South Okanagan Similkameen
INITIATIVE UPDATES Summer 2018
Dear Primary Care Providers and MOAs,
FEATURED IN THIS ISSUE
Please take a moment to read our newsletter...
What we're doing to make our communities more attractive to physicians:
We promise it's worth it! We publish quarterly as a quick way for you to learn about new incentives offered by the Division, and about local projects that can improve your practice. In this age of email overload, we are trialing delivery to your office, as well as continuing to make the newsletter available on the Division website homepage. Primary Care Providers and MOAs can receive a .5 hour sessional for reading this newsletter and completing the enclosed Newsletter Survey. Simply make copies of the short Survey, fill out, and fax back to our office.
New team-based care clinic New Primary Care funding for resources and health professionals in clinics Assistance with practice recruitment, retirement transitioning, and more! Pages 3-4
SOS Division of Family Practice: connecting, collaborating and creating change
MOA Education Event, May 2018
Residential Care Summit, April 2018
Helping connect rural physician offices with Community Paramedics, June 2018
Ask/Tell a Specialist CME, May 2018 South Okanagan Similkameen
Martin St. CME with Dr. David Stoll, May 2018
Residential Care Summit: Local physicians and facility managers agree on ways to improve care Local physicians came away from a recent Residential Care Summit energized and ready to continue to find ways to improve care at residential care facilities throughout our region. Those in attendance agreed that proactive visits need to be prearranged and built into a clinic day if physicians want to regularly see patients, build better relationships with care teams, and reduce faxes. Many have been trying to see patients when they have time at the end of the day, or on a day off. But if they arrive unannounced, facilities aren't ready for them. Dr. Margaret Myslek spoke at the event about creating office efficiencies in order to be able to predictably visit residential care facilities. "I'm surprised how much better I know the residents when I see them once per month," she says. "And it's become so much easier to answer nursing questions." Many Penticton physicians in attendance want to move towards clustering their patients at fewer facilities, understanding that smaller teams of physicians also help facilities provide better care.
Twenty-six physicians, a pharmacist, MOA and five facility managers attended a Residential Care Summit on April 24th, and took away ideas on how to better organize and assist with physician visits at residential care facilities.
A House Physician Incentive is available to physicians across the region who want to make improvements. Whether it's clustering, pre-arranging rounds, or working more closely with the pharmacist, physicians with 5 or more patients in a facility, on a facility Rota, and with an improvement focus, will be eligible for the House Physician Incentive. Physicians will be faxed directly to submit for the incentive in the coming weeks. "Physicians and MOAs can contact me to assist with clustering, incentive
questions, and enhancing proactive visits," says Lisa Needoba, SOS Division Residential Care Lead. "We've come a long way in recognizing the value of clustering and pre-arranged proactive visits for all patients, and it's nice to see how many physicians are successfully incorporating that into their practices," says Dr. Bob Mack, Residential Care Medical Coordinator. House Physician Model is enclosed in this newsletter. More information: email@example.com.
Physician champions step up to help residential care evacuees in Keremeos With the Similkameen River on the rise, longterm care residents were evacuated from Keremeos' Orchard Haven in mid-May. The 35 residents were temporarily relocated to a number of different facilities in Oliver, Osoyoos, Penticton and Summerland. Supporting the residents through the move took incredible teamwork, and all parties are relieved that things went well. Physicians including Dr. Margaret Myslek, Dr. Robert Calder and Dr. Richard Tatham were instrumental in stepping up to take on the patients' 2
care, and to quickly attend to the distressed patients. "The physicians were very responsive, and I know that the facilities really appreciated their support," says Lisa Needoba, Residential Care Initiative Project Lead at the SOS Division of Family Practice. Orchard Haven made sure that the residents were sent with two weeks of medications, IH contacted SOS Division for assistance with coordinating physician care, and the receiving facilities took on settling the patients well into the evening.
