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

ECHO Update MOHLTC September 27th 2019

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Outline

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

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Wound Care Knowledge Translation Pyramid

Level 6: Consensus Documents Inform Curriculum

e.g. Wounds Canada Best Practice Recommendations, RNAO BPGs, HQO

Level 5: Advanced Education

Advanced Health Care Practice (MClSc) in Wound Healing MScCH: Wound Prevention and Care

Level 4 Canadian Nursing Association (CNA) Certification in Enterostomal

Therapy - CETN (C) ETNEP includes preceptor program International Interprofessional Wound Care Course

Level 2: Skills Level 3: Preceptorships Level 1: Basics

BPRs, BPGs

PhD, Masters etc.

CAET ETNEP IIWCC

Wounds Canada Education Individual Initiated, ECHO

Wounds Canada Education (online, onsite) CAET K2P Wound Care program (online, onsite)

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ECHO = Extension for Community Health Outcomes

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• 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

This is What We Do

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• 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

Spoke / Community Partner Requirements

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• 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

Project Progress

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• Project will run 3 cohorts of ~30 Spoke
• rganizations
• 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

Project Progress

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• 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

Project Progress

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Hub Experts

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Team Member Specialty WoundPedia Hub

• Dr. Gary Sibbald

Project lead, Dermatologist, Internist/Speaker Interest Wound Care/Education, Professor of Medicine/ Public Health

• Dr. Xiu Zhao

Primary Care Physician, Wound Care specialty

Heather Nesbeth

Registered Nurse, Diabetes Educator

Patricia Coutts

Registered Nurse, Wound Care Nurse

Laura Lee Kozody

Chiropodist

James Elliott

Project Manager, Diabetes Researcher, Patient Advocate

Reneeka Persaud-Jaimangal Clinical Coordinator Queen’s University Sub-Hub

• Dr. Karen Smith

Associate Professor, Physical Medicine and Rehabilitation

Jolene Heil

Advance Practice Nurse, Wound Care, Providence Care Hospital

Jen Railer

Queen’s Project Manager & Health Education Research Associate

Kate Kittner

Office Manager, Office of Professional Development

Eleftherios Soleas

Educational Consultant

Jessica Bamhour

Research Assistant

Map of Spokes

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https://batchgeo.com/map/fd06406ab42dd51 7e466343a8af1bd9c

Map of Spokes

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https://batchgeo.com/map/fd06406ab42dd51 7e466343a8af1bd9c

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 Wound Clinic Mississauga Halton 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 Services North West 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 Fort Frances FHT North West

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

Project Progress

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• Website up
• Recordings

available

• Online

registration for program

• Key readings

Project Progress

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Evaluation to Date

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• 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

• First will be at Providence Health Care

Kingston, May 2/3 2020

• Ongoing discussions with:

–Manitoulin Island –Sioux Look-Out

Boot Camp Discussions

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Project ECHO Ontario Skin and Wound Care Schedule

Cohort 1: ECHO Session DATE AND TIME OF SESSIONS

Diabetic Foot Ulcer

Intro Session - Introduction to the diabetic foot and HbA1c

May 8th 2019

Intro Session - Prevention of diabetic foot ulcer

May 15th 2019

Intro Session - Infrared thermometry

May 22nd 2019

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

Infection

June 26th 2019

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Project ECHO Ontario Skin and Wound Care Schedule

Lower Limb – Venous Leg Ulcers, Arterial Leg Ulcers, Mixed Ulcers

Pain control, wound bed preparation and pain, local measures, nociceptive and neuropathic approaches.

September 4th 2:00pm to 4:00pm

Vascular Leg ulcers, differential diagnosis - vascular and lymphatic.

September 11th 2:00pm to 4:00pm

Venous ulcers and lower leg edema- compression therapy

September 18th 2:00pm to 4:00pm

Other leg ulcers - skin biopsies, adjunctive therapies, etc.

September 25th 2:00pm to 4:00pm

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Project ECHO Ontario Skin and Wound Care Schedule

Pressure Injuries and Surgical Wounds

Prevention of Pressure Injuries

October 16th 2:00pm to 4:00pm

Pressure Injury: Pressure Relief and Redistribution

October 23rd 2:00pm to 4:00pm

Management of the Pressure Injury Contributing Factors: Infection, Investigation, and Treatment

October 30th 2:00pm to 4:00pm

Nutrition Treatment of the Whole Patient for Wound Healing

November 6th 2:00pm to 4:00pm

Non-Healable Maintenance and Inflammatory Wounds

November 13th 2:00pm to 4:00pm

Post-Surgical Wound

November 20th 2:00pm to 4:00pm

Burns and Trauma

November 27th 2:00pm to 4:00pm

Skin and Ostomy Care

December 4th 2:00pm to 4:00pm

• Accepting applications for 2nd co-hort now

https://www.echoontario.ca/Register/Wound.aspx/

• 2nd 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

Get Involved

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