1200 - 1300

Registration

1300 - 1630

Knowledge (World) Café on Accelerating Primary Care

Workshop Co-Chairs:
Judith Krajnak, Senior Evaluation and Research Consultant, Charis Management Consulting Inc.
Scott Oddie, Director of Innovation and Evaluation, Primary Care Innovation and Integration, Alberta Health Services

A knowledge café (or "world café") is a workshop in which a group of people gather to openly and creatively discuss a topic of mutual interest to surface their collective knowledge, share ideas and insights, and gain a deeper understanding of the subject and the issues involved.

The workshop will provide an opportunity for participants to engage in discussions regarding key questions and issues common in many developed health care systems:

What performance measures and strategies assess success? How do we enhance role clarity and effective partnerships in a multi-stakeholder environment? What does collaborative practice look like and what impact will it have? Do incentives change outcomes?

Workshop Objectives:

• Catalyze discussions on collaborative and innovative strategies to enhance primary care
• Provide an engaging opportunity for participants to learn, network and exchange knowledge

Who will this Workshop Benefit?
All health care professionals and decision makers interested in advancing thinking around the concepts of primary care.

1830 - 1930

Conference Opening and Registration

1830 - 1930

Welcome Reception

1930 - 1935

Opening Remarks

Lee Hall, Chair, Conference Planning Committee; Program Director, Primary Care Initiative

1935 - 2035

Do it Well. Make it Fun. A Prescription for Effective Teamwork - download handout

Ron Culberson, Director of Everything, FUNsulting

Research shows that humour can reduce stress, improve creativity, increase productivity, make the work environment more enjoyable, and most importantly, balance the seriousness of life and work. If we approach everything we do as a process, then every step in that process has the potential of being more fun. When things are fun, life and work are more enjoyable. Join Ron as he helps us understand how combining excellence with humour can lead to greater levels of success than you ever imagined.

0700 - 0745

Breakfast

0800 - 0845

Opening Remarks
Fred Horne, Parliamentary Assistant to the Minister of Health and Wellness
Ken Hughes, Board Chair, Alberta Health Services
P J White, Past-President, Alberta Medical Association

THEME ONE: PROGRESS IN PRIMARY CARE REFORM IN CANADA AND BEYOND: WHERE ARE WE?

0845 - 0915

Transforming Care for Canadians with Chronic Health Conditions: Where is Canada lagging behind and where are the islands of innovation? - download handout

Louise Nasmith, Professor and Principal, College of Health Disciplines, University of British Columbia

Almost half of Canadians live with one or more chronic health conditions. In spite of investments in new models of health care delivery, Canada has fallen behind most OECD countries in achieving specific health outcomes. The Canadian Academy of Health Sciences has sponsored a panel assessment on Transforming Care for Canadians with Chronic Health Conditions: Put People First, Expect the Best, Manage for Results which reviews current innovations in Canada as well as persistent challenges and makes recommendations that target funding models, performance measurement and accountability, education, patient self-management, electronic health information and research.

0915 - 0945

UK Perspective - download handout

Stephen Campbell, Reader in Primary Care, Health Sciences Research Group Primary Care, University of Manchester, Professor of Primary Care Research/Research Director, APHCRI, ANU, Australia

Dr. Campbell will briefly describe 20 years of mostly "top down" reform/change including changes to structures (tiers of health authorities), fundholding, Primary Care Groups/Primary Care Trusts, clinical governance, new contractual arrangements for GPs, pay-for-performance and practice based commissioning. He will also discuss the current (and much contested) plans for reorganising the NHS. Is there any evidence that such structural reorganisations actually produce benefits and improve performance, quality and efficiency? What will be the intended and unintended/adverse costs and benefits of (yet another) reorganisation of the "NHS"?

0945 - 1015

Break and poster viewing

1015 - 1045

International Perspective - download handout

Grant Russell, Professor of General Practice Research, School of Primary Health Care, Monash University; Director, Southern Academic Primary Care Research Unit, Australia

Most Western nations have sought to reform primary care to control the rising costs of health care. A common reform mechanism has been the introduction of multidisciplinary teams into traditional primary care practice settings. Despite considerable financial investment and enthusiasm, the implementation of enduring reform has been challenging. This presentation will provide an overview of the current international state of primary care reform and highlight some of the challenges to enduring reform in team oriented care as revealed by a recent CIHR funded international comparative study.

1045 - 1145

Panel Discussion and Q&A

1145 - 1245

Lunch

1245 - 1300

Poster viewing

1300 - 1345

The Promise and Peril of the Medical Home Movement - download handout

John Rogers, Professor and Executive Vice Chair, Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas

The "medical home" is being promoted as a model for primary care reform that should be adopted by organizations and specialties. In assessing strategic directions for clinical practices or professional disciplines, it can be helpful to examine the internal and external factors that are instrumental in trying to achieve a stated objective. This presentation will outline the strengths, weaknesses, opportunities and threats that primary care specialties and medical practices may want to consider in determining the potential success of a medical home initiative.

