North York Family Health Team Virtual Care Framework

Virtual care is growing rapidly across the country, as more primary care providers use technology to deliver healthcare. Healthcare Excellence Canada (HEC) launched an initiative to help care providers and patients work together to ensure virtual care is provided in an appropriate, safe and equitable way.

About this Promising Practice

• Program: Partnering on Appropriate Virtual Care

• Location: North York, Ontario

North York Family Health

The primary goal was to better meet patient needs and provide safe and effective care by increasing the percentage of interprofessional healthcare provider (IHP) visits that met patient preferences by 10 percent.

For more information:

Neil Shah
CEO & Executive Director
North York Family Health Team
nshah@nyfht.com

The North York Family Health Team utilized Ontario Health’s framework for clinically appropriate virtual care to improve patient satisfaction and provider efficacy in delivering safe and effective care for a broad spectrum of stakeholders, including clinicians, non-clinical staff and patients. The framework was adapted for virtual home care visits, focusing on incorporating the patient voice and addressing equity barriers in the community.

Objective and purpose of the promising practice

The primary goal was to better meet patient needs and provide safe and effective care by increasing the percentage of interprofessional healthcare provider (IHP) visits that met patient preferences by 10 percent. Patient satisfaction was measured through ongoing surveys.

The implementation of a virtual care framework dually aimed to improve patient satisfaction and provider efficacy in delivering safe and effective care.

Approach

Engagement

The North York Family Health Team collaborated and consulted with the Patient and Family Advisory Committee (7 members) to design and implement the new virtual care framework. This engagement provided a deeper understanding of patient needs and preferences. For example, they discovered patients were eager to participate in surveys and appreciated the option to select a modality of care. Early and frequent provider engagement facilitated co-design and uptake of the virtual care framework.

Outcomes

Key measures demonstrated significant improvements:

• A reduction of 115 patients seen1 that otherwise would have gone to the emergency department, over the 10-month duration of the project visits.

• 90 percent of patients who responded to a survey following a virtual visit agreed that the care they received was in their preferred format (n=53).

• Although not initially prioritized, the initiative fostered a culture of quality improvement around virtual care within the allied health team.

Impacts and learnings

Key takeaways

• Incremental changes through PDSA (Plan-Do-Study-Act) cycles helped address assumptions and misunderstandings among clinical and non-clinical staff.

• Engagement with patients, clients, families and caregivers revealed preferences, many seniors expressed a preference for in-person or phone visits over video visits; eagerness to provide feedback; and appreciation for flexible care modalities.

• Facilitators

• Guidance from teams with similar experiences was invaluable.'

• Dedicated coaches provided essential support and expertise.

• The most significant contributor was the inclusion of the patient voice in the pathway.

Barriers

• Competing organizational priorities frequently impacted progress.

• Navigating the learning curve around the importance of virtual visits compared to other care modalities.

By leveraging Ontario Health’s framework and prioritizing patient engagement, the North York Family Health Team successfully enhanced virtual home care delivery, improving engagement with patients, staff and patient satisfaction and an emergency department diversions.