SND Division Annual Report 2022-2023

Live well. Practice well.

2022 | 2023 ANNUAL REPORT

OUR VISION AN EMPOWERED, VITAL AND INTERCONNECTED NETWORK OF FAMILY PHYSICIANS WHO DRIVE PATIENT WELLNESS AND HEALTH SYSTEM CHANGE IN OUR COMMUNITY.

2022-2023 ANNUAL REPORT

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REPORT CONTENTS

2022-2023 ANNUAL REPORT

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Messages from Our Leaders

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Organizational Overview

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Pillar 1: Physician Engagement and Support

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Pillar 2: Recruitment, Wellness & Retention

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Pillar 3: PCN & Strategic Initiatives

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Pillar 4: HR, Administration & Operations

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New Division Goals

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MESSAGE FROM OUR CO-CHAIRS Dear Colleagues, This year has been one of dual realities for Family Physicians in Surrey-North Delta and beyond. In many respects, it has been a year of historic “wins,” from the LFP Payment Model, which acknowledges the essential, often unseen labour that Family Physicians perform, to the launch of several new primary care services in Surrey-North Delta as part of our PCN implementation.

It has also been a year of continued slow recovery from the challenges of COVID-19, exacerbating the cumulative effects of an already stressed primary care system, with Family Physicians reporting higher rates of burnout and moral injury than ever.

Amid these contrasting experiences, our Division has had one of its most productive years to date – thanks in no small part to the tireless support of our Family Physician members and leaders.

As a Division, we have welcomed 18 new FPs to our community, including locums, and 5 Nurse Practitioners. Thank you for welcoming them into our community.

We have successfully completed our first year of PCN implementation – a feat that seemed like a distant dream only five years ago.

As a Board, we have begun a process of “futureproofing” our organization to ensure the sustainability of the successes we have achieved and to guide our collective action as we move forward. As part of this process, we have re-imagined our organizational goals to reflect our members’ priorities and our community’s primary health needs. As we write this letter, we are engaged in a comprehensive evaluation of our strategic direction through the lens of these new goals.

Ultimately, all our work as an organization is about serving a common purpose: quality, accessible primary care for patients and a system that supports the well-being and purposefulness of Family Physicians.

Working in the wings to ensure we reach these goals are dozens of dedicated Family Physician members serving on our board, committees and working groups, acting as leaders for critical initiatives and participating in SND Division events and projects.

We could only succeed at our work with your support, leadership, and enthusiastic participation. Our achievements as a Division are your achievements. Thank you for everything you do.

As we look forward to the year ahead, we are excited to drive healthcare change in our community alongside you - our talented, dedicated, skilled colleagues.

Sincerely,

2022-2023 ANNUAL REPORT

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MESSAGE FROM OUR EXECUTIVE DIRECTOR Four years ago, when I began my tenure as ED, the Division was in a phase of transition and restructuring. What had begun as a small but powerful grassroots movement led by Family Physicians who wanted more for their peers and their patients was evolving into a larger organization with the potential to have a significant, system-level impact in Surrey-North Delta and beyond.

For several years now, we have been laying the groundwork to enable this impact. The Board of Directors has been examining and fine-tuning our organizational values; we have been building the operational structures and systems to allow us to carry out complex, large-scale initiatives in a sustainable way; and of course, together with our committees, working groups and general membership, have been envisioning and planning Primary Care Networks in Surrey-North Delta.

This year, we have really begun to see the fruits of that early labour.

In this report, you’ll see: A section highlighting some of the reasons we are proud to be in Surrey-North Delta A brief overview of the ongoing PCN implementation Growing interconnectedness of our initiatives and health partners These achievements represent an important, but small piece of the whole of the exciting work that is being done in Surrey-North Delta.

What is beginning to emerge is a truly community-based response to health system challenges in our community, with Family Physicians playing a leading role in the conversation. This is part of the vision of PCN, and of our Division even from the earliest days.

As we continue on our journey, my vision is that Surrey-North Delta will continue to grow into the well-supported, interconnected, accessible, metropolitan health system that our Family Physicians and patients deserve and require.

I am excited and honoured to work alongside you towards this bright future. Thank you to all our members for your hard work and ongoing support of your Division, and especially to our Family Physician leaders – you are the heart and soul of our mission, vision and action.

