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TRANSCRIPT
Stakeholder Meeting Chronic Disease Management
September 30, 2015
ADVANCED LEARNING | ADVANCED PRACTICE | ADVANCED CARE
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TABLE OF CONTENTS
AGENDA ......................................................................................................................................... 3
OPPORTUNITIES FOR PARTNERSHIPS, GROWTH, AND IMPACT ................................................ 4
About ACPAC ....................................................................................................................................... 4
Impact, Scope, and Value of ACPAC .............................................................................................. 5
2015 and Beyond .................................................................................................................................. 5
Partnership with CPD ............................................................................................................................ 5
New Activities ........................................................................................................................................ 6
Opportunities for Partners and Champions ...................................................................................... 6
PROGRAM IMPACT AND ACADEMIC SUCCESS ....................................................................... 7
NATIONAL SCOPE ......................................................................................................................... 9
THE PROGRAM ............................................................................................................................10
Learning Objectives ........................................................................................................................... 10
A NEW MODEL OF CARE: CHRONIC DISEASES MANAGEMENT ...........................................11
Chronic Diseases Management: An Integrated Solution ............................................................. 12
UPCOMING EVENTS ....................................................................................................................13
PARTNERS AND FUNDERS ...........................................................................................................14
SELECTED PUBLICATIONS ............................................................................................................15
SELECTED PRESENTATIONS .........................................................................................................15
SELECTED AWARDS .....................................................................................................................16
RESEARCH PAPER OVERVIEW ....................................................................................................17
The patient perspective: Arthritis care provided by Advanced Clinician Practitioner in Arthritis
Care program-trained clinicians ...................................................................................................... 17
Don’t let up: implementing and sustaining change in a new post-licensure education model
for developing extended role practitioners involved in arthritis care ......................................... 18
NOTES............................................................................................................................................19
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AGENDA Wednesday September 30, 2015
7:30am – 10:00am
07:30am—
08:00am Registration, Open Networking, and Refreshments
08:00am—
08:05am
Welcome, Introductions, and Goals for the Meeting
Suzan Schneeweiss MD, MEd, FRCPC Academic Director, Continuing Professional Development
Director of Education and Staff Emergency Paediatrician
Division of Paediatric Emergency Medicine
The Hospital for Sick Children
Associate Professor, Department of Paediatrics
Faculty of Medicine, University of Toronto
08:05am—
08:30am
The ACPAC Education Model for Chronic Diseases Management
Katie Lundon BSc (P.T), MSc, PhD ACPAC Program Director
Faculty of Medicine, University of Toronto
ACPAC Therapist Presentation: Innovation in Patient-Centric Care
Sue MacQueen BSc (P.T) Advanced Clinician Practitioner in Arthritis Care, The Arthritis Society
Building Capacity in Arthritis Care and Chronic Disease Management
Rachel Shupak MD, FRCPC ACPAC Program Medical Director
Clinician-Educator, Associate Professor
Division of Rheumatology, Department of Medicine
St. Michael’s Hospital
Faculty of Medicine, University of Toronto
08:30am—
08:45am
Community Champions
All hands in the middle: The necessity of an inter-disciplinary approach to service
provision for Children's Mental Health
Kimberly Moran President & CEO, Children's Mental Health Ontario
08:45am—
08:50am
Become a Champion: Invitation to Support ACPAC and CDM
Peter Azmi MSc, PhD Business Development, Innovations + Education Office
Faculty of Medicine, University of Toronto
08:55am—
On
Closing Remarks; Open Q&A; Networking
Trevor Cuddy BCom, BA, MEd Director, Continuing Professional Development
Faculty of Medicine, University of Toronto
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OPPORTUNITIES FOR PARTNERSHIPS, GROWTH, AND IMPACT
About ACPAC
The Advanced Clinician Practitioner in Arthritis Care (ACPAC) program is a unique
post-licensure academic and clinical educational program that prepares
experienced physical therapists, occupational therapists and nurses for extended
practice roles using advanced knowledge and skills training in the diagnosis and
management of patients with arthritis.
More about ACPAC: http://acpacprogram.ca
ACPAC serves the interests of many stakeholders within the arthritis care and chronic
disease care communities and beyond:
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Impact, Scope, and Value of ACPAC
1. The ACPAC Program facilitates the development of new models of care by expanding the
role of existing human health-resources in chronic disease management care.