"This quick coordination is really a tribute to the relationships that have been forged amongst physicians, IH and facilities," says Needoba. "We realized that it really did take an entire team to orchestrate everything and ensure the residents were safely transported and looked after in their respective sites," says Peggy Mutch, Nurse Manager at the South Similkameen Health Centre. "Everyone was amazing in their willingness to do their part." The residents are now settled back in Keremeos and are doing well.
Making our community attractive for physicians to practice OUR STRENGTHS: • •
We have a strong existing network of engaged physicians providing primary care services in a coordinated way. This includes Inpatient Care, Mental Health and Substance Use, Maternity, Residential Care and Afterhours care. We have good relationships with Interior Health.
OUR CHALLENGES: • • • • •
We have more than 14,000 unattached patients in Penticton and Summerland alone. We have approximately 10 physicians retiring in the next three years. We have many physicians who work in small or solo practices. The majority of new physician graduates want to work in larger clinics and within teams. We are in competition with other areas across Canada that are also experiencing doctor shortages.
The Primary Care Network Initiative is an opportunity to create local solutions. Penticton and Summerland are among the first five communities in BC to receive new money to come up with a local service plan to improve primary care delivery, and consequently address physician shortages. Based on the plan that builds on the strength of the existing network of care, additional money will allow for new resources such as adding nurse practitioners, social workers, and other healthcare professionals to new or existing clinics. We expect to be able to start building service plans for Oliver, Osoyoos, Keremeos and Princeton in 2019. Through meetings and discussions with local physicians, Interior Health and our First Nations partners, we have collected strong and workable ideas to put in our plan, which must be ready for Ministry approval by early August: Open New Team-based Care Clinic in Penticton A new clinic, which will co-locate retiring and new physicians, nurse practitioners and other healthcare professionals. This will increase attachment to regular care providers and gets patients "attachment ready". (See diagram below). Sustain and Expand Martin St. Outreach Centre To include 1-2 nurse practitioners, more social worker time and an MOA. Explore Adding Nurse Practitioners and Community Workers into Summerland Clinics Sustain Inpatient Model and the South Okanagan Maternity Centre Start Physician Outreach to the PIB Health Centre and the Foundry Youth Centre Explore Integration of IH Home Health and MHSU Services with Physician Practices
Attached Patient Care
Team-based Care Clinic: Preliminary Design New New New Physician Physician Physician
Afterhours Afterhours Network Network
Retiring Retiring Champion CIS Pharmacist Physician Physician Physician Physicians
Walk in and After Hours Care
Retiring physician relocates to clinic, sharing patient panel with new physician and NP. After approx. 2 years, the new physician, NP and MOA relocate within the community. This allows for mentoring of new physicians, and offers new physicians a way to explore opportunities in our community.
Unattached Patient Care
Nurse practitioners working within a team of health professionals address needed services, and get patients attachment ready. Follow-up and care for unattached patients. 3
Ways the SOS Division is supporting physicians in our region Recruiting Services...
Engaging the media...
If you need to fill a temporary or permanent vacancy at your office, the SOS Division can help. We provide assistance advertising vacancies on HealthMatch BC, the Society of General Practitioners Locum jobs board, and on the UBC Family Medicine residency career opportunities notice board. Division staff will find out about the practice and personal interests of potential candidates, and then facilitate introductions to clinics. The Division also coordinates visits for candidates and their families. This includes a personalized tour led by recruiting specialist, Riley Gettens. Depending on the visiting physician's interests, the physician, family and recruiter tour local clinics, the hospital, visit city amenities, as well as explore neighbourhoods and specific areas of interest for the entire family. We are also currently looking at ways we can support our locums and visiting physicians with housing, and partner with municipalities and local services to create a welcoming environment for physicians. More info: firstname.lastname@example.org.
