NAVIGATING THE WAY TOGETHER Burin Peninsula Two-Year Report by Eastern Health

NAVIGATING THE WAY TOGETHER Burin Peninsula Two-Year Report

MESSAGE FROM BOARD CHAIR

WELCOME, DR. BRETT WILLIAMS Ophthalmologist’s Commitment to the Burin Peninsula During the needs assessment process, residents and health providers of the Burin Peninsula expressed concern about the lack of ophthalmology clinics on the peninsula. That changed in September 2007 when Dr. Brett Williams held his first ophthalmology clinic at the Burin Peninsula Health Care Centre. “We were very pleased with the recruitment of Dr. Williams,” says Dr. Justice Arthur, Clinical Chief, “and his commitment to holding clinics on the Burin Peninsula.” “The Burin Peninsula Health Centre has a very well-equipped Ophthalmology area in the outpatient department, thanks to generous donations by the Lions Club,” says Dr. Williams. “I enjoy the clinics in Burin. The patients are so friendly and grateful to have someone come to the peninsula, especially those patients who find it difficult or who are unable to travel off the peninsula. The nurses and staff in the hospital are great to work with,” continued Dr. Williams. From September 2007 to May 2008, Dr. Williams saw over 200 patients. Dr. Williams also notes a personal connection to the Burin Peninsula. “My parents lived in Burin in the late 1960's when my father practiced at the cottage hospital. They still talk about the good times they had there.” Dr. Williams indicates that he will be traveling to Burin every one to two months usually for one to two days of clinic time. During the summer, he anticipates bringing his family along to visit the area. Dr. Brett Williams was born in St. John’s and lived in Clarenville from the age of 2 to 7 when he moved back to St. John’s. He completed high school at Prince of Wales Collegiate in St. John’s. Dr. Williams completed his undergraduate degree at the College of William & Mary in Virginia. He then completed two years of Optometry training at New England College of Optometry in Boston before deciding to pursue his medical degree at Memorial University of Newfoundland. Dr. Williams then completed a five-year residency in Ophthalmology at Queen’s University, graduating in June 2007. He has been practicing Comprehensive Ophthalmology in St. John’s since August 2007 and has been performing laser refractive surgery in St. John’s and Halifax since October 2007.

In June 2006, the Board of Trustees of Eastern Health was very pleased to release Navigating the Way Together: The Burin Peninsula Community Health Needs Assessment. The creation of Eastern Health provided the opportunity to complete community health needs assessments based on the full continuum of health. The Board of Trustees identified this as one of its strategic priorities, and the Burin Peninsula was the first area of the Eastern Health region to have a needs assessment completed. Through telephone surveys, key informant interviews and focus groups, a large amount of data was collected from the residents of the Burin Peninsula. This information, combined with secondary information and utilization/statistical Joan Dawe, Chair, Board of Trustees of Eastern Health, information, provided a unveiled Navigating the Way Together: The Burin Peninsula Community Health Needs Assessment in a public meeting in comprehensive picture of June 2006 at the Hotel Marystown. the Burin Peninsula as a ___________________________________________ community and as a people. A number of recommendations came from the findings, and the Board of Trustees has been monitoring the progress of these recommendations every six months since the release of the report. The Board of Trustees committed to reporting back to the people of the Burin Peninsula on the implementation of the recommendations. This report is our fulfillment of that commitment. We are very proud of the people who provide you with health and community services. They work very hard and are committed to their patients, residents and clients. As you look through this report, you will recognize the people and the stories profiled. They are the people of the Burin Peninsula – your friends, relatives and neighbours. Eastern Health will continue to monitor the needs of the people of the Burin Peninsula through initiatives such as satisfaction surveys and regular reporting activities like quality reports and operational planning updates. We acknowledge the commitment of the people of the Burin Peninsula to the needs assessment process and we look forward to continuing to work together towards achieving healthier people and healthier communities. Yours sincerely,

___________________________________________________ Ophthalmologist Dr. Brett Williams with patient Cyril Adams at the Burin Peninsula Health Care Centre. Since beginning his clinic on the Burin Peninsula in September 2007, Dr. Williams has seen over 200 patients.

Joan Dawe Chair, Board of Trustees

HIGHLIGHTS INSIDE 2

A Two-Year Report: Recommendations & Progress

Health Promotion Matters

Enhanced Mental Health and Addictions

Marystown Group Benefits from Eastern Health’s Community Development Fund

Long-Term Care on the Burin Peninsula Continuous Improvement and Monitoring

Catching Up With Olive Fancy One Dialysis Patient’s Story

Health Services on the Burin Peninsula The Future

Healthy People, Healthy Communities

NAVIGATING THE WAY TOGETHER:

A TWO-YEAR UPDATE

“Navigating the Way Together: The Burin Peninsula Community Health Needs Assessment was an opportunity for Eastern Health to determine the health needs of the Burin Peninsula from the full continuum of health,” says Louise Jones, Interim President and Chief Executive Officer of Eastern Health.

