Ontario’s doctors lead you to better health

Newborn screening by pediatricians happens in hospitals shortly after birth to identify conditions that could affect a baby's long-term health. The surge of COVID and other viruses put immense strain on performing these vital assessments. How being centered on care ignited new collaborations that increased capacity and access. 

At our hospital, we typically see up to 20 births per day, and all of these newborns require assessment. Hey there, thanks so much. Our pediatricians were facing an immense challenge; they had to balance the needs of seeing the acute patients in the hospital as well as doing those newborn assessments. Collaboration was key and the foundation for how we innovated. By bringing together the nurses, hospital family physicians, and pediatricians, we were able to implement faster. 

In just four weeks, educational sessions were run for the family doctors by the pediatricians to allow them to learn how to perform the newborn assessments. Family physicians and pediatricians co-designed new integrated workflows. This method involves a shift-based approach where the family doctors were able to provide coverage for a longer period of time throughout the day while also being able to maintain their practices, increasing capacity to care for the whole community. 

There were numerous positive outcomes both for patients and physicians, as well as benefits we didn't expect immediately. Pediatricians were freed up to focus on more pressing cases as family doctors took on the assessments. Newborns got their assessments in a more timely manner, helping to get babies home faster. By getting family doctors involved in the newborn assessments, we helped families meet and connect with a family doctor. This was an unexpected but important benefit of the program because it offered families without family doctors a way to get one, and family physicians became more engaged in the hospital environment, creating a greater sense of community and connection. 

Our award-winning collaborative approach can be replicated in other hospital settings. The program has been so successful that it is now permanent at Credit Valley Hospital. Moving forward, we're looking at ways that we can leverage the expertise of family physicians to better support and streamline patient care and improve that connection between family doctors and the hospital. 

Dr. Damji and his colleagues at Trillium Health Partners boosted screening capacity, getting babies home sooner while helping some of these families find a family doctor. The future of healthcare is looking more promising because of their collaborative approach. Sign up to show your support for the work of Ontario's doctors. 

What do these people have in common? On the surface, nothing. But actually, they all have some kind of eating disorder. How being centered on care helped ignite a change in the way people think about their bodies. 

Over two million Canadians are experiencing an eating disorder at any given time. They're serious, complex, brain-based illnesses, and they've got really high mortality rates. One of the biggest problems is that the treatment for eating disorders is primarily hospital-based, but that's not what most people need. They need community-based care—care when they need it, at the time that they need it. 

My daughter Sonia struggled with a terrible eating disorder that lasted for eight years. It was a terrifying experience. Getting help for her was so difficult—long waiting lists. Fortunately, over time, she slowly began to get better. Then one day, she phoned me and said, "Mom, I think you should quit your job, I'm going to quit mine, and we're going to start a community organization to support people with eating disorders." Our vision was to provide community-based support for people surviving with eating disorders. So that's how Body Brave began. 

When the COVID pandemic hit, Body Brave was faced with a major challenge. The numbers of people reaching out to us more than doubled. We switched to virtual services within a week. We also harnessed the power of technology to develop what we call a recovery support program hosted on the CareTeam app. The recovery support program is a suite of self-help services that allows someone, within 24 or 48 hours of reaching out to Body Brave, to access a self-assessment questionnaire. We hope that this will really help to reduce wait times and avoid people ending up on the wrong level of services. 

Team-based care is super important. We have a social worker who's our clinical director, an occupational therapist who leads our team of psychotherapists, two dietitians, and physicians. Without the whole team, we couldn't possibly address a condition as complex as eating disorders. 

Body Brave has grown so much. It's incredible. Adding the recovery support program after COVID, I think that was really key. Yeah, and we do have about 4,000 people using that program now. It's an exciting journey. 

Dr. Arya Sharma, Sonia Kumar, and the Body Brave team have made a profound difference to the lives of thousands of people living with eating disorders. The future of healthcare is looking more promising because of them. 

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The 2SLGBTQ+ community has its own unique health-care and mental-health challenges. There’s a clinic in Toronto that’s innovating like nowhere else in the world to make it easier to access the care they need. Here is how being centred on care prioritized the well-being of the 2SLGBTQ+ community. 

There’s a lot of challenges that people in the 2SLGBTQ+ community face when trying to access care. First of all, you want to access culturally competent care—practitioners who understand you and where you’re coming from. When we talk about sexual health testing, there’s delays in terms of getting those results. It can take a week to two weeks for results to come back, and that can lead to a lot of stress and a lot of anxiety when people wait for results, wonder if they’re going to get the results, and when it’s going to happen. 

Here at HQ, we’ve really tried to change that to provide those results very quickly—within a business day of people getting their test. That’s really revolutionary for Canada and really the world in terms of the speed of access to care that these individuals can get. 

Let’s take a look at how we do that here. When someone’s actually been to HQ before, they’re able to swipe their health card. The kiosk itself is available in 15 different languages. The system’s going to ask them some simple questions around their health today—if they need to see a practitioner. If not, if they just want testing, then labels will print out for their specimens. They can go and collect them in one of our self-collection rooms. 

All of our testing is done here on site. After someone’s collected their samples and dropped them at the lab, we’re able to process their HIV test, syphilis testing, chlamydia, and gonorrhea, with results available the next business day for individuals. 

