What is a Family Health Team?
A Family Health Team (FHT) includes:
- Reception and administrative staff
- Family Physicians
- Nurse Practitioners
- Registered Nurses
- Registered Practical Nurses
- Social Workers
- A Dietitian and other professionals
- A Board of Directors
These professionals work together to provide patients with the health care they need when they need it within their community, as close to home as possible.
CHFHT’s community includes the Municipality of Centre Hastings, Township of Madoc, Municipality of Marmora & Lake and the Township of Tudor & Cashel.
What does the Central Hastings Family Health Team do?
The Central Hastings Family Health Team (CHFHT) is very active in meeting and exceeding the expectations of the Ministry of Health and Long Term Care.
Our programs include:
- Lung Health – this features a smoking cessation program (the STOP Program) and breathing tests (called spirometry) for smokers and past smokers.
- Hypertension –patients are taught to make lifestyle changes to help them control high blood pressure.
- Diabetes – patients are helped with diabetes management and are taught to self-manage their diabetes.
- Foot Care – this program is for high risk foot care needs, including complications of diabetes.
- Ontario Telemedicine Network – this links patients with specialists (such as a Dermatologist or Psychiatrist), via television, right from our own site.
Ø CHFHT has been recognized with the Leading Practice Initiative from Canada Health Infoway and the Bright Lights Award (2013) for “Harnessing Electronic Medical Records to Improve Diabetic Patient Management”.
Who works at CHFHT’s clinics?
Approximately 32 people comprised of Physicians, Physician-employed staff, and CHFHT-employed staff [AS1] work to support healthcare and programs over CHFHT’s three clinic sites:
- Nurse Practitioners
- Registered Nurses
- a Registered Practical Nurse
- Social Workers
- a Dietician
- a System Navigator Nurse (funding provided by our Ministry of Health for the Health Link program)
- Reception and administrative support staff
- a Quality Improvement Decision Support Specialist
- a Program Coordinator
- an Administrator
- an Administrative Assistant
CHFHT also hosts nursing, medical, health information management and health administration students for clinical and work placements.
Are CHFHT’s clinics open to the public?
- The Gilmour site is a public clinic staffed once per week by a CHFHT Nurse Practitioner. Patients are welcome regardless of who their regular healthcare provider might be.
- The Madoc and Marmora clinics are organized differently. One must be a patient of these clinics in order to be seen there. Neither Madoc nor Marmora is a “walk-in” clinic.[AS2]
- Due to the way that the two clinics are funded, they are reserved for patients who are “rostered” with the Family Physicians who belong to the Family Health Organization (FHO) that is associated with CHFHT.
- The Ministry of Health and Long Term Care funds FHO Physicians under a plan that encourages patients to be rostered. The Ministry funds the administration, some of the physical costs (like building and utilities), some staffing and the Interdisciplinary Health Practitioners (Nurse Practitioners, Registered Nurses, Registered Practical Nurses, Dietitians, Social Workers, Chiropody) based on the number of patients who are rostered in total.
- The Madoc and Marmora clinics are organized and run according to the individual practices of all the practitioners, including the FHO Physicians.
- The FHO Physicians work in collaboration with Central Hastings Family Health Team. They operate their own privately funded medical practices in a cooperative model, with their own agreement in place to cover each other’s absences and vacations.
- Our Physicians’ practices are private, enriched by additional CHFHT services and programs offered primarily to rostered patients. Therefore, neither the Madoc clinic nor the Marmora clinic is a “walk in clinic”.
- As part of the physicians’ (FHO’s) agreement with the Ministry of Health, the Physicians offer five After-Hours Clinics each week for rostered patients.
Definition of “rostered patient”:
At CHFHT, a “rostered patient” is a patient who is enrolled with a Family Physician who is part of the Family Health Organization associated with CHFHT. A rostered patient’s primary care giver may be a Nurse Practitioner.
Patient enrollment formalizes the relationship between the Physician and the patient. A rostered patient promises to seek treatment from his or her enrolling Family Physician, or another Physician within the Family Health Organization to which the Family Physician belongs, unless he/she is traveling or experiences an emergency situation.
What about patients who have their Family Physician elsewhere, or have no Family Physician?
- Patients who are visiting the area, or who are not our patients, are sometimes seen at the Madoc and Marmora sites dependent upon the presenting medical issue and if time allows.[AS3]
- In case of an emergency[AS4], to reduce the loss of critical response time, 911 should be called immediately in order to get the patient to the nearest hospital emergency department as quickly as possible.