2. In keeping with Ontario’s Action Plan for Health Care 2012 and the Government of
Canada Advisory Panel on Healthcare Innovation Report 2015, ACPAC graduates (n=54)
have successfully provided:
Improved access to and quality of arthritis care
Strengthened healthcare capacity
Responsiveness to demographic challenges
2015 and Beyond
Over the last 10 years, ACPAC has proven to be an extremely successful post-licensure training
model1. Since 2013, ACPAC has established an administrative model that will ensure ongoing
support for the Program, and will better allow for investment and new growth opportunities.
The success of ACPAC has led to an increase in demand for ACPAC-trained professionals,
while simultaneously developing complementary training programs based on the ACPAC
model.
To sustainably address these needs, the Program has partnered with the University of Toronto’s
Department of Continuing Professional Development (CPD), where ACPAC can leverage
existing infrastructure, staff and business resources required to grow and support the Program
into the future.
Partnership with CPD
The Office of Continuing Professional Development (CPD), University of Toronto offers ACPAC
several key operational advantages, which include:
The ability to offer ACPAC as an advanced certificate program accredited by CPD,
University of Toronto
Access to a dedicated academic business development and knowledge translation
team (see innovatingedu.ca)
Communications and information technology resources, including development of the
new website, http://acpacprogram.ca
Project management and event coordination services (see cpd.utoronto.ca)
Legal and copyright services
1. Lundon, K., Shupak, R., Schneider, R., and McIlroy, J. 2011. Development and Early Evaluation of an Interprofessional Post-Licensure Education
Program for Extended Practice Roles in Arthritis Care. Physiotherapy Canada 63(1):94-103.
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New Activities
ACPAC trainees have been shown to significantly improve patient health outcomes, while
improving the rate at which patients are managed in the healthcare system2. Over the next
several years, ACPAC’s objectives are to:
Increase the number of learners we train in the ACPAC Program per year
Improve access to the ACPAC Program across Canada
Expand strategic partnerships with key stakeholders and address emerging needs
Enhance the impact of ACPAC workshop events and community outreach initiatives
Improve network connectivity among current and past ACPAC graduates
Opportunities for Partners and Champions
ACPAC is actively seeking partners to
support the Program’s action plan.
2. Passalent, L., Kennedy, C., Lundon, K., Rozmovits, L., Sinclair, L., Soever, L., Schneider, R., Brooks, S., Warmington, K., Shupak, R. 2013 System
integration and clinical utilization of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) program-trained extended role practitioners in
Ontario: a 2-year system-level evaluation. Healthcare Policy 8(4):56-70.
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PROGRAM IMPACT AND ACADEMIC SUCCESS
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NATIONAL SCOPE
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THE PROGRAM
The ACPAC (Advanced Clinician Practitioner in Arthritis Care) Program is an innovative,
interprofessional academic and clinical-education training program in advanced
musculoskeletal/arthritis care currently offered to experienced physical therapists,
occupational therapists, and nurses. The program is hosted by St. Michael’s Hospital, in
collaboration with The Hospital for Sick Children. It is a certificate-based program offered at
the post-licensure level in association with CPD, University of Toronto.
The ACPAC Program was developed in response to the well-recognized need for an
interprofessional, patient-centred collaborative approach to better manage patients
presenting with osteoarthritis (OA) as well as in the early detection of rheumatoid arthritis (RA)
by improving access to (shortened wait times) and efficiency of care.
The ACPAC Program provides the mechanism for training extended role practitioners to
assume vital roles of triage, education and in select cases, management of patients with
osteoarthritis and inflammatory arthritis.
Learning Objectives
1. Participants will learn the basic and clinical science underlying arthritis/musculoskeletal
disorders.
2. Participants will learn to identify, assess and provide differential diagnosis between
inflammatory and degenerative arthritic disorders.
3. Participants will learn an approach to interpretation of plain musculoskeletal radiographs.
4. In relation to the above, the participants will learn skills of triage for arthritic disorders.
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A NEW MODEL OF CARE:
CHRONIC DISEASES MANAGEMENT
In the current health care paradigm, patients needing to seek appropriate care are
faced with several challenges, all of which limit appropriate access to care for the
patient.
These challenges arise from several distinct issues:
1. Difficulties in managing complex, chronic diseases, including:
1. Inadequate triage at the point of primary care
2. Inadequate management post specialist intervention leading to
suboptimal treatment outcomes
2. Access to specialists is diminished through:
1. A dearth of specialists in comparison to the demand for services
2. Specialists consulting on a large number of inappropriate referrals
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Chronic Diseases Management: An Integrated Solution
Chronic Diseases Management (CDM) focuses on developing the skills of the allied
health professional, which in-turn can help develop innovative models of care.