The Process The needs assessment was overseen by a Steering Committee comprised of Eastern Health staff. To assist the Steering Committee, a Community Advisory Committee consisting of people from the Burin Peninsula was established. This committee provided advice and feedback on the process and outcomes of the needs assessment.

The needs assessment report resulted in 35 recommendations. In addition to an administrative/organizational category, the recommendations were grouped according to Eastern Health’s lines of business: 1) promote health and well-being; 2) provide supportive care; 3) treat illness and injury.

Organizational/Administrative Recommendations Recommendations in this category focused on administrative issues within the organization such as developing consistent Eastern Health administrative and clinical policies. Other recommendations focused on addressing the challenge of geography by using technology as well as helping people understand the programs and services available to them and developing a regional health services plan. 1

Two over-riding beliefs governed the needs assessment:

Promote Health and WellBeing Recommendations These recommendations considered ongoing enhancement of health promotion activities such as increasing parenting education and increasing membership on the Eastern Regional Wellness Coalition. Community capacity building activities were also seen as important and recommendations centred 2

Communities have the strengths, knowledge and skills necessary to originate programs which influence the determinants of health and which promote a healthy lifestyle. Individuals have an important role to play in making communities a healthier place to live.

Provide Supportive Care Recommendations The Provide Supportive Care recommendations spoke to Eastern Health’s community-based support and continuing care, residential care options, home support and nursing home care. Access to long-term care was noted as being important, particularly given the aging demographics. Other recommendations considered the need to provide education sessions for staff dealing with clients with complex disabilities and increasing the number of alternate family care homes. 3

A summary of the recommendations is as follows:

Qualitative and quantitative data was Hannah Farrell and LPN Amanda Walsh. collected from ________________________ primary and secondary sources. Qualitative data was collected through 20 focus groups, 24 key informant interviews and 486 telephone interviews. Eleven written submissions from the public were also received. Quantitative data was drawn together from several administrative data bases and other sources of secondary data. The report is available at your local public library as well as at www.easternhealth.ca.

on sponsoring a fund to increase community knowledge of the determinants of health and to strengthen relationships with groups such as the Rural Secretariat and the Eastern School District.

Recommendations

Treat Illness and Injury Recommendations A number of recommendations were made around the line of business of Treating Illness and Injury. These recommendations centred on the development of an integrated model for primary health services delivery. There were also recommendations regarding medical equipment (i.e. CT scanner, dialysis) and services (i.e. visiting clinics, mental health, ambulance services, dental services). 4

Progress of Implementing Recommendations Substantial work has been ongoing in the past two years to address the issues raised in the needs assessment report. Some recommendations were implemented fairly quickly while others are ongoing. Here are some of the highlights: Organizational/Administrative Recommendations Since the creation of Eastern Health, work has been ongoing to develop regional clinical and administrative policies. A standardized policy development framework has been approved and many administrative and clinical policies have been developed or drafted. Departments have assessed their policy inventory to identify priorities and gaps and a Planning Specialist and a regional Policy Advisory Committee have been put in place to assist with this process. The Board of Trustees has identified the integration of clinical policies as a strategic priority.

Work continues on the development of a comprehensive health services plan. Elements that have been completed include mental health, palliative care, capital equipment, capital infrastructure, human resources and health promotion.

Eastern Health has established a regional telehealth committee to co-ordinate telehealth planning and implementation throughout the region. A portable video unit for the Burin Peninsula Health Care Centre is in place and is being used by the renal dialysis and oncology programs as well as other programs such as pediatric psychiatry. The need for a guide to Eastern Health services is well recognized and the Board of Trustees of Eastern Health has established this as a goal in their 2008-2011 Strategic Plan. Such a “navigation plan” will include information appropriate for all users, including those with literacy and technology challenges. In the interim, initiatives such as improvements to signage, website and a telephone directory have provided some assistance. A tollfree appointment line for use on the Burin Peninsula has also been installed 1-866-990-7730.