- Our practitioners will see visitors to the area as time allows.
- CHFHT also provides a teen clinic weekly for all students, not just students who are our rostered patients.
- The Gilmour site has a weekly outreach program with a Nurse Practitioner which is open to anyone.
At the Marmora site, non-rostered patients may be seen during its After-Hours Clinic, after all of the rostered patients have been looked after.
How does a patient get an appointment with his/her healthcare provider?
- Every Physician and Nurse Practitioner reserves several appointment slots of different lengths for various issues. They also keep parts of their days open for Same Day Appointments.
- Our goal is to have as much Same Day Access as possible, to try to give patients the healthcare access they need when they need it, and to keep patients from having to go to the Hospital Emergency Department for issues that they should be discussing with their Family Physician.
- Same Day Appointments fill quickly, but we keep a waiting list and are able to call people to come in if there are any cancellations.
- Physicians and Nurse Practitioners are also able to call their patients to discuss why they need to come in and possibly address the issue over the phone.
- Overall, about 80% of patients who call in are seen on the second day after calling in. 100% are seen on the third day after calling in. This is some of the best access in Ontario.
- Due to this type of pressure and limited capacity, any patient who simply walks in wishing to be seen is likely to be disappointed unless the issue is quite urgent.
- We try to ensure accessibility for everyone. Patients with mobility or transportation issues can request that they be allowed to book ahead. Reception staff are happy to help patients make appointments with their health care providers.
- When the receptionist is scheduling an appointment, she/he needs to know what block of time to book. For example, a physical may be booked for 30 minutes, but a follow up for a blood pressure test or medication review may be booked for just 10 minutes. It is understandable that sometimes issues are “personal” or “private” but please know that providing some details about the reason for your visit will help to ensure that appropriate time is allotted and our team can be better prepared to help you at your visit. The receptionist will likely book 15-20 minutes for such appointments.
What happens when a Physician leaves?
- Whenever a Physician retires or leaves the area, a large number of patients are left without a Family Physician. When faced with this situation, every CHFHT Physician and Nurse Practitioner takes on as many additional patients as he or she can safely manage.
- The patients who are taken on by other CHFHT Physicians and Nurse Practitioners are usually the ones who are the most elderly and fragile, and those with the highest medical needs such as people with diabetes, chronic pain, and patients who are pregnant.
- All remaining patients who are left looking for a Physician in this area are advised to use walk-in clinics in Belleville and the Hospital Emergency Department for urgent issues.
- Patients should contact Health Care Connect (1-800-445-1822) to get on the waiting list for the next Physician taking on patients in the area.
- CHFHT’s need for another Physician is advertised at medical schools and in medical journals. Hastings County has placed recruitment advertisements as well.
Who owns the patient’s medical records (chart)?
- The patient’s chart belongs to the Physician who the patient is rostered with. Patients whose primary health care provider is a Nurse Practitioner are still assigned to a Physician’s roster.
- When a Physician leaves and his/her medical practice closes, by law the Physician has to make sure that patients’ records (“charts”) are kept securely and that their former patients can obtain copies of their records if they wish. The records must be kept securely by the Physician for up to ten years and, for children, for ten years after they reach the age of eighteen.
- If a patient wishes to obtain a copy of his/her medical records, a fee is charged to cover the cost of copying the records onto paper or onto a disc. The patient’s former Physician might review the records with the patient before releasing the copy. The patient can then give the records to his/her new Physician.
Why do I have to wait outside until the door is unlocked?
The doors must remain locked until the appropriate opening time for safety reasons.
We have changed our staffing hours to open the doors 10-15 minutes early in the mornings and close the doors later in the evenings. We have chosen not to have different lunchtimes for our staff, so the clinic doors are locked from noon until 12:50pm.
Patients can leave messages for prescription renewal on a dedicated line. Phones are closed at 3:00pm, but on evenings when we have an After-Hours Clinic, the phones open again from 5:00pm to 8:00pm and we open the clinic doors at 4:50pm.
Clinic doors are locked during the lunch period from noon to 1:00 pm, but not prior to evening clinics.
On After-Hours Clinic days patients can sign up an hour ahead of the clinic’s start time. They then need to remain at the clinic until they are seen. The Marmora After-Hours Clinic runs from 6:00pm-8:00pm on a first come, first served basis.
Why can’t everybody be seen at the After-Hours Clinics?
It is a matter of capacity. The After-Hours Clinics are for rostered patients of the CHFHT in order to provide healthcare access outside of regular day time hours.
