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2018 / 2019 YEARBOOK

Realizing the Evidence

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Musings from the CEP Board

Tupper Bean On Change

​​​​​​​“For the past decade, the Centre for Effective Practice has sat on the precipice of the health system, constantly reinventing its services to meet the ever-changing needs of the primary care providers. As the health system undergoes massive change, we as an organization are excited by this opportunity to once again redesign and rethink how we can do better, collaborate smarter and work more efficiently. This is par for the course in small non-profit, entrepreneurial organizations. It’s impossible to be in the business of change management without being able to embrace change as an organization or a leader.”


—TUPPER BEAN, EXECUTIVE DIRECTOR 

Bernita Drenth on Partnerships

“Strong partnerships are built on shared values and trust. Inherent in the term is the sense that both or all parties are equal and bring substantive value to the relationship regardless of size or budget. In practice, this means co-planning and working together to set the direction. All too often, these are sound ideas in theory but fail in practice. Smaller organizations in the past, such as the CEP, have partnered for various reasons including out of necessity. However, today it has given them the advantage because they have the capacity and capability to know how to partner effectively. As we forge ahead, strategic partnerships must put patient outcomes and system sustainability first.”

—BERNITA DRENTH, BOARD CHAIR

At a Glance

  • 95k

    TOTAL TOOL DOWNLOADS SINCE 2017

  • 76

    TOOLS, RESOURCES & PROGRAMS DEVELOPED TO DATE

  • 225

    TOTAL STAKEHOLDER ORGANIZATIONS ENGAGED

  • 2000+

    TOTAL GUIDELINE REVIEWS CONDUCTED

Knowledge Translation in Primary Care

As the largest knowledge translation for primary care organization in Canada, we continue to partner with the Ontario College of Family Physicians (OCFP) and the Nurse Practitioners’ Association of Ontario (NPAO) to meet the needs of primary care providers on the frontlines. Through the Knowledge Translation in Primary Care Initative (KTinPC), we have developed and disseminated 13 tools that have received more than 70,000 (of the 95,066 total) downloads by providers over the past two years.

The KTinPC initiative focuses on the development of clinical tools and resources for Ontario’s primary care providers (PCPs) and explores opportunities to support PCPs with electronic medical record (EMR) optimization and the localization of tools. Innovation for providers’ preferences is a key focus of this initiative: we are working with 15 clinic sites in various parts of Ontario (family health teams and solo practices) to pilot test custom EMR tools, including the Chronic Non-Cancer Pain Tool, Preconception Health Care Tool and CORE Back Tool.

Academic Detailing for Primary Care

Our academic detailers have been visiting family physicians on the topics of managing opioid therapy, caring for patients living with chronic non-cancer pain and caring for patients living with opioid use disorder. In July, the topic of caring for older adults on benzodiazepines will become available to all participating family physicians.

This past year, we have offered visits to more than 700 family physicians across the province including those in rural and northern communities.

Clinically Speaking

Through the Clinically Speaking podcast, we have had conversations about evidence-based medical practices with experts across Canada, hearing varied perspectives. Below are key quotes from these experts. Their views speak about where medicine has been, where it is now and where it could be in the future.

To listen to the full interviews, visit cep.health/clinically-speaking.

