AFHTO 2024 Bright Lights Awards Nomination Form

Little innovations, big impact - Bright Light Award winners are innovators, making meaningful changes to improve the patient experience, health outcomes and reduce overall costs to the health care system. The awards program recognizes AFHTO members’ leadership, outstanding work and the significant progress being made to improve the value interprofessional primary care teams across Ontario deliver.

Awards will be presented at the AFHTO 2024 Conference Awards ceremony, which will be held at lunchtime on October 22, 2024.

The deadline to complete the online form is July 15, 2024.

How to submit a nomination:

By July 15, 2024:
- Review the Bright Lights nomination guide for evaluation criteria, award categories and tips to complete the submission.
- Complete the online nomination form in full. To avoid the risk of losing information, it is best to complete the online form in one session. (You can also review the submission form template before filling out this SurveyMonkey form and save a copy.)
- Submit supporting evidence and materials as appropriate to info@afhto.ca by 12 noon on July 15, 2024.
By July 26, 2024:
- Submit 1-4 high-quality photos in png. or jpg. format and a signed statement to release photos to be featured at the awards ceremony on Oct. 24.
- Take a video (30-90 seconds long) with your smartphone and share with info@afhto.ca. We’ll be promoting nominations before the conference, so please consider providing an overview of your initiative as part of your nomination(optional).

Question Title

* 1. Select the theme category that best fits for this nomination:
(See full descriptions of each category)

1. Expanding access to team-based care

2. Supporting the implementation of primary care networks

3. Investing in the digital health of primary care

4. Mental health and addictions

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* 2. Achievement to be recognized (brief title):

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* 3. Brief description of the achievement and why it merits recognition:
(100 words or less)

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* 4. Describe the actions taken and evidence available to demonstrate how the nominee recognized and addressed the needs of their local population (100 words or less)

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* 5. Describe the evidence available to demonstrate the impact of this achievement. Quantitative or qualitative data will be accepted as appropriate for the achievement being recognized. (100 words or less)

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* 6. What is the nominee doing to sustain this achievement and continue to improve in this area? (100 words or less)

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* 7. To what extent does this achievement offer other teams new learning, processes and/or resources that can lead to improvement? (100 words or less)

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* 8. Describe action taken by this nominee to spread this achievement more broadly (i.e. mentoring others, presentations to others, publications, etc.)
(100 words or less)

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* 9. We are considering a Bright Lights poster section to provide greater exposure for nominees. Would you like to participate?

Yes

Maybe

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* 10. Nomination submitted by:

Name

Surname

Phone #

E-mail

Question Title

* 11. Nominee Information:

Name of organization and/or individuals

Contact person for nominee

Phone #

E-mail

Thank you for submitting your nomination for the 14th annual AFHTO "Bright Lights" Awards.

Awards will be announced and presented at the AFHTO 2024 Conference Awards Ceremony, on October 24, 2024.

Award recipients will be selected by an independent review committee consisting of AFHTO members.

Please send any supporting data or documents to info@afhto.ca to complete your application.

The Association of Family Health Teams of Ontario (AFHTO)
400 University Avenue, Suite 2100
Toronto, Ontario M5G 1S5
Phone: 647-234-8605 x1200
E-mail: info@afhto.ca
Web: www.afhto.ca

Question Title

* 1. Select the theme category that best fits for this nomination: (See full descriptions of each category)

Question Title

* 2. Achievement to be recognized (brief title):

Question Title

* 3. Brief description of the achievement and why it merits recognition:(100 words or less)

Question Title

* 4. Describe the actions taken and evidence available to demonstrate how the nominee recognized and addressed the needs of their local population (100 words or less)

Question Title

* 5. Describe the evidence available to demonstrate the impact of this achievement. Quantitative or qualitative data will be accepted as appropriate for the achievement being recognized. (100 words or less)

Question Title

* 6. What is the nominee doing to sustain this achievement and continue to improve in this area? (100 words or less)

Question Title

* 7. To what extent does this achievement offer other teams new learning, processes and/or resources that can lead to improvement? (100 words or less)

Question Title

* 8. Describe action taken by this nominee to spread this achievement more broadly (i.e. mentoring others, presentations to others, publications, etc.) (100 words or less)

Question Title

* 9. We are considering a Bright Lights poster section to provide greater exposure for nominees. Would you like to participate?

Question Title

* 10. Nomination submitted by:

Question Title

* 11. Nominee Information:

* 1. Select the theme category that best fits for this nomination:
(See full descriptions of each category)

* 3. Brief description of the achievement and why it merits recognition:
(100 words or less)

* 8. Describe action taken by this nominee to spread this achievement more broadly (i.e. mentoring others, presentations to others, publications, etc.)
(100 words or less)