Relational Continuity CPG for Primary Care
June 18, 2019
New: June 2019
Relational continuity improves patient outcomes and satisfaction. This guideline is intended to help physicians and the teams they work with to understand the value of relational continuity and to work toward improvements in and ultimately adopt practice behaviors that result in increased relational continuity.
Practice Guide for Sickle Cell Trait Identified in Newborn Screening
April 16, 2019
New: April 16, 2019
TOP and the AHS Newborn Metabolic Screening Program have developed a practice guide to assist health care providers when a newborn in their care is identified as an SCT carrier.
TOP & Alberta Health release new transgender health care practice tools
April 15, 2019
April 15, 2019
The new practice tools designed for primary care offer an Alberta-specific approach to assessment and management of health care needs which are known to be prevalent in the transgender population.
Patientâ€™s Medical Home Journey in Alberta, 2018 Infographic
November 8, 2018
See the newest infographic showing the latest data on panel adoption in Alberta. Improvements shown in panel identification and maintenance processes support relationship continuity, benefiting patients, physicians, and the health care system. The improvement capacity built within Primary Care Networks will continue to support practices with panel, continuity of care, and future priorities.
New Report: Scaling Up Primary Care Transformation in Alberta - Insights from Local Cognitive Science Studies
October 22, 2018
October 22, 2018
Get the full report highlighting findings from two local cognitive science studies which address the question, "how can we take innovations like the Patient's Medical Home to scale in Alberta?". Alternatively watch Dr. Lee Green presenting this research at the 2018 Fall PCN Strategic Leadership Forum.
New Guideline on 2nd Trimester Obstetrical Ultrasound
June 13, 2018
June 13, 2018
The new guideline outlines the benefits of and requirements for a second trimester detailed anatomic study, highlighting prompt and appropriate action on abnormal results and communication thereof, and the importance of standardized reports.
Major Revision to Asthma Guidelines
April 24, 2018
April 24, 2018
Key features of the guideline include:
- The importance of a definitive asthma diagnosis that includes spirometry testing
- A systematic approach to evaluating asthma control, and the need for ongoing re-evaluation
- The use of newly revised Alberta Asthma Action Plan which supports patient-centred care
New Guideline on Iron Deficiency Anemia
April 8, 2018
April 7, 2018
The new IDA guideline will assist primary care to understand the assessment, diagnosis, treatment and management of iron deficiency anemia (IDA).
New Guideline on Medical Cannabinoids
February 25, 2018
February 26, 2018
The new guideline responds to primary care physicians’ need to better understand the quality of evidence with respect to medical cannabinoids prescribing for treatment in various conditions.
Update to ASaP Screening Maneuvers Menu for Adults
November 9, 2017
October 2017: The updated ASaP Screening Maneuvers Menu for Adults reflects new evidence and changes to recommendations while coninuting to balance impact and practicality in primary care settings.
What is the value of relational continuity with a primary health care provider? 2017 Update
October 18, 2017
Get the updated evidence summary of 137 articles evaluating relational continuity. Evidence points to the association of relational continuity with improved outcomes & satisfaction. This update includes 25 new articles, a new section on the value of relational continuity to patients and providers, and more detail on utilization outcomes and on the impact of continuity on complex patients.
What is the evidence supporting the concept of the Patientâ€™s Medical Home? 2017 Update
September 11, 2017
Get the updated evidence summary of 115 articles evaluating the Patient’s Medical Home. Recent studies have found that with the implementation of a Patient’s Medical Home, practices have experienced several improved outcomes. This 2017 update includes more detail on utilization outcomes, and the impact of the PMH on complex patients. 42 new studies were reviewed.
New Guideline on Third Trimester Fetal Well-Being Studies: Criteria and Managing Results
June 12, 2017
June 12, 2017: Alberta has an opportunity to improve prenatal diagnosis of fetal abnormality and access to specialized multidisciplinary care, as both are associated with improved perinatal outcomes. Effective evaluation of fetal well-being in the third trimester, when indicated, is an important component of prenatal care. The guideline was developed for radiologists and clinicians to enable early recognition of abnormalities or complications and expedited management.
New Guideline on Ultrasound for Twin and Multiple Pregnancies
June 12, 2017
June 12, 2017: Accurate and early determination of chorionicity and amnionicity by ultrasound is essential, ideally in the first trimester. The guideline was developed for radiologists and clinicians to enable early recognition of abnormalities or complications and expedited management.