Promote Health and Well-Being Recommendations The people of the Burin Peninsula told us that they wanted an enhanced commitment to health promotion, prevention and early intervention. To this end, Eastern Health developed a regional Health Promotion Plan that identifies health promotion priorities for the next three years. The organization has awarded Health Promotion School Grants to 13 schools on the Burin Peninsula. Eastern Health School Teams are well established on the peninsula and have been involved in many health promotion initiatives (i.e. sexual reproductive health initiatives, drug abuse in schools, health fairs). The School Health Promotion Liaison Consultant along with the Health Promotion Consultants and school teams continue to work with schools to support the implementation of the School Food Guidelines and the Eastern School District Nutrition Policy. Other activities with schools include participating in the Living Healthy Commotion and public health nursing education session on school food guidelines. 2

A number of health promotion initiatives have been ongoing. A Parenting Capacity Workshop has been offered to community health staff and facilitators for the Nobody’s Perfect Parenting Program. Parenting education and support is offered on an individual basis through many of our program areas. Group parenting sessions are also offered as demand warrants.

A cervical screening initiative is ongoing and communities with low cervical screening rates (less than 20%) have been identified. To address this, community health nurses developed health promotion plans that focus on increasing awareness around cervical screening and education initiatives have been held in Marystown, St. Bernard’s area, Grand Bank, St. Lawrence, English Harbour East and Terrenceville areas. Family physicians and nurse practitioners are very supportive of this initiative. From 2005 to 2007, women’s participation rates for cervical screening on the peninsula increased from 29% to 43%. A number of the recommendations from the report centered on strengthening partnerships. This has been done in a number of ways. Eastern Health regularly meets with Rural Secretariats from within the Eastern Health region to discuss issues of common concern. Eastern Health has also established formal linkages with the RCMP, the Department of Human Resources, Labour and Employment and the Eastern School District as well as a number of local community groups through the Wellness Coalitions. Building community capacity on the Burin Peninsula is important and Health Promotion workshops have been offered to staff and Eastern Regional Wellness Coalition members. Eastern Health also initiated a Community Development Fund to assist community groups with achieving healthy people, healthy communities. In March 2007, the organization awarded $50,000 to community groups, including one on the Burin Peninsula.

COMMUNITY ADVISORY COMMITTEE

HIGHLIGHTS OF PROGRESS

One Member’s Perspective

• Communicated needs assessment report via website, public libraries, media • Established a toll-free telephone line for use on the Burin Peninsula • Continued to investigate uses of telemedicine, with a portable video unit now in use by Renal Dialysis and Oncology Programs • Highlighted need for a navigation plan in the Board of Trustees 2008-2011 Strategic Plan • Offered regularly scheduled ophthalmology clinics • Monitored visiting specialty clinics to ensure regular occurrence and added child development and dermatology visiting clinics • Made a submission to the Healthy Aging initiative of the Department of Health and Community Services • Increased Burin Peninsula membership on the Eastern Regional Wellness Coalition from 9 to 23 • Established regularly scheduled linkages with Rural Secretariat – Burin Peninsula • Increased long-term care bed capacity on the Burin Peninsula by 10 beds • Trained staff to deliver parenting workshops/supportive services • Increased human resources in key areas, including nurse practitioner services, community health nursing, mental health and addictions, discharge planning and clinical efficiency • Established a Regional Mental Health Promotion SubCommittee to identify actions to support mental health promotion throughout the region • Developed a Community Development Fund and awarded $50,000 to community groups throughout the region, including $10,000 to the Marystown Recreation Committee • Developed a regional Health Promotion Plan • Developed a proposal for integrated primary health care services • Initiated a liaison committee for the Burin Peninsula ambulance operators and Eastern Health • Established a dialysis service and installed a CT scanner • Continued to monitor occupancy levels of acute care beds and long-term care beds • Increased support for home care and palliative care services • Increased cervical screening participation from 29% in 2005 to 43% in 2007 • Continued significant renovations at Blue Crest Nursing Home and started new community health centre in Grand Bank

The Burin Peninsula needs assessment was overseen by an Advisory Committee made up of residents of the peninsula who responded to advertisements by Eastern Health and who represented various determinants of health. A number of influences and their interactions have an impact on the health and well-being of the population. Factors such as social, economic, cultural and physical environment play a role in the health of a community. These are the determinants of health.

Advisory Committee members are: (sitting L-R) Lisa Slaney, Vivian Hollett, Ellen Picco; (standing L-R) Charles Penwell, Andy Moriarity, Alphonsus Ward and Eastern Health's Senior Director, Corporate Strategy and Research, Wayne Miller. Missing from the photo are Stella Hollett, Marilyn Hannum and Lisa Browne. ___________________________________

“Establishing a Community Advisory Committee was very important,” says Wayne Miller, Senior Director of Corporate Strategy and Research. “Advisory Committee members played an integral role in acting as a resource to help guide the needs assessment process. Having people from the Burin Peninsula with local knowledge act in an advisory capacity to the needs assessment was invaluable.” Mr. Miller also noted that each member brought with him or her experience and knowledge of the various determinants of health.