1345 - 1400

Medical Home Model for Canada? Response - download handout

Cal Gutkin, Executive Director and Chief Executive Officer, College of Family Physicians of Canada, Mississauga, Ontario

The medical home concept is relatively new to Canada. This session will discuss the applicability of this concept for Canadian health care and specifically how the medical home relates to effective, successful primary health care delivery.

1400 - 1430

Break and poster viewing

THEME TWO: MEASUREMENT: HOW DO WE KNOW WHAT'S WORKING?

1430 - 1530

Measuring Effectiveness of Primary Health Care

Lee Green, Professor and Incoming Chair, University of Alberta - download handout
Bill Hogg, Professor and Director of Research, University of Ottawa - download handout
Alan Katz, Associate Professor, University of Manitoba - download handout

What gets measured is what gets managed. This session will discuss how measurement is done now to evaluate the several aspects of quality and accountability in primary care, how it should be done going forward to promote the kinds of changes desired in primary care, and what the unintended consequences of current and future measurement might be.

1530 - 1550

Discussion and Q&A

1550 - 1600

Room Change

1600 - 1700

Concurrent Sessions

Session 1

Oral Presentation of Selected Abstracts
Session Chair: Marion Relf, Consultant, MRelf Consulting

1. Re-Designing Primary Health Care in Saskatchewan: A Framework Built by Many Hands - handout not available
Sheila Achilles, Saskatchewan Ministry of Health/Saskatoon Health Region

2. Fuel the Future: RN's Working to Full Scope of Practice - download handout
Michelle Allard, Family Medical Centre, St. Boniface Hospital

3. Utilizing an Innovative Team Based Approach to Increase Access to Chronic Disease Care - download handout
Shelly Storozuk, South Calgary Primary Care Network

Session 2

Oral Presentation of Selected Abstracts
Sessino Chair: Johanna Dietrich, Communications Consultant

1. Obesity Management in Primary Care - no handout available
Sheri Fielding, Edmonton Southside Primary Care Network

2. Quantifying, Documenting and Articulating First Nations' Health Needs - download handout
Sharon Rudderham, Tui'kn Partnerhship

3. Skills, Knowledge, and Confidence in Managing One's Own Health: Can Patient Activation be compared across Ethnic and Language Groups in Primary Health Care? - download handout
Sabrina Wong, University of British Columbia

Session 3

Primary Care Teams in Action
Session Chair: Anne-Marie Stacey, Knowledge Transfer Facilitator, Primary Care Initiative

COPD Case Finding and Management - download handout
Cathy Faulds, London Family Health Team, Quality Improvement and Innovation Partnership
Adriana Pietrzak, London Family Health Team, Quality Improvement and Innovation Partnership

Session 4

Getting Practical about Practice Guidelines: Shining evidence on guidelines and performance measures - no handout available
Session Chair: Steven Lewis, Access Consulting

Mike Allan, Associate Professor, University of Alberta

In this presentation clinical practice guidelines (CPG) will be considered under both a critical and practical review. The discussion will include: the purpose of CPG and where they can help; understanding the challenges in the evidence that lead to inconsistency and concerns with recommendation, and; the practical application of CPG's and their recommendations. Our speaker will put this in context of how CPG decisions actually happen, and will examine a few examples from recent guidelines and consider directions forward.

1700

End of Sessions

1830 - 2200

Dinner at the Art Gallery of Alberta with Gallery Access

(A ticketed event - pre-registration required)

0715 - 0800

Breakfast

THEME THREE: PRACTICAL ISSUES FOR PRIMARY CARE

0815 - 0845

Compensation Models: A critical review - download handout

Isser Dubinsky, Associate Director, Hay Group Care Consulting Associate Professor, Departments of Family and Community Medicine and Health Policy, Management and Evaluation, University of Toronto

Compensation models are in a state of evolution in many constituencies. Much has been made of the positive and negative attributes of models that range from fee for service to salary, from capitation to population risk-based. Lately, the notion that pay for performance is necessary to ensure quality has been promulgated. Isser Dubinsky will present a critical review of many of the existing payment schemes and focus specifically on the presumed merits of pay for performance.

0845 - 0930

Paying Physicians for Quality: Primary Care Reform in the UK - download handout
Stephen Campbell, Reader in Primary Care, University of Manchester; Research Director, Australian Primary Health Care Research Institute, Australian National University

Stephen Campbell will give an update on the role, evidence base and impact of pay-for-performance in the UK and worldwide. He will argue in defense of pay-for-performance but only as one part of a wider systems-based quality improvement strategy that combines professional as well as financial incentives. Paying physicians is not a magic bullet to quality improvement. He will highlight the shortcomings of the indicators chosen for incentives in the Quality and Outcomes Framework (QOF), some unintended consequences that have ensued, and recommend how pay-for-performance should, and should not, be used.