Patients Collaborating with Teams (PaCT) invites PCNs to Participate
April 18, 2017
Patients Collaborating with Teams (PaCT) takes a proactive, systematic approach to enable patients to manage their care when they have, or are at risk for having, multiple chronic diseases or other complex health needs. PaCT is inviting Primary Care Networks (PCNs) and primary care clinics to participate as Innovation Hubs. Building on the panel and screening work already underway in Alberta, Innovation Hubs will test innovative ideas to systematically support their patients with complex needRead More
New Guideline on Environmental Exposures from Oil and Gas Emissions
March 24, 2017
The new guideline addresses the role and responsibility of primary care providers when patients present with complaints and/or symptoms possibly related to oil and gas activity and operations in Alberta.
New Cognitive Impairment Guidelines Released
February 24, 2017
February 24, 2017 - Assessment to Diagnosis and Diagnosis to Management will inform Alberta primary care physicians and teams to assess patients presenting with cognitive concerns, manage the majority of these patients and support their caregivers. A clinical care algorithm is included. See the supplement for resources/services and planning tools/tips for aging individuals.
Primary Care Management of Headache in Adults, 2nd ed
December 20, 2016
December 20, 2016 - The clinical practice guideline for the Primary Care Management of Headache in Adults has been revised. Key messages have been added to the revised Quick Reference summary which includes an algorithm and medication tables.
STEP (Supportive Tools for Every Panel) Documents
December 16, 2016
December 16, 2016 - Three Documents outlining the activities and outputs for panel identification and panel management screening for use at both the practice and PCN levels.
STEP Checklist - a summary of the activities and outputs for panel identification and panel management screening in a checklist format.
STEP Toolkit - the activities and outputs of panel identification and panel management screening with suggested tools and related liRead More
New Evidence Summary: the Benefits of Continuity in Primary Care
July 27, 2016
July 27, 2016 - A growing body of evidence points to the association of provider continuity, and to a lesser extent practice continuity, with improved outcomes and satisfaction. In most cases, the greater the continuity, the better the outcomes (112 articles reviewed).
TOP is hiring!
July 20, 2016
TOP is seeking resumes for a contract part-time Evaluation Coordinator.
Updated ASaP Chart Review Tools and Resources
July 15, 2016
• Super Form at a Glance (highlighting changes to the super form)
• Frequently Asked Questions - 2016 Updated Maneuver Menu for Improvement Facilitators
• Provider Super Form
• EMR Chart Review Instructions
• Paper-Based Chart Review Instructions
• Paper Chart Review Instructions & Forms
• Forms User Guide
Major update to H. pylori CPG
June 20, 2016
May 20, 2016: Highlights of the updated Diagnosis and Treatment of Helicobacter pylori clinical practice guideline (CPG) include:
• Updated evidence-informed recommendations
• New treatment and treatment options
• Increase in treatment duration
Updated Alberta Screening and Prevention Maneuvers Menu Now Available!
June 1, 2016
May 31, 2016 - We’re pleased to announce the updated 2016 ASaP Maneuvers Menu for Adults is now available along with many other updated tools and resources. Physicians and Nurse Practitioners enrolled in the ASaP program, we recommend you reach out to your teams’ Improvement Facilitators to discuss how best to implement the updated recommendations into your practices.
Updated Alberta Screening and Prevention Maneuver Menu: Coming Later this Month!
May 12, 2016
May 17, 2016 - Later this month, an updated ASaP Screening Maneuvers Menu for Adults will be released. Updates to the menu will reflect new evidence and changes to recommendations, while continuing to balance impact and practicality in primary care settings. To learn more about the updates read on.
Revised Cervical Cancer Screening Clinical Practice Guideline
April 29, 2016
May 1, 2016 - The revised guideline offers age-appropriate screening recommendations with a greater awareness of harms versus benefits. Frequently asked questions are available to assist with the discussion and patient decision-making. An updated Managing Abnormal Pap Test Result algorithm is included.
Multiple Sclerosis Care Coordination Collaborative
April 27, 2016
April 27, 2016 - Access a highlights report outlining our key learnings from this work, resources teams developed to support patient attachment and care coordination for people living with MS and more!
Lakeland PCN and the Multiple Sclerosis (MS) Society Team Up to Enhance Care for People Living with MS
April 18, 2016
April 18, 2016 - It’s been four years since Lakeland Primary Care Network (PCN) and the Lakeland Multiple Sclerosis (MS) Society began collaborating to enhance access to services and resources for people living with MS in their area.The relationship initially began when Robb Foote, Executive Director, Lakeland PCN, learned about a mobile neurologist clinic the MS Society was running.
New Clinical Practice Guideline: Identification and Symptom Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
April 11, 2016
April 11, 2016 - Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, chronic, debilitating physical condition that can be identified and successfully managed in the primary care setting. The CPG aims to equip clinicians with knowledge and tools to identify and provide symptom management while empowering the patient by acknowledging the legitimacy of the condition.
