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HealtH Care providers week Transition to new health authority yielding benefits

by Jonathan hamElin

The Government of Saskatchewan speaks with authority about the benefits realized through the massive transformation of the province’s health care system. On Dec. 4, 2017, the Saskatchewan Health Authority (SHA) was launched. It’s an amalgamation of the 12 regional health authorities that had previously existed in the province. As the oneyear mark of the SHA approaches, the government said there’s a lot to celebrate. “We expect to see cost savings between $10 million to $20 million annually, but this is really about making our health care system more responsive to the needs of patients,” Minister of Health Jim Reiter said. “We eliminated the old region boundaries, which previously got in the way of things like care home placement and hospital discharge planning. We’re also working to eliminate

Saskatchewan Minister of Health Jim Reiter. S u p p l i e d p h o to

ambulance response zones so that the closest available ambulance is the one that responds, regardless of who’s sending it. “Greater integration will enable frontline care providers to serve patients better, and these are just a few examples of how we’re doing that. So far, the results are encouraging. ” As Reiter explained, moving from 12 regions to

a single organization is a “major undertaking”, largely because it requires moving from 12 different ways of doing things to a establishing a consistent set of best practices. “We have great people working on things like information technology, policies and processes that varied from one region to the next,” he said. “This work will lay the foundation for greater integration across the health care system and completing it will free up resources for other areas of improvement. “I want to thank our staff and frontline care providers across the province. Their hard work and dedication is greatly appreciated. Without them, none of this would be possible.” Reiter said the top priority of the SHA is recruiting doctors, nurses and other health care professionals, and this effort will continue with the addition of the Physician Recruitment Agency of Saskatchewan (saskdocs) to the SHA. There are now

nearly 900 more doctors in the province than in 2007. Moving forward, Reiter said there will be new opportunities to align recruitment efforts with the needs on the ground. He said the SHA is also focusing on improving mental health services by recruiting more psychiatrists, increasing mental health supports in schools and establishing community recovery teams to better support people with persistent mental illnesses in eight communities. Police and crisis teams, which pair police officers with mental health workers to attend crisis situations, are also being established in additional communities. The SHA has also been working hard on some important initiatives such as the Connected Care Strategy. This strategy uses a teambased approach to providing care in the most appropriate setting – whether in the hospital, a clinic, or at home in the community. “An important part of this

is providing a seamless transition from one care setting to the next,” Reiter said. The SHA has also established accountable care units in Saskatoon and Regina, with more on the way. Reiter said the results are extremely promising so far, with wait times reduced by as much as 30 per cent at the Pasqua Hospital in Regina. He added that community health centres are also being established in Saskatoon, Regina, and Prince Albert and will focus on patients with complex needs, providing care in the community and avoiding emergency department visits and hospital stays. A massive undertaking such as the SHA requires the right leadership. Reiter said the government is confident that they have found the right person to lead the charge in CEO Scott Livingstone. Prior to joining the SHA, Livingstone was the President and Chief Executive Officer (CEO) of the Saskatchewan Cancer Agency (SCA) and he has also served

as the CEO of the Saskatchewan Health Information Network (now eHealth Saskatchewan). “He’s a strong leader that is also open-minded,” Reiter said. “What has really impressed me is the innovative approaches he and his team come up with. For the first time, we have physician leaders as part of the senior team. The ‘dyad’ model pairs them with vice-presidents, ensuring that the decisions they make have a medical perspective built into them.” The SHA has come a long way since the planning process began, but Reiter noted that this is still the early stages of the health care transformation. “Significant progress has been made, but there’s more work to do,” he said. “Moving from 12 regions to a single SHA is a major undertaking. It will take a few years to fully realize our vision – a health care system that is more consistent and better coordinated across the province.”

What’s involved in recruiting health professionals to Saskatchewan? by ElizabEth irEland

According to recent statistics, Saskatchewan has approximately 900 more doctors working in the province than it did 10 years ago – due in large part to the efforts of Saskdocs. Saskdocs facilitates physician recruitment and retention for the Saskatchewan Health Authority and medical practices across Saskatchewan. Its sister agency, Health Careers in Saskatchewan, helps recruit and retain other health-related professions to the province. These professions range from continuing care assistants to Registered Nurses. Health Careers also posts positions for well-paying health care facility support roles, such as administrators, cooks and environmental services workers.

