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South Okanagan Similkameen

INITIATIVE UPDATES

Inside this issue

Team-based Care

Winter 2018

CY Physician Roster

Residential Care

New inpatient model on track to roll out in April The locally-designed model for inpatient care was presented at the Department of Family Medicine in early December, and is on track to roll out in April. The inpatient model addresses the burden of unassigned patients, whose numbers have been increasing at Penticton Regional Hospital. This model, designed by Penticton and Summerland physicians, will complement our existing community model of primary care. As shown below, Community Family Physicians will be expected to continue to care

for their own inpatients. A New Group will care for unassigned patients during the day, and participate in Doctor on Call duties. In addition, the New Group will be expected to 'chip in' in another capacity in the community such as at a walk-in clinic or as a locum. Physicians in the New Group will start in April. Rather than draw from our already-stretched physician pool, it's expected that this model will attract new physicians to town. Much work needs to be done to make this a reality. The new inpatient

solution will cost additional money, currently being sought from the Ministry of Health, GPSC and Interior Health. A commitment to this funding is expected by mid-January, with full details available at the next Department of Family Medicine meeting, Jan.23rd, 2018. In the meantime, a small group of physicians continues to refine details of the model, including compensation levels and New Group expectations. Conversations with individual specialty departments will be scheduled early in the new year.

Proposed model Proposed Model for Inpatient Care at Penticton Regional Hospital New Group

Unassigned Patients (7 days/week: 8am-6pm)

Community Family Physicians

Assigned Patients (Weekdays: 7am-5pm); (Weekends: 7am-noon)

Doctor on Call

Weekdays: 7am-5pm–Backup Call for Assigned + Residential Care 5pm-7am–Unassigned, Assigned + Residential Care Weekends: 7am-noon–Backup Call for Assigned + Residential Care Noon-7am–Assigned + Residential Care

South Okanagan Similkameen

www.divisionsbc.ca/sos


Penticton's White Clinic: working as a team to enhance care The White Clinic in Penticton is going the extra mile to enhance their practice. The entire team, including family physicians, a resident, MOAs and an LPN, recently met at the SOS Division office to explore the concept of Patient Medical Home (PMH), a resource that can help clinics assess their needs and strengths, and design or make adjustments to their practice. Using these resources can help a clinic make the shift from working as a group to working as a team. At this initial meeting, the White Clinic self-assessed what is going well, and areas they would like to build upon. As a team, they identified new ways to run their office more efficiently, and have their team members working at top of scope. They also had discussions about the benefits of working collaboratively in an inter-professional team environment, which can lead to improved professional satisfaction and new learning opportunities. “We do some of these things already,

The White Clinic Team: (back row, from left): Dr. Robin Masson, Dr. Izak Van der Westhuizen, Dr. Tyler Murphy (Resident), Deborah Chadwick, Dr. Greg Selinger, Lori Garay, Dr. Johan de Kock, Dr. Marius Snyman, (front row) Amanda Clarke, Courtney Thompson, Sybilla Bartram, and Rebecca Boychuk

but it’s helpful to know what the [PMH] concept is and what resources are available," says Dr. Robin Masson. Many clinics in the region are already working within the scope of Patient Medical Home, but may not realize it. Using Patient Medical Home resources is an easy way to optimize and build on teamwork and identify areas of opportunity for enhancement. Dr. Khati Hendry, GPSC Peer Mentor, spoke to the White Clinic about how working as a team leads to better care, more efficient work hours and a better

work life balance, which is attractive for many physicians, especially new grads that may be interested in coming to our community. Resources and support for exploring what Patient Medical Home might look like in your clinic are jointly offered by SOS Division, PSP (Practice Support Program) and GPSC. If you are interested in learning more about Patient Medical Home and how it could enhance your practice, please contact suzanne.moccia@sosdivision. ca or 778.476.5696. One call Æ More than 150 languages

1 844 office 350 8224 Free-of-charge translation services now available for patientsTollatfree: your

