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South Okanagan Similkameen

INITIATIVE UPDATES

Inside this issue

Rural Care Improvements

Fall 2017

Team-Based Care

Partnerships

Why do patients choose the ED over other care options?

A

new South Okanagan Similkameen Emergency Department survey, developed in partnership with the SOS Division of Family Practice and UBC Okanagan researchers, aims to answer the question: "Why are certain patients choosing to go to the Emergency Department when a better alternative to care may have been available? "We need to understand why patients come to the ED before we can change their behaviour," says UBCO behavioural scientist, Dr. Heather Gainforth. The survey will be implemented from September to December 2017 by UBC residency student Dr. Travis Thompson as part of his scholarship project. Thompson expects to gather between 50-100 surveys, completed by patients at the Penticton Regional Hospital Emergency Department. To ensure the survey's success, the SOS Division of Family Practice hosted a focus group this summer in collaboration with the Patient Voices Network. Participation included eleven patient volunteers. Suggestions from the focus group have led to many changes in the

Dr. Travis Thompson, and UBCO researchers Rhyann McKay and Dr. Heather Gainforth partnered in a recent focus group to develop an Emergency Department patient survey for use at Penticton Regional Hospital

format and content of the survey, making it more user friendly, and more useful to researchers when assessing behaviours that led to Emergency Department visits. Results of the survey will help with understanding current behaviours and pinpoint future solutions such as systems changes to relieve pressure on the emergency department and family physicians, and patient South Okanagan Similkameen

education on how to better access primary care in the community. The survey results will also inform the Shared Care Project: Vulnerable Frail Elderly Discharge from Emergency, which is working to ensure that patients receive the right care, at the right time, by the right provider. For more information: Suzanne Moccia, Project Lead suzanne. moccia@sosdivision.ca

www.divisionsbc.ca/sos


Improving office workflow in Keremeos was 'an absolute pleasure' Keremeos family physicians recently tackled their clinic and office flow challenges with amazing results. They were able to make efficient, practical changes by accessing the coaching and guidance of the Practice Support Program Advanced Access/ Office Efficiency series, supported by the SOS Division of Family Practice and a local MOA peer mentor. "We offered protected time to work out details that would lighten workloads, and make sure office staff and physicians were working within the scope of their roles," explains Wendy Boyer, PSP Coordinator for the South Okanagan Similkameen. "Working with Wendy and Rob was an absolute pleasure," says Dr. Johan Boshoff. "We have benefited from their facilitation experience in identifying the varied issues at our clinic. This has greatly improved our clinic efficiency, workplace atmosphere and overall enjoyment in our employment." To begin the improvement journey, South Similkameen Health Centre physicians and multidisciplinary team members came together for an evening learning session, which included confidential team

Physicians and staff pictured in front of the South Similkameen Health Centre in Keremeos (from left): Danielle Lanneville, Gloria Sheets, Stacey Carter, Lisa Porter, Nadine Allen, Janet Young, Laurel Skadberg, Dr. Mark Baillie, Dr. Marina Louw, Dr. Ifeju Omojuwa, Dr. Johan Boshoff

discussions, process mapping, and problem and solution identification. "The physicians and team were so dedicated to making improvements," says Boyer. "All attended the planning meeting, and expressed 100 percent buy-in for change." This quickly led to an office work plan that prioritized improvements ranging from scheduling/work flow, attaching patients, EMR panel updates, EMR user-training, communications, and setting aside dedicated time for rapid access patients. "Being able to see patients expeditiously with Advanced Access built into every day has helped to be of service, and improve patient

satisfaction without compromising being 'relatively' on-time," says Dr. Mark Baillie. "The whole journey was very practical and it was enlightening to get input from other offices," says Dr. Marina Louw. Improvements to clinic workflow also made it easier to cope when locums and an LPN were added to clinic operations. The Keremeos team encourages other clinics thinking about improvements to contact the SOS Division of Family Practice (info@ sosdivision.ca), or Wendy Boyer (wendy.boyer@interiorhealth.ca).

Rural physicians and their families get connected at Osoyoos Social South Okanagan Similkameen Rural Corridor physicians enjoyed sunny Okanagan weather at a recent Get Connected event at Watermark Beach Resort in Osoyoos. This get-together combined a rural physicians' meeting with a chance for physicians and their families to connect. It included a family social, lunch, and plenty of fun for kids. The rural physicians' meeting included discussions on current and completed projects of the SOS Rural Corridor Developing Sustainable Rural Practice Communities Initiative, and presentations by Dr. Alan Ruddiman and Dr. Tim Phillips.