For more information: http://chronicdiseases.ca/ipe/
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ACPAC
UPCOMING EVENTS
Contact Us for Partnership Opportunities
Visit acpacprogram.ca or email [email protected]
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ACPAC
PARTNERS AND FUNDERS
In 2014-2015, the ACPAC Program has been generously supported by tuition fees, The
Ontario Ministry of Health, St. Michael’s Hospital Foundation, The Arthritis Society
(Ontario), and Industry.
The ACPAC Program is endorsed by the Arthritis Alliance, the Canadian Rheumatology
Association, and the Arthritis Health Professionals Association.
Thank you!
ACPAC Program trainees and graduates; academic and clinical faculty.
The Ministry of Health and Long-Term Care (Health Force Ontario), Ontario, Canada.
St. Michael’s Hospital Foundation, Toronto, Canada.
The Arthritis Society.
Arthritis Health Professions Association (AHPA), Canada.
Canadian Rheumatology Association (CRA) and Ontario Rheumatology Association
(ORA).
Canadian Initiative for Outcomes in Rheumatology Care (CIORA).
Industry Supporters: AbbVie, Amgen, Janssen, Pfizer, Roche, UCB, Wyeth.
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ACPAC
SELECTED PUBLICATIONS Lundon, K., Shupak, R., Canzian, S., Ziesmann, E. Schneider, R. (2015). Don’t
Let Up: Implementing and Sustaining Change in a New Post-Licensure
Education Model for Developing Extended Role Practitioners involved in
Arthritis Care. Journal of Multidisciplinary Healthcare. Journal of
Multidisciplinary Healthcare 2015(8):389–395
Warmington, K., Kennedy, C., Lundon, K., Soever, L., Brooks, S., Passalent, L.,
Shupak, R., Schneider, R.. (2015). The Patient Perspective: Arthritis care
provided by Advanced Clinician Practitioner in Arthritis Care (ACPAC)
Program trained clinicians. Open Access Rheumatology: Research and
Reviews 2015(7):45–53
Passalent, L., Kennedy, C., Lundon, K., Rozmovits, L., Sinclair, L., Soever, L.,
Schneider, R., Brooks, S., Warmington, K., Shupak, R. (2013). System
integration and clinical utilization of the Advanced Clinician Practitioner in
Arthritis Care (ACPAC) program-trained extended role practitioners in
Ontario: a 2-year system-level evaluation. Healthcare Policy 8(4):56-70.
Lundon, K., Kennedy, C., Rozmovits, L., Sinclair, L., Soever, L., Schneider, R.,
Brooks, S., Passalent, L., Warmington, K., Shupak, R. (2013). Evaluation of
Perceived Collaborative Behaviour Amongst Stakeholders and Clinicians of
a Continuing Education Programme in Arthritis Care. Journal of
Interprofessional Care 27(5): 401-407.
Lineker, S., Lundon, K., Shupak, R., Schneider, R., MacKay, C, and
Varatharasan, N. (2011). Arthritis Extended-Role Practitioners: Impact on
Community Practice (An Exploratory Study). Physiotherapy Canada
63(4):434-442.
ACPAC
SELECTED PRESENTATIONS Lundon, K., and Soever, L. Leadership and Innovation in Post-Licensure
Education: The ACPAC Program Model. Podium. Canadian Physiotherapy
Association, National Congress, Halifax. June 18-20, 2015.
Lundon, K. The ACPAC Program: Ahead of its Time or Just in Time? Podium,
Guest Speaker, Canadian Rheumatology Association Annual Scientific
Meeting- Whistler, BC. February 26-29, 2014.
Lundon, K. The Advanced Clinician Practitioner in Arthritis Care (ACPAC)
Programtrained Extended Role Practitioner: Can They Fill the Gap in Post-
Licensure Education and Practice in Arthritis Care? Irish Society of Chartered
Physiotherapists Annual Conference “Innovation: Ideas into Action” -Dublin,
Ireland. KEYNOTE SPEAKER, November 16-17, 2012.
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Warmington K, Passalent L, Kennedy C, Soever L., Brooks S, Lundon K,
Shupak R, Schneider R. The Impact of Advanced Clinician Practitioner in
Arthritis Care (ACPAC) program-trained extended role practitioners on
healthcare delivery: A two year prospective study. Poster presentation:
Annual European Congress of Rheumatology - EULAR, Berlin, Germany. June
6-9, 2012.