Panel + EMR = Stronger Patient Relationships
March 29, 2016
March 29, 2016 - Calgary Foothills PCN family doctor Heather La Borde says panel work is strengthening her relationship with her patients. "My patients actually tell me they feel more cared for," Dr. La Borde said. "I'm not only providing a service when patients turn up. I'm taking care of them in the background, doing a little bit every day, and they appreciate it." Part of Dr. La Borde's daily activities include setting up rules in her EMR to identify patients wRead More
Mosaic PCN – 42, 162 Proactive Screening Offers Made and Counting!
March 22, 2016
March 22, 2016 - Great work is happening in Mosaic PCN. As of March 15, 42, 162 screening offers have been made proactively to patients across the PCN. Equally interesting, while you are reading this article, that number has likely gone up! Metrics like screening offers and more are all captured in real time in a database fed using a web portal the PCN built to capture data from clinics.
Local Physician Talks about How He's Choosing Wisely
March 16, 2016
March 16, 2016 - Dr. Anthony Train, Calgary based family physician, shares how he's incorporating the Choosing Wisely Campaign into patient care.
New Clinical Practice Guideline: Identification and Management of Depression in Multiple Sclerosis
February 16, 2016
February 16, 2016 - The new CPG responds to the need for greater awareness that the prevalence of depression is high among patients with multiple sclerosis (MS) and aims to equip clinicians with the necessary knowledge and tools to successfully identify, treat and manage depression in their patients with MS.
Infomercials from the 2016 Winter PCN Forum on YouTube!
February 5, 2016
February 4, 2016 - Get out your popcorn and watch these 1950 public service announcement video parodies debuted at the 2016 Winter PCN Forum. These videos highlight a number of resources and supports available to PCNs, physicians and teams to continue their Patient's Medical Home journeys.
SUBSCRIBE - Patient’s Medical Home Implementation Field Kit
December 17, 2015
December 17, 2015 - The kit offers a "bird's eye" view of many of the resources, tools and supports available to PCNs and practice teams to support the work of building medical homes for patients in Alberta. Use our new SUBSCRIPTION feature to get email updates about what’s new!
What is the evidence supporting the concept of the Patient’s Medical Home?
November 12, 2015
November 12, 2015 - Get the newly generated evidence summary of 73 peer reviewed articles about the Patient’s Medical Home.
Ever Consider Group Medical Visits?
October 28, 2015
October 28, 2015 - Watch our group medical visit series and learn more about TOP's supports for PCNs and practice teams to engage in this enhanced access appointment option.
Attention Accuro Users -New Tip Sheet!
October 21, 2015
October 21, 2015 - The Accuro tip sheet for panel identification and proactive screening care has been extensively updated.
Feature Article - South Calgary PCN - A Recipe for Patient's Medical Home Success
October 15, 2015
October 15, 2015 - South Calgary PCN shares their approach to supporting practice teams in the work of building medical homes for patients – starting with panel.
Notice a few new additions to the TOP website?
October 8, 2015
October 8, 2015 - take our 3 minute video tour to learn more about what's new!
Read the latest TOP Newsletter
September 30, 2015
September 30, 2015 - read the latest TOP newsletter highlighting Sherwood Park PCN's and Westaskiwin Family Medical Practice's great work as part of the Alberta Screening and Prevention Program.
Alberta Peer to Peer EMR Network Program - Starting Soon!
September 23, 2015
September 23, 2015 - The Alberta Medical Association (AMA), Primary Care Network Program Management Office (PCNPMO) and Toward Optimized Practice (TOP) are pleased to announce that Canada Health Infoway is supporting an Alberta Peer-to-Peer EMR Network Program to enhance EMR use and information technology for PCN Evolution. The peer leaders will share their approach to planned panel-based care with others who use the same EMR solution.
HealthCareCAN talks to Dr. David Naylor, Chair of the Advisory Panel on Healthcare Innovation
August 31, 2015
August, 31 2015 - On August 13, 2015, HealthCareCAN sat down with Dr. David Naylor, Chair of the Advisory Panel on Healthcare Innovation, to discuss the development of the Unleashing Innovation: Excellent Healthcare for Canada report, its recommendations and highlights. Dr. Naylor provided valuable and thought-provoking insights as you can see and hear in the videos below.
TOP is Hiring - Administrative Assistant (Edmonton - Full Time)
August 12, 2015
August 12, 2015 - The Alberta Medical Association is recruiting for an Administrative Assistant, on behalf of Toward Optimized Practice (TOP)
Alberta Screening and Prevention - It's Working!
August 6, 2015
August 6, 2015 - Check out the latest results. 521 enrollees and counting!
