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| HEAD'S MESSAGE 2010-11 represented year three of our five year strategic plan and to date, several major projects have been realized. The Department made strides in health care delivery, education and research, but "success is a journey, not a destination (Ben Sweetland)." Indeed we are humble about our achievements, as these did not occur without sacrifice. The hours were long and there were many trials and tribulations (four words – electronic medical record conversion). Commitment of faculty and staff to the vision outlined in our strategic plan has been critical to our success; acknowledging each team member’s input is important. When challenges arise, I am apt to think of the early explorers who founded our country. Without modern navigation technologies or even a map, these brave souls forged new opportunities in extremely harsh and dangerous conditions. What made them successful leaders – was it a superior education, a moral compass, sheer bravery? Crossing the Barren Lands of Northern Canada, Samuel Hearne founded the first inland trading post called Cumberland House, which opened up new supplies of beaver pelts for the Hudson’s Bay company. Hearne was only eleven years old when he left school to join the British Navy. David Thompson’s exploration and mapping for the North West Company covered an area of two million three hundred and forty thousand square miles. He opened the first trade with the northwestern aboriginals, interestingly, without resorting to trading whiskey. As one of our most famous explorers, Henry Hudson discovered Hudson’s Bay while looking for the Northwest Passage, but later met his end when mutineers set him and his son adrift in a small boat without supplies. So we are in good company historically – life does have its challenges, but also great rewards. Expansion Phase 2 saw the department branching out with the formation of two satellite programs in Belleville-Quinte and Peterborough-Kawartha. Both have been very successful and feedback from residents has been encouraging. The Oshawa-Lakeridge program is set to come on stream in 2012, and faculty there are working hard in preparation. We expect great things from this program as Queen’s extends into this region with its higher population and great medical traditions. Queen’s Family Medicine builds on strong linkages with these communities as distributed education has been a long-standing tradition. We are grateful to the many stakeholders for their support in terms of commitment, energy and resources. The Department has been an innovator in the realm of curriculum and evaluation. Drs. Karen (Pinky) Schultz and Ian Sempowski led the way in development of the horizontal curriculum, which allows residents to spend more time training within a family medicine practice. Dr. Jane Griffiths’ innovative thinking has led to the development of a web-based portfolio for all of our residents. This information management system for different types of objective evaluations, reflective exercises and other documents acts as a repository and tremendous educational tool now sought after by other universities. Another milestone for the Department included managing the Provincial Faculty Development Project on behalf of Ontario’s six departments of family medicine. This $825,000 initiative was led by the Council of Ontario Faculties of Medicine (COFM) Family Medicine Chairs. Under the chairmanship of Dr. Ruth Wilson and with support from Project Manager Tracy Weaver, it facilitated a collaboration between each of the Schools’ Directors of Faculty Development and their community preceptors. The culminating Provincial Forum held in Toronto on February 25, 2011 was a success, with a call for more such faculty development events. The College of Family Physicians of Canada has agreed to assume management of the R-scope website which houses a plethora of faculty development resources. With one-time support from the Ministry of Health and Long-Term Care, the $960,000 Building Capacity Project, under the management of Candice Christmas, Manager of Policy & Communications, and Jordan Alderman-Sinnett, Manager of Education, allowed the Department to better link to our satellite programs and community preceptors via the implementation of new technologies. Major investments were also made to the Simulation Lab at Queen’s University and a collaboration was formed with faculty in the FM/Anesthesia program to develop new curriculum. Additional training in obstetrical emergencies as well as procedural skills were also part of the initiative The Interprofessional Care Project or IPC Project culminated in a conference held January 20th, 2011 in Belleville which included family health team collaborators from across the Province of Ontario. With Dr. Diane Lu playing a key role as physician liaison, the IPC Project identified collaborative care best practices, launched interventions, and measured changes in cultural shift related to interprofessional care within the Queen’s family Health Team (QFHT). The formation of family health teams did not come with a blueprint. The IPC project has provided recommendations for the QFHT to establish ways to better communicate within teams – to be more self-aware – all the while keeping the patient at the centre of care … a compass of sorts. In the realm of clinical operations, The QFHT Quality Plan was developed and adopted under the leadership of QFHT Physician Lead Dr. Karen Hall Barber with the support of a community-based multi-disciplinary Advisory Board chaired by Florence Campbell. The plan acts as a road map to patient care, outlining accountabilities and focusing on improving safety, timeliness, efficiency, patient-centeredness, effectiveness and equity. The success of primary care research at Queen’s has been unprecedented thanks to the leadership of the Centre for Studies in Primary Care. The Canadian Primary Care Sentinel Surveillance Network (CPCSSN), a national data repository, will greatly increase research capacity. While recently in Australia investigating primary care