James Winkel is communications manager with Saskdocs and Health Careers. He says that the types of physicians Saskdocs is looking for include internal medicine specialists, family physicians and psychiatrists. “There is always a need for physicians in more rural and remote parts of our province. We know from studies, and anecdotally, that physicians can be attracted to rural and remote locations by monetary incentives. The top reasons that physicians stay in these roles are spousal opportunities and a good lifestyle fit,” said Winkel. Saskdocs has a threepronged approach to making sure Saskatchewan has the right number of physicians for the province’s growing population: the Saskatchewan International Physician Practice Assessment (SIPPA)

program, engaging with University of Saskatchewan medical students as soon as they are accepted into the College of Medicine, and working with Manitoba and British Columbia to recruit and place physicians. SIPPA is a competency assessment program for physicians from other countries. Beginning in 2011, SIPPA ensures that internationally trained physicians – who want to practice family medicine in Saskatchewan – have the right clinical skills and knowledge to provide quality patient care. “We are really proud that of the 41 physicians who moved through the 2017-2018 SIPPA program, there was the highest-ever pass rate at 91 per cent,” said Winkel. On the Health Careers side, in-demand professions include combined labora-

Medical professionals who are recruited by the Saskatchewan Health Authority are joining a dynamic “patient first” health care team, said Dr. Susan Shaw, chief medical officer with the Saskatchewan Health Authority. Sup p lied p hot o

tory and x-ray technologists (CLXT), medical lab technologists, medical sonographers and Registered Nurses.

Health Careers uses different tactics to recruit hard-to-fill positions, including social media and tracking gradu-

ating classes in these professions. “The Saskatchewanderer actually did a story on a CLXT named Pam Rauscher who saw a Facebook post and moved from Mackenzie, BC, to southwest Saskatchewan in 2016. Pam’s move was a smooth transition. We often find this happens when the candidate either grew up in a small town or currently lives in a small town,” explained Winkel, who is himself from the town of Middle Lake. Dr. Susan Shaw is chief medical officer for the Saskatchewan Health Authority and a member of the Provincial Leadership Team. She also actively practices critical care medicine and anesthesiology in Saskatoon. Dr. Shaw is considered a leader in patient- and family-centred care, continuous improveS e e R E C R U I T I N G o n B6

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HealtH Care providers week RNs demonstrate leadership as health care system evolves

by Jonathan hamElin

Saskatchewan’s Registered Nurses (RNs) are working hard to help address the complex issues in the province’s health care system. RNs are self-regulated health care professionals who have attained at least a four-year baccalaureate degree in nursing and have passed the national registered nurse licensure exam. There were 11,699 RNs in the province with a practicing membership as of 2017. This includes 231 RN Nurse Practitioners (RN[NPs]) – RNs who have completed advanced education and provide a broader range of health care – and 94 RNs with Additional Authorized Practice, who work exclusively in northern Saskatchewan and can diagnosis and treat individuals with limited common medical disorders. “RNs make a significant contribution to the health care system and demonstrate leadership when it comes to direct care, education, research, administration and policy development,” said Jayne Naylen Horbach, interim executive director of the Saskatchewan Registered Nurses’ Association (SRNA), the professional regulatory and advocacy voice for nurses. “We’re one of the most valued, trusted health care professionals and we embody the RN values, which involve providing safe, compassionate, competent and ethical care. R E C R U I T I N G F r o m B5

ment and large-scale system change. “When we recruit health care providers to Saskatchewan, we talk about how they’ll join a dynamic health care team that grounds itself in Patient First and continuous improvement to provide high-quality care to the people of Saskatchewan,” said Dr. Shaw. “Saskdocs supports the recruitment of University of Saskatchewan College of Medicine graduates to medical careers in our province. The team also recruits doctors trained both within and outside Canada who like what our province has

