening, assessment and possibilities around management and interventions for social isolation and loneliness in older adults.         In this workshop, we will present information regarding the processes taken to draft clinical guidelines with this complex context, including the recruitment and support of Pan Canadian Working Group, the findings of the Literature Review and the results of two national surveys.     Following this overview, an interactive workshop has been designed to engage the professional experiences and insights from participants with respect to the draft recommendations and further seek their ideas for relevant,  effective and innovative approaches for the dissemination and knowledge translation of the guidelines.
 
  1. Using a population-based approach to provide care to the community Virtual Simulation-Based Foot Education Program for Adult Patients with Diabetes:  Lessons Learned from a Feasibility Trial in Ethiopia. 
 		 This paper explores the lessons learned from a feasibility trial that included adult patients with diabetes at the University of Gondar Referral Hospital (UoGRH), in Gondar, Ethiopia. The study was designed to evaluate the acceptability and practicality of a virtual simulation-based Diabetes Foot Care Education (DFCE) program among adult patients with diabetes. Methods:  A sample of 40 participants was recruited, of which 20 participants received the virtual simulation-based education program, and the other 20 participants continued with their usual diabetes care. After the education program, a questionnaire and structured interview were used to explore the feasibility (acceptability, practicality) and the potential impact of virtual simulation-based DFCE intervention in patients with diabetes. Results: The main lesson learned from the current study is that virtual simulation-based DFCE is acceptable, and practical and improves participants’ foot care knowledge and practice. Such educational approaches are highly acceptable to this population and can be integrated into the existing foot care education program. Moreover, virtual simulation-based education can be designed in local languages by incorporating the contextual realities of patients and offers a great potential solution to the lack of diabetes management education in a hard-to-reach population.  Conclusion/ Potential impact:  An innovative patient education approach using Virtual Simulation Games (VSG) is acceptable and practical and holds great promise in improving access to diabetes education for the hard-to-reach population.   
 
  2. Optimising teams’ capacity and creating efficiencies Involving Mental Health Providers to Increasing Rates of Breast Cancer Screening Women who have mental health challenges are less likely to engage in preventative health care.   At the St. Josephs Health Centre Urban Family Health Team( SJHC UFHT) in March 2023 only 70% of our patients eligible for breast cancer screening with a diagnosis of depression/anxiety/personality disorder/PTSD/or trauma history had had a mammogram in the last 2 years. This is compared to 78% of our eligible patients who do not have any of these diagnoses.  To address this gap, we engaged our mental health team to raise awareness of the importance of self care including cancer screening with their patients. This poster demonstrates the impact of their efforts.    All family health teams have some individuals who are difficult to engage in cancer screening.  This initiative tries to increase self-agency and address a potential cause for the lack of engagement some patients have in preventative care.  It is an innovative approach to share the work of cancer screening beyond primary providers and nurses.  If successful, this work will be worth spreading  
 
  2. Optimising teams’ capacity and creating efficiencies A Multidisciplinary Approach to Deprescribing Potentially Inappropriate Prescriptions (PIPs) – A SPIDER Protocol Polypharmacy is common in older adults and can be associated with elevated risks of poor health, reduced quality of life, high care costs, and persistently complex care needs. This project targets medications where the potential risks may outweigh the benefits and where deprescribing should be considered. We focused on the following therapeutic classes with established evidence-based deprescribing tools: proton pump inhibitors, benzodiazepines, antipsychotics, and sulfonylureas.     The objective of this project is to implement the SPIDER protocol to assist in deprescribing PIPs in the older adult population at risk of drug therapy problems due to polypharmacy.    Within a one year timeframe, our multidisciplinary team consisting of physicians, pharmacists, and quality improvement specialists identified eligible patients 65 years and older with ten or more medications using UTOPIAN and our EMR system. We performed chart reviews and patient interviews to assess their eligibility for deprescribing of PIPs. Based on eligibility, patients were initiated on a deprescribing protocol with regular follow-ups.
 