0930 - 1000

Remuneration: Promoting Performance and teamwork in primary care - the US perspective - download handout

Meredith Rosenthal, Professor of Health Economics and Policy, Harvard School of Public Health

Both policy makers and private payers in the U.S. have begun to recognize that improving care coordination across the fragmented health care delivery system is essential to improve the quality and affordability of care. One set of proposals is focused on supporting "patient-centered medical homes" - enhanced primary care practices that would act as the locus of integration and coordination of care. In this presentation, Meredith Rosenthal will place the recent surge of interest in the medical home in the broader context of payment reform trends and the medical home's prospects and limitations. New empirical results on the impact of a medical home intervention in a large health system will be discussed to illustrate the potential value to payers of similar investments in primary care.

1000 - 1030

Break and poster viewing

1030 - 1100

What's the Best Way to Pay Members of the Primary Care Team in Canada? - download handout
Ruth Wilson, Professor Department of Family Medicine Queen's University; Consulting Director, Health Policy, College of Family Physicians of Canada

Drawing on experience across Canada, Ruth Wilson will describe features of remuneration models for family physicians and other members of the primary health care team. Capitation, pay for performance and salary and fee-for-service will be discussed along with practical examples of how to negotiate and implement new models of payment.

1100 - 1145

Panel Discussion and Q&A

1145 - 1245

Lunch

1245 - 1300

Poster viewing

1300 - 1400

Concurrent Sessions

Session 1

Oral Presentation of Selected Abstracts
Session Chair: Marion Relf, Consultant

1. What do you Mean by "Registry"? Creating Processes for Panel and Chronic Disease Management - download handout
Nolan Schaaf, Chinook Primary Care Network

2. Mobile Medical Outreach to High Schools in High Risk Areas of Calgary - download handout
Petra Bourqui, The Alex Community Health Centre

Session 2

Oral Presentation of Selected Abstracts
Session Chair: Johanna Dietrich, Communications Consultant

1. Alberta AIM: Improving Access, Efficiency and Clinical Care through culture, learning, collaboration and measurement - download handout
Steve Clelland, Alberta AIM

2. Trends Analysis of Family Physician to Specialist Referral Data in the Edmonton North Primary Care Network - download handout
Leanne McGeachy, Edmonton North Primary Care Network
Margaret Wanke, Charis Management Consulting, Inc

3. Primary Care Has an Impact on CTAS Level 4 & 6 Emergency Room Visits - download handout
Lisa Cook, Chinook Primary Care Network

Session 3

CIHI and CHSRF
Session Chair: Johanna Dietrich, Website Lead, Primary Care Initiative

Using Data to Advance Primary Health Care - from Practice to Policy - download handout
Patricia Sullivan-Taylor, Canadian Institute for Health Information
Brenda Tipper, Canadian Institute for Health Information

Mobilizing Change, Learning from Innovation: Accelerating Primary Healthcare Transformation in Canada - no handout available
Erin Leith, Canadian Health Services Research Foundation
Dr. Jean-Frédéric Levesque, Université de Montréal

Session 4

Innovative Projects in Primary Care
Session Chair: Steven Lewis, Access Consulting

The BETTER Project - download handout
Donna Manca, University of Alberta

This session will describe the process, evaluation and tool development that the BETTER project used with an aim to improve chronic disease prevention and screening for cancer, heart disease and diabetes.

The CUPID Project - download handout
Paul Woods, University of Calgary

As issues related to health care spending, access and effectiveness continue to challenge health systems everywhere, traditional paradigms are being replaced by the appeal of interdisciplinary team based care. This session will review the Care Utilization Plan for Improving Depression (CUPID) - a collaborative care model for depression developed at the Department of Family Medicine of the University of Calgary.

1400 - 1405

Room Change

THEME FOUR: THE FUTURE - FOCUSING ON THE RIGHT THINGS

1405 - 1415

Presentation of the Best Poster Award

1415 - 1500

Moving into the Future: A practical perspective - no handout available

Nurse Practitioner: Nicole Kinniburgh, Chinook PCN
Mental Health Coordinator: Crystal Degenhardt, Edmonton Southside PCN
Administrator: David Ludwick, Sherwood Park PCN
Physician: Gerry Prince, Palliser PCN
Patient: Jim Starko, Corporate Communications and Business Generalist

Our panelists will share their insight into the changes required to accelerate progress in the development and adoption of primary care networks by both practitioners and patients. Dialogue and Q&A with the audience will be encouraged to gather additional perspectives from other professionals on primary care teams

1500 - 1600

Making the Future Reality: Response to the practitioner panel - no handout available

Academic Perspective: Roger Palmer, Professor, Alberta School of Business, University of Alberta
National Perspective: Cathy MacLean, Past President, College of Family Physicians of Canada
Policy Perspective: Fred Horne, Parliamentary Assistant to the Minister of Health and Wellness

Our speakers will respond to the suggestions for change made by the previous panel and by the audience, engaging in what promises to be a lively discussion on the future of primary care and how to accelerate the adoption of effective policy and research practices. Where does Canada need to go? What are the concrete steps essential to getting there?

1600 - 1610

Conference Closing

Rick Spooner, Professor and Chair, Department of Family Medicine, University of Alberta