Rural physicians are invited to a fall meeting and social on October 28th 10:30am- 2:30pm To RVSP or for more info: renate.hayden@sosdivision.ca 2


New and amazing UBCO Family Medicine Residents roll into town To welcome the latest batch of family medicine residents to the South Okanagan, Dr. Murali Venkataraman organized an Amazing Race South Okanagan. The teams who raced across Penticton by bike were Drs. Zuzana Praslickova (year-one resident) and Elizabeth Watters; Andrew Ashley (year-one resident) and Jackie Bourdeaux (year-two resident); Tyler Murphy (year-one resident) and Travis Thompson (year-two resident); Claire Lobsinger (year-one resident) and

Drs. Andrew Ashley and Jackie Bourdeaux

Amazing Race beach volleyball challenge

Sheena Manning. The race included challenges at Skaha Beach, King's Park, Penticton Regional Hospital and the South Okanagan Similkameen Division of Family Practice. "The amazing race

was fantastic! It really showcased the community," says Thompson. "It also demonstrated how easy it is to get around Penticton on a bicycle, which encourages health promotion."

New UBCO family medicine residents (the class of 2017-2019) (from left) Drs. Andrew Ashley, Claire Lobsinger, Tyler Murphy and Zuzana Praslickova

Local physician makes a Physician community responds to the opioid crisis splash fundraising for South Many local physicians provide the right time, Martin St. physicians Opioid Agonist Therapy, the mainstay continue to maintain services for Okanagan Similkameen treatment for an opioid use disorder, unattached patients with mental Medical Foundation including Drs. Lloyd Westby, Driaan

This summer, Dr. Lloyd Westby motored through the Great Ogopogo Bathtub Race representing Penticton Regional Hospital. Westby narrowing missed capturing the win, having so much fun that he actually completed three more laps than were required! "On behalf of Penticton Regional Hospital, I want to thank Lloyd Westby for an amazing and nailbiting bathtub race," says Carl Meadows, Health Services Administrator. "Although he didn't win the trophy, he won our hearts."

van der Vyver, Peter Entwistle, Tim van der Heide; and four Martin St. Outreach Centre physicians, Drs. Leslie Lappalainen, Kyle Stevens, Lisa Friesen and David Stoll. Last week, local prescribers got together to discuss their capacity to treat opioid use disorder patients. Due to the current opioid crisis, OAT prescribers, locally and across the region, have been expanding their efforts to address an increased demand and ensure minimal waitlists to access treatment. In August, Martin St. alone accepted 39 new OAT patients. Getting OAT treatment is vital, especially for those who have had non-fatal overdoses, leaving them at an increased risk of subsequently having a fatal overdose. "This ‘near-miss’ may represent a period where they are amenable to addiction treatment," explains Dr. Leslie Lappalainen. In order to reach these patients at

health and/or addiction issues, but will now also see attached patients requiring OAT. To deal with the opioid overdose emergency, which has continued to result in fatal and non-fatal overdoses at alarming rates locally and across the province, Martin St. is asking community physicians for help. Specifically, they are looking for physicians willing to accept a stabilized patient from Martin St. (who is not on OAT). A stabilized patient consistently attends appointments, can be seen in 10-15 minutes, and has had no recent admissions to hospital for psychiatric and/or addiction issues. If an individual de-stabilizes, they could be transitioned back to Martin St., a one-stop centre providing mental health and primary care services to a targeted at-risk population. For more information please contact: Aarin Frigon aarin.frigon@ sosdivision.ca. 3


New training enhances rural maternity care A sustainable model for maternity care for all South Okanagan Similkameen communities is being developed, thanks to work done by the Shared Care Primary Maternity Care Working Group. Over the past year the group's work has included a focus on improving patient transitions between rural communities and primary maternity care options in Penticton. Princeton is the latest community to benefit from this group's collaborative efforts. Currently, all expectant mothers in Princeton are transferred at different stages of their prenatal term to Penticton. All births are planned for Penticton as Princeton General Hospital isn't equipped for deliveries. Of course, babies don't always follow the rules, and a recent uplanned birth

Susie Lobb

Dr. Greg Selinger

at the Princeton General Hospital highlighted a need for training and a contingency plan. This spring/summer, Dr. Greg Selinger and midwife Susie Lobb, members of the inter-professional collaborative maternity team, travelled to Princeton to provide two workshops: the Neonatal Resuscitation Program and Emergency Obstetrical Training. The workshops were attended by GPs and nursing staff at PGH who used available equipment to practice onsite emergency drills.

