South Okanagan Similkameen
Inside this issue
Sustainability in Rural Practice
Princeton Community Worker
Residential Care Spread
New approach helps vulnerable MHSU patients D octors at the Martin Street Outreach Centre are meeting the needs of some of the most vulnerable people in our community by taking a new approach to primary care for patients with mental health and/or substance use issues. The centre opened on May 15th and already 350 patients are receiving primary care from a team of care providers. Four local doctors are providing 25 hours of coverage each week and a social worker is on site three days a week. Patient care is also shared with Interior Health’s Mental Health and Substance Use counsellors, as well as a STOP HIV nurse. Dr. Kyle Stevens is one of the Martin Street Outreach Centre’s physician leads and has been involved from the very beginning. He says working with a social worker is essential. “In the past, I would see patients who needed help finding housing, but I didn’t know how to help them. The social worker is amazing at working with patients to find housing, helping them fill out forms for welfare benefits, and connecting patients to essential community services.” A major factor in the success of the centre is the emphasis on teamwork and partnership. Dr. Stevens says the clinic only became possible after the establishment of the SOS Division of Family Practice. The consistent support of Interior Health was also a key component.
MP Richard Cannings, Tana Wyatt (patient), Wendy Hansson, Susan Brown, Joseph Savage (Interior Health), Dr. Kyle Stevens, and MLA Dan Ashton cut a cake to celebrate the Martin Street Outreach Centre at a recent open house.
“Everyone was pulling in the same direction, and when we weren’t, we would stop, remind ourselves of our common goals and get moving again,” says Dr. Stevens. Everything at the centre is innovative and unique, including the pay structure. Doctors pool their MSP billings to pay themselves a competitive salary, while covering the cost of clinic overhead and the social worker through a partnership with the local non-profit, Penticton and District Community Resources Society. A fifth doctor will be joining the team shortly and there are plans to expand docSouth Okanagan Similkameen
tor coverage to 30 hours and to increase the centre’s capacity to 1,000 patients. “Ultimately, the goal is to help our patients become stable enough to be transferred to a regular family doctor,” says Dr. Stevens. “To do this, we need to be able to meet them where they are, take a gentle approach, and invite them to take the next step to recovery.” The Martin Street Outreach Centre is actively seeking new primary care referrals for unattached patients with mental health and/or substance use issues. For more info, please call 250.770.3696.
Princeton doctors no longer hanging on by a thread Princeton physicians have lowered stress levels and at the same time are helping vulnerable patients, thanks to A GP for Me’s Community Worker Project in Princeton. Michelle Johnson, local Community Worker, has helped more than 30 complex patients during the last six months by connecting them with much needed community resources and through offering general support. As a result, patients have been able to get the help they need and have not had to use the emergency department. Prior to the Community Worker Project, a particular Princeton resident was using the emergency department at least once a week. Now, this individual is connected to a variety of services in Princeton and has stopped using emergency entirely. “Just that one case — the load that is off our system, that’s off our staff — that’s off the hospital is tremendous,” said one of the local physicians in a recent evaluation survey with medical staff. The Community Worker Project has lifted a significant burden of stress from physicians. “You don’t know
Family Practice Help Line Beginning in the new year, any family physician and their medical office assistants will be able to call the Family Practice Help Line for questions related to EMR, billing, human resources, and other office efficiency questions.
Billing code reminder for: Most Responsible Physician status Billing code G14088 Unassigned Inpatient care compensates FPs when taking on MRP status for unassigned patients during their hospital stay.
Michelle Johnson, Princeton Community Worker, has helped more than 30 complex patients during the last six months, keeping patients out of the Emergency Room, and reducing stress for Princeton family physicians
how hanging on by a thread we were, how close we were to bailing out on this whole community, which would have meant not enough doctors to keep the emerg open, which would have meant the emerg closing, which probably would have then led to the hospital closing, “ wrote another physician on the evaluation survey. “We were just on the brink of a total catastrophe here.” Princeton family doctors credit Michelle, along with a few other office efficiency changes, for reducing their workload by at least 20%. Prior to the Community Worker arriving,
physicians were each working up to 100 hours per week. “For many people, social problems become medical problems if they go unaddressed”, explained a local Princeton physician. The community worker is able to target highly vulnerable patients and offer support to navigate and access systems such as WCB and Income Assistance, food security, and provide general support for medical and/or other appointments. The community worker is also used for time-limited support such as for bereavement, or for patients just needing a check-in.
