September 27 th 2019 1 Outline 1. Hub and Spoke Model 2. - PowerPoint PPT Presentation

ECHO Update MOHLTC September 27 th 2019 1

Outline 1. Hub and Spoke Model 2. Progress to Date 3. How to Get Involved 2

Wound Care Knowledge Translation Pyramid BPRs, Level 6: Consensus Documents Inform Curriculum BPGs e.g. Wounds Canada Best Practice Recommendations, RNAO BPGs, HQO Level 5: Advanced Education PhD, Advanced Health Care Practice (MClSc) in Wound Healing Masters etc. MScCH: Wound Prevention and Care Level 4 Canadian Nursing Association (CNA) Certification in Enterostomal CAET ETNEP Therapy - CETN (C) ETNEP includes preceptor program IIWCC International Interprofessional Wound Care Course Individual Initiated, ECHO Level 3: Preceptorships Wounds Canada Education Level 2: Skills Wounds Canada Education (online, onsite) Level 1: Basics CAET K2P Wound Care program (online, onsite) 3

ECHO = E xtension for C ommunity H ealth O utcomes 4

This is What We Do • Weekly 2 hour tele-ECHO sessions via Zoom • Short didactic lecture; then case-based learning • Wednesdays 2 pm to 4 pm • Spokes present their own patient cases for discussion • In-person skills training over extended long weekend “boot camps” • Physicians awarded CME credit hours 5

Spoke / Community Partner Requirements • Form inter-professional teams • Commit to attending minimum of 75% of these sessions • Teams must be willing to present cases • Attendance at boot camps is encouraged • Must sign a Statement of Collaboration that outlines expectations and responsibilities 6

Project Progress • Launch in spring 2019 • Hiring and training complete • Over 150 applications to-date • 35 Spoke partners with signed Statements of Collaboration, exceeding target of 10 by launch • Success in combining applicants / applications into one Spoke e.g. WW LHIN, MH LHIN 7

Project Progress • Project will run 3 cohorts of ~30 Spoke organizations • Each cohort participant can attend 16 sessions, divided into two 8 session groups • Currently 50% through the first cohort • Project will conduct at least 4 in person practical skills training boot camps 8

Project Progress • 32 patient cases discussed as of this week • 8 sessions + 3 information sessions held • 16 hours of CME credit awarded • Partners include: long-term care homes , LHIN teams , community hospitals (Guelph, Napanee, Brockville) Family Health Teams (Atikokan, Points North, Nipigon District FHTs), physician offices 9

Hub Experts Team Member Specialty WoundPedia Hub Project lead, Dermatologist, Internist/Speaker Interest Wound Care/Education, Dr. Gary Sibbald Professor of Medicine/ Public Health Primary Care Physician, Wound Care specialty Dr. Xiu Zhao Registered Nurse, Diabetes Educator Heather Nesbeth Registered Nurse, Wound Care Nurse Patricia Coutts Chiropodist Laura Lee Kozody Project Manager, Diabetes Researcher, Patient Advocate James Elliott Reneeka Persaud-Jaimangal Clinical Coordinator Queen’s University Sub -Hub Associate Professor, Physical Medicine and Rehabilitation Dr. Karen Smith Advance Practice Nurse, Wound Care, Providence Care Hospital Jolene Heil Queen’s Project Manager & Health Education Research Associate Jen Railer Office Manager, Office of Professional Development Kate Kittner Educational Consultant Eleftherios Soleas 10 Research Assistant Jessica Bamhour

Map of Spokes https://batchgeo.com/map/fd06406ab42dd51 7e466343a8af1bd9c 11

Map of Spokes https://batchgeo.com/map/fd06406ab42dd51 7e466343a8af1bd9c 12

Name of Spoke Team Geographic Location Wyndham Manor Mississauga Halton The Village of Erin Meadows Mississauga Halton Mississauga Halton LHIN Mississauga Halton Custom Orthotic Design Group Ltd. Mississauga Halton Medical Oxygen Repair/Mississauga Mississauga Halton Wound Clinic Hilltop Manor Waterloo Wellington Waterloo Wellington LHIN Waterloo Wellington Guelph General Hospital Waterloo Wellington Napanee Hospital South East CBI Home Health South East South East LHIN Team South East Greenstone Family Health Team North West Fort Frances Tribal Area Health North West Services Rainville Foot Health North West North West LHIN Wound Team North West Atikokan Family Health Team North West Points North Family Health Team North West Nipigon District Family Health Team North West 13 Fort Frances FHT North West