Shared Care Steering Committee expands its membership

SC Steering Committee (from left) Kathleen Jagger, Dr. Glen Burgoyne (retiring), Dr. Michelle Teo, Dr. Marius Snyman, Tracy St. Claire, Dr. Shannon Walker, Susan Brown, Dr. Jacqueline Stewart and John Yarschenko (Missing: Drs. Jeff Harries, Robin Masson, Rob Swan; Carl Meadows, Karen Leach-MacLeod, Deborah Runge, Robin Watt, Amy Woodruffe) Committee membership now includes Interior Health's SOS MHSU Administrator and the Penticton Physician Medical Society, allowing the Committee to align all activities involving physicians in the region. In the fall, the Committee will be developing a community plan that encompasses all physician health care initiatives.

SOS Division of Family Practice: New and Retiring Physicians

Welcome new physicians

Dr. Jennifer Begin Fairview Medical, Penticton Dr. Andrew Daly Family Health Clinic, Oliver Dr. Andrew Dargie Dr. Glen Burgoyne’s practice, Penticton Dr. Tom Irvine Dr. Sue Severide's practice, Rosedale

Medical Associates, Summerland Dr. Jayden McIntyre Osoyoos Medical Centre Dr. Bert Neethling Kelly Ave., Summerland

Thank you, retiring physicians

Drs. Glen Burgoyne, Sue Severide and Derek Barkhuizen

Study finds thousands of medications wasted in BC residential care facilities The SOS Division of Family Practice and partner pharmacy Remedy's Rx recently conducted a four-week study on medication wastage stemming from the unnecessary return and subsequent discarding of residential care patient medications. The study, spearheaded by physician lead Dr. Bob Mack, found significant factors contributing to wastage. Medicines in many of our region's care facilities are delivered in weekly multi-dose packages. Due to this, one medication order change can result in a week's worth of medications being discarded. For example, a simple reduction in the dosage of Acetaminophen, costing pennies, can lead to the disposal of approximately $100 of medication. In addition, many medications are unnecessarily returned because, currently, physician medication orders at residential care facilities are considered STAT. "Many physicians didn't know this was the case," says Dr. Mack. "As soon as they found out, they spontaneously volunteered to make immediate changes, allowing an order to wait until the next medication delivery day." One of the recommendations stemming from this study is to have all medication order changes occur on next medication delivery day by default, unless overridden by a physician. Reducing the number of medications returned to pharmacies is an important way to decrease wastage, as all returned medications are disposed for safety reasons. A second recommendation includes the creation of a provincial working group to look at collaborative solutions. For more information or for access to a copy of the report: tracy.stclaire@ sosdivision.ca. 4


Team-based care attracts new physician to Summerland Dr. Danielle Weisgarber established her practice at the Rosedale Medical Clinic in Summerland in large part because it provides team-based care. "Being relatively new to family practice, it's super appealing to work in this type of environment," says Weisgarber. "It's nice to work in a team and the group is lovely. Once they had a spot for me I could not turn it down!" Working at the Rosedale Clinic means that Weisgarber has coverage if something comes up, and that physicians in the office can support and learn from each other. These networks extend to include specialists, which is one of the attributes of a Patient Medical Home. "We have a very lovely balance of being a big enough community that we have specialists, but not so big that you don’t get to know them." Weisgarber says that many physicians are seeking a better work/life balance. "The days I am not working in the clinic, I worry about my patients, their tests

Dr. Danielle Weisgarber, who graduated from the University of Saskatchewan and completed a 2-year family medicine residency, now practices in Summerland.

etc. The model at Rosedale allows me to have support so that when needed I can step back and take care of myself, without my patients suffering." Weisgarber says it's hard to be disciplined about work/life balance,

but is grateful that this type of practice allows her to do so. Rosedale's team-based care includes seven (soon to be eight) physicians as well as MOAs, an office manager, an RN, and an LPN. Having nurses in the clinic is extremely valuable as they can take phone calls and do procedures, allowing physicians to work more efficiently. Some may be detracted by overhead costs; however, Weisgarber adds that it's worth it to work in a well-run office and have extra clinical support. A team-based approach to care in the community such as having coordinated support from providers including home care nursing and community-based social workers is important to Weisgarber. For this to work, good communication and knowledge of community resources is essential. "Penticton has one of the better medical set ups compared to many places," adds Weisgarber. That's why I like working here."