If a patient in your office needs a translator, help is now just a free phone call away. Thanks to a Provincial Health Services pilot project, you can call up an on-demand telephone service, and be connected to a translator in just minutes. More than 200 languages are available for translation. For information on how to use the on-demand translator phone service, and to download patient handouts, please visit the South Okanagan Similkameen Division of Family Practice website: www.divisionsbc.ca/ sos/ or contact Julie Young, SOS DoFP Operations Coordinator for assistance: member.services@sosdivision.ca or 778.476.5696. 2

Visit us online: pls.phsa.ca

English

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Mandarin

 晎通čŻ?âˆ•ĺ›˝čŻ­ 晎通芹 âˆ•ĺœ‹čŞž

čŻˇćŒ‡ĺ?‘ć‚¨ä˝żç”¨çš„čŻ­č¨€ďźŒćˆ‘äťŹĺ°†ä¸şć‚¨ĺŽ‰ćŽ’ĺ?ŁčŻ‘ĺ‘˜ă€‚ čŤ‹ćŒ‡ĺ?‘ć‚¨ä˝żç”¨çš„čŞžč¨€ďźŒćˆ‘ĺ€‘ĺ°‡ç‚şć‚¨ĺŽ‰ćŽ’çżťč­Żĺ“Ąă€‚

Punjabi

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Vietnamese

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Farsi

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‍ďť&#x;ﺎ ﺸﺎن ﺑﺪهﺪ ﺑ ﭟ زﺑﺎﯽ ﺣﺎ٠ﯽ زﺪ ﺗﺎ‏ .‍ﺑﺎاﯟ ﺗﺎن ďťŁďş˜ďşŽďş&#x; ﺑﺎ ŮˆŘąďť§ďşŞâ€Ź

Arabic

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Cantonese

 ĺšżä¸œčŻ? 坣ć?ąčŠą

čŻˇćŒ‡ĺ?‘ć‚¨ä˝żç”¨çš„čŻ­č¨€ďźŒćˆ‘äťŹĺ°†ä¸şć‚¨ĺŽ‰ćŽ’ĺ?ŁčŻ‘ĺ‘˜ă€‚ čŤ‹ćŒ‡ĺ?‘ć‚¨ä˝żç”¨çš„čŞžč¨€ďźŒćˆ‘ĺ€‘ĺ°‡ç‚şć‚¨ĺŽ‰ćŽ’çżťč­Żĺ“Ąă€‚

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French

Montrez-nous quelle langue vous parlez, s’il vous plaÎt. Nous vous fournirons un/e interprète.

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Hindi

â&#x201E;˘Ă&#x17D;Xf apnI Bfâ&#x20AC; f kI aor s<kyq kry<. afpky ilE anuvfdk ko bulfXf jfEgf.

Russian

 Đ Ń&#x192;Ń Ń ĐşĐ¸Đš

Đ&#x;ОкаМиŃ&#x201A;Đľ, какиП Ń?СŃ&#x2039;кОП вŃ&#x2039; вНадооŃ&#x201A;Đľ. Đ&#x2019;Đ°Ń Ń ĐžĐľĐ´Đ¸Đ˝Ń?Ń&#x201A; Ń ĐżĐľŃ&#x20AC;овОдŃ&#x2021;икОП.

Spanish

 EspaĂąol

Por favor seĂąale su idioma y llamaremos a un intĂŠrprete.

.â&#x20AC;Ť ﺳ٠ďş&#x2DC;ďşźďť&#x17E; ďş&#x2018;ďş&#x2DC;ﺎďş&#x; ďť&#x;ﺴďş&#x17D;ďť&#x2039;ﺪďş&#x2014;ďť&#x161;â&#x20AC;Ź.â&#x20AC;ŤŘŁďşˇďşŽ ŘĽďť&#x;ďť° ďť&#x;ďť?ďş&#x2DC;ďť&#x161;â&#x20AC;Ź Translation previouslyTagalog only free-of-charge at Interior Health ć&#x2014;Ľć&#x153;ŹčŞ&#x17E; Japaneseservices, which Tagalog were facilities, are now available for physician offices. Shown above is a handout for ă &#x201D;ĺ¸&#x152;ć&#x153;&#x203A;ă Žč¨&#x20AC;čŞ&#x17E;ă&#x201A;&#x2019;ć&#x152;&#x2021;塎ă &#x2014;ă Śă ?ă ă &#x2022;ă &#x201E;ă&#x20AC;&#x201A; Pakituro mo ang iyong wika. patients toé&#x203A;ťčŠąé&#x20AC;&#x161;訳㠍ă &#x160;㠤㠪ă &#x17D;ă &#x2014;ă žă &#x2122;ă&#x20AC;&#x201A; point to the language they require. Magpapatawag ako ng â&#x20AC;&#x2DC;interpreterâ&#x20AC;&#x2122; (tagasalin ng wika). Korean