One of the participants on the Community Advisory Committee was Lisa Slaney. “When I saw the ad asking for expressions of interest to participate on the committee, I was immediately interested for both personal and professional reasons,” says Lisa. “I grew up in Marystown and, as I got older, I realized that some areas of the peninsula don’t have easy access to services. As Executive Director of Grace Sparkes House, women often told me about the difficulties that they had in getting services. I thought participating on this committee would help me to understand the needs that exist on the peninsula as “The great thing about this a whole.”

needs assessment was that it came from the people of the peninsula; it wasn’t from one group.”

“The whole process and result was a real eyeopener for me,” says Lisa. “Usually, we have our own understanding of something and we talk to our circle of friends about it and we have one perspective. The great thing about this needs assessment was that it came from the people of the peninsula; it wasn’t from one group. Participating on the committee made me realize that we need to consider the needs of the whole community—the whole of the Burin Peninsula—to make it a viable, healthy community. Health is not just about the services at the hospital. I found it to be very enlightening.” The Community Advisory Committee met in April 2008 to review the progress of the recommendations. “I think the needs assessment has had an impact on the community,” says Lisa. “The process was very comprehensive and the needs were identified. It’s two years later and I can see a difference.”

Provide Supportive Care Recommendations To ensure appropriate levels of long-term care services, wait list and occupancy statistics are reviewed monthly. Ten additional long-term care beds were opened in July 2007 at the U.S. Memorial Health Centre. These beds provided extra capacity during renovations to Blue Crest Nursing Home. These beds will remain open for new clients, thus increasing long-term care bed capacity on the peninsula by ten. 3

The lack of home support workers was identified in the needs assessment and an education program is now offered at a post-secondary institution on the peninsula. Staff at our long-term care facilities on the Burin Peninsula have agreed to provide preceptor training to personal care attendant students. While recruitment for alternate family care homes is ongoing and advertisements have been placed, we have had little success in recruiting more family homes. This is an issue across the province and more work will need to be completed in this area. Three additional Community Health Nurses have been hired to enhance acute care and palliative/end of life home care services on the peninsula. Treat Illness and Injury Recommendations Throughout the needs assessment, the geography of the Burin Peninsula was consistently referenced as a challenge for people. Attempts to address this are being made in a number of ways. Specialty visiting clinics (oncology, cardiology, nephrology) continue to be offered and have expanded to include child development and dermatology. Ophthalmology clinics are now being offered on a regular basis. 4

The Burin Peninsula has seen an enhancement of medical equipment and services in the past couple of years. Since the implementation of the CT scanner, over 6,000 scans have been completed. Dialysis services have been up and running on the peninsula since November 2007 with 6 clients receiving service. Significant renovations at the Blue Crest Nursing Home are ongoing and the new community health centre in Grand Bank is scheduled to early Fall 2008. Eastern Health secured funding for a Mental Health/Addictions Worker for Burin in March 2007 and wait lists for mental health and addictions services have decreased. Mental Health and Addictions clinics are also offered in Grand Bank, St. Lawrence and St. Bernard’s and a Regional Mental Health Promotion SubCommittee has been established to identify actions to support mental health promotion.

The organization is continuing discussion with the Department of Health and Community Services on the principles of a centralized clinic in the “...I particularly note area North of the dedication of Marystown. the staff, physicians and volunteers of the Burin Peninsula. They are extremely committed to their clients, residents and patients.”

“We are pleased with the progress made on the recommendations,” says Ms. Jones. “The needs assessment provided comprehensive information about the health of the people of the Burin Peninsula. This would not have been possible without their enthusiastic participation. I particularly note the dedication of the staff, physicians and volunteers of the Burin Peninsula. They are extremely committed to their clients, residents and patients.”

A Clinical Efficiency Facilitator was hired to support clinical efficiency at the Burin sites. A Discharge Liaison Nurse for the Burin Peninsula Health Care Centre has also been hired to work as part of an interdisciplinary team to ensure that discharge planning occurs on a timely basis. These initiatives should assist in having inpatient beds available when they are needed. Eastern Health developed a proposal for an integrated primary health care initiative on the peninsula and submitted it to the Department of Health and Community Services in February 2007.

HEALTH PROMOTION MATTERS! We all want to lead a healthy life in the places that we live, work and play. To be as healthy as possible, we must have the resources, knowledge, skills and surroundings to make healthy choices and take on healthy behaviours. Health as we know it is more than the absence of disease and illness. Health involves your physical, mental and social well-being. Many factors affect our health, including where we work, where we live, our income, our social support networks such as family and friends, personal health habits, childhood experiences, education and coping skills. When individuals are healthy, communities are healthy. Eastern Health is committed to working with individuals, families, communities, organizations, groups and other partners toward a vision of Healthy People, Healthy Communities.

