attachment update divisions provincial roundtable may 31, 2012
TRANSCRIPT
Attachment Update
Divisions Provincial RoundtableMay 31, 2012
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Timeline
*Program design
*Prototype selection
*Development funding June
2010
*Research*‘Good enough’ definition
*Engage CSC*Develop plan
*Year 1 Implementation funding March
2011*Practice
payments using algorithm
*Research and finalize plans,
implement*Engage docs, HA and local
partners
*Year 2 Implementation funding March
2012
*Connect and strengthen *Practice
payments using algorithm
*Test My GP, refine definition
*Evaluate
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Innovations to share
• Practice Assessment Survey• Integrated practice supports• Practice payments and PIA• Multidisciplinary grants • Community survey of patients• Community level gaps analysis• Community engagement• Primary care clinic with distribution focus• Patient engagement• Definition of attachment• Patient confirmation process – primary care provider
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Evaluating the Issue: Unattached Patients
Prince George•Estimated unattached patient population: 15,000 • variation according to life circumstance and chronic conditions
White Rock–South Surrey•5 to 35% of population unattached:
• Hospital discharges: 5-20%
• ER: 10-35%
Cowichan Valley
• 5% (4,143) Unattached Patients
• 40% (33,148) Poorly Attached Patients
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Attachment Strategies:Enhancing capacity of the local primary care system:
• Practice coaching• Recruitment and locum coverage• Making coordination of care easier – technology, Integration• Recognizing and rewarding longitudinal care provision
Creating multidisciplinary care models• Stand-alone clinics with assessment and distribution
functions• In-practice enhancement of non-physician providers• Enabling access to phychiatrist, pharmacist, other providers
Improving health of population overall to reduce demand• Community-level collaboration with public health,
municipalities
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PGDoFP Strategic Directions
Providing and Supporting Access to Multidisciplinary Care Multidisciplinary care for patients who are
unattached and require team-based care Timely and appropriate access to services, and active
communication between the patient, the team, and the Primary Care Home
Aligned and integrated with Northern Health’s services
Developing and Supporting Excellent Primary Care Homes (PCH) Supporting Primary Care Homes to provide
longitudinal, comprehensive, safe, team-based, measurable, quality care with an attention to relationships and diversity
Empowering and supporting Family Physicians and their practice teams towards excellence by providing individualized assessment, coaching and ongoing support
Sustain a Strong Community of Family Physicians Attract and retain an adequate number of
Physicians to meet the health and wellness needs of Prince George
Strengthen the skills, knowledge, personal growth, and engagement of our Family Physicians
Continue to build a dynamic, healthy, resilient, caring community of Physicians
Reducing Demand Through Healthier Communities Build upon the understanding that healthy
communities ultimately ensure the most effective and appropriate use of health resources
Building relationships with partners toward creating and maintaining a healthy community
All citizens of Prince George will have access to quality, coordinated, sustainable, integrated, longitudinal care in an appropriately supported Primary Care Home that is integral to improving Quality of Life for all.
VISION Through innovation and engaging our skilled physician population we will be a leader in providing sustainable, quality, longitudinal care that is focused on the unique needs of individual patients and our community as a whole.
MISSION
• Increasing capacity in patient-centered Primary Care • Mentoring for continued improvement
• Leading from within and fostering shared leadership • Building consensus • Meeting people where they are at, both physicians and patients • Encouraging inclusiveness
GUIDING PRINCIPLES
S T R A T E G I C
D I R E C T I O N S
2 0 1 2
2 0 1 5
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Prince George - Attaching Patients
Current activities
• Unattached patient clinic – opened May 2008• Inpatient Primary Care Program (for unattached patients)• Managing ‘retirements’• Analysis of Practice Assessment Survey Data• Recruitment• Supporting practice effectiveness
Next Steps
• Primary health care clinic (will incorporate UPC)• Opening July 2012• Increase support for practice effectiveness and capacity
Cowichan Initiatives
Provincial Attachment
Working Group
Family Practice Hospital Support
Program
Cowichan Maternity Clinic
Aboriginal Health Working Group
Chronic Pain Working Group
Warmland Health Services:
Unattached Patient Services
End of Life/Palliative Care
Working Group
CVDFP Attachment
Working Group
Current Initiatives:
Proposed Initiatives:
Practice Coaching
Locum Coordinator
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Cowichan - The synergistic effect of taking a mixed approach…
… allows the community to develop an overall vision and then implement portions of the vision as funding and resources allow.
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White Rock-South Surrey - Attachment Strategies
Increase Capacity &
Support Strength of Attachment
Develop &/Support Targeted Programs for Vulnerable Populations
Increase Public & Patient Understanding of Attachment
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White Rock-South Surrey
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Results to Date
WRSS: 2500 patients attached
• 900 through 2 new doctors
• 600 through PCAC
PG: 3771 patients attached
• Recruitment (3192)
• Residential care (114)
• IPC (465)
Cowichan: 575 patients attached
• Maternity clinic (133)
• Hospital support program (21)
• Locum program (421)
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Risks and Challenges
•No Physician Master Agreement, resulting in funding uncertainty•Administrative stability (staff turn-over)•Hospital care pressures•Physician burnout•Patient inflow•Unrealistic stakeholder expectations•Accommodating patient choice•Physician office space limitations•Difficulty recruiting new physicians to some communities•Difficulty staffing clinics
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Thank you....
Questions?