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ě&#x201A;Źě&#x161;Ší&#x2022;&#x2DC;ě&#x2039;&#x153;ë&#x160;&#x201D; ě&#x2013;¸ě&#x2013;´ëĽź ę°&#x20AC;댏ěź&#x153; 죟ě&#x2039;­ě&#x2039;&#x153;ě&#x2DC;¤. í&#x2020;ľě&#x2014;­ě&#x201A;ŹëĽź ëś&#x2C6;ë&#x;Źë&#x201C;&#x153;ëŚŹę˛ ě&#x160;ľë&#x2039;&#x2C6;ë&#x2039;¤.

Italian

 Italiano Indicare la propria lingua. Verraâ&#x20AC;&#x2122; chiamato un interprete.


New team of physicians brings positive change to The Hamlets Staff at The Hamlets are thrilled to have six physicians signed up to take on new and orphaned residents at this Penticton facility. Just a few months ago, no physicians were in a position to take on this role. Much has changed at this facility to create an atmosphere where physicians can provide efficient and effective care, and to do so while working as a team. With the help of new staff and managers at The Hamlets, these six physicians, Drs. Lloyd Westby, Laura Hodgson, Leona Harries, Johan de Kock, Jennifer Begin and Andrew Dargie, found solutions to past frustrations and barriers to care. Led by Dr. Westby, staff and physicians have collaborated to overcome difficulties with parking, door codes, chart organization and nursing station keys. While dealing with these issues, the physicians have also been working together to develop an efficient system to care for groups of patients by scheduling regular visits, collaborating with nurses, and doing regular rounds with a pharmacist. With all these

Clare Graham (Co-Director of Nursing), Frances Quick (Director of Care), Lisa Beattie (Director of Operations), and Chris Browning (Co-Director of Care) present Dr. Lloyd Westby with an appreciation basket at The Hamlets in Penticton.

changes and more, locating and accessing patients is easier, and charts are prepared. Working as a team has led to increased physician satisfaction. "There has been a significant change for the better," says Westby. "The workflow is much smoother and the team approach removes pressure on us as individual physicians." The loss of the Complex Care Billing Code (14074) was also a barrier;

however, a new residential care bonus has since been implemented by the Division of Family Practice Residential Care Initiative to help foster a move towards teams of house physicians at local care facilities (See below for details). For more information, or if you're interested in joining one of the teams at other Penticton residential care facilities, please contact: lisa. needoba@sosdivision.ca.

RESIDENTIAL CARE: News and Opportunities SOS Division Residential Care New Patient Bonus of $200 WHAT For physicians taking on: sPatients going into Residential Care without a Most Responsible Physician (MRP) sResidents in need of an MRP (ie: orphaned, MRP is retiring, etc.) sResidents who are being transferred from another physician WHEN Effective Oct. 1, 2017 to March 31, 2019 WHY To recognize the time and care involved in taking on new Residential Care patients; the recent ending of the GPSC 14074 Complex Care billing code; and to encourage clustering to foster better resident care. HOW TO APPLY Submit by fax on Physician Office Letterhead: To the SOS Division of Family Practice, Attn: Residential Care Initiative (Fax number: 778-476-5992) Include: sPatient Initials sDate assumed MRP status (for new patients since Oct 1, 2017) sFacility name sWhere the patient transferred/referred from

CME Opportunity, Feb. 27th

Residential Care Best Practices: Speaker, Dr. Doug Smith, Residential Care Regional Executive Medical Director, Interior Health 3