Physicians and Board Directors shared ideas about how to talk the to media, and how to engage the public on local issues at a recent media training event in Oliver. Through the media training experience, the group discovered that they are facing many common challenges and talked about how their communities can support each other as they build primary care plans for the entire SOS region. "The media training event was an excellent way to learn about tips and tricks, but also to discuss challenges
and hear about what's working in other communities," says Dr. Claire Kuzmochka. Media training participants included two physicians from Oliver, two from Osoyoos, a Nurse Practitioner from Princeton and two Penticton physicians. From left: Brent Weiss (Doctors of BC), Tanya ter Keurs NP, Tracy St. Claire, Heather Allen, Dr. Jaco Bellingan, Dr. Tim Phillips, Aarin Frigon, Dr. Greg Selinger, Tara Lyon (Doctors of BC), Dr. Lorraine Kane and Dr. Claire Kuzmochka. (Dr. Madia Smallwood, missing from photo).
Providing incentives for the PRH Community Inpatient Service... At Penticton Regional Hospital, unattached inpatients are cared for by a group of Community Inpatient Service (CIS) physicians. As this program gets up and running, we are looking for physicians to temporarily fill CIS shifts. We have hired 4 CIS physicians, and are
currently recruiting 3-4 more. The Doctor of the Day is required to take unattached admissions when CIS is closed. CIS may also transfer stabilized patients to local family physicians for duration of stay to open CIS availability. Physicians can fax the Division
office to receive $75 incentive for the transfer of a stabilized CIS patient (778 476 5992). We are also currently offering a $100/ day incentive for CIS shifts from June 5th - Sept.4th. This increases to $200 for long weekend shifts.
Please join us Monday, July 16th for a Dialogue and Design session We will refine ideas for a Penticton/Summerland primary care service plan, and see how it might start to fit with an SOS-wide plan for primary care. 5:30-8:30pm, Linden Gardens More info/RSVP: email@example.com 4
Local physicians receive accolades for their work The team of physicians at Martin St. Outreach Centre (Drs. Kyle Stevens, Lisa Friesen, David Stoll, Leslie Lappalainen, Cathy Rooke and Heather Filek); Dr. Mark Lawrie, Dr. Chad Dyck and Dr. Leona Harries, recently won awards to acknowledge their outstanding contributions to the community. At the beginning of June, Dr. Stevens travelled to Toronto to accept the 2018 Collaborative Mental Health Care Award on behalf of the Martin St. team. Awarded by the College of Family Physicians of Canada and the Canadian Psychiatric Association, they were recognized for outstanding work providing mental health care in a primary care setting, which involves collaboration with mental health services and providers. The UBC Department of Family Practice has also given two awards for outstanding teaching to local physicians. At the June residency graduation ceremony Dr. Chad Dyck received the Postgraduate Teaching Award, which recognizes preceptors who have demonstrated excellence in teaching. Dr. Mark Lawrie was presented with
Dr. Kyle Stevens receiving an award on behalf of Martin St. Outreach Centre
the Peer Selected Award, chosen by colleagues for excellence in faculty and clinical/academic teaching. In addition, Dr. Andrew Ashley, first year resident of the Okanagan
Welcomes, Thank Yous and Congratulations! The South Okanagan Similkameen Division of Family Practice extends a warm welcome to Dr. Josh Webb, who will be taking over Dr. Johan Boshoff's patients in Keremeos. “We are looking forward to Dr. Webb joining our clinic and community in July,” says Dr. Marina Louw. “I’m sure the community will assist us in welcoming him and helping him make Keremeos feel like home.” We also wish to thank Dr. David Surkan for 40 years of practice in family medicine, with 29 of those in Penticton. Enjoy a well-deserved retirement!
Dr. Josh Webb will begin practice in Keremeos in July Welcome and thank you to nurse practitioner, Tanya ter Keurs, who is taking over Viola Brown's position on the SOS Division of Family Practice Board of Directors. Congratulations to Viola Brown on the birth of her twins, Rosa and Ryland on June 5th.