Health Promotion happens when we: • Provide support, education and information to help people make healthy choices. • Create safe and enjoyable environments for work and play. • Encourage people to get involved and take action in decisions that affect their community’s health. • Make public laws and rules that keep health in mind. • Create services that change the focus from illness to wellness.

Health Promotion is the process of enabling people to increase control over and to improve their health. When people are in control of their own health needs, they are happier and healthier.

• St. Joseph’s, Lamaline • Holy Name of Mary, Lawn • Sacred Heart Academy, Marystown The three successful applicants received funding to assist with the promotion of physical activity in their schools.

School Teams Health Promotion focuses on actions that maintain or improve the health of individuals, families, and communities. Health Promotion can help to break down the barriers that affect some people’s ability to make healthy choices for themselves or their family.

Health Promotion is something that involves us all. Whether you are a health professional, a member of a community service club or group, a parent, a neighbour, a town councilor, a student, a teacher or a minister, we all have a role. Health promotion can happen in many settings such as schools, communities, hospitals, workplaces, family resource centres, community centres, youth centre, churches, town council offices, recreation centres and seniors clubs. Even though many people may not call it health promotion, we are doing it! Here are some examples:

Beacon Grants In November 2007, all schools in the Avalon West, Vista and Burin areas of the Eastern School District were invited to apply for a Beacon Grant offered through Eastern Health - School Services Committee. The purpose of the Beacon Grants is to support schools and Eastern Health School Teams to develop and deliver school-based initiatives that promote health within the school community and foster a partnership between Eastern Health School Teams and the schools. A total of 34 schools applied for the grant. Eight schools were awarded grants for a total of $7,600. Twelve of thirteen schools on the Burin Peninsula applied for a grant with three being successful in their application.

Community based staff at Eastern Health are involved in Health Promotion initiatives in all schools on the Burin Peninsula. In 2001 Eastern Health staff began to use a team based model for providing individual and health promotion services. The School Teams are made up of Eastern Health staff and a liaison from each school. These people work together to identify the needs in each school and work to address these needs. There are four teams on the Peninsula. They are based in Grand Bank, St. Lawrence, St. Bernard’s and Burin. The Burin and Grand Bank Teams were recently involved in health fairs for several different schools. In May, the Burin School Team participated in delivery of a health fair at Sacred Heart Academy for grade seven students from 3 schools that graduate students to Pearce Junior High. This year the students had an opportunity to learn about healthy eating, healthy relationships, stress management and drug awareness. On May 9, Lake Academy hosted a health fair for students. The Grand Bank school team participated in this event and provided information on various topics. All of these topics build on material that is part of the curriculum and include issues faced by students at this age.

LONG-TERM CARE ON THE BURIN PENINSULA

PARTNERING WITH THE RURAL SECRETARIAT – BURIN PENINSULA

Continuous Improvement and Monitoring

While the needs assessment process was ongoing, many people spoke about the need for partnerships. Working with community partners can lead to many successes for communities. One of Eastern Health’s partners is the Rural Secretariat.

The Burin Peninsula, like most communities in the province, has an aging and Nurse Practitioner Carol Ann Riggs with resident declining population. Clayton Johnson and LPN Dave Kendal. Population projections for __________________________________ the peninsula in 2020 put the population at 18,134 compared with 21,600 in 2006. While the school age population has been declining, the seniors population (65+ years) increased from 2,400 in 1986 to 2,900 in 2007. All of this means that long-term care needs on the peninsula must be monitored carefully to ensure appropriate services are available. Eastern Health has long-term care facilities at the U.S. Memorial Health Centre and the Blue Crest Nursing Home. Since July 2007, renovations have been ongoing at Blue Crest to enhance the environment for residents. This has meant that some long-term care beds were temporarily closed at Blue Crest in order to accommodate the renovations. The renovations are scheduled to be completed at Blue Crest in September. The additional ten beds at the U.S. Memorial Health Centre will then be available to address the needs of the population on the waitlist. “The waiting list for long-term care beds is closely monitored on a monthly basis,” says Beth Mayo, Director of Integrated Health Services, Burin Peninsula. “We are proud of the services that we offer in the area of long-term care.”