  2. Optimising teams’ capacity and creating efficiencies Team Based Obesity Medicine | ACT (Acceptance and Commitment T ) for Metabolic Health Program The 2020 Canadian Obesity Guidelines highlight the importance of a multidisciplinary approach to the obesity living with obesity. To this end, the ACT for Metabolic Health Program integrates key aspects of care including lifestyle intervention with a registered dietician, psychological intervention through an Acceptance and Commitment approach with the social work and physician team and pharmacotherapy with the physician and pharmacy team.     As of 2017, most Canadian adults live with being overweight or obesity. The burden of this care will fall on primary care practitioners who need to be supported through a team-based approach to this complex disease.  The ACT for Metabolic Health Program provides a successful model of how this approach can be implemented in one of the largest family health teams in Ontario. 
 
  2. Optimising teams’ capacity and creating efficiencies Implementing LEAN Techniques and Quality Improvement Tools in Primary Care: How to Optimize Administrative Workflows Medical receptionists play an important role in Primary Care as they are often the first point of contact for patients. The medical reception team is closely tied to the undesirable, and often unintentional, delays in care. Common misconceptions would assume that these delays are attributed to limitations to human resources. However, LEAN Sigma would suggest these potential sources of delays in care are affiliated with unexpected absences, coverage structures, scheduling and allocation of resources to meet workload demands. The Health for All Family Health Team conducted several focus groups with team members and leveraged quality improvement tools to redesign administrative processes and workflows. Innovative ideas include dividing administrators in strategic teams for easier coverage and scheduling, integrating technology such as active telephone call dashboard monitoring and self-check-in kiosks. Through measuring our peak times and overall throughput we can effectively utilize our administrative team to fulfill demanding duties such as answering telephones, completing messages in the EMR, scanning documents and moving patients through the waiting room. Building a strong administrative team structure and implementing effective communication strategies with Primary Care providers will help improve patient access, decreases provider burnout and enhances staff morale. 
 
  2. Optimising teams’ capacity and creating efficiencies Facilitators and Challenges Shaping the Experiences of Primary Care Teams’ Engagement in COVID-19 Vaccination Distribution in Ontario, Canada: A Qualitative Study  Primary care has historically established itself as an important part of vaccinations efforts due to its successful delivery of flu and childhood immunisation programmes centred on counselling and strong infrastructure. An effective and efficient distribution of a vaccine was essential for the recovery from the COVID-19 pandemic. Although primary care teams contributed to all phases of the COVID-19 vaccination distribution, involvement of primary care in the distribution of the COVID-19 vaccinations has been varied. Criticisms have emerged regarding the under-utilization of the expertise primary care in guiding implementation of vaccinations. An increased understanding of the role primary care teams had in the distribution of the COVID-19 vaccines in Ontario will help determine the unique experiences of interprofessional primary care providers, and provide guidance for future vaccination planning. Our study seeks to identify facilitators and challenges of integrating COVID-19 vaccination in interprofessional primary health care teams across Ontario. We utilized a descriptive, qualitative focus groups conducted with providers, administrators, and staff working in primary care teams across Ontario. Focus groups were guided with an interview guide and audio recorded to assist with creating a verbatim transcript that was then analyzed. The poster will provide an overview of our research study and highlight key findings regarding the role of primary care with COVID-19 vaccinations and in future vaccination efforts.
 
  2. Optimising teams’ capacity and creating efficiencies A Community of Practice for Health Professional Educators: Exploring an innovative approach to supporting HPEs in Family Medicine at the University of Toronto (work in progress) Background: Health Professional Educators (HPEs) are educators who are not physicians by training and who teach medical learners within academic Family Medicine (FM).  At the University of Toronto (UofT), the Department of Family and Community Medicine (DFCM) formally recognizes the important contributions that HPEs make in ensuring that learners are ready to practice collaboratively on interprofessional teams. The DFCM aims to better integrate and support this group of teachers with a number of new initiatives, including the creation of a Community of Practice (CoP) where networking, collaboration, and sharing of information amongst HPEs can be facilitated.   Purpose: This project aims to describe the current and desired state of the DFCM’s HPE CoP to inform ongoing development and future direction of the community, and to provide an enhanced collective understanding of the experiences, challenges and support needs of HPEs regarding their academic roles in FM.  Methods: Thorough utilization of CoP design and development methodology, this project will explore the support needs of members and their preferences for the CoP’s role and function. A mixed methods approach (surveys and focus groups) will evaluate the design, development, and potential advancement opportunities for the CoP and to learn from HPE participants about their practice experience and preferences for participation.    
 