Sincerely,

06/10

2022-2023 ANNUAL REPORT

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BOARD OF DIRECTORS DR. NAZIA NIAZI

DR. GAGAN WILKHU

DR. PREENA SAHOTA

Co-chair

Treasurer/secretary

Member-at-large

DR. SUJATHA NILAVAR

DR. SACHIT SHAH

Co-chair

Member-at-large

DR. HARPREET BRAR

DR. JOAN FUJIWARA

Term Completed November 2022

Term Completed November 2022

2022-2023 ANNUAL REPORT

DR. UZAIR SHEIK Member-at-large

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PHYSICIAN ENGAGEMENT AND PRACTICE SUPPORT

STRATEGIC PILLARS

RECRUITMENT, WELLNESS, RETENTION AND RETIREMENT

PCN AND STRATEGIC INITIATIVES

HR, FINANCE AND ADMINISTRATION

2022-2023 ANNUAL REPORT

1 2 3 4

OUR MEMBERS

513 30 41

FAMILY PHYSICIANS

RESIDENTS

NURSE PRACTITIONERS

138

MOAS

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SAIRA ABRAR PES Manager

PHYSICIAN ENGAGEMENT AND PRACTICE SUPPORT

NORTH DELTA WEST NEWTON

Email Saira

MEET YOUR PES TEAM Your Physician Engagement and Support (PES) Team's core mandate is to work to build and strengthen relationships among Family Physicians in the community; to connect you with different programs and services according to your practice needs; and to develop, implement and evaluate initiatives, education and engagement that address the unique challenges and opportunities facing primary care in our community.

SUPPORTS OFFERED Practice support and in-person visits, including onboarding for newto-practice physicians PCN Neighbourhood Network development and maintenance Empowerment to provide exceptional patient care through useful tools and connections Relationship building with physicians and partners leveraging digital and communication tools Education and awareness through in-person and online events

CORE PES THEMES ATTACHMENT | PHYSICIAN WELLNESS | QUALITY OF CARE | ACCESS TO CARE | TEAM-BASED CARE

04/10

PILLAR 1: PHYSICIAN ENGAGEMENT AND PRACTICE SUPPORT

ALAN HUANG PES Lead NORTH SURREYWHALLEY GUILDFORD

Email Alan

LAPE OGUNSULIRE PES Lead CLOVERDALEPANORAMA EAST NEWTON FLEETWOOD

Email Lape 07

PES TEAM-SUPPORTED INITIATIVES PRIMARY CARE NETWORK Facilitating governance meetings | FP recruitment for working groups and initiatives | Roots CHC RECRUITMENT, WELLNESS, RETENTION + RETIREMENT FP Welcome Package | connecting FPs with peer mentors | audit support | support for sudden clinic closures

HIGHLIGHTED PROJECTS DIGITAL COMMUNICATION & NEIGHBOURHOOD NETWORK ENABLEMENT The PES Team facilitates 3 FP WhatsApp neighbourhood groups with 240 total participants. Groups are a forum for FPs to support each other, discuss relevant current issues and strengthen the SND FP-to-FP network.

OTHER INITIATIVES

IMPRESSIONS

Project recruitment for Shared Care and other initiatives |

"I learn from the questions answered and I've also learned about lots of resources that are shared here!”

emergency management and mobilization

"Love the WhatsApp group very helpful in creating ‘connectiveness’ with the SND Family physicians.”

Ask to Join a Group

PES TEAM-SUPPORTED EVENTS May 19: PCN Approval Event August 25: NTP FP Event October 26: Annual General Meeting November 16: Physician Cafe + PCN Forum

FIRST ANNUAL MEMBER SURVEY In 2022, the PES Team conducted the SND Division's first annual member survey to "take the pulse" on a wide variety of topics.

KEY FINDINGS The majority of respondents were very satisfied with the Division's FP engagement and support efforts The majority felt that FP Leaders are approachable

March 29: One Year of PCN See Survey Summary

PILLAR 1: PHYSICIAN ENGAGEMENT AND PRACTICE SUPPORT

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Completed March 31

WITH OUR MEMBERS, EVERY STEP OF THE JOURNEY PHYSICIAN ENGAGEMENT IS CENTRAL TO OUR DIVISION'S MISSION. THE PES TEAM USES A COMPREHENSIVE TOOLKIT TO CREATE A SEAMLESS MEMBER JOURNEY FROM JOINING THE DIVISION TO RETIREMENT.