SOS Division projects will be showcased at the Quality Forum The Division of Family Practice is pleased to announce that it will be sending four projects to the Quality Forum in February 2018. Martin Street Outreach Centre: Innovative partnerships at one-stop MHSU clinic Dr. Kyle Stevens will be presenting on the creation of a clinic where issues related to mental health are treated alongside primary care. Medication Wastage at Residential Care Facilities Dr. Bob Mack will lead this presentation, which focuses on a study of medication wastage conducted at local residential

care facilities. Currently, one medication order change often results in a week's worth of medications being thrown out. Community Team-based Care: A CYMHSU Case Study in Summerland Dr. Kyle Stevens will present on his work teaming up with a group of school counselors to identify and comanage the health of youth at risk. Primary Maternity Care: Trust and Culture Change This poster presentation will address the specific steps taken to build a level of trust that is needed to initiate a collaborative maternity care model.

Are you considering using telemedicine in your office? Pick up brand new, locallycreated how-to guides for you and your patients The Shared Care Telemedicine Working Group is pleased to offer brand new, locally-developed guides on how to use different types of telemedicine software in your office. Each folder contains a how-to guide for physicians for three different software programs: ConsultDerm, Medeo and RealPresence. It also contains patient handouts for Medeo and RealPresence. Each software program has a slightly different function, which may suit your working environment: Medeo helps connect to patients at their home or office; RealPresence is for use with patients located in the hospital or at another Interior Health facility; and ConsultDerm helps family physicians consult with dermatologists. "Telemedicine has revolutionized how I provide care to my out-of -town patients," says Dr. Michelle Teo. "Patients no longer need to risk their safety for an in-person appointment with dangerous driving conditions, and can still have a rheumatologic 4

Dr. Michelle Teo using the telemedicine software, Medeo, to connect with a patient

assessment if unable to leave the home." It also reduces travel that physicians may make to rural communities, especially in the winter months. The telemedicine handouts were designed for two CMEs held at the Dec. 8th Dept. of Medicine Rounds in Penticton, and at the Dec. 15th rounds at SOGH. Both featured Dr. Michelle Teo speaking on Medeo, and Dr. Shannon Walker on RealPresence. If you missed these CMEs, but would like more information or to obtain a folder contact: info@sosdivision.ca.

Attend the Quality Forum, Feb. 21-23rd 2018, free of charge! The Joint Collaborative Committees will sponsor the registration fees, travel and sessional for any BC practicing physician to attend the 2018 Quality Forum. Physicians must attend the preForum session, Champions of Change to qualify. Contact JCC@doctorsofbc.ca for more information

Chronic Pain Seminars in Osoyoos and Keremeos popular with the public Free Chronic Pain seminars held in Osoyoos and Keremeos this fall attracted large numbers of people dealing with chronic pain, as well as their caregivers. This audience learned about selfmanagement and options for their care from a panel of experts, which included Dr. Peter Entwistle; Neil Pearson, physiotherapist; and Connie Chan, pharmacist. "The public was extremely appreciative, and showed a great deal of interest in alternative pain control," says Aarin Frigon, SOS Division Project Lead. These seminars, hosted by the SOS Division of Family Practice and the communities, through the Developing Sustainable Rural Practice Communities Initiative (funded by Joint Standing Committee on Rural Initiatives), followed the success of a similar event in Princeton in 2016.

SOS Division of Family Practice: Congratulations! Congratulations to Drs. Elizabeth Allen, Leslie Lappalainen, David Van Den Berg and their partners on the recent births of their baby boys.


School counselor says connecting local at-risk youth to family physicians is making a huge difference

I

t's easy for Penticton Secondary School counselor, Michelle Glibbery, to list several students who are overcoming mental health issues, thanks to a local Child and Youth Physician Roster. "I work with a student, who in her former community, was diagnosed with depression and self-harming behaviour," says Glibbery. "She was assigned a physician, had her medications straightened out, and made a huge turnaround at school." CY Rosters, one in Penticton and one in Summerland, are a way for school counselors in each of those communities to find care for high-risk students who are without a primary care physician. "Assisting with this connection is so important," says Glibbery. "We can ensure a high-risk student doesn't go without much-needed health care." Only school counselors are able to access the Rosters in order to make sure that the number of referrals is targeted and small. In addition, school counselors only refer high-risk students. In fact, less than 20 students are referred per year in both Penticton and Summerland combined.