  2. Optimising teams’ capacity and creating efficiencies Connecting Again: Optimising and Improving Nurse-Resident Relationships in a Post-COVID World  On-site learning opportunities dwindled with the emergence of the COVID-19 pandemic. Physical distancing and masking became the norm, and nurses were redeployed or redirected to support other pandemic efforts. As a result, the relationship between residents and nurses was lost; residents felt unsupported, and nurses felt disconnected.     A nurse-resident informal mentorship program was launched in July 2022 in an effort to rebuild connections and foster a stronger collaborative relationship between the nursing team and resident physicians. Components of this program included: randomized assignment of residents to members of the nursing team (known informally as a “nursing buddy”), a formalized nursing-led skills lab for incoming residents to learn basic clinical skills, and partnership with nursing during resident-led urgent care clinics.    This program aims to create a supportive and positive learning environment for residents, build better understanding of respective roles, and enhance collaboration between disciplines. Participating in resident education and investing in their growth and development has also had a positive impact on the nursing team. Establishing a strong foundation of inter-professional relationships within the residency program will encourage the practice of maintaining collaboration with nurses in their future careers as physicians.  
 
  2. Optimising teams’ capacity and creating efficiencies Impact of implementing a patient-centered type 2 diabetes self-management virtual educational program with glucose sensor technology on A1C, time in range and patient satisfaction. In 2021, the Credit Valley Family Health Team (CVFHT) proactively assessed the impact of the pandemic on their diabetes patient care using a triangulated approach of a clinic survey, EMR query, and a patient survey. The problems identified were disruption of continuity of care and increased risk of comorbidities. Identified needs were: 1. Patient self-management support; 2. Digital tools for virtual education and management; 3. A patient recall process. An intervention was developed to address all 3 needs. The intervention included a virtual educational strategy, named Take Control, designed to reduce deterioration of diabetes outcomes, foster patient engagement, and improve patient self-management. It incorporated an EMR patient diabetes registry and other digital tools to facilitate effective and efficient care. The 2-part education intervention utilized a patient-centered, team-based approach grounded in adult learning and behavioural psychology principles with the goal of promoting behaviour change. The design incorporated active learning for high-level engagement, promotion of memory retention, peer learning using patient “Bright Spots”, group discussion and glucose sensor technology.  Key learnings for patients included: 1. Discovering the impact of their own lifestyle factors on their glucose levels; 2. the importance of increasing Time in Range (TIR) to improve diabetes management; 3. Utilization and shared access of glucose data for decision making. Take Control continues to be offered and the impact of the program on glucose management and patient self-management was assessed after 1 year using EMR data, sensor data and patient surveys. Results show an improvement in A1C, TIR and overall patient self-management.
 
  2. Optimising teams’ capacity and creating efficiencies Obesity management strategy - providing evidenced based practice and addressing wait times Our dietitian and pharmacy teams have collaborated to develop our obesity management services to align with evidence-based practice. All three pillars for obesity management are now part of the BCFHT program. The Tools for Successful Weight Management with Medications (SWM) group class was added in response to an increase in referrals for this. We continue to run our Diet and Lifestyle class and our Post Bariatric Surgery Management class. With the addition of our most recent group class (SWM) patients can be directed to obesity management services required for their unique needs.  Our program design has been very helpful in processing referrals and addressing our wait times, improving access to both our Dietitian and Pharmacy services.  
 
    Low Income Population Focus for Cervical Cancer Screening in a FHT RN-Led Pap Clinic There is great potential to building a sustainable program for community cervical cancer screening.  Through this programme we have initiated 1) Took a health equity approach to increase access for patients in income quintile 1 and 2; 2) Optimized RN scope of practice and capacity, including increased opportunities for medical education and training; 3) Incorporated patient perspectives and  feedback to optimize clinic care and ensure positive patient experience. 
 
