Shifting Culture, Shifting Care: From ‘Usual Care’ to Chronic Care

Held April 1, 2015

The first of 4 webinars in our Shifting Culture, Shifting Care: From ‘Usual Care’ to Chronic Care Webinar Series. 


‘Usual care’ treats acute illness over brief periods of time and does little to help prevent disease or support patients or providers in more effectively managing chronic conditions. Good chronic illness care distinguishes itself in its focus on primary care with ‘whole-person’ knowledge of the patient, clearer accountability for the totality of care, and relationships with specialists that improve care and increase primary care expertise.

Chronic care challenges the old adage, “We’ve always done it this way” and moves from a fixation on volumes to a focus on value (what matters to patients). A chronic care approach is ultimately about shifting from disease-oriented, provider-centric and hospital-driven care to care that is person- and family-centred and meets people where they are. The success of the healthcare system depends on our ability to develop chronic care in concert with acute care. It requires changes structurally, institutionally and culturally.

Learning Objectives:

  • Explore the problems associated with a predominantly acute care model and the barriers in shifting to a chronic care paradigm
  • Highlight some significant challenges we face in shifting our healthcare culture to deliver more coordinated, patient- and family-centred chronic care
  • Share some creative solutions for moving ahead using real-life examples of clinicians who are shifting culture and shifting care


Jeffrey TurnbullJeffrey Turnbull, MD, FRCPC, Chief of Staff, The Ottawa Hospital

In addition to a BSc (University of Toronto) and a Masters Degree in Education (University of Western Ontario), Dr. Turnbull received his Doctorate in Medicine at Queen's University and later achieved specialty certification in Internal Medicine through the Royal College of Physicians and Surgeons of Canada in 1982.

Dr Turnbull has been the Vice Dean of Medical Education at the University of Ottawa from November 1996 to July 2001, the President of the Medical Council of Canada from 1998 to 2001, the President of the College of Physicians and Surgeons of Ontario from November 2006 to November 2007 and finally the President of the Canadian Medical Association from August 2010 to August 2011.

Dr. Turnbull has pursued an interest in poverty and its effect on health nationally and internationally. He is one of the founders and is currently the Medical Director of the Inner City Health Project for the homeless in Ottawa. As well, he has been involved in education and health services initiatives to enhance community and institutional capacity and sustainable development in Bangladesh, Africa and the Balkans. He is the recipient of several national and international grants and awards, including the Order of Canada, the Queen Elizabeth II Diamond Jubilee Medal and an Honorary Degree of Law from Carleton University.

In addition to being a specialist in Internal Medicine, Dr. Turnbull was the Department Chair of Medicine at The Ottawa Hospital and University of Ottawa from July 2001 to June 2008, a position he left to take on the role of Chief of Staff. He also currently serves as Senior Medical Officer for Correction Services Canada as well as Chief, Clinical Quality for Health Quality Ontario. He remains committed as a medical educator with special interests in “Poverty and Health Inequity” and associated health policy.

Clare-Liddy-125Dr. Clare Liddy is the Director of Research (interim) and a Clinical Investigator at the C.T. Lamont Primary Health Care Research Centre of the Bruyère Research Institute (BRI) and an Associate Professor in the University of Ottawa’s Department of Family Medicine.

She has received international and national acclaim for her experience in health services implementation research, particularly in the fields of improving access to care, chronic disease prevention and management, and implementation of health technology. Dr. Liddy and the innovative Champlain BASE eConsult service were recently recognized by Canada Health Infoway through the Monthly Max Impact award and also the Ontario Minister of Health through the annual Minister’s Medal, Honouring Excellence in Health Quality and Safety program.

Dr. Liddy’s interest in chronic care and self-management support originates from her clinical practice at the Ottawa Hospital Academic Family Team and she is driven by the goal of improving access to health service delivery for her patients and the population as a whole.


claudia-amar-107Claudia Amar, RN, BScN, MHA, Improvement Lead, Collaboration for Healthcare Improvement, Canadian Foundation for Healthcare Improvement

Claudia joined CFHI in 2012 and brings six years of nursing experience, including three years as a COPD clinical case manager at the Centre Hospitalier de l’Université de Montréal (CHUM). Claudia continues her work in COPD as the co-lead of the INSPIRED Approaches to COPD Care: Improving Care and Creating Value Collaborative - a spread collaborative supporting 19 teams from every province across Canada. She is also the project lead of the evaluation for CFHI's Atlantic Healthcare Collaboration in Chronic Disease - in addition to co-designing and implementing the evaluation, Claudia offers support to the teams involved from across Atlantic Canada. Another noteworthy project is Claudia's leadership of CFHI’s organizational self-assessment tool, Accelerating Healthcare Improvement: CFHI’s Assessment Tool. Claudia holds a Master of Health Administration from the University of Montreal and is also a graduate of the University of Montreal School of Nursing.