APPROACHES TO ENGAGEMENT IN-PERSON VISITS Customized support Personal connections

EVENTS

DIGITAL COMMUNICATION

Networking and collegiality Division updates

Peer-to-peer support Current, relevant information

JOURNEY MAPPING TOOLS CUSTOMER RELATIONSHIP MANAGEMENT

ENGAGEMENT LEVEL INDICATORS

The PES Team has developed a robust customer relationship management (CRM) tool that tracks important information such as member engagement levels, anticipated retirement dates and clinical interests. This allows us to tailor the supports we offer to each member.

Through a colour-coded indicator system, the PES Team can clearly determine members' engagement levels and necessary steps to support members to become more engaged.

IMPACT

Actively involved members increased from 28% to 40% in 2022-23 including participation in Division events and initiatives

Least engaged

Number of Family Physicians participating in leader cohort grew from 10 to 50+

PILLAR 1: PHYSICIAN ENGAGEMENT AND PRACTICE SUPPORT

Somewhat engaged

Very engaged

A clearer picture of key member demographics will enable us to provide more meaningful support

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MOA NETWORK FP LEAD: DR. NAZIA NIAZI

NEW STEERING COMMITTEE 4 MOA members Strategic direction Event planning

AIM The aim of the MOA Network is to empower our MOAs through education and wellness opportunities in addition to the careful cultivation of professional relationships that encourage positive communication and support.

2022-23 OVERVIEW The 2022-23 fiscal year saw big changes for our MOA Network. In order to better support our MOAs, the MOA Network saw a recommitment to new goals and the revamping of a vision statement that reflected the unique challenges and joys that come with being an MOA.

BASECAMP 138 MOA members Information sharing Important news and updates

Learn More about the MOA Network

CREATING A CULTURE OF CONNECTEDNESS On March 10, the MOA Network came together for the first time since COVID to reconnect and learn around the theme, "Creating a Culture of Connectedness". 47 MOAs attended and 100% of attendees felt more connected to their MOA community as a result of the event.

WHATSAPP 60 MOA members Quick, informal connection Peer support

Watch MOA Appreciation Video

PILLAR 1: PHYSICIAN ENGAGEMENT AND PRACTICE SUPPORT

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R3W COMMITTEE FP LEAD: DR. HARV DHILLON The Recruitment, Wellness, Retention and Retirement Committee sets the direction for the Division's recruitment, wellness and retention initiatives.

RETURN OF SERVICE (ROS) INITIATIVE 4 ROS Family Physicians from the UBC Residency program 3 ROS Family Physicians via compassionate consideration

MENTORSHIP AND PRECEPTORSHIP Collaborated with Douglas College’s Career Paths for Skilled Immigrants program to facilitate 8 Clinical Observerships Collaborated with UBC on pilot project: A day in the life of a Preceptor

CHANGES PHYSICIANS RECRUITED

OTHER COMMITTEE INITIATIVES Wellbeing Index championed by Dr. Sujatha Nilavar New-to-SND Family Physician Welcome package created Participation in the Doctors of BC Physician Wellness Program

7 Family Physicians including 3 locums 11 New-to-Practice Contract Family Physicians PHYSICIANS RETIRED 7 Family Physicians

PILLAR 2: RECRUITMENT, WELLNESS, RETENTION AND RETIREMENT

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R3W-SUPPORTED EVENTS

RECRUITMENT AND RETIREMENT SUPPORTS

July 7: Scholar Day - Hosted 2022 UBC graduates September 22: Walk with your Doc September 29: NTP Family Physician Dinner October 26: Annual General Meeting December 6: Christmas at Red Truck Farms February 6: Longitudinal Family Medicine Event March 2: Fraser Valley Regional Career Fair

The Division offers a number of recruitment and retirement supports for our members: Recruitment of a physician to join your practice (all FPs in the practice must be SND Division members in good standing) Assistance finding a new practice Liaising with the Health Authority and navigating questions about the NTP contract Retirement support – information, options to consider Preceptor opportunities, opportunities for personal learning to prepare for being a preceptor Colleague support/mentorship - opening a practice Coordination of CMEs, with an emphasis on topics that support physician wellness Contact Megan Shymanski to Learn More

PILLAR 2: RECRUITMENT, WELLNESS, RETENTION AND RETIREMENT

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PRIMARY CARE NETWORKS (PCN) FP LEAD: DR. GAGAN WILKHU Our vision for Surrey-North Delta as a PCN community is to build an integrated healthcare system with a strong physician network at its core, where the community’s residents, including newcomers and refugees, those identifying as marginalized and overlooked, feel confident and safe in accessing timely, quality, and culturally appropriate care.