  2. Optimising teams’ capacity and creating efficiencies Improving Access and the Experience for Patients Having Hip and Knee Replacement With post pandemic concerns around the surgical backlog the system requires creative, team-based solutions to expedite and enhance care for patients needing hip and knee replacement surgery. Sunnybrook Holland Centre is a high volume orthopaedic surgery centre in downtown Toronto. The centre performs over 4000 orthopaedic surgeries each year. A regional partnership has been formed with several other hospitals (Toronto Regional Arthroplasty Collaborative) and has recently opened up weekend elective surgical access to reduce wait times.  We will highlight aspects of the model including our interprofessional central intake model, expert assessments, right time surgical consult, patient centred pre-op care, expert surgical teams and early supported discharge.  Further, we will discuss our innovative tools and approaches to care to support patients throughout their hip and knee replacement pathway.  With the introduction of e-Referral to our Central Intake model, Ontario primary care providers are able to efficiently refer patients to the next available surgeon in the Toronto region or the patient/providers choice of hospital or surgeon.  Within the Rapid Access Clinic, advanced practice providers ensure patients are optimized for surgery and are matched with the most appropriated surgeon based on wait times, urgency, patient preference and surgical sub-specialties.  Postoperatively, our interprofessional team has developed tools to support patients for successful early discharge and optimal surgical outcomes. We will highlight key digital initiatives including our myHip&Knee app and virtual follow up care.  
 
  2. Optimising teams’ capacity and creating efficiencies Pharmacist-Led Penicillin Allergy Assessment and Management in Primary Care "Penicillin allergies are the most commonly self-reported drug allergy with estimates approaching 10% of the population (1,2). The majority of people with a reported penicillin allergy can safely be treated with beta lactams (3), since the majority experience intolerance or non-allergic reaction to penicillins or they outgrow their allergy over time.  Despite this, beta-lactams are commonly avoided, leading to the use of second-line antibiotics, which may be less effective, have a greater risk of adverse events including C. difficile infections, be more costly (4,5).      Our initiative evaluates the feasibility of performing standardized penicillin allergy assessments in primary care in collaboration with a hospital-based antimicrobial stewardship physician. Patients rostered to the South East Toronto Family Health Team (SETFHT) with a penicillin or amoxicillin allergy label are contacted by email or are directly referred by their provider for assessment of their allergy history and, if indicated, are offered a direct oral amoxicillin challenge. The penicillin allergy de-labelling clinic is led by a pharmacist and nurse practitioner and occurs one half-day per month.     In patients where amoxicillin oral challenge is performed and the result of the test is negative, the patient’s penicillin allergy is removed from their medical records and the information is also disseminated to other key members of the patient’s healthcare team (ie. community pharmacy, local hospital).     Once the initiative has been ongoing for a few years, we plan to complete a retrospective chart review to compare antibiotic use in each individual before and after the standardized penicillin allergy assessment.      References:   1.    Rimawi, R. H.  et al. The impact of penicillin skin testing on clinical practice and antimicrobial stewardship. J Hosp Med, v. 8, n. 6, p. 341-5, Jun 2013. ISSN 1553-5606. D    2.    Solensky, R. Hypersensitivity reactions to beta-lactam antibiotics. Clin Rev Allergy Immunol, v. 24, n. 3, p. 201-20, Jun 2003. ISSN 1080-0549.    3.    Solensky R. Clin Rev Allergy Immunol. Hypersensitivity reactions to beta-lactam antibiotics.2003 Jun;24(3):201-20.   4.    Macy E and Contreras R. Health care use and serious infection prevalence associated with penicillin ‘‘allergy’’ in hospitalized patients: A cohort study. J Allergy Clin Immunol 2014 Mar; 133:790-796.    5.    Charneski L, Deshpande G, Smith SW.  Impact of an antimicrobial allergy label in the medical record on clinical outcomes in hospitalized patients.  Pharmacotherapy.  2011; 31: 742-7.  
 