The After-Hours Clinics are operated on a first come-first served basis. At times, there may also be a couple of pre-booked appointments. We do understand that waiting can be inconvenient.
In order to reduce the wait times at the After-Hours clinics, if your concern is not urgent, please consider following up with your regular Physician or Nurse Practitioner during regular business hours.
If your concern is of a long-standing (chronic) nature, it is best to follow up with
with your regular Physician or Nurse Practitioner, rather than seeing a physician at the After-Hours clinic who is unfamiliar with you.
Thirteen patients can be booked into each After-Hours Clinic and occasionally we can see about fifteen or sixteen patients in the time available. More than that number of patients would not allow for safe healthcare.
There are times that a high volume of patients will mean that some will be redirected to the hospital emergency department.
The After-Hours Clinics are not urgent care clinics. All emergency cases should be transported directly to the hospital’s emergency department.
Do CHFHT’s clinicians do House Calls?
All Physicians and Nurse Practitioners do house calls for their own palliative and shut-in patients. Nurses and the Social Workers also occasionally do house calls.
All Physicians and Nurse Practitioners provide palliative visits to the Heart of Hastings Hospice House in Madoc.
Two Physicians work two mornings a week at the Caressant Care Nursing Home in Marmora and a Nurse Practitioner provides care for Caressant Care Retirement Home residents.
Communication and Expectations
Face-to-face discussion about issues and concerns is often the best way to understand different points of view and to work out how to avoid problems in the future. It is also the best way to truly relate to another person’s position. Sometimes it takes more than one attempt to identify errors or oversights and find answers.
Issues such as phoning for test results should be discussed with your Physician or Nurse Practitioner. Each provider works in a different way. Many providers do not regularly phone their patients to provide test results, preferring instead to speak face-to-face with the patient to discuss their health issues and the plan for managing their health.
We understand that it can be stressful waiting to hear for results. We do our very best to keep you informed as soon as possible.
We have suggestion boxes, paper and pencils in the waiting rooms at the Madoc, Marmora and Gilmour Clinics. Our Practitioners’ Committee reviews each suggestion and discusses it for feasibility. We welcome all positive or constructive feedback.
What if I want to switch to another Physician?
Unfortunately, not every patient-Physician relationship works well, so there are times when a patient may wish to switch to another Physician or health-care provider. We recommend that the patient de-roster, then apply to Health Care Connect for the next available Physician in the area.
Who sees the charts?
The CHFHT works within the values of confidentiality, privacy and trust. Our staff members access patients’ charts when booking appointments, answering patients’ questions, locating information and faxing and copying information to the charts.
Our Physicians and Interdisciplinary Health Practitioners document their professional interactions in the charts.
We have policies that provide rules for the maintenance and auditing of our electronic charts. The policies set out who is permitted to access the charts and for what specific reasons. Even Physicians are not permitted to browse through the charts of patients if they have no professional reason to access the charts.
Our reception staff members are careful, skilled and caring when communicating information between patients and providers. Our documentation also respects patients’ rights to privacy.
Who owns the Tri Area Medical Centre, Marmora Medical Centre and the Gilmour Clinic?
The CHFHT is a joint tenant with the Physicians in the Madoc and Marmora clinics. CHFHT is a sole tenant at the Gilmour clinic. The Marmora Medical Centre building is owned by the Municipality of Marmora & Lake. The Gilmour Clinic building is owned by the Municipality of Tudor & Cashel. The Tri Area Medical Centre building is owned by the Municipality of Centre Hastings
As a separate organization, the CHFHT leases space from each of the landlords, similar to other businesses that lease space in the buildings.
Can patients attend CHFHT meetings?
Patients do not attend CHFHT meetings. These meetings are set up internally for professional development and quality planning. The Family Health Team is a private, not-for-profit organization, not a public organization.
Can patients attend CHFHT Board meetings?
Patients do not attend Board meetings. The Chair of the Board can invite guests, where appropriate.
The Board of Directors oversees CHFHT’s goals and governance, rather than day-to-day operations.
To ensure that the community has a voice, CHFHT has a Community Advisory Committee which includes community members. The Chair of the Community Advisory Committee is also a Board Member, so information from the Community Advisory Committee is passed along to the Board.
The Terms of Reference document for the Community Advisory Committee is available on CHFHT’s website.
If you have any further questions, please feel free to forward them in writing to the Administrator or Lead Physician of the CHFHT.