The successful applicants from the Burin Peninsula were:

The Provincial Government has established Regional Councils throughout the province to develop visions and priorities. The Regional Councils, which are made up of community residents, identify barriers and assets available for regions to be successful and identify the policies and programs that are needed in order to help move the vision forward. Both the Rural Secretariat-Burin Peninsula and Eastern Health recognize that they have common issues. “Eastern Health has a vision of Healthy People, Healthy Communities and the Rural Secretariat works towards achieving sustainable communities, so there are a lot of opportunities for collaboration,” says Wayne Miller, Senior Director, Corporate Strategy and Research. Staff of the two organizations have committed to meeting every six months to discuss those common issues and exchange information. “Our initial meetings have been opportunities to share some of the work that we do,” says Mr. Miller. “For example, we gave a presentation to the Regional Planners on the outcomes of the Burin Peninsula and the Southern Avalon needs assessments. The needs assessments provide such comprehensive profiles on both areas that they may be a valuable resource for the Rural Secretariat.” Eastern Health and the Rural Secretariat look forward to maintaining open communication and identifying opportunities for collaboration. It is a partnership that will undoubtedly have benefits for both organizations.

MARYSTOWN GROUP BENEFITS FROM EASTERN HEALTH’S COMMUNITY DEVELOPMENT FUND During the past couple of years, the Board of Trustees of Eastern Health has met with a variety of community groups, organizations and individuals to find out what is helping people and communities stay healthy and what is making it difficult. Through these discussions, Eastern Health was identified as being able to help community partners to build and maintain healthier communities. To support this, Eastern Health established the Community Development Fund. The purpose of this Fund is to support local nonprofit community groups and organizations by providing funding for projects that foster the development of healthy communities. The Community Development Fund provides grants of up to $10,000 to community organizations/groups to identify and take action on priority needs that contribute to a healthier community. One of the recipients of the inaugural Community Development Grant is the Town of Marystown’s Recreation Committee, in partnership with the Lions Fifty Plus Club, the Marystown High School and the Pearce Junior High School, Burin. The project, Healthy Living – Older Adults Eating Well and Being Active, involves an indoor walking program combined with an education component. “The goal of the program is to promote, facilitate and contribute to adult healthy living through physical activity and nutrition programming,” said Gordon Brockerville, Marystown Healthy Seniors Coordinator. The program will be open to

seniors in Marystown and Burin and neighbouring communities. Mr. Brockerville used the Burin Peninsula needs assessment report findings to develop his proposal for a Community Development Fund. “We recognized that the Burin Peninsula Needs Assessment Report identified a number of health and community issues on the Burin Peninsula,” said Mr. Brockerville. “Issues such as maintaining a healthy diet, loneliness, obesity and recreation were referenced and this project may help to address these issues. We feel that our project contributes to two of the recommendations from the report: 1) Strengthening the commitment to health promotion, prevention and well-being and 2) Partnering with community groups to promote and enhance community development and capacity.” “During the summer months, I will be working with seniors from the 50+ Club to seek out more partnerships. This will include healthy food services for the nutrition component of the program and securing regular transportation for participants who may not have their own modes of transportation to the walking program at the school venues. As well, I will be working with a local company to develop a marketing plan. Once that is in place and the schools reopen in the Fall, I am anticipating a large interest from our senior population.”

ENHANCED MENTAL HEALTH AND ADDICTIONS While listening to the people of the peninsula, mental health and wellbeing and addictions surfaced as an area of concern. Access to Mental Health and Addictions Services on the Burin Peninsula was becoming more and more difficult for people, as the waiting lists grew. “Referrals that were not urgent were taking up to 9-12 months to get an appointment with a counselor,” said Evelyn Tilley, Leslie Ann Avery and Diane Dunphy work in the area of Mental Health and Addictions Manager of Mental Health and Services on the Burin Peninsula. Addictions Services, Rural ______________________________ Eastern. In March 2007, Mental Health and Addictions Services implemented a Crisis Intake pilot project in Burin to improve access to services. This temporary position, a Mental Health/Addictions Intake Social Worker, was implemented to screen all incoming referrals. The Intake Social Worker meets with those people referred in person or by telephone to complete a brief assessment and to provide crisis intervention as needed. “Since this position has been added, all referrals to Mental Health and Addictions Services are seen for a brief assessment within two weeks,” says Ms. Tilley. Individuals requiring brief intervention are seen by the Intake Worker; this reduces their time waiting for a service. “This has resulted in a significantly reduced waiting list,” says Ms. Tilley. “For example, the total waiting list decreased from 141 people in March 2007 to 100 in April 2008.” Given the improved access to services, the Intake Worker was made a permanent position in January 2008. “The wait list as of April 2008 is 72 people for mental health services and 28 people for addictions services.” This position has also resulted in improved service delivery. Since January 2008, we have been able to offer regular clinics in Grand Bank, St. Lawrence and St. Bernard’s. This reduces the time and cost that people living in those areas incur if they have to travel for services. Other improvements in Mental Health and Addictions have also occurred. “Eastern Health provides the full continuum of health and over the past couple of years, we have been pleased with the improvements made in collaborative practice. The Mental Health and Addictions team has identified our Mental Health Nurse Case Manager as an established link with the Burin Peninsula Health Care Centre, thereby strengthening our ability to help people access the continuum of care available,” says Ms. Tilley.