Lundon K, Kennedy CA, Soever L. The ACPAC (Advanced Clinician
Practitioner in Arthritis Care) Program Trained Extended Role Practitioner
(ERP): Can They Fill the Gap in Post licensure Education and Practice in
Arthritis Care? Podium presentation: Canadian Physiotherapy Association
Congress, Saskatoon, SK. May 24-27, 2012.
ACPAC
SELECTED AWARDS 2015 Canadian Physiotherapy Association (CPA) Honorary Membership
Award (Katie Lundon)
2015 Arthritis Health Professions Association (AHPA) Clinical Innovation
Award
2012 Queen Elizabeth II Diamond Jubilee Medal (Rachel Shupak)
2009 Ministry of Health Ontario Innovation in Human Health Resources
Award
2008 Ted Freedman Ontario Hospital Association Award: Certificate of
Excellence at HealthAchieve2008 for innovation, effective use of
technology and ability to positively impact change using education
2007 Colin Woolf Award: Excellence in Course Design and
Coordination from Continuing Professional Development, Faculty of
Medicine, University of Toronto (Rachel Shupak)
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ACPAC
RESEARCH PAPER OVERVIEW
The patient perspective: Arthritis care provided by Advanced Clinician
Practitioner in Arthritis Care program-trained clinicians
Warmington K., Kennedy C.A., Lundon K., Soever L.J., Brooks S.C., Passalent L.A., Shupak R.,
Schneider R. (2015). Open Access Rheumatology: Research and Reviews 2015(7):45–53
Abstract
Objective: To assess patient satisfaction with the arthritis care services provided by graduates
of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) program.
Materials and methods: This was a cross-sectional evaluation using a self-report questionnaire
for data collection. Participants completed the Patient–Doctor Interaction Scale, modified to
capture patient–practitioner interactions. Participants completed selected items from the
Group Health Association of America’s Consumer Satisfaction Survey, and items capturing
quality of care, appropriateness of wait times, and a comparison of extended-role practitioner
(ERP) services with previously received arthritis care.
Results: A total of 325 patients seen by 27 ERPs from 15 institutions completed the
questionnaire. Respondents were primarily adults (85%), female (72%), and living in urban
areas (79%). The mean age of participants was 54 years (range 3–92 years), and 51% were not
working. Patients with inflammatory (51%) and noninflammatory conditions (31%) were
represented. Mean (standard deviation) Patient–Practitioner Interaction Scale subscale scores
ranged from 4.50 (0.60) to 4.63 (0.48) (1 to 5 [greater satisfaction]). Overall satisfaction with the
quality of care was high (4.39 [0.77]), as was satisfaction with wait times (referral to
appointment, 4.27 [0.86]; in clinic, 4.24 [0.91]). Ninety-eight percent of respondents felt the
arthritis care they received was comparable to or better than that previously received from
other health care professionals.
Conclusion: Patients were very satisfied with and amenable to arthritis care provided by
graduates of the ACPAC Program. Our findings provide early support for the deployment and
integration of ACPAC ERPs into the Ontario health care system and should inform future
evaluation at the patient level.
To read the paper visit: http://acpacprogram.ca/wp-content/uploads/2015/01/The-patient-
perspective-Publication.pdf
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ACPAC
RESEARCH PAPER OVERVIEW
Don’t let up: implementing and sustaining change in a new post-licensure
education model for developing extended role practitioners involved in
arthritis care
Lundon K., Shupak R., Canzian S., Ziesmann E., Schneider R. (2015). Journal of Multidisciplinary
Healthcare 2015(8):389–395
Abstract
Key message: Across a 9-year period, the Advanced Clinician Practitioner in Arthritis Care
program has achieved a set of short-term “wins” giving direction and momentum to the
development of new roles for health care practitioners providing arthritis care.
Implications: This is a viable model for post-licensure training offered to multiple allied health
professionals to support the development of competent extended role practitioners
(extended scope practice). Challenges at this critical juncture include: retain focus, drive, and
commitment; develop academic and financial partnerships transferring short-term success to
long-term sustainability; advanced, context-driven, system-level evaluation including fiscal
outcome; health care policy adaptation to new human health resource development.
Supporting evidence: Success includes: completed 2-year health services research evaluating
37 graduates; leadership, innovation, educational excellence, and human health resource
benefit awards; influential publications/presentations addressing post-licensure education/
outcome, interprofessional collaboration, and improved patient care.
To read the paper visit: http://acpacprogram.ca/wp-content/uploads/2015/01/Dont-let-up-
Publication-.pdf
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NOTES
© 2015 University of Toronto ACPAC Program
For more information [email protected] http://acpacprogram.ca