  2. Optimising teams’ capacity and creating efficiencies The Current Landscape and Future Vision of the Role of Social Work in Primary Care Teams Social workers contribute to the comprehensiveness and patient-centred services offered in interprofessional team-based models of primary care. Guided by a biopsychosocial framework, social workers attend to the social determinants of health and align with primary care’s aim for health equity. Social workers provide a range of services, including psychosocial care, mental health care, patient education, and end-of-life care. The COVID-19 pandemic significantly impacted social workers due to expanding patient complexities, transitioning to virtual care, adapting in-person services, and increasing provider burnout. Examining social work practice in primary health care teams will enable social workers to better meet the robust mental health and complex patient needs, as well as how social workers contribute to interprofessional collaborations. Across Canada, there are significant variations with social work practice in primary health care, highlighting the need for a national vision to guide the future of social work in primary care. This presentation will report on findings from two mixed-methods projects focused on primary health care research that describes current social work practice and envisions a future for the role of social work. One project is a mixed-methods study consisting of I) a cross-sectional online survey, and ii) descriptive qualitative focus groups. Eligible participants were Ontario social workers working in primary health care teams. The second project includes a scoping review on the role of social work in primary health care, online training modules to enhance knowledge and skills, and an environmental scan to identify and develop a plan for implementing a community of practice for social workers in primary health care.
 
  2. Optimising teams’ capacity and creating efficiencies Health and Wellness Program(s) for the Employees – The Change Needed at the Organizational level: Systems Approach Stress accounts for about 80% of all illnesses and diseases for human beings and is currently the prime reason linked to mortality. It is not unknown for healthcare workers to be working under stressful environments; both physical and psychological, even before the pandemic.     In healthcare professionals, burnout resulting from stress can cause not only some serious health problems in the individual but also some serious issues for the organization resulting in an overall operational failure of the workplace leading to poor quality of patient care. For the organization, it could also mean an increase in health benefit costs because of higher usage of services, high turnover rate for employees, and difficulty in filling job vacancies.     Even though employee wellness programs have become an important topic for all companies, most programs still focus on individuals rather than taking a systems approach to the problem.    We at Prescott Family Health Team utilized a systems approach by collaborating with a consultant to design a program for our employees, giving them tools to build resilience, courage, and confidence. The program was geared towards managing their time better, helping them prioritize their responsibilities, providing brain power habits to maximize their productivity, and enhancing communications between their colleagues, clients, and supervisors.     The organization plans to invest in creating a strong culture of learning new information and/or skills for a good cause, i.e., to change the lives of their employees and patients in a better way and achieve great heights for the organization.    
 
  2. Optimising teams’ capacity and creating efficiencies Virtual Simulation-Based Learning Modules in Dietetics for Interprofessional Team-Based Primary Care Settings This 3-phased project is designed to gain a deeper understanding of dietitians’ role and learning needs in team-based primary care (TBPC); and create corresponding supportive competency-based learning modules available in both French and English.  Phase 1 Survey: The expert working group including primary care dietitians, dietetic educators, and interprofessional healthcare practitioners will develop a survey to determine: 1) key competencies needed for pre- and post-licensure dietitians to work in TBPC, 2) a comprehensive list of nutrition-related health issues commonly encountered, and 3) perceived knowledge gaps and challenges facing dietitians and dietetic learners in TBPC. This survey will be distributed by several selected provincial and federal organizations and networks to maximize the reach across the country.  Phase 2 Asynchronous Virtual Simulations: The survey will guide the development of 3 interprofessional clinical scenarios and corresponding learning outcomes for the creation of asynchronous Virtual Simulations (VS).  The CAN-Sim (https://can-sim.ca/) standardized scenario template will be used to guide the development process.  In addition, key resources including the Integrated Competencies for Dietetic Education and Practice in Canada, will be identified in each VS.  Priority topics will be given to vulnerable populations and/or issues that benefit synergistically from TBPC.   Phase 3 Dissemination: Each VS learning module will include additional resources such as assessment rubrics, preparation material and reflective questions.  These bilingual learning modules will be made available through a dedicated open-access website.  Dissemination and awareness of these learning modules will be conducted through presentations at regional, national and international conferences and professional websites.    
 