Gordon Brockerville (in blue shirt) with members of the walking club. _______________________________________________

Eastern Health awarded $50,000 to projects within its region through the Community Development Fund in 2007, its first year. “We were overwhelmed with the number and quality of the applications,” said Pat Coish-Snow, Chief Operating Officer (COO), Peninsulas and Chair of the Community Development Fund Review Committee. “The Review Committee used a rating scale with specific criteria to assess each application. Seven applications were deemed to best meet the criteria of the program.” Ms. CoishSnow indicates that the Community Development Fund will continue next year. A call for applications will be made in the Fall and will be promoted through the Eastern Health website www.easternhealth.ca and the media.

CATCHING UP WITH OLIVE FANCY One Dialysis Patient’s Story One of the stories highlighted in the needs assessment report was the story of Olive Fancy of Burin. Here is Olive’s story as it appeared in the needs assessment document. On April 1, 2005, Olive Fancy of Burin began dialysis. Until January 2006, she travelled to Clarenville three times a week for this service and relied on family and good friends to drive her the 200 kilometres to Clarenville since her husband Edgar is working. Travelling to Clarenville meant that Olive left her home at 6:15 a.m. and returned at about 3:30 p.m. In a nine month period, her gas receipts totalled approximately $5,000. On Friday, January 6, 2006, Olive and Edgar moved to St. John’s for a three month period to avoid travelling the Burin Peninsula highway during the winter months. “The highway can be very difficult and dangerous to drive on during the winter months,” said Olive. “You never know when you leave Burin what weather conditions you may encounter.” The Fanceys stayed with their son and his wife while in St. John’s. The move to St. John’s means that Edgar had to take three months off work. On March 1, 2006, the provincial government announced that dialysis services will be provided on the Burin Peninsula. We spoke to Olive again in May 2008 and things have certainly changed for her. “Things are wonderful,” says Olive. “I can live at home without traveling for dialysis. In fact, I’ve resumed my regular volunteer activities and even added a few more,” Olive adds with a chuckle, indicating that she is now serving on the Burin Heritage Board and the Burin Come Home Year Committee. “The dialysis unit at the Burin Peninsula Health Care Centre is lovely with excellent staff,” says Olive. “Right now there are six patients and we’re just like family.” Olive Fancy with nurse Patricia Legge at the Burin Peninsula Health Care Centre’s Dialysis Unit. ___________________________________

CONTINUING THE PROGRESS While substantial progress has been made on the needs assessment recommendations, there are a few that have not yet been achieved for various reasons. Some recommendations in the report centred around the development of an integrated model for the delivery of primary health care services. These recommendations included developing an operational plan for submission to the Department of Health and Community Services, establishing a Community Advisory Committee associated with the primary health care initiative and sponsoring a rural health forum.

Director and developed by the Quality & Learning Coordinators, was recently established. The purpose of this program is to ensure standards of care are being met by those providing prehospital care. Education about the program and evaluation of ambulance service staff has began. Once completed, the quality assurance component of medical control will begin. The Burin Peninsula ambulance services will be included in this process. Eastern Health’s Manager of Paramedicine & Medical Transport will be facilitating a liaison committee for the Burin Peninsula ambulance operators and Eastern Health. The Terms of Reference of this committee have been drafted and the first meeting is planned within the next few months.

HELPFUL PHONE NUMBERS Burin Peninsula Health Care Centre . . . . . . .891-1040 Burin Peninsula Health Care Centre Appointment Line (Toll-free) . . . . . . .1-866-990-7730 Blue Crest Nursing Home . . . . . . . . . . . . . .832-1660 Grand Bank Community Health Centre . . . .832-2500 U.S. Memorial Health Centre . . . . . . . . . . . . .873-2220 Mental Health and Addictions Services . . . .891-5033

