1. OCN: Clinic Updates
Quarterly Meeting
June 8-9, 2017

2. Overview Hospital / Staffing issues Trends (referral, clinical)
Engagement in care (strategies)
Community issues or trends
New tools

3. Who we heard from 13 responses received 21 clinics invited
62% response rate

4. 1.
Staffing issues
Key themes

5. Staffing issues New staff Change in location Vacancies
SIS team leader, NP relief, 4 new RN relief (OASIS, Ottawa)
New clinic coordinator (St. Joseph’s, London)
New clinic medical director (Elevate NWO, Thunder Bay)
Change in location
Move to new location out of hospital went well (SIS, Hamilton)
Vacancies
Psychologist (CHEO)
Nurse on leave due to surgery, no replacement (Sunnybrook)
Staff turnover (medical reception, NP on leave) (OASIS, Ottawa)
Applied for more funding for NP (Univ of Ottawa Health Services)

6. 2.
Trends
Referrals & Clinical

7. Refugee claimants / foreign students Newly returned to clinic
Trends: New referrals
Increased testing
Increase in number of people coming in for testing (St. Joseph’s, London)
PREP
More referrals (St. Mikes 410 Sherbourne, Lakeridge, Whitby)
Refugee claimants / foreign students
Refugee claimants, foreign students illnesses (Sunnybrook, Toronto)
HCV
Increase referrals (St. Mikes 410 Sherbourne, OASIS Ottawa)
More new patients infected with Hep C (St. Joseph’s, London)
Newly returned to clinic
1 out of 6 new patients are patients not seen for a few years (Sunnybrook, Toronto)
Transfers to adult care
Referrals from Sick Kids (Sunnybrook, Toronto)
Increased referrals
Increased referrals for people whose risk factor is IDU (St. Joseph’s, London)
Referrals to mental health support (Bloom, Brampton)
Referrals for primary care (Univ of Ottawa Health Services)
1 newly diagnosed patient resistant to treatment (Univ of Ottawa Health Services)

8. Trends: Clinical Treatment Community Care issues Patient profile
- RAPID antiretroviral initiations for newly diagnosed on intake visit (Lakeridge Whitby)
Community
Refugee referrals with court dates in 3 weeks and need results returned in 2 weeks (Sunnybrook Toronto)
Care issues
Syphilis (St. Josephs London, )
Cluster of HCV in MSM with HIV with gen 4 HCV (St. Mikes 410 Sherbourne)
Increased health care needs related to chronic disease and aging (Bloom, Brampton)
Case of poor compliance following pregnancy and denial of diagnosis leading to poor health outcomes (Univ of Ottawa Health Services)
Patient profile
MSM and young gay men new diagnoses (Lakeridge)
HIV epidemic for PWUD (St. Josephs London)
New infections in patients prescribed PREP (St. Mikes 410 Sherbourne)
Increased use of fentanyl (OASIS Ottawa)

9. 3.
Engagement in care
Strategies

10. Engagement in care: Strategies
Collaboration
Outreach contacts, assistance from community partner, OTN MD & psychiatry (Lakeridge, Whitby)
Community planning committee for all agencies to work together (St. Joseph’s London)
Patients lost to follow-up decided to see family doctor only (Sunnybrook Toronto)
Collaboration with onsite programs (food bank, complimentary therapy) (Elevate NWO Thunder Bay)
Communication with patients
Reminder calls, s, texts, (Lakeridge Whitby, UHN Toronto General Hospital)
Scheduling
Stagger staff schedule for better coverage (Lakeridge Whitby)
Flexible scheduling, walk-in appts (St. Mikes 410 Sherbourne, OASIS Ottawa, Elevate NWO Thunder Bay)
NEW
Tracking tools in EMR to look at engagement strategies (Lakeridge, Whitby)
NEW
Report of ER visits for patients that have fallen out of care (HAVEN Sudbury)

11. 4.
Community
Issues & Trends

12. Community Meeting with women’s health providers (CHEO Ottawa)
Referrals to CMHA health link to better coordinate care (Haven Sudbury)
Social worker meets weekly at ASO (Lakeridge Whitby)
ASO community forum (St. Mikes 410 Sherbourne)
Application for SIS ongoing (OASIS Ottawa)
Drug strategy and local groups working towards SIS application (Elevate NWO Thunder Bay)
Collaboration with health unit, ASO and community partners to coordinate response to HIV epidemic
(St Joseph’s London)

13. 5.
New tools
Examples

14. New tools
Intimate partner violence (IPV) screen collaboration with social work and nursing. A safety initiative is being developed for a gender neutral IPV assessment tool and strategy. (UHN Toronto General)
Cryogun and cryocontainer (ARCH Guelph)
Multi-agency consent form to improve communication among partners (St. Joseph’s London)
New EMR coming soon (Windsor)
QI on syphilis management and follow-up (St. Mikes 410 Sherbourne)

15. Thank you Comments? Reflections?
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