As of 2017, there were 11,699 Registered Nurses practicing in Saskatchewan. This includes 231 RN Nurse Practitioners who have completed advanced education and provide a broader range of health care, and 91 RNs with Additional Authorized Practice, who can diagnose and treat individuals with limited common medical disorders. S up p lied p hot o

We’re educated to be strong critical thinkers and I think we’re also committed to understanding the complexities not only of our system, but the complexities of society nowadays and we take our role of leadership within the system and supporting our patients very seriously.” At the SRNA Conference and Annual Meeting in May, some key steps were taken to shape the direction of RNs. One of these steps involved adopting a new code of ethics that emphasizes how RNs should demonstrate leadership, support collabora-

tive efforts and help foster a sense of community. At the meeting, nurses also voted to give RN[NP]s the ability to prescribe medication to help people addicted to opioids and methadone for palliative pain management. The bylaw has since been approved by the Ministry of Health in Saskatchewan and the SRNA will be moving forward with it later this fall or early in 2019. Opioids are medications that relieve pain, but when misused they can cause addiction, overdose and death. There were 63 opioid-related deaths in Sas-

to offer in terms of personal and professional development, along with work-life integration. Health Careers in Saskatchewan helps recruit all the other providers who make up these dynamic teams. Combined, these people make the province and the Saskatchewan Health Authority a real leader in health care design and delivery,” said Dr. Shaw. While there is always a need for psychiatrists, the demand will increase with the opening of Saskatchewan Hospital North Battleford – a new 284-bed facility with 32 more beds than the existing hospital. This includes 96 secure beds for incarcerated offenders living

with mental health issues. The new North Battleford hospital will be an innovative approach for delivering mental health care to two separate groups with significant psychiatric rehabilitation needs. Other related roles that Health Careers is recruiting for are Registered Psychiatric Nurses and mental health therapists. Dr. Shaw concluded: “I urge any health care provider to view all our opportunities on the Saskdocs and Health Careers in Saskatchewan websites and apply today. We have so much to offer.” Find out more at www. saskdocs.ca or www.healthcareersinsask.ca.

katchewan in 2017. “From our perspective, it’s huge,” Horbach said. “We definitely hear from our patients who are struggling with this crisis and in talking with our partners and colleagues at the table I think that we all have an important need to respond to this problem to ensure that we meet the needs of our population. This new bylaw will allow for improved access to important care.” Another complex issue in the health care system concerning RN[NP]s is medically assisted deaths. Since Bill

C-14 was passed in June 2016, eligible Canadian adults are able to request medical assistance in dying. RN[NP]s are one group of health care professionals who can perform this procedure. “That’s a real point of discussion out in society right now; it really is a different way of thinking about nursing,” Horbach said. “The active involvement of RN[NP] s means that those nurses need to understand the laws and respond to their patients in a real dignified manner that holds to our values as professionals.”

A new issue that RNs will need to address has just arrived. Non-medical cannabis became legalized in Canada on Oct. 17, 2018. Horbach said this has a diverse set of implications for the professional nursing practice. “There are so many components and variables to cannabis,” she said. “We’re engaged in conversations about how we’re going to move forward as a RN body here in Saskatchewan. We’re also engaged in discussions nationally with our RN colleagues. We need to ensure we have all the regulatory processes and measures in place to ensure that we are fulfilling our mandate of protecting the public.” It has been nearly one year since Saskatchewan underwent a transition from 12 Regional Health Authorities to the single Saskatchewan Health Authority. While Horbach noted that moving to one health region is a big change for RNs, care providers and patients alike, she said it’s provided RNs with an opportunity to show initiative. “I believe that with change comes opportunity. RNs are leaders and this is an opportunity for us to lead throughout this change,” she said. “I’m reminded of how RNs are not only resilient, but we’re innovative and we really are true partners and we will be there alongside our colleagues caring for the people of Saskatchewan and working to create the best health care system we can.”