“In February 2007, Eastern Health submitted a proposal to the Department of Health and Community Work continues on the Hilda Barnes and her son, Sam Barnes. Services to development of a ________________________________ establish an comprehensive health integrated primary services plan. Elements health care model on the Burin of the plan have been completed, Peninsula,” says Pat Coish-Snow, Chief including mental health, palliative care, Operating Officer, Peninsulas. Although capital equipment, capital infrastructure, Eastern Health continues to work with human resources and health promotion. the Department of Health and Further direction and policy decisions Community Services on this initiative, to from the Department of Health and date it has not received funding and Community Services will help to guide consequently, activities associated with the planning with respect to services. this initiative—establishing a Community Advisory Committee and sponsoring a Ms. Coish-Snow also notes that the rural health forum—have also not organization is building its occurred. “We also submitted a communications strategy and resources proposal for a clinic in the North of to enhance communications both Marystown area in order to enhance internally and externally. The Board of primary health care services and Trustees has identified a “navigation discussions are ongoing with the plan” as a priority and will be working to Department of Health and Community improve the ability of people to be Services.” aware of the services available.

Child Youth and Family Services . . . . . . . . .891-5025

“Another recommendation centred around ambulance services on the peninsula,” says Ms. Coish-Snow. A Medical Control Program, under the direction of the Provincial Medical

Grace Sparkes House (Toll-free) . . . .1-877-774-4957

Community Health - Burin . . . . . . . . . . . . . .891-5025 Community Supports Program . . . . . . . . . . .891-5025 Community Health St. Bernard’s/Jacques Fontaine Office . .461-2737 St. Lawrence Office . . . . . . . . . . . . . . . . .873-2880 Grand Bank Office . . . . . . . . . . . . . . . . .832-1602 Clinics North of Marystown English Harbour East . . . . . . . . . . . . . . .245-4556 Grand LePierre . . . . . . . . . . . . . . . . . . . .662-2206 Parker’s Cove . . . . . . . . . . . . . . . . . . . . . .443-2525 Petite Forte . . . . . . . . . . . . . . . . . . . . . . . .428-3341 South East Bight . . . . . . . . . . . . . . . . . . .428-4281 Terrenceville . . . . . . . . . . . . . . . . . . . . . . .662-2215 Mental Health Crisis Line (24 hour Toll-free) . . . . . . . . . . . . . . . .1-888-737-4668 Poison Information Centre (24 hour Toll-free) . . . . . . . . . . . . . . . .1-866-727-1110 Pediatric Advice Line (Toll-free) . . . . .1-866-722-1126 Newfoundland & Labrador HealthLine (24 hour Toll-free) . . . . . .1-888-709-2929

“Work on these recommendations is ongoing,” says Ms. Coish-Snow, “and we will continue to work on and monitor the progress of these recommendations.”

Sexual Assault Crisis Line (Toll-free) .1-800-726-2743 Kids Help Phone (Toll-free) . . . . . . . .1-800-668-6868

Contributors:

THIS REPORT WAS PRODUCED BY EASTERN HEALTH This report provides the residents of the Burin Peninsula with an update on the progress of recommendations from Navigating the Way Together: The Burin Peninsula Community Health Needs Assessment, released June 2006. The report is available at www.easternhealth.ca and at public libraries.

Lisa Browne Joan Dawe

Maxine Paul Jane Macdonald

Photos:

Design:

Cynthia Farrell

Angela Lawrence

Natalie Moody Evelyn Tilley

For more information about the Burin Peninsula needs assessment report, please contact: Lisa Browne, Planning Specialist, Eastern Health, 466-5863 lisa.browne@easternhealth.ca

HEALTH SERVICES ON THE BURIN PENINSULA The Future “While the Burin Peninsula Community Health Needs Assessment has been completed,” says Pat Coish-Snow, Chief Operating Officer, Peninsulas, “the information gathered from the report will continue to be used. The majority of recommendations will continue to be monitored on an ongoing basis and others will still need work in order to be completed. The report itself provides a comprehensive review of the determinants of health on the peninsula,” says Ms. Coish-Snow, “and is a good resource for many community groups and Eastern Health staff.” “Eastern Health has a number of mechanisms that allow us to monitor and react to the needs

on the peninsula,” says Ms. Coish-Snow. In keeping with the Board of Trustees’ Strategic Plan, each departmental director develops an operational plan every three years and reports on the progress made “We acknowledge the toward their objectives every six people of the Burin Peninsula months. Quality reports enable the and their commitment to organization to monitor indicators improving their health.” and the quality of the programs and services it offers. “Our satisfaction surveys are an important way to monitor the satisfaction levels of our patients, clients and residents,” says Ms. Coish-Snow, “and we will continue to use them.” “We acknowledge the people of the Burin Peninsula and their commitment to improving their health,” says Louise Jones, Interim President and Chief Executive Officer. “We will continue to work with them to achieve our vision of Healthy People, Healthy Communities.”