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| HEAD'S MESSAGE Our vision in Family Medicine at Queen’s is to be a Department acknowledged for its excellencein primary care delivery, education and research. The five-year strategic plan developed in 2008 has drawn to a close, and we collectively feel a sense of accomplishment in achieving our articulated mission. On the surface, it would appear that we have “arrived.” We feel particular pride in our education programs, which are under the leadership of Dr. Karen Schultz as Postgraduate Education Director, Dr. Geoff Hodgetts as Director of Education and Enhanced Skills, and Dr. Michael Sylvester as Undergraduate Program Director. Each of our postgraduate programs received full accreditation by the College of Family Physicians of Canada in January 2012. We were also very proud to receive the 2012 Professional Association of Internes and Residents of Ontario (PAIRO) Residency Program Excellence Award, which recognizes the Queen’s Family Medicine program for its positive and rewarding experiences for residents, while producing expertly trained physicians.
Having accomplished our goals from the last strategic plan and with the firm foundation of our recent accreditation, we begin a new chapter. Our vision of excellence commits us to responding effectively to the needs of our patients, communities and learners. As Family Physicians working closely with our communities, we remain sensitive to the fast-changing and complex communities in which our patients live their lives. Austerity, budget cuts and anxiety are pervasive. The increasing prevalence of obesity and mental health issues, the challenges of effectively managing multiple co-morbidities in an aging population, the marginalization of some individuals and groups, and the intense stresses faced by younger generations create the context for much of our work as Family Physicians. And as Family Physicians, we are only too aware of our challenges in addressing these common realities.
So, perhaps we haven’t really “arrived.” Collectively, we must keep moving with society to address those who are sick or disadvantaged, and help as many people as possible to move forward on their path of wellness. Over and above our traditional roles, it is increasingly clear that we need new tools such as leadership and collaborative care skills, and the ability to work across sectors in society to coordinate effective approaches to the determinants of our patients’ health.
The Department of Family Medicine at Queen’s is in the community and responding to its needs. For example, the leadership of Dr. Ian Casson in raising the bar for the care of people with Developmental Disabilities. It is Family Doctors such as Dr. Casson who remain aware of patients who otherwise might be neglected in the system. Not only is excellent care modelled, but new and innovative ways of teaching about the needs of this population are being introduced into both undergraduate and postgraduate programs.
As always in our discipline, we will move forward – striving for the best possible way to address societal needs. Our Department has some of the keys to accomplish this. Like many other organizations, we are learning how to work in interprofessional teams in increasingly effective ways. We know this is a process. We know there are steps to be taken and we have been deliberate in moving forward. Members of the management team, physicians, residents, nurses, nurse practitioners, social workers, our dietitian and pharmacist, IT experts, receptionists, administrative assistants and students all appreciate that they don’t work alone. The care of our patients is improving and is more comprehensive as we appreciate the skills each brings to the challenges of patient care. Collaborative approaches are improving care – and it’s not always as easy as we make it look!
We know we are making progress. We measure it. Under the leadership of Dr. Karen Hall Barber and with the support of the entire Department, we have embarked on a number of quality improvement initiatives that are described in this report. Our best progress is in areas where we have learned to work with all members of our team to attain specific goals. Group teaching sessions for patients have been initiated. With the support of Tracy Weaver, new venues forcommunication with our patients are being explored.
This is all part of recognizing the patient as a member of the team. To be an effective team member, the patient needs information. This is why we are participating in a pilot project funded by eHealth Ontario to allow patients access to certain aspects of their medical record from their home computer or smart phone. They will be able to update their family history, check the accuracy of their medication and allergy lists, and review laboratory results. They can submit data such as home blood pressure or blood sugar results. The system, known as MyOscar, will also allow patients to book their appointments online and to communicate with our health care team electronically. Being more involved in their own health care allows patients to be more directly responsible for their care, to maintain autonomy, and to be active participants in achieving their best possible health. We think this will improve outcomes for some patients. We will measure this to determine if it does improve outcomes and we will then share our findings with others.