"Why don't we spend more time doing the actual shared decision making with our patients — listening to their stories, listening to their concerns and addressing those? Rather than: ‘I've got to get through this huge checklist of preventative care maneuvers and this periodic health exam today. I've got to squeeze it into your complaint about your ankle today, so I'd like to skim along and talk about the PSA - which is going to take 10 minutes.’"
—DR. MIKE ALLAN DIRECTOR, PROGRAMS AND PRACTICE SUPPORT, COLLEGE OF FAMILY PHYSICIANS OF CANADA
"I think at some point in the process of training people to do critical appraisal, we realized it's extraordinarily time consuming and extremely difficult. There's a ton of nuance that is hard to capture. When is a clinician going to review enough clinical articles to answer every question they might have?"
—DR. ONIL BHATTACHARYYA SENIOR SCIENTIST, WOMEN’S COLLEGE RESEARCH INSTITUTE
"I think that really motivated some of the clinical practice guidelines as a concept. The idea that somebody is going to filter the information, condense it and put it into a usable format."
—DR. ONIL BHATTACHARYYA SENIOR SCIENTIST, WOMEN’S COLLEGE RESEARCH INSTITUTE
"It's very hard to trust any published papers. The degree of bias: the extent is huge…. It is very striking. What's published in the literature is what guides us as clinicians. It's what guides clinical practice guidelines and all such [documents]."
—DR. ELIA ABI-JAOUDE PSYCHIATRIST, CLINICAL EDUCATOR AND RESEARCHER, HOSPITAL FOR SICK CHILDREN

Policy to Practice

POLICY TO PRACTICE

Pain Management and Opioids

“I have been using the CORE Back Tool and the CORE Neck tool and Headache Navigator since they were released. It has made me more confident as I deal with these problems, especially decreasing my worry that I am missing something serious. Also, I am ordering fewer imaging tests because of these tools. And I feel that my patients are getting better care.”

—DR. JOHN AXLER, FAMILY PHYSICIAN

Downloads by Tool

  • 15,050

    CORE BACK TOOL

  • 8,234

    OPIOID MANAGER

  • 5,267

    CORE NECK TOOL AND HEADACHE NAVIGATOR

  • 6,359

    OPIOID TAPERING TEMPLATE

  • 10,230

    MANAGEMENT OF CHRONIC NON-CANCER PAIN

  • 2,024

    OPIOID USE DISORDER TOOL

Policy to Practice

  • Pain Management and Opioids

    POLICY TO PRACTICE

    The CEP has been focusing various interventions on pain management and opioids, recognizing these topics often go hand-in-hand.

  • Mental Health

    POLICY TO PRACTICE

    Mental health has consistently been a priority topic for tools and projects at the CEP. The current suite of mental health tools available to primary care providers includes: Keeping Your Patients Safe Tool, Youth Mental Health: Anxiety and Depression Tool and Management of Chronic Insomnia Tool.

  • Care of the Elderly

    POLICY TO PRACTICE

    Work is continuing on a number of projects to support providers in elderly care. We have updated the Behavioural and Psychological Symptoms of Dementia Guides for Long-Term Care, and for residents, families and caregivers.

  • Cancer

    POLICY TO PRACTICE

    We continue our work with the Canadian Partnership Against Cancer (the Partnership) to update the Partnership’s Cancer Guidelines Database.

  • Non-Medical Cannabis

    POLICY TO PRACTICE

    After many requests from health system partners and providers, CEP developed a Non-Medical Cannabis Tool.

  • Women’s Health – Preconception and HIV

    POLICY TO PRACTICE

    We updated the Preconception Health Tool and its EMR form in the winter of 2019.

Ongoing Stakeholders

College of Family Physicians of Canada

Association of Family Health Teams of Ontario

Continuing Professional Development Ontario

Departments of Family Medicine

Primary Care Local Health Integration Network Primary Care Leads

Ontario Primary Health Care Nurse Practitioner Programs

Ontario Ministry of Health and Long-Term Care

Mental Health and Addictions Branch

Healthy Living Initiatives Unit

Strategic Policy and Planning Division

Partnerships and Consultation Unit

Specialized Models Programs

Ontario Ministry of Children and Youth Services

Indicates Topic Selection Advisory Panel Members

Ontario College of Family Physicians

Nurse Practitioners’ Association of Ontario

College of Physicians and Surgeons of Ontario

Health Quality Ontario

Local Health Integration Networks

Ontario Medical Association

Registered Nurses’ Association of Ontario

Primary Health Care Branch

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