We aim to build a connected, full-service primary healthcare system that addresses the health needs of our community and attracts innovative and dedicated family physicians and other primary care practitioners.

The PCN community we are building will recognize SurreyNorth Delta as a full-fledged community with its own needs and complete healthcare resources to serve its residents.

Read 2022-23 PCN Report

YEAR 1 MILESTONES The Division achieved its PCN implementation goals for year one: MHSU program design completed and staff hired Social Work program referral process designed and staff hired Indigenous Health RNs and Clinical Counsellor hired PCN temporary space designed and opened Virtual Care Network design began Attachment Coordinators hired and Health Connect Registry launched Senior community partner leaders engaged for PCN governance 11 NTP contracts approved 5 NPs recruited

2022-23 PCN EVENTS May 19: PCN Approval Celebration

FAMILY PHYSICIAN LEADERSHIP IN PCN SND BOARD OF DIRECTORS | PMH STEERING COMMITTEE | PCN OVERALL STEERING COMMITTEE | PCN NEIGHBOURHOOD STEERING COMMITTEES | PCN WORKING GROUPS | FAMILY PHYSICIAN LEADERSHIP GROUP

PILLAR 3: PCN AND STRATEGIC INITIATIVES

November 16: Physician Cafe + PCN Forum March 29: One Year of PCN

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PATHWAYS FP LEAD: DR. ELAINE JACKSON | SP LEAD: DR. PHIL HUI

MEDICAL PATHWAYS | PUBLIC MEDICAL DIRECTORY | COMMUNITY SERVICES DIRECTORY | REFERRAL TRACKER Pathways is an online specialist referral tool for physicians and their office staff. The aim of Pathways is to facilitate quality referrals by providing a comprehensive database of specialists and clinics across the province, allowing users to quickly sort through and filter specialist and clinic information to find a provider that best meets a patient’s needs.

AS OF MARCH 31, 2023:

4387

587

RESOURCES

SPECIALISTS

852

REFERRAL TRACKER ACHIEVEMENTS Contracted a new Project Coordinator, Elyzia Finogwar, in October 2022 Launch of the very successful “Move The Dial” campaign in January 2023 Addition of the PCN social workers onto the referral tracker as the primary method for receiving referrals

AS OF MARCH 31, 2023:

ACTIVE USERS

Visit Pathways Page

PILLAR 3: PCN AND STRATEGIC INITIATIVES

119

60

SENDERS ONBOARDED

RECEIVERS ONBOARDED

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Coordinated Complex Care for Older Adults Dr. Mark Blinkhorn + Dr. Karanveer Sall

SHARED CARE

Adult Mental Health and Substance Use Dr. Pawandeep Dhillon + Dr. Karima Jiwa

WHAT IS SHARED CARE? The Shared Care Committee is a province-wide committee that "supports family and specialist physicians to improve the coordination of care from primary to specialist services".

Our Shared Care projects bring together Family Physicians, Specialists and other partners to tackle specific health system challenges in Surrey-North Delta.

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Heart Failure Dr. Lamis Samaan + Dr. Tarun Sharma Substance Use Disorder Dr. Nooshin Nikoo + Dr. Karima Jiwa Postpartum Gestational Diabetes Dr. Nicole Soltermann + Dr. Reena Khurana

Contact April Bonise to Get Involved

PROJECTS COMPLETED

Admission and Discharge Communication Dr. Mark Blinkhorn + Dr. Sanjay Khandelwal

3

PROJECTS LAUNCHED OR RE-LAUNCHED

PILLAR 3: PCN AND STRATEGIC INITIATIVES

18

FPS INVOLVED

15

Completed March 31

Completed December 1

Completed January 31

COORDINATING COMPLEX CARE FOR OLDER ADULTS

ADMISSION AND DISCHARGE COMMUNICATION

ADULT MENTAL HEALTH AND SUBSTANCE USE

KEY IMPACTS

KEY IMPACTS

KEY IMPACTS

2 Meet & Greets created connection between 50 FPs and 15 Community Health Nurses Home Health CHN fax cover sheet and patient list now sent to FPs quarterly Wound Care CME attended by 40 FPs