UBC Family Practice Residents coming to Penticton A core group of enthusiastic local champions have taken up the challenge to expand the UBC family practice residency program to the South Okanagan. Starting in 2016, the two-year family practice residency training program will launch a Penticton-based teaching site, drawing on resources throughout the South Okanagan. Led by site directors, Dr. Catherine Rooke and Dr. Marjorie Krabbe, the local program will initially welcome four residents. Offices and learning facilities will be based at Penticton
Regional Hospital. Dr. Barbara Main will lead the development of the curriculum schedule, using expertise she has gained creating other curriculum models. The curriculum will be based on a longitudinal block model, with four set rotations, and will engage family physician faculty as well as specialty colleagues. In addition to finalizing the curriculum, next steps for the program include finalizing the list of eight family medicine preceptors, and beginning the matching process. 2
Adding new faces:
Residential care model spreads to local communities Three years ago, seven care facilities were part of a prototype to improve residential care in Penticton and Summerland. The concept has spread across the province, including to surrounding local areas. “We are so pleased to see our model of care spreading throughout the province, and especially to see it starting in our local areas,” says Dr. Bob Mack, residential care medical coordinator. Just this month, the residential care prototype started in Oliver/Osoyoos and Princeton. We are happy to announce that Dr. Margaret Myslek is the physician lead in Oliver; Dr. Robert Calder in Osoyoos and Dr. Colleen Black in Princeton. Implementing these local initiatives in Oliver/Osoyoos and Princeton will involve working with Interior Health and local facilities, and will address the five best practices: 24/7 availability and onsite attendance when required, proactive visits to residents, meaningful medication reviews, completed documentation, and attendance at
care conferences. We anticipate that we will also be working with local physicians in Keremeos to secure similar funding in the near future. In Penticton, the residential care program is continuing to grow and add new features. Dr. Mark Lawrie will be leading a polypharmacy reduction strategy, which will involve Penticton and Summerland physicians in mentored medication reviews. These mentored medication reviews will occur in three of our residential care facilities, and will involve working with local pharmacists. Dr. Mack is working on the development of physician champion roles in each of our seven facilities. Discussions with physicians about this feature will begin in the new year. For more information about local residential care programs, please contact Arlene Herman (email@example.com) or Julie Young (firstname.lastname@example.org), or visit the GPSC website: www.gpscbc.ca.
Physician leads for Residential Care in our area Dr. Robert Calder Osoyoos
Dr. Colleen Black Princeton
Dr. Bob Mack Summerland
Dr. Mark Lawrie Penticton
Dr. Margaret Myslek Oliver
New funding aims to develop sustainability in local rural practices Rural communities are extremely vulnerable to small changes, which can threaten the sustainability of health care in an entire region. “By working together and pooling resources, small rural communities can provide health care that our patients deserve and need,” says Dr. Peter Entwistle, a family physician and South Okanagan General Hospital Chief of Staff in Oliver. Oliver, Osoyoos, Keremeos and Princeton now have a unique opportunity to do just that. Together with Interior Health, Entwistle successfully submitted an application to receive Joint Standing Committee on Rural Issues funding for $500,000 over the next two years. This funding will be used to facilitate innovative and
Dr. Peter Entwistle
novel service delivery arrangements, which could potentially resolve issues of recruitment, retention, and/or service delivery in these communities. The South Okanagan Similkameen Division of Family Practice has already hosted an initial meeting to discuss current successes and ongoing projects in the communities, as well as the development of a steering committee
for the project. Held at the Keremeos Health Unit, attendees included physicians from Princeton, Keremeos, and Oliver and other health service providers such as BC Ambulance, and Interior Health. Community representatives, the RDOS, the Osoyoos and Lower Similkameen Indian Bands, and the Okanagan Nation Alliance also came to the meeting. In the upcoming months, additional meetings will be held to explore strategies that address the most pressing needs in each community. If you would like more information or would like to take part in this initiative, please contact: Aarin Frigon at: 778.476.1878 or email@example.com. 3
SOS Division in our Community ... what is it?
