An innovative method of caring for a challenging patient population.
IMPACT (Interprofessional Model of Practice for Aging and Complex Treatment ) is a plan for assessing and providing care to elderly patients with complex health needs. The main IMPACT intervention is a 2-3 hour appointment where a multi-disciplinary team of health care professionals work together, real-time, to ‘unpack’ the patient’s condition by looking at a diverse range of medical, functional and psycho-social issues.
Partners
Funder
| • | HealthForceOntario Ministry of Health and Long-Term Care & Ministry of Training, Colleges and Universities |
Patients invited to IMPACT undergo comprehensive assessment and management by an interprofessional team. Working with the patient’s regular health care provider, the team collects information on a diverse range of medical, functional and psycho-social issues. The appointment is characterized by a high degree of inter-disciplinary cooperation: team members discuss their impressions as a group, and participate in each others’ examinations or assessments or observe via closed-circuit TV. Knowledge is shared amongst the team –one practitioner may incorporate information obtained by a practitioner of another discipline in his or her assessment – and the team’s final recommendations to the patient, family and referring practitioner are arrived at through a collaborative and consultative process. Participating patients often find the IMPACT approach to be very different from their typical encounters with their family physician, which tend to be more rushed and more focused on a specific disease.
While the IMPACT appointment is time- and labour-intensive, it offers a promising alternative to the traditional model of patient care. Patients are able to see practitioners of multiple disciplines in one appointment, and their collective knowledge, skills and real-time information sharing results in thorough and efficient communications among team members.
History
IMPACT was initially a project undertaken by the Department of Family and Community Medicine at Sunnybrook Hospital, and funded by a grant from the Ministry of Health and Long Term Care and sponsored by HealthForceOntario. The first phase of IMPACT, which began in 2007, saw the creation of a comprehensive, interprofessional team-based model of care for chronic disease management. This model was used to care for elderly patients of the primary care clinic where IMPACT was based; the weekly IMPACT sessions provided an enriched clinical learning environment for trainees and current staff.
When a second grant was funded by HealthForceOntario, the Centre for Effective Practice was brought on board to bring the IMPACT model to other primary care practices. Over the past year, CEP has worked with the Sunnybrook team to pilot the IMPACT model with Family Health Teams in Toronto and surrounding areas. These pilot sessions were designed to help FHTs develop and implement this innovative method of caring for a challenging patient population. The model is flexible, to be able to fit with individual FHTs' health human resources. In the process, we’ve helped develop a handful of useful tools and resources, available below.
Tools
About IMPACT, an overview of how IMPACT works, including a case study of an IMPACT patient
The IMPACT referral form, to guide providers in the selection of patients for assessment and care by the IMPACT team
The IMPACT interview guide, a document intended to guide the team in their initial discussions with IMPACT patients and help prioritize health concerns identified by the patient, caregiver(s), and team
The IMPACT care plan, completed by the team to guide the patient’s regular provider in their ongoing care for the patient
The IMPACT patient to-do list, for use by patients following their appointment with the IMPACT team
Learn More About this Project
Watch Dr. Leslie Nickell give an hour-long presentation on the project, at the Ontario Telemedicine Network's Webcasting Centre
View the accompanying slides