Communication Workflow Assessment & Gap Analysis at SMH Emergency Department

3 part CME series supported FPs with medication management

Emergency Medicine for SMH on the RACE app

MOA education + engagement

Revised the FP-to-ER referral form Improved MRP Identification

KPI Data Dashboard implemented at JPOCSC SSC Complex Care Rounds Toolkit revised to improve FP-SSC communication

Final Report

Engagement event built bridges between FPs and ER physicians

Final Report

PILLAR 3: PCN & STRATEGIC INITIATIVES

6 education videos created for FPs + NPs FH Transition Checklist assessment + recommendations OCD Care Pathway developed

Final Report

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2022-2023 ACHIEVEMENTS

Created an LTCI Physician Standards of Care document to expand on, and provide clarification for, the 5 Best Practice Expectations for LTC. Implemented an

LONG TERM CARE INITIATIVE

FP LEADS: DR. MARK BLINKHORN + DR. HARV DHILLON

The aim of the Long Term Care Initiative (LTCI) is to design and implement local solutions that deliver dedicated FP MRP services for residents in long-term care homes.

The LTCI is comprised of two physician committees: the LTCI AllPhysicians Committee, which is open to all SND physicians currently providing long-term care in Surrey-North Delta, and the LTCI Steering Committee, which guides the decisions around provision of long-term care in our community.

PILLAR 3: PCN & STRATEGIC INITIATIVES

after-hours central phone line for facilities to be patched directly to the after-hours on-call physicians. All LTC physicians participate.

Hosted a 3-part endof-life CME series: Pre-Planning for Healthcare Decision Making A Palliative Care Case Study on Pain Management MAiD in Canada 2022

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Completed March 31

SURREY-NORTH DELTA SHINES GREAT THINGS ARE HAPPENING IN SURREY-NORTH DELTA! FROM MEMBER ACHIEVEMENTS TO EXCITING NEW HEALTH CARE INFRASTRUCTURE, WE HAVE A LOT TO CELEBRATE.

MEMBERS MAKING A DIFFERENCE SND Members: rallied in Victoria in May for Primary Care with BC Healthcare Matters Dr. Lawrence Yang: Hosts a Healthcare podcast: #FTSintheZoom Dr. Sujatha Nilavar: Champions a Physician Wellbeing Index Dr. Kim Costley: Founded a women's health primary care clinic

HEALTHCARE MATTERS New PCN services: beginning in early 2023, social work, clinical counselling and clinical pharmacy became available within a primary care context in Surrey-North Delta SFU Surrey Medical School: funding was announced in November 2022 New Hospital and BC Cancer Centre: funding was announced in 2019 and construction begins in 2023

ROOTS COMMUNITY HEALTH CENTRE

BEYOND SND

Founded in part by Dr. Hala Ahmed, Roots CHC aims to provide person-centered, longitudinal care to vulnerable newcomers.

Surrey-North Delta Family Physicians are shining at a provincial level. Their achievements include:

This year, Roots has worked with Fraser Health and the Ministry of Health regarding the details for the infrastructure, contracts, and hiring, as well as with Community Partners, including BCACHC, to inform and discuss future planning process Near future plans include moving to a new space and hiring an interdisciplinary team.

Becoming the alternate delegate for the Fraser Region at the FPSC (Dr. Nazia Niazi) Becoming a BC Family Doctors District Delegate (Delta, Surrey, White Rock) and helping to bring the LFP model into action this year (Dr. Sujatha Nilavar) Attending a summit with Premier Adrian Dix (Dr. Sujatha Nilavar) Tell Us About a Member Making a Difference

PILLAR 4: HUMAN RESOURCES, FINANCE AND ADMINISTRATION

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2022-2023 HIGHLIGHTS

Transitioned our banking from ScotiaBank to TD. Office space was reconfigured to make

OPERATIONAL HIGHLIGHTS With our PCN implementation underway, and our other projects and initiatives not only reaching but exceeding pre-pandemic levels of activity and growth, the 2022-23 fiscal year has seen significant staff growth and supportive organizational changes.