  2. Optimising teams’ capacity and creating efficiencies Re-engaging Patients Living with Diabetes: A Pro-active Team Based Approach As a result of the COVID pandemic, patients with chronic diseases have been lost to follow-up (LTFU).  A team based strategy to re-engage patients with type 2 diabetes was piloted at St Michael’s Academic Family Health Team (SMHAFHT).   LTFU was defined as patients with a diagnosis of type-2 diabetes who did not have an AIC or BP in the past 12 months.  Patients were then prioritized if last AIC  was > 0.085.  Patients meeting criteria for LTFU were identified from an EMR search.  Inter-professional case conference led by a pharmacist, diabetes education program dietician or nurse, was held to review each provider list.  Thereafter, patients were prioritized and re-engaged through telephone contact, email or mailed letters.  Where possible, booking of follow up appointments with the provider and team either by telephone or in person ensued.  
  3. Organizing primary care to advance Ontario Health Teams The role of physician engagement and practice facilitation specialists in building highly effective primary care teams
 		 Integrated healthcare delivery requires more than just gathering a team of healthcare professionals and referring individuals to programs and services. To establish a highly functioning primary care team, changes in practice are a necessity and is crucial to establishing team cohesion that incorporates physicians through dedicated resources for physician change management, practice facilitation, and engagement. Through an affiliation agreement, CPH has affiliated with 82 PCPs in Mississauga who operate under various funding models (FFS, FHG, FHO). This connects them and their patients to a coordinated, comprehensive team of health care professionals who collaboratively deliver holistic care by addressing patients’ physical health, mental health, and social determinants of health.    This presentation will review how CPH has integrated physician engagement and facilitation as an essential role within the team. This presentation will highlight the core functions of the role and the key factors required to be successful. The physician engagement and facilitation team’s role have different responsibilities that allow for sustainability in building and maintaining physician relationships. This includes recruiting and building relationships with physicians to participate in improving access to team-based care, providing support and resources to practices, working with providers and the CPH team to improve effectiveness and practice efficiency, and creating resources and infrastructure to support a Community of Practice. If the team requires providers to use specific digital tools like OCEAN, HRM or other tools to enhance patient care, the CPH engagement team offers change management and on-site technical support to help providers navigate the transition to these tools. The consistent touchpoints ensure physicians feel well-supported from the point of affiliation and onwards. Furthermore, this presentation will address the need for continued focus on physician engagement and practice facilitation and how this role can advance the broader primary care transformation work required within OHTs, including supporting the development of Primary Care Networks. 
 
  4. Embedding mental health and home care in primary care The Right Information When You Need It: Knowledge Translation and The Canadian Coalition For Seniors’ Mental Health The Canadian Coalition For Seniors’ Mental Health is currently completing a large scale knowledge mobilization project funded by the Public Health Agency of Canada. This involves the dissemination of practice guidelines to clinicians, and public health education to older adults and their caregivers. Using print, video, social media, and web resources they are disseminating best practices for the prevention and treatment of depression, anxiety, dementia, substance use, and social isolation in older adults. They are also raising public awareness of older adult mental health. As part of the project, CCSMH is demonstrating the value of multimedia approaches to public education and clinical knowledge dissemination. The work of CCSMH has direct value for primary care by providing best practices, patient information materials, and encouraging prevention activities in the older adult population. They are providing primary care practices with useful, accessible and evidence-based materials to share with patients and help guide their practice.  The work will demonstrate the value of implementing a coordinate knowledge mobilization strategy for growing clinical awareness of best practices in primary care and increasing patient health knowledge.     
 
  4. Embedding mental health and home care in primary care Hybrid By Force, Now By Choice:  Patient and Provider Experiences of Mental Health Services in Dufferin/Caledon Prior to March 2020, within the Dufferin Area Family Health Team (DAFHT), mental health counselling/therapy services were primarily delivered in-person - and occasionally by phone.  Virtual care was limited to exceptional patient circumstances, such as distance or disability.  However, Covid, as a disruptor, forced rapid adoption of phone and virtual care as a response to needs and circumstances.     Consequently, over the past three years, for most Dufferin-Caledon patients seeking mental health counselling/therapy, the primary approach has been phone-based. Even now, in 2022-23, while in-person counselling/therapy services have substantially increased, phone and virtual sessions continue to be offered and are often chosen by both patients and providers. This presentation will explore the current ‘hybrid by choice’ impact on mental health services for Dufferin-Caledon patients and providers.      Through summary data, reflecting input of 100+ patients who have accessed mental health counselling services during the past three years, considerations for hybrid care, equity and access, as well as satisfaction and perceived effectiveness will be reviewed.  In addition, the perspectives of 15 mental health therapists will be highlighted.      By actively seeking patient and provider input, the DAFHT Mental Health Team seeks to confront assumptions, respond to challenges, and to ensure approaches chosen are for quality mental health care.  
 