South Family Medicine Residency program, won the Peter Grantham Resident Teaching Award. As the name suggests, this award recognizes first year residents who have demonstrated interest and excellence in teaching. In May, Dr. Leona Harries won the BC College of Family Physicians 'My Family Doctor' award, which gives British Columbians the opportunity to recognize and honour their own family doctors. She was just one of five BC physician recipients. A patient expressed her gratitude for Dr. Harries' work: “Dr. Leona Harries is the most caring, giving human being and doctor I have ever had the privilege to know. She took on both my parents as they were dying, mom from cancer, dad from pulmonary fibrosis. There are no words to express what she did for my mom and dad and us as a family throughout the most horrific two years plus of our lives. Dr. Harries is the embodiment of what it means to be a physician." Congratulations to all of these deserving recipients for their work in our communities.
SOS Division AGM Save the Date
Sept. 12th AGM and Dinner Linden Gardens
More information to follow, or contact: Julie Young firstname.lastname@example.org 778 476 5696 5
SOS Division in our Community DIVISION INITIATIVES Primary Care Network
Creating an integrated system of care, which enables access to quality primary health care
Patient Medical Home
Supporting family practice offices to operate at their full potential
Developing Sustainable Rural Practice Communities (JSC)
Working to establish sustainable and patient-focused healthcare in the South Okanagan Simlikameen Rural Corridor
Martin Street Outreach Centre
Primary care for the most complex MHSU patients in Penticton
South Okanagan Maternity Centre
Interdisciplinary care clinic now open at Penticton Regional Hospital
Residential Care Initiative
Supporting physicians to provide proactive and collaborative care, and enhance resident and provider experience
Project contact: email@example.com, tel: 778 476 5696
Penticton/Summerland Project contact: firstname.lastname@example.org, tel: 778 476 5896 Oliver/Osoyoos/Keremeos/Princeton Project contact: email@example.com, tel: 778 476 1878
Project contact: firstname.lastname@example.org, tel: 778 476 1878 Project contact: email@example.com, tel: 778 476 1878
Project contact: firstname.lastname@example.org, 778 476 5896
Project contact: email@example.com, tel: 778 476 5696
Inpatient Care Programs
Coordinating physician inpatient care in the South Okanagan Similkameen
Recruitment and Retention
Helping attract and retain physicians in the South Okanagan Similkameen
Helping family physicians and specialists get accreditation, and local access to education opportunities
Project contact: Julie Young firstname.lastname@example.org, tel: 778 476 5696
Project contact: Julie Young email@example.com tel: 778 476 5696
Project contact: firstname.lastname@example.org email@example.com, tel: 778 476 5696
SHARED CARE INITIATIVES Partnering with specialists , IH and PPMS to improve patient and provider satisfaction
Project contact: firstname.lastname@example.org, tel: 778 476 5896
Vulnerable Frail Elderly Discharge from Emergency
Project contact: email@example.com, tel: 778 476 5896
Primary Maternity Care
Bringing together primary maternity care providers to co-design a sustainable model of maternity care for the community
Optimizing a care pathway for vulnerable frail elderly from the ED back to the community
Project contact: firstname.lastname@example.org, tel: 778 476 5896
Acute Polypharmacy Telemedicine Residential Care Polypharmacy Executive Director Tracy St. Claire 778 476 5696 email@example.com
SOS Division Fax: 778 476 5992
Polypharmacy risk reduction in an acute care setting Project contact: firstname.lastname@example.org, tel: 778 476 5896
Using technology to connect rural patients to Penticton specialists Project contact: email@example.com, tel: 778 476 5896
Oliver/Osoyoos physician mentorship to reduce polypharmacy risks in longterm care Project contact: firstname.lastname@example.org, tel: 778 476 5896 Operations Lead Julie Young 778 476 5696 email@example.com
SOS Division of Family Practice Board of Directors Drs. Tim Phillips (Physician Lead), Colleen Black, Ron Gans, Alan Gow, Brent Harrold, Margie Krabbe, Cathy Rooke, Greg Selinger; Tanya ter Keurs