1. Primary Health Care and Service Integration: Improving Healthcare in Mount Waddington Victoria Power Director, Primary Health Care, Chronic Disease Management & Rural Health Services September 22, 2010

2. What You Requested to Hear What is primary health care and how does it differ from traditional health care? There are 5 facilities in Mt. Waddington. What changes will we see at the sites related to primary health care? Please review the Mt. Waddington redesign structure to explain how the principles of primary health care are rolling out at each facility. Please explain how this affects the way doctors and staff do their jobs and provide care.

3. Mount Waddington Redesign for Integration Changing the way we plan and provide services: Identify the best supports to ensure success and sustainability of this work

4. The Focus is on Two Goals: 1. Improve the health of Mount Waddington people and communities 2. Demonstrate an integrated management solution for rural and remote communities

5. Mount Waddington Vision: A Primary Health Care Approach Comprehensive, seamless and locally accessible primary health care services delivered by a network of provider teams, integrated into a regional health care system that supports our population to stay healthy, get better, manage illness and disease, and cope with the end of life. Mt. Waddington Health Service Plan 2007

6. What is Primary Health Care? VIHA Working Definition Primary health care is the range of services and supports that individuals and communities receive on an ongoing basis in order to stay healthy, get better, manage illness and disease and cope with end of life. VIHA Primary Health Care Strategy June 2006

7. An approach to health services delivery across the system Key Attributes of Approach: a. First point of contact to access care b. Comprehensiveness of care c. Coordination of care d. Continuity of care

8. Traditional Care vs Primary Health Care Episodic / urgent in nature Services typically delivered in silos Treating illness one person (and one illness) at a time Referral to other providers…your story over & over Sometimes long waits Coordinated, proactive service Care delivered through integrated approach Patients, families & care givers as partners Focus on self-management Population health approach

9. New Service Delivery Framework

10. Namgis Health Services (FN) Mt Waddingtons Regional Services Port Hardy Cluster of Integrated Services Port McNeill Cluster of Integrated Services Port Alice Primary Health Centre Sointula Nursing Centre Holberg Fort Rupert Gwasala-nakwaxdaxw Quatsino Kingcome (outreach) Woss Integrating VIHA Services in Mount Waddington… Guilford (outreach) Hopetown Cormorant Island Service Cluster

11. An approach to health services delivery across the system Key Attributes of Approach: a. First point of contact to access care b. Comprehensiveness of care c. Coordination of care d. Continuity of care

12. First Point of Contact Same Day Appointments Group Visits Nurse Practitioners Fly-in teams Telehealth Expanding Scope of Practice

13. Comprehensiveness of Care Integrated Care Teams & Community Partnerships Chronic Disease Management supports Mental Health Supports Divisions of Family Practice & Collaborative Services Committees VIHA Rural Health Framework

14. Divisions of Family Practice Groups of physicians organized at a community level: Working together to address common health care goals for their communities Influencing population health

15. What Divisions Offer … Networking support for communities of physicians. Avenue for health system decision-makers to effectively engage community GPs. Opportunities for enhanced clinical services, developed and supported in collaboration with partners.

16. Coordination of Care Community Health Integration Initiative A single patient care plan that can be accessed across the health care system and created in partnerships with patients Shared care between patient, NP-GP and specialists Improved communication during care transitions

17. Patient as Partners A collaborative relationship between patients (and their families and caregivers) and health care professionals so that patients can achieve better health Patients have a better experience at a reasonable cost Supporting patients to have greater confidence in managing their own care

18. Patient as Partners Goals: Voice Choice Representation www.patientvoices.ca

19. Continuity of Care Attachment of every willing British Columbian to a family practitioner will reduce the number of emergency room visits and hospital admissions. Maternity, Residential, End-of-Life, Inpatient care incentives in place Hollander, M.J., Kaldec, H., Hamdi, R., & Tessaro, T. (2009) Increasing value for money in the Canadian healthcare system: New findings on the contribution of primary care. Healthcare Quarterly, 12(4), 30-42.

20. Benefits of Attachment For patients More appropriate preventative care. Better access to long- term and coordinated care. For physicians Strong support through health care partners Incorporate inter- professional care teams. Understanding of patient population/needs. 20 of ?

21. Attachment Benefits to System Health system annual cost for person living with diabetes Unattached: $10,175 Attached $4,027 Health system annual cost for person living with heart failure Unattached: $16,710 Attached $7,379 21 of

22. Rural Health Services Framework & Strategy Vision: Healthy people, healthy rural communities, integrated service

23. Next Steps…looking toward the future

24. Questions/ Discussion http://www.viha.ca/p hc_cdm/