Name of Spoke Team Geographic Location Hamilton Niagara Haldimand Brant Hamilton Niagara Haldimand LHIN Wound Team Brant Royal Victoria Regional Hospital North Simcoe Muskoka Erie Saint Clair LHIN Erie Saint Clair Teck Pioneer Residence North East Brockville General Hospital wound South East team St Elizabeth Health Care South East Quarry Medical Clinic South East Queen's Department of Family South East Medicine ParaMed Toronto Central SRT Med Toronto Central The Michener Institute Toronto Central Back2feet Inc. Toronto Central Toronto Central LHIN Toronto Central 14

Project Progress • Website up • Recordings available • Online registration for program • Key readings 15

Project Progress 16

Evaluation to Date • Attendees interprofessional: large groups of primary care, esp registered nurses, with smaller groups of orthotists, physicians, and chiropodists. • 100% of respondents agreed that they learned something valuable during every session . • Teaching methods were found to be effective by the vast majority Strengths of the Program • Prioritized topics • Modelling and preaching interdisciplinary and collaboration • Chat function to ask questions • Case studies • Ease of access Weaknesses: Tech, fast-paced, 2 hours hard to answer all questions 17

Boot Camp Discussions • First will be at Providence Health Care Kingston, May 2/3 2020 • Ongoing discussions with: – Manitoulin Island – Sioux Look-Out 18

Project ECHO Ontario Skin and Wound Care Schedule Cohort 1: ECHO Session DATE AND TIME OF SESSIONS Diabetic Foot Ulcer May 8th 2019 Intro Session - Introduction to the diabetic foot and HbA1c May 15th 2019 Intro Session - Prevention of diabetic foot ulcer May 22nd 2019 Intro Session - Infrared thermometry Wound bed preparation paradigm and HbA1c June 5th 2019 Arterial Assessment June 12th 2019 Offloading treatment to promote healing of foot ulcers June 19th 2019 June 26th 2019 Infection 19

Project ECHO Ontario Skin and Wound Care Schedule Lower Limb – Venous Leg Ulcers, Arterial Leg Ulcers, Mixed Ulcers September 4 th 2:00pm to Pain control, wound bed preparation and pain, local measures, nociceptive and neuropathic approaches. 4:00pm September 11 th 2:00pm to Vascular Leg ulcers, differential diagnosis - vascular and lymphatic. 4:00pm September 18 th 2:00pm to Venous ulcers and lower leg edema- compression therapy 4:00pm September 25 th 2:00pm to 4:00pm Other leg ulcers - skin biopsies, adjunctive therapies, etc. 20

Project ECHO Ontario Skin and Wound Care Schedule Pressure Injuries and Surgical Wounds October 16th 2:00pm to 4:00pm Prevention of Pressure Injuries October 23rd 2:00pm to 4:00pm Pressure Injury: Pressure Relief and Redistribution Management of the Pressure Injury Contributing Factors: Infection, Investigation, and October 30th 2:00pm to 4:00pm Treatment November 6th 2:00pm to Nutrition Treatment of the Whole Patient for Wound Healing 4:00pm November 13th 2:00pm to Non-Healable Maintenance and Inflammatory Wounds 4:00pm November 20th 2:00pm to Post-Surgical Wound 4:00pm November 27th 2:00pm to Burns and Trauma 4:00pm December 4th 2:00pm to Skin and Ostomy Care 4:00pm 21

Get Involved • Accepting applications for 2 nd co-hort now https://www.echoontario.ca/Register/Wound.aspx/ • 2 nd Cohort starts in January 2020, beginning again with diabetic foot and lower limb ulcers • Observers welcomed • Questions: james.elliott51@gmail.com • Project lead: rgarysibbald@gmail.com 22