PROJECTS ON THE GO... In-patient Care Program
Physicians care for their own patients in-hospital and care for patients admitted without an FP, cover call collaboratively, provide Doctor of the Day support at residential care facilities Providing proactive care, reducing barriers to good residential care and decreasing avoidable visits to the ER at residential care facilities
Joint Standing Committee on Rural Issues
Facilitating innovative and service delivery arrangements to resolve issues of recruitment, retention, and/ or service delivery in Oliver/Osoyoos, Keremeos and Princeton
A GP for Me
Practice Efficiency Project
Enables patients who want a family doctor to find one Increases the capacity of the primary health care system Confirms and strengthens the continuous doctor-patient relationship, including better support for the needs of vulnerable patients
Recruitment and Retention
Shared Care Shared Care initiatives enable family and specialist physicians to work together within their communities to improve patient care
Mental Health and Substance Use Stabilization Clinic (Martin St. Centre) Community Worker Project GP Patient Matching System Clinical Non-dispensing Pharmacy Project
Princeton Access to Specialist Care Telemedicine Primary Maternity Care End of Life Advance Care Planning Emergency Palliative Symptom Management Child and Youth Mental Health and Substance Abuse
SOS Division of Family Practice: New and Retiring Physicians Thank you, Retiring Physicians
Drs. Michael Biggs, Tom Francis, Rusty Harris, Warren Julien, John Kennedy, Rob McIntosh, Gerald Partridge, Cathy Sheehan
Welcome, New Physicians
... and whoâ€™s involved Drs. Ron Gans, Ella Monro, Garnett Tarr Division staff project contact: Julie Young 778 476 5696 firstname.lastname@example.org
Drs. Colleen Black, Robert Calder, Mark Lawrie, Bob Mack; Margaret Myslek, and (IH) Cindy Reiger Division staff project contact: Arlene Herman Project Manager tel: 778 476 7696 email@example.com Drs. Peter Entwistle, Marina Louw, Ella Munro; Interior Health, BC Ambulance, Osoyoos Indian Band, Upper Similkameen Indian Band, Okanagan Nation Alliance, RDOS, Viillage of Keremeos, Towns of Oliver, Osoyoos, and Princeton Division staff project contact: Aarin Frigon Project Manager tel: 778 476 1878 firstname.lastname@example.org Advisory Committee: Drs. Peter Entwistle, Ron Gans, Brent Harrold, Cathy Rooke, Driaan van der Vyver; (MOAs) Kelly Hawes, Cindy Mikkelson; (IH) Wendy Boyer, Susan Brown, Joseph Savage, Karla Warkotsch; (ACCESS) Elmie Saaltink; (PDCRS) Tanya Behardien Division staff project contact: Aarin Frigon Project Manager tel: 778 476 1878 email@example.com
Steering Committee: Drs. Glen Burgoyne, Marius Snyman, Brian Forzley, Michelle Teo, Shannon Walker and Elizabeth Watters; Susan Brown, Lori Motluk, Robin Watt; Terrie Crawford, Ida Keller, Lisa Needoba, Tracy St. Claire Shared Care projects contact: Tracy St. Claire Shared Care Project Manager tel: 778 476 5694 firstname.lastname@example.org
Sept- Dec 2015 Drs. Elizabeth Allen (Summerland Rosedale Medical Clinic), Laura Hodgson, Kevin Renaud (OBGYN), Yves Thomas (Oliverâ€™s Family Health Clinic),Tim Van Der Heide (Princeton), Nicholaas Walters 4
South Okanagan Similkameen Division of Family Practice Initiative Updates November 2015