2015-2016 Annual Report
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It has been an exciting year for the Hamilton Family Health Team, and our vision for “A Healthier Hamilton” is rapidly taking shape. We’re continuing to grow community partnerships, expand our clinical programs and empower patients to take control of their health — all while improving access to health care services in our diverse city.
We think you will be pleased with this year’s streamlined annual report. Click the down arrows to learn more about our new strategic plan, our efforts to build community capacity, the many ways we have helped our patients achieve improved health, our dedication to continuous quality improvement and our commitment to fiscal responsibility.

We’re Certified
Future Fit
We asked, and our stakeholders, employees and partners answered. After an in-depth strategic planning exercise involving patient surveys and focus groups, staff sessions and consultations with 30+ local, regional and provincial agencies, we have a new three-year strategic plan. The input of more than 1,000 individuals helped craft the key HFHT focus areas you see on the left. We also developed 10 core directions to clearly define our vision for the future over the next three years and beyond.

Care for the Community, in the Community, by the Community
Our focus is shifting toward providing population based care that overcomes potential inequities due to socioeconomic conditions, gender, LGBTQ status, ethnicity and other factors. Over the past year, we have experimented with new models of care delivery that fit with this approach. In Dundas, we facilitated Community Health Planning Tables — teams of health and social service providers that address a patient’s unique needs in the context of his or her own community. We call this the patient’s “medical home.” Read more about creating a Patient Medical Home in Dundas.

Care for the Community, in the Community, by the Community
The HFHT has responded to the needs of the 1000 Syrian refugees who have come to Hamilton since January 2016. We’re a member of the Mayor’s Advisory Table on Syrian Newcomers, with a mandate to ensure the mental, emotional and physical health needs of Syrian newcomers are reviewed, understood and supported.
We are proud to provide support to Wesley Urban Ministries, the lead resettlement agency for Syrian refugees in Hamilton.



Unique Care Delivery Models
We embrace innovative ideas and community partnerships that ensure HFHT patients receive the best support and care possible. Over the past year, we have established and refined a number of collaborative programs designed to meet specific needs. Click on the green circles to the left to learn more about our programs.
We are always thinking about innovative ways to provide care. One HFHT mental health professional uses her German Shepherd, Max, as a therapy dog to soothe patients’ anxiety.

Creating Positive Spaces
We recognize that members of the LGBTQ community have particular health needs. We also know the importance of creating safe, positive spaces and opportunities for LGBTQ patients to talk about their health. To this end, the HFHT provides additional medical and awareness training for our providers and staff. We also post Positive Space signs in our clinics to put patients at ease and provide a list of LGBTQ resources on our website.
Dr. Robert Kerr is an HFHT Family Physician and advocate for improving health care for the LGBTQ community.

Empowering our Patients
Our physicians and interprofessional healthcare providers offer a broad range of clinical services to our patients. They focus on teaching, goal setting and arming patients with the tools they need to take control of their health.
Patients are raving about how effective this approach to care has been. One of our most powerful patient stories comes from Mr. Dobson who smoked for 50 years and recently wrote to tell us about overcoming addiction with help from an HFHT smoking support group.

Delivering Quality Care – and Results
In the past year, HFHT clinics and programs had a meaningful impact on the health of thousands of patients seeking care or support to improve and maintain their health. Click the image on the left to open an infographic summarizing key stats about the diverse programs we offer.

Continual Improvement for Quality Care
The HFHT is dedicated to ensuring the care our patients receive is of the highest possible caliber. Over the past year, our Quality Improvement (QI) Unit has continued efforts to improve care across several different dimensions. Read a summary of our organizational QI Plan, and click the down arrows for a more detailed look at some of our activities.


Actively Engaging Our Patients
The best way to ensure our patients are satisfied with their care is to ask them about it. Some of our practice teams surveyed patients about their experiences using an electronic tablet in their waiting rooms. Read how the Ocean Tablet program helped our health care providers improve services for patients.


Access to Services
We care about providing patients with the care they need, when they need it. Some of our patients completed a patient experience survey (see “Actively Engaging Our Patients” above) to tell us about their healthcare experiences. Read what patients had to say about accessing our services.


Enhanced Care
Co-Ordination
We want to ensure that patients with chronic conditions get follow-up care from their primary care provider after leaving the hospital.


Population Health
Our health care providers are encouraging patients to get screened for chronic diseases such as cancer and diabetes in order to prevent health problems before they start. Read about the ways our practice teams are working to improve screening rates for cancer and diabetes.
Dr. Meghan Davis is a HFHT physician and the Regional Primary Care Lead of Cancer Care Ontario. Dr. Davis uses her leadership and expertise to help HFHT practice teams be leaders in cancer screening.

The Hamilton Family Health Team looks forward to collaborating with the communities we serve to achieve the important goals identified in our new strategic plan. We will be working with the McMaster Family Health Team, local hospitals and social service agencies and the Hamilton Public Health Unit, with the support and encouragement of the Hamilton Niagara Haldimand Brant LHIN, to achieve our targets.
We will fulfil our vision of “A Healthier Hamilton” by providing better care, together.