  4. Embedding mental health and home care in primary care Addressing the Other Pandemic: A Multidisciplinary Approach to Mental Health 

Across the province, there is a growing need for increased mental health services and supports. Patients lack access to services to address needs such as adult ADHD, caregiver burnout and depression and anxiety. Our primary care goal is to be able to provide time efficient and client centered care to patients that is accessible and comprehensive. Our vision is to utilize the inter-professional resources we have to plan programs that will address mental health concerns and close the gaps in services that our health care system faces.  Our adult ADHD program will involve the NP, OT and SW. Our NP will assess, diagnosis and explore medication management with patients. Our OT will provide support and treatment for non-pharmacological management of ADHD. Our SW will manage any psychosocial impacts that patients experience. This inter-disciplinary support and management for adult ADHD is lacking in the community and is not accessible for people without financial resources.   A group-based CBT program will provide patients with specific strategies, peer support and weekly follow up for managing symptoms of anxiety and depression. A group setting will reduce wait times between appointments for patients and will offer a supportive environment for patients to share their experiences with peers and learn new coping skills.   Our Caring for the Caregiver Series 3 week series will be held in person and/or virtually. Post-pandemic, patients identify feeling more isolated and are looking for personal connections, stress management skills and supports. The group will include information, resources, specific tools and peer support for managing mental health concerns that come with caregiving.  
  4. Embedding mental health and home care in primary care Improving Mental Health Outcomes of FHT patients: Applying Lessons Learned from MindBeacon's COVID program and Previous FHT Public-Private Partnerships

"When the federal and provincial government announced one-time money being flowed to FHTs in January with spending by year end (March 31), 23 FHTs  engaged in a public private partnership with MindBeacon/CBT Associates to support their patient’s mental health. The validity and credibility of MindBeacon’s recent COVID TAiCBT program and a previous CBT Associates-FHT Consortium collaboration, further sealed the partnership.      The partnership offered  •    Accessibility and health equity to mental health services for FHT patients and employees   •    Access to mental health services (iCBT and Virtual) outside of regular office hours  •    Reduction in waitlists  •    Patient choice  •    Decrease in time to treatment  •    Lower overall cost    We will expand on the lessons learned and insights/data from the previous CBT Associates – FHT Consortium and  MindBeacon’s COVID program and its application to this partnership.      These areas will be expanded upon:  

  •  Access and Equity
  • Effectiveness
  • Value
  • Operational Process and Learning"
  4. Embedding mental health and home care in primary care “Where The Client Is At”: Reflections on Social Work Practice In the Client’s Home  Social work practice strives to assist wherever “the client is at” by appreciating the client’s past experiences and current circumstances. As a Primary Care at Home social worker, part of the wider scope of primary care teamwork within the Guelph Family Health Team, I reflect on various practice lenses that promote “where the client is at” among the homebound. These lenses are: social justice including health inequity, social work theories and interventions, and the social worker’s world views. The social justice lens acknowledges the health and social inequities found among people who are homebound. These injustices are addressed by me through relevant social work theories. For example, the wide-angled lens of social theory warrants that people who are homebound are entitled to equitable healthcare as provided to those more socially advantaged. Within the client relationship, the therapeutic alliance seems more meaningful to clients than any attempted social work theory or strategy. And finally, four of my own world views are part of my use of self as a social worker supporting people who are homebound. I enact a “whatever it takes” method to manifest change. I generalize learning from my own experienced health inequities with those of the client.  In the “walking with” or companioning lens I hold, the social worker attempts to reduce the client’s sense of aloneness and isolation which seems to be beneficial regardless of outcome.  Finally, my view that meaningfulness can be found within hardship is sometimes helpful. Overall, support for "where the client is at" requires an understanding of the important intersection between home-based practice, social justice, social work theories and strategies, and the practitioner's world views.
 