ABOUT THE CY ROSTERS Approximately 20 students per year are referred to the Penticton and the Summerland CY Rosters combined

"There is a huge sense of relief when we inform high-risk, unassigned youth and/or their parents that we may be able to assist with finding the youth a physician." â&#x20AC;&#x201C; Michelle Glibbery, Penticton school counselor

"Working together with the school counselors is rewarding, and it's much less of a burden to be on a Roster than it might seem," says Dr. Barb Main, who is on the Penticton CY Roster. Glibbery cites other examples of students who have turned around their situation because of this Roster. A student with bipolar disorder, eating disorders and substance abuse was connected to a physician, has gone into treatment and is 113 days clean. "Some physicians and youth have since developed caring relationships," adds Glibbery. In one case, a student benefits from monthly check-ins with the assigned physician regarding substance misuse, medication and overall mental and physical health. sReferrals only by school counselors

Another youth is being supported by a Roster physician as he enters into his journey living 'out' as transgender. The idea for these Rosters came from physicians and school counselors working together at a 2014 Practice Support Program Child and Youth Mental Health Module. The two community CY Rosters were then developed by Drs. Cathy Sheehan and Kyle Stevens. To ensure their ongoing success, we are currently seeking physicians for both CY Rosters. In Penticton, please call: MOA, Corissa Gerow at Dr. Ron Gans' office: 236.422.0101. In Summerland, contact MOA Chris Leardo at Kelly Ave. Clinic: 250.494.3432.

sReferrals only for at-risk students

The Summerland Roster is kept at Kelly Ave. Clinic (250.494.3432)

sPDCRS offers support or advice to

The Penticton Roster is kept at Dr. Ron Gans office (236.422.0101)

without a primary care physician physicians, if needed

Local resources for Child and Youth Mental Health and Substance Use patients at your office Folders filled with information to help physicians find appropriate local care and resources for their CYMHSU patients are available free-of-charge. Developed by CYMHSU Local Action Teams, these resources are specifically tailored for children and youth in Penticton/Summerland,

Oliver/Osoyoos/Okanagan Falls and Keremeos/Princeton. In the folder, physicians will find: sAn interactive checklist for guiding a conversation with a youth, which also acts as a take home action plan sDesktop and exam room posters which outline how and when to

access local mental health resources and organizations sTake home resource brochure, and wallet cards To order a CYMHSU resource folder or to obtain refills for your existing folder, please email info@sosdivision. ca or call 778.476.5696. 5


SOS Division in our Community DIVISION MEMBER SERVICES

...AND WHO IS INVOLVED

Inpatient Care Program Coordinating physician inpatient care in the South Okanagan Similkameen

Recruitment and Retention

Helping attract and retain physicians in the South Okanagan Similkameen

Drs. Andrew Dargie, Ron Gans, Jeff Harries, Sheena Manning, Ella Monro, Tom Oliver, Tim Phillips, Jan Venter, Elizabeth Watters, Danielle Weisgarber, Murali Venkataraman Division project contacts: tracy.stclaire@sosdivision.ca and Julie Young member.services@sosdivision.ca tel: 778 476 5696 Division project contact: aarin.frigon@sosdivision.ca tel: 778 476 1878

Martin Street Outreach Centre

Drs. Lisa Friesen, Leslie Lappalainen, Kyle Stevens, David Stoll; (IH) Kevin Fraser, Deb Salverda, John Yarschenko, (MOA) Kelly Hawes Division project contact: aarin.frigon@sosdivision.ca, tel: 778 476 1878

Primary care for the most complex MHSU patients in Penticton

...AND WHO IS INVOLVED

DIVISION PROJECTS Residential Care Providing proactive care, polypharmacy risk reduction, reducing barriers and decreasing avoidable visits to the ED