STAFF CHANGES We welcomed several new staff members, including for 2 newly created roles: Alina Alesu | Shared Care Project Manager

room for new hires.

Adopted Monday.com for use as a CRM and project organization tool.

OneDrive was adopted to replace Dropbox as our cloudbased file organization and sharing solution.

Prabhjit Malhi | PCN Coordinator (new role) Nadia Shoukat and Monica Khan | PCN Attachment Coordinator (new role)

Restructured and

Elyzia Finogwar | Referral Tracker Coordinator

standardized team

Jody Friesen | returned from maternity leave

templates.

Kristin Warkentin | Communications Specialist We also bid farewell to Katie Phillips and Alicia Parker.

PILLAR 4: HUMAN RESOURCES, FINANCE AND ADMINISTRATION

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STAFF TOMAS REYES

SAIRA ABRAR

PRABHJIT MALHI

APRIL BONISE

Executive Director

PES Manager

PCN Coordinator

Project Manager - Seniors' Initiatives, Pathways, MOA Network

JODY FRIESEN

ALAN HUANG

MONICA KHAN

ALINA ALESU

Director of PCN & Strategic Initiatives

PES Lead

PCN Attachment Coordinator

Project Manager - Shared Care

SUSAN KREIS

LAPE OGUNSULIRE

NADIA SHOUKAT

MEGAN SHYMANSKI

Administration, HR & Finance Manager

PES Lead

PCN Attachment Coordinator

Project Manager - Physician Recruitment, Retention & Wellness

VICTORIA ROTARU

JOAN LAROCHELLE

KRISTIN WARKENTIN

PCN Manager

Administrative Assistant

Communications Specialist

PILLAR 4: HUMAN RESOURCES, FINANCE AND ADMINISTRATION

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FINANCIAL REPORT ASSETS AND LIABILITIES

PILLAR 4: HUMAN RESOURCES, FINANCE AND ADMINISTRATION

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FINANCIAL REPORT REVENUE AND EXPENDITURES

PILLAR 4: HUMAN RESOURCES, FINANCE AND ADMINISTRATION

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NEW DIVISION GOALS IN FEBRUARY OF 2023, THE BOARD OF DIRECTORS BEGAN THE PROCESS OF EXAMINING AND REDEFINING OUR ORGANIZATIONAL PRIORITIES AND GOALS. THESE GOALS AND THE VISION STATEMENT OPENING THIS REPORT ARE A RESULT OF THAT PROCESS.

GOAL 1

GOAL 2

GOAL 3

GOAL 4

To Champion Physician Wellness with a particular emphasis on addressing, reducing and preventing burnout, which is a primary barrier for many physicians to achieving wellness

To Embed Dynamic (Active and Effective) Practice Management within a healthful approach to family practice via resources (AH and otherwise), tools, training, mentorship and change management.

To Enhance Family Physician Connections by evolving and strengthening our FP-toFP network, removing system barriers, enabling collegial relationship building and providing opportunities for collaboration.

To Empower Family Physicians to Be Change Leaders and to act as a collective voice for advocacy, influence, and for successful navigation of healthcare system change in our community and beyond.

SEE UPDATED PURPOSE AND VALUES

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WE WOULD LIKE TO EXTEND A SINCERE THANK YOU TO OUR MEMBERS, PARTNERS, AND COMMUNITY, WITHOUT WHOM NONE OF OUR ACHIEVEMENTS WOULD BE POSSIBLE. The Surrey-North Delta Division of Family Practice acknowledges that we work within the traditional and ancestral territory of the hən̓ q̓ əmin̓ əm̓ speaking peoples, including the Kwantlen, Semiahmoo, Tsawwassen, Katzie, Kwikwetlem, Qayqayt, and numerous Stó:lō First Nations.

Acknowledging that we are on the traditional territories of First Nations communities is an expression of cultural humility and part of a recognition of our duty and desire to support the provision of culturally safe care to First Nations, Inuit, and Métis people in BC.

SURREY-NORTH DELTA DIVISION OF FAMILY PRACTICE 214-5455 152 Street Surrey, BC V3S 5A5

www.divisionsbc.ca/snd info@snddivision.ca @snddivision