  4. Embedding mental health and home care in primary care Building competency in first-line insomnia care: An interprofessional approach

In Canada, there is a major access issue for cognitive behavioural therapy for insomnia (CBT-I) – the first-line treatment for chronic insomnia. Although CBT-I is superior to sedative-hypnotics in terms of efficacy, safety and durability, medications remain a default intervention for insomnia complaints despite their limitations. One reason for the discrepancy between insomnia treatment recommendations and practice is that health professionals often lack working knowledge of CBT-I. Our team sought to directly educate health professionals to build competence in first-line insomnia care.     Over the past four years, our interdisciplinary group (representing family medicine, social work, psychology, pharmacy, and psychiatry) has collaborated on numerous knowledge translation efforts aimed at bolstering first-line insomnia treatment capacity among healthcare providers.  Our collective goal is to make CBT-I practicable and the go-to treatment for chronic insomnia in primary care. We have developed an on-demand, online CFPC-credentialed insomnia training program. Our approach uses the framework of a stepped care model and takes a team approach to CBT-I use and sedative-hypnotic deprescribing in primary care. This model can be easily applied to many settings, and family health teams are particularly well-suited for providing interdisciplinary care for insomnia.  
  4. Embedding mental health and home care in primary care Ontario Structured Psychotherapy Program in Brampton, Halton and Mississauga: Lowering barriers to evidence-based mental health care
 		 The Ontario Structured Psychotherapy (OSP) Program is an initiative funded by the government of Ontario to provide access to free, short-term, cognitive-behavioural therapy to people in the community experiencing depression, anxiety, or anxiety-related concerns. OSP is offered through multiple OSP networks across Ontario. Each network comprises one Network Lead Organization (NLO) and multiple Service Delivery Sites (SDS). The NLO for Brampton, Halton, Mississauga is CarePoint Health,  the only NLO in the province that is a primary care organization This presentation will first provide an overview of the OSP Program, and then describe the characteristics and outcomes of one NLO – the OSP-Brampton-Halton-Mississauga Region (OSP-BHM) managed by CarePoint Health, a primary care organization and in partnership with Waypoint Centre for Mental Health Care, CMHA Halton, CMHA Halton, CMHA Peel Dufferin, Punjabi Community Health Services and Queen Square Family Health Team. The presentation will highlight the network’s approach to decreasing barriers to OSP services in the region including introducing self-referral options, partnering with local centralized access programs, removing the need for primary care attachment, offering in-person and virtual options, and establishing partnerships with mental health and social service providers. The presentation will also highlight how launching OSP from a primary care setting brought a primary care lens to engagement and communication activities. For example, receiving input from primary care physicians in communication products, leveraging local primary care networks and already established relationships to ensure key stakeholder perspectives are incorporated. 
 

Virtual Posters

Poster # Theme Title Summary
  1. Using a population-based approach to provide care to the community Patient Experience Survey Co-Design to Drive Participation, Engagement and Quality Improvement Patient experience measures and use of patient feedback are well established pillars to achieving quality healthcare. Despite this understanding, patient experience indicators, data collection processes and utilization continue to be suboptimal. The goal of the quality improvement project detailed below aimed to enhance patient experience data quality through collaboration with patients and providers. Quality improvement frameworks including Knowledge-to-Action and the Model for Improvement were employed to perform gap analysis, change idea generation and Plan-Do-Study Act cycles. Significant increases in patient experience survey completion (30%), participation (n providers = 120), patient responses (n=17,150) and utilization were achieved. Learnings gained and strategies used offer important insights for other primary care organizations embarking on patient engagement work.
 
  4. Embedding mental health and home care in primary care The Right Information When You Need It: Knowledge Translation and The Canadian Coalition For Seniors’ Mental Health The Canadian Coalition For Seniors’ Mental Health is currently completing a large scale knowledge mobilization project funded by the Public Health Agency of Canada. This involves the dissemination of practice guidelines to clinicians, and public health education to older adults and their caregivers. Using print, video, social media, and web resources they are disseminating best practices for the prevention and treatment of depression, anxiety, dementia, substance use, and social isolation in older adults. They are also raising public awareness of older adult mental health. As part of the project, CCSMH is demonstrating the value of multimedia approaches to public education and clinical knowledge dissemination. The work of CCSMH has direct value for primary care by providing best practices, patient information materials, and encouraging prevention activities in the older adult population. They are providing primary care practices with useful, accessible and evidence-based materials to share with patients and help guide their practice.  The work will demonstrate the value of implementing a coordinate knowledge mobilization strategy for growing clinical awareness of best practices in primary care and increasing patient health knowledge.  

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