Physicians addressing Inpatient hassle factors at Penticton Regional Hospital Family physicians are actively addressing hassle factors related to Doctor of the Day and assigned inpatient care with IH nurses and administrators. Drs. Main, Pugachev, Burgoyne, Gans and Westby met with IH twice in August, and plan for at least two more

sessions in September. The meetings, mandated at the June Department of Family Medicine meeting, will focus on role clarity, improving workflow and developing a collaborative framework to ensure the family physician role in inpatient care is supported as a valued member of the health care team.

Results of these sessions will be reported back to physicians through the Department of Family Practice, Penticton Physician Medical Society and SOS Division of Family Practice. Recent improvements include the development of a standard patient chart order throughout IH.

Save time and speed along applications for Patients With Disabilities designation The Penticton Access Centre can help your patients through all stages of applying for a Person With Disabilities designation. Physicians need only to fill out the Physician's Report section of the application, which Penticton Access Centre clients will bring to your office. Once completed, give the application back to the patient to take to the Access Centre, or call the Centre

to have it picked up from your office. The Access Centre will then take care of the rest of the application process for your patient. Some points to remember when filling out the Physician's Report – the four tests for Patient With Disability eligibility are: 1. A physician must confirm that the impairment is likely to continue for two years or more from the date of

application. 2. The disability must be confirmed as severe in nature by a licensed physician. 3. The applicant must be significantly restricted from performing activities of daily living either periodically or continuously for extended periods. 4. An applicant must need significant help or supervision from another person, or have an assistance animal. 5


SOS Division in our Community DIVISION MEMBER SERVICES Inpatient Care Program Coordinating physician inpatient care in the South Okanagan Similkameen

Recruitment and Retention

Helping attact and retain physicians in the South Okanagan Similkameen

Martin Street Outreach Centre

Primary care for the most complex MHSU patients in Penticton

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

Patient Medical Home and Primary Care Network

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

Developing Sustainable Rural Practice Communities (JSC) Working to resolve issues of recruitment, retention, and/or service delivery in Oliver, Osoyoos, Keremeos and Princeton

SHARED CARE PROJECTS Steering Committee

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

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

...AND WHO IS INVOLVED Drs. Ron Gans, Ella Monro, Tim Phillips, Jan Venter, Elizabeth Watters 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

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

...AND WHO IS INVOLVED Drs. Colleen Black, Robert Calder, Mark Lawrie, Marina Louw, Bob Mack, Margaret Myslek, Peter Bennett, Richard Tatham, Elizabeth Watters; (IH) Cindy Regier Division project contact: lisa.needoba@sosdivision.ca, tel: 778 476 5696

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

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

...AND WHO IS INVOLVED 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 Drs. Jennifer Begin, Catherine Botting, Armelie dela Cruz, Steve Evans, Lisa Friesen, Jose Goncalves, Sheena Manning, Manoj Parameshwar, Kevin Renaud, Greg Selinger, Marius Snyman, Murali Venkataraman; (midwives) Tiffany Holdworth-Taylor, Alyson Jones, Suzanne Lobb, Christy Raynolds, (IH) Ruth Johnson, Carl Meadows, Patricia Park, Maureen Spinks, Kerry Rollison, Shannon Taylor; (RN) Joline McNolty; Sally Bouchard; Shared Care project contact: kathleen.jagger@sosdivision.ca, 778 476 5896 Drs. Jose Goncalves, Ella Monro, Robert Swan, Michelle Teo, Shannon Walker; (IH) Susan Brown, Chris Danby, Scott Frymire, Mark Mogan, Deborah Runge, Cherie Whittaker; 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; Shared Care project contact: suzanne.moccia@sosdivision.ca, 778 476 5896

Drs. Chad Dyck, Mark Lawrie, David Paisley, Marius Snyman, Shannon Walker; (Pharmacists) Christine Rutherford, Karen Lapointe, Patrick Edwards; (IH) Candis Davis, Sharon Fekete, Jessica Nattress, Lois Neufeld; Shared Care project contact: kathleen.jagger@sosdivision.ca, 778 476 5896

SOS Division of Family Practice Board of Directors Dr. Tim Phillips (Physician Lead); Drs. Colleen Black, Ron Gans, Brent Harrold, Margie Krabbe, Cathy Rooke, Greg Selinger, Murali Venkataraman

Profile for Divisions of Family Practice

SOS 2017 Fall Newsletter  

SOS 2017 Fall Newsletter  

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