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HealtH Care providers week

BridgePoint Center: changing lives for two decades by ElizabEth irEland

For the past 21 years, the BridgePoint Center for Eating Disorders has impacted the lives of individuals across Saskatchewan. The facility was established in the central Saskatchewan town of Milden and provides residential eating disorder programming as part of the province’s continuum of care. Participants are supported through an effective multidisciplinary team approach in a safe, nurturing space. BridgePoint’s programming is free for Saskatchewan residents and participants are age 16 and older. Carla Chabot is the Executive Director of BridgePoint and she lives in nearby Outlook. Members of the BridgePoint team also include Registered Nurses, group facilitators and social workers of different ages and backgrounds. There are 15 beds made available to participants. “At BridgePoint, our participants can get away from the stress of daily life so that they can start the journey of discovery and recovery from their disordered eating. We treat most types of eating disorders and we don’t put individuals into groups based on their diagnosis,” said Chabot. “Another thing that’s unique about us is that participants can self-refer for our initial retreats. The hardest part is coming through those doors, but our participants find a safe community to heal in very quickly.” In 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) made changes to its eating disorders section. One of the biggest changes is that binge eating disorder is now a separate diagnosis for the first time. The other two common eating disorders are anorexia nervosa and bulimia nervosa. Chabot said that the inclusion of binge eating disorder in the DSM-5 increased demand for BridgePoint’s programming quite a bit.

Established 21 years ago in Milden, SK, BridgePoint Center provides treatment for eating disorders by focusing on positive shifts in body image, emotional and physical self-care, self-esteem and relapse prevention. Executive director Charla Chabot leads a team of Registered Nurses, group facilitators and social workers. S u ppli e d ph oto

“Eating disorders are challenging to overcome because they survive in secrecy, sometimes for years. A lot of people don’t know that an eating disorder is a mental disorder and can be fatal. An eating disorder often has comorbidity with other mental disorders such as anxiety, depression, bipolar disorder or PTSD.” Chabot explained that the program is key in reducing unnecessary hospital stays, admissions and readmissions for eating disorders. BridgePoint continues to be a costeffective program and saves the province money as admissions to acute facilities may be prevented or reduced. BridgePoint can also provide post-hospitalization support when a participant is stable. With eating disorders, recovery is rarely linear. Over the past year, BridgePoint has served 101 participants with its residential programming, as well as education sessions for 38 family members and supports. Participants are referred by friends and family, counsellors and physicians, or they find out about BridgePoint online. BridgePoint’s approach is holistic and focuses on positive shifts in body image, emotional and physical self-care, self-esteem and relapse prevention.

The first step in BridgePoint’s programming is a weekend retreat. Retreats include an in-depth assessment interview, meal preparation and planning, and small group/individual support sessions to prepare for an ongoing program, plus all meals.

The month-long Module 1 includes eating disorder-specific group therapy, developing tools for a healthier attitude towards food and weight, nutritional support with a dietitian, ongoing meal preparation and planning support, creative expression and yoga.

Module 2 is 17-days long and focuses on the development of self in relationships, especially during a time of crisis or stress. It also builds on tools participants learned in Module 1. BridgePoint is considered a community-based organization and falls under the Saskatchewan Health Authority and the Ministry of Health. As a registered charity and a nonprofit organization, BridgePoint also accepts funding from foundations and individual donors. Going forward, BridgePoint is continuing to expand its programming. “We are aiming to include more options for male participants and youth under the age of 16 and their families. We know that the treatment of disordered eating and eating disorders works best when it starts early on.” If you, or someone you know, would like to find out more go to the website at www.bridgepointcenter. ca or phone (306) 935-2240.

B RIDGE P OINT C E NT ER F O R E AT I NG D I SO R DE R S

Intensive Recovery, Discovery & Healing for those with disordered eating. Program costs are covered with a valid Saskatchewan Health Card. (306) 935-2240 Email: bridgepoint@sasktel.net

www.bridgepointcenter.ca

Respected, Responsible, Competent Oral Health Professionals Ph: 306-252-2769 Fax: 306-252-2089 Email: sdaa@sasktel.net www.sdaa.sk.ca

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