systems, I discovered that each region is struggling with organizing and handling health data for chronic disease management. Queen’s is leading a national initiative that will be the envy of many countries, and positions us as a major research centre that will attract PhDs and Masters students as the data repository grows. We have the talent and the leadership at the centre, including Dr. Richard Birtwhistle, Director, Dr. Michael Green, Associate Director, and Jyoti Kotecha, Assistant Director. The academic mission of the Department is deepening. Indeed, Dr. Susan Phillips is co-investigator of an initiative awarded $1.5 million by CIHR to support and international study on mobility loss in seniors. This six-year study will examine 1,600 seniors in Canada, Colombia and Brazil. Dr. Lawrence Leung had ten peer-reviewed publications this year alone! We can acknowledge that all of our GFT Faculty are involved in scholarly activities, which in essence entails reflecting on their work in education, research and/or clinical practice, and sharing what they have learned with residents and peers. This universal uptake of academic activities is one of the Department’s greatest strengths. Dale Carnegie wrote "the person who gets the farthest is generally the one who is willing to do and dare. The sure-thing boat never gets far from shore." This has been a year of tremendous success and recognition for the faculty who make our Department so vibrant. Dr. Ruth Wilson received Family Medicine’s most prestigious international medical award: the Wonca 5-Star Doctor Award, the highest award for doctors from the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (Wonca). Dr. Richard Birtwhistle received the Physicians Researcher of the Year Award from the Canadian College of Family Physicians. Dr. Jane Griffiths received the CAME Education Award. Dr. Diane Lu received the PAIRO Excellence in Clinical Teaching Award. Dr. Walter Rosser, who can be credited for putting primary care research on the proverbial map received the Order of Canada! This has also been a year of transitions. Dr. Geoff Hodgetts returned to the Department as the Director of Education, following a thirteen-year secondment to the Bosnia Project. Dr. Willa Henry, Director of Postgraduate Education, left the Department in the spring to undertake new pursuits at the University of British Columbia. Heartfelt thanks are extended to Willa for her vision and tenacity in redeveloping the educational program over the past five years. Willa is succeeded as Director of Postgraduate Education by Dr. Karen (Pinky) Schultz. A veteran in postgraduate medical education at Queen’s, we expect Pinky’s experience to bring new depth to the program. The management team continues to grow and mature. The addition of Diane Cross as Clinic Manager has brought new skills and support to Clinical Operations. New recruitment is planned, including a Manager of Operations, a Communications Officer, and a Physician Compensation Administrator. The Tactical and Working Implementation Group has undertaken a series of initiatives in workplace safety and risk management, human resource support, and information technology. The Department is now focusing some significant energy on a plan to develop space to house the entire Kingston operation under one roof, a longer-term goal of the strategic plan. The Departments’ Information Technology Project, including the implementation of a new Electronic Medical Record (EMR) called OSCAR, the migration of email from two systems (Queen’s and Hotel Dieu) to the Google Cloud, and the installation of a SunRay thin client enterprise system across three geographic sites, was a herculean effort. Under the leadership of Dr. David Barber, Chair of the Information Management Committee, and with the support of Candice Christmas, Manager of Policy & Communications, a complete changeover of the Department’s IT system has allowed for the integration of our business and clinical systems. This involved forging new relationships with Queen’s University and Kingston Hospitals. Working with eHealth Ontario, the Department is now positioned to play a leadership role in extending connectivity to various facets of primary care in the region as well as linkages to secondary and tertiary centres. This type of initiative is never easy, but electronic transfer of data from one EMR system to OSCAR went better than predicted thanks to the dedication of our EMR User Group and Indivica, our OSCAR provider. The strength of our IT system is clear to all, but that is not to say there weren’t dark days. Undeniably, perseverance and good will on the part of our personnel and residents has been critical to the success of the project and special thanks are extended to all as we emerge from this transition, faster, stronger, better. As I write this message, the Department recently hosted a graduation reception for our PGY 2 residents who are moving on to the next phase of their careers. This group of residents has been very involved, contributing useful feedback on curriculum and organizational changes. Our faculty are confident they are ready to move on to their own unsupervised practices, to set their own course. But we also know they are committed to life-long learning, and that their intellectual journeying is far from over. They are interested in the social determinants of health and are clear that what family physicians do must be socially relevant. The tenets of Global Health and Health Equity are values that this group espouses to, and this excites me because they are issues that deserve to be at the forefront of education. So what makes good leaders? Architect and writer Frank Lloyd Wright declared: “I know the price of success: dedication, hard work, and an unremitting devotion to the things you want to see happen.” I extend my thanks to our faculty, staff and residents who have shown leadership, and have forged ahead, devoted to the cause, to realize the many worthwhile initiatives outlined in our strategic plan. Sincerely,
Glenn D. Brown
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