As a Department, we are extremely pleased to have an incredible group of postgraduate trainees – our “residents.” They are the best. We are very fortunate to have trainees with us who have graduated from Queen’s medical school, other schools from across Canada, and schools from around the world. The residents set the tone – creating a scholarly environment, maintaining high standards of patient-centred care, and ensuring a collegial environment. From the orientation barbecue to the wilderness emergency care program in Temagami, academic days, resident research day, and weekly department rounds, the residents have engaged in all aspects of the program with enthusiasm. It’s been a particularly successful year, and special thanks go to our Program Chief Resident, Dr. Hannah Shoichet; our Kingston-1000 Islands Site Chief and Site Senior Residents, Dr. Crystal King and Dr. Emily Robson; our Belleville-Quinte Site Chief Residents, Dr. Stacey Hoselton and Dr. Ashley McCann; our Peterborough-Kawartha Chief Resident, Dr. Jesse Wheeler; and our Oshawa Senior Resident, Dr. Okuda Taylor.
The residents truly make our Department thrive and grow. I want to give special mention to our new residents and teachers in our satellite programs in Belleville-Quinte and Peterborough-Kawartha. As the first group of residents are about to graduate from these programs, it is clear to all that they have been successful pioneers and have already embedded postgraduate education into the medical culture of these communities. There is palpable enthusiasm, and I salute all involved for the foundations they have developed – the foundations on which these programs will continue to grow and thrive. Special thanks to Dr. Kim Curtain and the faculty at the Peterborough site and Dr. Robert Webster and the faculty at the Belleville site.
I also want to recognize the dedicated team at our third satellite site, Queen’s Bowmanville Oshawa-Lakeridge (QBOL), which is in the final stages of preparing for the arrival of its first cohort of eight residents on July 1, 2012. Under the leadership of Dr. Wei-Hsi Pang, Site Director, with input from other key faculty, I have no doubt our QBOL residents will enjoy the same positive and rewarding experiences as their colleagues at our Kingston, Belleville and Peterborough sites.
The Centre for Studies in Primary Care (CSPC) is the research arm of the Department. Under the direction of Dr. Richard Birtwhistle, the Centre is recognized as one of the research strengths in the Faculty of Health Sciences at Queen’s. The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) project is already producing interesting data on chronic diseases. This data will improve our understanding of chronic disease across the country and will inform our approaches to management.
The Centre is also doing some interesting “community-based” projects. The OASIS (Aging Well at Home) project, led by Jyoti Kotecha and Dr. Richard Birtwhistle, is a collaboration with the Frontenac Kingston Community On Aging, Victorian Order of Nurses, South East Community Care Access Centre and KFL&A Public Health to develop an innovative community care collaborative that supports aging at home and primary health care management. The Hospital @ Home program, led by Dr. Richard Birtwhistle, Jyoti Kotecha and Dr. Michael Green, has the Centre working with the Prince Edward Family Health Team to assist them with forming an innovative virtual primary care rural ward for patients at high risk for hospital admission and re-admission. And the International Mobility in Aging Study (IMIAS), funded by CIHR for six years, will examine how life-course events such as exposure to violence, connectedness to family and neighbours, income, and many other individual and community factors affect mobility among those age 65 to 74 and whether these effects are different in men and women. The Queen’s Principle Investigators for this project are Dr. Beatriz Alvarado, Dr. Angeles Garcia and Dr. Susan Phillips. There are many other research projects in the Centre that will positively influence care for our patients. The breadth and quality of research activity is growing, and the Centre for Studies in Primary Care is making an important contribution to our communities and patients.
And so the journey continues. As this report goes to press, our Department is engaged in its strategic planning exercise. The outcome is not known but it is clear from early discussions that there are many ideas, and there is lots of passion and commitment to the vision of the Department. Along with our partners in the University, the teaching hospitals, community hospitals, community agencies and doctors’ offices across eastern Ontario, the work of the Department of Family Medicine continues with conviction and determination – knowing that our work is not yet done.
Sincerely,
Glenn D. Brown
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