Drs. Colleen Black, Robert Calder, Mark Lawrie, Marina Louw, Bob Mack, Margaret Myslek, Peter Bennett, Richard Tatham, Elizabeth Watters; (IH) Connie Hattum, Dr. Doug Smith; all South Okanagan Similkameen residential care facilities Division project contact: lisa.needoba@sosdivision.ca, tel: 778 476 5696

Patient Medical Home and Primary Care Network

Drs. Tim Phillips, Murali Venkataraman Division project contact: suzanne.moccia@sosdivision.ca, 778 476 5896

Optimizing team-based care at the family physician office and in the community

Developing Sustainable Rural Practice Communities (JSC)

Drs. Peter Entwistle, Marina Louw, Tim Van Der Heide, Yves Thomas; Interior Health, BC Ambulance, Osoyoos Indian Band, Lower Similkameen Indian Band, Okanagan Nation Alliance, RDOS, PDCRS, Princeton Family Services, Lower Similkameen Community Services Society, Support our Health Care, Village of Keremeos, Towns of Oliver, Osoyoos, and Princeton; Division project contact: aarin.frigon@sosdivision.ca, tel: 778 476 1878

Working to establish sustainable and patient-focused healthcare in the South Okanagan Simlikameen Rural Corridor

SHARED CARE PROJECTS

...AND WHO IS INVOLVED

Steering Committee

Drs. Jeff Harries, Robin Masson, Marius Snyman, Michelle Teo, Jacqueline Stewart, Rob Swan, Shannon Walker; (IH) Susan Brown, Karen Leach-MacLeod, Carl Meadows, Deb Runge, John Yarschenko; (PPMS)Amy Woodruffe; (Shared Care) Tracy St. Claire, Kathleen Jagger, Ida Keller, Robin Watt

Partnering with specialists , IH and PPMS to improve patient and provider satisfaction

Primary Maternity Care Bringing together primary maternity care providers to co-design a sustainable model of maternity care for the community

Telemedicine

Drs. Robert Swan, Ella Monro, Michelle Teo, Shannon Walker; (IH) Susan Brown, Scott Frymire, Mark Mogan, Deborah Runge, Cherie Whittaker; Shared Care project contact: kathleen.jagger@sosdivision.ca, 778 476 5896

Using technology to connect rural patients to Penticton specialists

Vulnerable Frail Elderly Discharge from Emergency Optimizing a care pathway for vulnerable frail elderly from the ED back to the community

Acute Polypharmacy Polypharmacy risk reduction in an acute care setting Executive Director Tracy St. Claire 778 476 5696 tracy.stclaire@sosdivision.ca

Drs. Jennifer Begin, Catherine Botting, Lisa Friesen, Jose Goncalves, Sheena Manning, Greg Selinger, Marius Snyman; (midwives) Tiffany Holdworth-Taylor, Alyson Jones, Suzanne Lobb, Christy Raynolds, (IH) Ruth Johnson, Carl Meadows, Patricia Park, Maureen Spinks, Shannon Taylor; (RN) Sally Bouchard; Shared Care project contact: kathleen.jagger@sosdivision.ca, 778 476 5896

Drs. Zoe Ayling, Brent Harrold, Robin Masson, Shannon Walker; (IH) Susan Brown, Lisa Danby, Karen LeachMcLeod, Carl Meadows, Anne Morgenstern, Deborah Runge, Darlene Russell, Shelley Smillie; Shared Care project contact: suzanne.moccia@sosdivision.ca, 778 476 5896

Drs. Chad Dyck, Mark Lawrie, Marius Snyman, Shannon Walker; (Pharmacists) Christine Rutherford, Karen Lapointe, Patrick Edwards; (IH) Sharon Fekete, Jessica Nattress, Lois Neufeld; Shared Care project contact: kathleen.jagger@sosdivision.ca, 778 476 5896 Operations Coordinator Julie Young 778 476 5696 member.services@sosdivision.ca

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; Viola Brown

Profile for Divisions of Family Practice

SOS Initiative Updates - Winter 2018  

SOS Initiative Updates - Winter 2018  

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