NEW CIHI Report: Continuity of Care With Family Medicine Physicians: Why It Matters
May 12, 2015
According to this CIHI report, continuity of care with a family
medicine physician can help reduce hospitalizations and
emergency department use. High continuity of care has also been
linked to improved patient health, as it allows many conditions
to be diagnosed early and managed effectively.
New Clinical Practice Guideline - Prevention and Management of Cardiovascular Disease Risk in Primary Care
April 13, 2015
The management of lipids and cardiovascular disease risk has been significantly simplified by removing lipid targets and associated monitoring of lipid levels, as well as other streamlining measures. Additionally, by targeting risk, clinicians can identify patients most likely to benefit while actively involving these patients in their care.
Patient's Medical Home Assessment for Practices
February 26, 2015
Toward Optimized Practice (TOP) is available to support PCNs with the engagement of their member practices in the Patient's Medical Home (PMH). To guide teams in their PMH journeys assessment tools and resources have been developed.
New Clinical Practice Guideline - Doctors Opposing Violence Everywhere (DOVE)
February 11, 2015
This CPG was developed to help physicians identify violence in their patient population, understand the physician’s role and responsibilities in these situations, and provide tools and resources for supporting and guiding these patients.
Attention all Telus Wolf EMR users!
January 21, 2015
Check out our newest tip sheet - using your EMR for panel identification & preventative care.
Why Care about Quality Improvement in Healthcare?
January 14, 2015
See Dr. Mike Evans' excellent video!
Attention ASaP Improvement Facilitators: Emerging Evidence on Fasting Lipids
December 18, 2014
No fasting before my plasma lipids test? Happy holidays, indeed! As per best practice at the time it was created, the ASaP maneuver menu calls for a fasting lipid profile for men aged 40 to 74 and women 50 to 74. However, there is emerging evidence that there are minimal differences between non-fasting and fasting HDL, LDL, and total cholesterol. Learn more about how this will impact your work...
See what's new with the Alberta Screening & Prevention Initiative
December 8, 2014
The December ASaP Newsletter is now available!
Check out our YouTube Channel!
November 25, 2014
Our channel is dedicated to supporting, sharing and celebrating the quality improvement work physicians/clinic teams and PCNs are engaging in across Alberta - watch our panel silent film series (!?!) and many inspiring improvement success stories from local clinics...
Watch the NEW TOP Feature!
November 4, 2014
This month's TOP feature - Dr. Shawn Webster and Suzie Mitchell, RN from the Vulcan Medical Clinic (Calgary Rural PCN) share two stories of patients whose lives have been significantly affected as a result of the panel management and screening processes implemented by their clinic.
Panel Management Stories from PCNs!
October 9, 2014
A number of clinics who are participating in ASaP (Alberta Screening and Prevention) have been implementing panel identification and management processes in their clinics to improve the care they offer their patients. Read the panel related success stories of 3 clinics!...
It's back-to-school and a good time to focus on the health care of Alberta children
September 24, 2014
Toward Optimized Practice (TOP) is pleased to provide a reminder of the 2014 Alberta Health Services Childhood Growth Monitoring Information originally provided to AMA members in the spring of 2014. Please read on for important messages and links to the Alberta Health Services Growth Charts and other growth monitoring information and tools.
Let’s talk about panel and PCN Evolution
August 15, 2014
To help PCNs begin their next phase of development - PCN Evolution - panel sessions have been developed. These PCN sponsored events are intended to facilitate an open discussion about the first steps in PCN Evolution and clinics' medical home transformations. To learn more or to book a panel session for your PCN...
New Patient Continuity Video (May 28, 2014)
June 25, 2014
Patient attachment is an important foundation for the provision of quality care and creating a sustainable primary care system in Alberta. We are excited to share a new patient continuity video entitled “Why it is important to have a regular family doctor”. This video (which uses photos of PCN physicians) is a useful tool to increase patient awareness of the benefits of having a regular family doctor.
Release of new CPG: Multiple Sclerosis and Management of Urinary Tract Infection (2013)
December 3, 2013
Treatment for UTI in patients with MS differs from the general population. Symptoms of UTI may be masked by underlying neurogenic bladder & sensory deficit and if untreated may lead to serious deleterious effects.
View recommendations for primary care.
Colorectal Cancer Screening CPG update released (2013)
November 27, 2013
The revised guideline includes recommendations for screening the average risk population using the Fecal Immunochemical Test (FIT) as well as recommendations for the increased risk population.
Release of updated Breast Cancer Screening CPG (2013)
September 11, 2013
Included are recommendations for screening women in the average risk population and new information on:
- Women with high risk factors requiring more intensive screening
- Criteria for referral to medical genetics based on maternal and paternal history
- The 50-69 age group now extended to 74 years