Once someone has gotten their labels printed out from the kiosk, they can come into one of our Express Testing self-collection rooms to do their test. People can grab their swabs and then watch one of our videos that actually explains how to do, for instance, a throat swab or how to do an oral swab. Once someone’s collected their specimens, then they’ll come and drop them off through a drop box. It’ll go into the laboratory, then they’ll go back into the waiting room, and our phlebotomist will call them to do their blood tests. At that point, the clinical team will actually review the test results, and then we’ll send a text out to the patient either saying they need to come back to clinic to talk to the clinical team, or, "Your test results are in, there’s no need to return to clinic, all of your tests are negative." 

We knew that the sexual health services could be innovative, and we also knew there was a huge need for mental health services within our community. The higher rates of suicide, the more common problems with mental health and substance use meant that we needed to put these services in the same space so we could innovate, and to have group rooms so that we can implement a stepped-care program. This way, we could match the intensity of services to the intensity of problems people are presenting. 

The social and recreational activities can now be integrated to the same space, and so we can have yoga nights here. There’s a gay men’s coffee night, and we’ve built the space so that there’s high ventilation so that there can be ceremony for Indigenous community to smudge in the rooms that we have available. 

Dr. Guimond and Dr. Woodward are providing groundbreaking care to the 2SLGBTQ+ community. 

People living with cognitive brain impairment like dementia must cope with this debilitating disease without any kind of curative treatment. How being centred on care reimagined ways to connect with and treat people living with dementia. 

Dementia is one of the biggest healthcare challenges of our time. Currently, there are approximately 600,000 people living with dementia in Canada, and that number is expected to grow to one million by 2030. People living with dementia are at higher risk for developing worsening confusion when they come to hospital. This can lead to more cognitive decline that can heighten their levels of confusion and bring on consequent aggressive behaviours, slowing their recovery. Patients risk delaying discharge or requiring alternate levels of care. 

Our team in the Acute Care for the Elderly Unit are using the innovative Butterfly Approach to care for these patients, making us the first in the world to do this in an acute care setting. With the progression of dementia, patients lose their ability to understand facts and logic. However, their emotional brain or feeling brain is not affected until much later on in the disease. The Butterfly Approach leverages this area to engage with patients through their feelings. We know that people who have dementia interpret colour five times lighter than an average person. The vivid colours do help in the context of orientating these patients. The atmosphere in the unit is designed in such a manner that it's a non-sterile hospital environment, but much more of a home-like atmosphere that diffuses people's anxieties. 

Knowing the patient's background before they had dementia helps to understand the whole person and their lived experiences. This gives staff insight to behaviours that may seem out of the ordinary. The unit is full of colourful activities that engage patients from a cognitive and sensory perspective. This includes interactive stations, games, puzzles, and books. 

Our clinical learnings show positive signs in the management of these individuals in an acute care hospital setting. We found that there was a lesser utilization of antipsychotics, a lower incidence of falls, and a reduction in behaviours driven by anxiety. We continue to gather data to inform and validate how we evolve our approach. We hope to change the mandate of how individuals with cognitive health issues are cared for around the world. 

Dr. Saha and the team on the Acute Care for the Elderly Unit at Brampton Civic Hospital are revolutionizing dementia care, providing patients a better quality of life and a renewed connection with their families. The future of healthcare is looking more promising because of their innovative and compassionate approach. Sign up to show your support for the work of Ontario's doctors. 

Northern Ontario's vast region and growing population is short hundreds of doctors, putting people at risk and forcing them to drive great distances to get care. How being centred on care inspired a new wave of doctors. 

Northern Ontario is in a crisis like the rest of Canada. We have a severe shortage of family physicians. There is a magnification of all the problems in health-care accessibility in Northern Ontario, four to five times more than the rest of the country—mental health, women's health, children's health, surgical and cancer issues. 

We're addressing these problems as Canada's first independent medical university. Our mission is to solve the physician workforce issues in Northern Ontario to make sure that everybody in Northern Ontario has a family physician. At NOSM University, we recruit students from Northern and rural Ontario. Ninety per cent of our students come from those communities, and when they train in those communities and experience the cultural diversity, they will stay and return to those communities. 

Every medical student is immersed in a four-week experience in an Indigenous community. Through that, they learn the customs, practices and the realities of being Indigenous. Our students graduate with the competence of cultural understanding of the diversity of Canada. Our partnerships with communities are valued and highly appreciated by them. 

When our students enter the third year, that's clerkship, and they spend the majority of their time in small, mid-sized communities like Kenora, Sioux Lookout, Temiskaming Shores and Timmins, they spend time immersed in family medicine, Indigenous and Francophone health. That equips them to take care in a unique way for communities that are in need. 

NOSM University has had an immeasurable impact because of the innovation that we're leading in medical education. We estimate that 400,000 people have access to health care and family medicine as a result of what we're doing. A majority of our students stay in Northern Ontario because of our community-engaged learning model. A vast majority of our students choose family medicine as a career. We're incredibly proud of what we do because of our innovation, our community-based learning and our impact. 

NOSM University's approach is a proven model for tomorrow. They are successfully bringing more doctors to these remote communities with the desire to be there and make a difference, providing important access to health care. The future of health care is looking more promising because of their innovative, community-centric approach. Sign up to show your support for the work of Ontario's doctors.