1. Facility Engagement Update: Fall 2018

2. For transformation of the Canadian health care system to be successful, physicians must play a central role in planning and implementing change.
– Canadian Society of Physician Leaders

3. What is Physician Engagement?
Active interest and participation of physicians in organizational and system change and improvement activities.
Achieved through building relationships, trust, communication and collaboration.

4. What challenges does FE address?
Meaningful physician engagement, influence and trust in the system is lacking.
Existing structures are not always effective for physician representation and input.
Facility based physicians have not have time, resources and support to engage effectively.
In the 2012 BCMA Member Survey, the following two issues were ranked first and second by members related to where members wanted greater BCMA support:
#1 Quality and Patient Safety (86%).
#2 Ensuring Physician Consultation about regional program and facility changes or redesign (85%).
At that time, Divisions of Family Practice were demonstrating value of community-based doctors having a collective voice, a way to connect with each other, and growing relationships with health authorities.
To create a way for physicians working in acute care facilities to come together (with different goals and objectives than divisions), Facility Engagement was negotiated as part of the 2014 Physician Master Agreement.

5. What is Facility Engagement?
First initiative of its kind in Canada which aims to:
Improve relationships, communication, and collaboration between physicians and health authorities.
Increase meaningful physician involvement in decisions that affect patient care and the physician workplace.
A Memorandum of Understanding signed by Ministry of Health, Doctors of BC, 6 Health Authority CEOs.
MOU categories
Issues of importance to the medical staff;
Health Authority decisions on planning, budgeting and resource allocation directly affecting the medical staff;
Significant decisions affecting physicians and the delivery of physician services;
The working environment for physicians
Matters referred by the Board of Directors, CEO or Medical Advisory Committee;
Medical Staff Bylaws and Rules;
Ensuring professional and collegial communications with health administrators, other physicians and members of the inter-professional health care team;
Quality and cost improvement opportunities
Physician access to data that will help to optimize patient outcomes
Quality improvement projects
A culture of constructive physician engagement and consultation
Physician commitments
have meaningful interactions with Health Authority Leaders that effectively represent their views
prioritize issues affecting patients and doctors
contribute to HA plans and initiatives, especially affecting physicians
MOH and HAs are committed to and will be mutually accountable for clarifying and strengthening their relationships with physicians at provincial, regional and local levels.

6. 72 62 + 10 MSAs now participating across BC (out of 75 potential)
LEGEND:
Interested (0) Expressed Interest 72
MSAs now participating
across BC
(out of 75 potential)
62 +
FULLY FUNDED 10
IN START UP
NORTHERN HEALTH
22 INTERIOR HEALTH
11 ISLAND HEALTH
11 FRASER HEALTH
4 PHSA
8 VANCOUVER COASTAL
+ PROVIDENCE
To November 1, 2018

7. Facility Engagement Site Status
LEGEND:
Interested (0) Expressed Interest
November 2018

8. 970 MSA Activities across BC
Site reported activities in SEAT tracker to

9. 63% involve input from / collaboration with health
Activities overview
63% involve input from / collaboration with health
authorities (either received or pending)
58% aim to strengthen physician-to-physician
relationships, community and/or well-being
39% aim to directly improve quality of patient care
(quality, safety, access, experience)

10. 10 Common Activity Themes
Across BC
Common Activity Themes
Patient care improvements — projects that improve quality, safety, access
Physician engagement activities that build community, connections and relationships
Physician engagement activities that have a clinical focus
Creations of regular collaborative processes / meetings with health authorities
Physician Health and wellness

11. 10 Common Activity Themes New communications tools or opportunities
Across BC
Common Activity Themes
New communications tools or opportunities
Staff Engagement with frontline/allied health, support staff
Training, education and workshops for physicians
IM/IT solutions — information sharing, virtual health, etc.
Redevelopment / redesign of spaces or sites
Does not include MSA business, working group meetings, etc.
Activities are not limited to these 10 themes.

12. xx
Across BC
Key Activity Strategies/ Themes in our MSA
Xxx

13. Provincial level: what are we learning?

14. Provincial Evaluation Stage 1 to 03.31.2018
Across BC
Provincial Evaluation Stage 1 to
Response to the initiative: positively accepted.
Response to the provincial structure and support: some challenges, information/guidance needed.
Vision / Understanding / Operationalizing: Balance and flexibility needed across MSAs for spending funds.
Participation Barriers: time, communication, resources, processes, skills, rural / urban differences.
Valued program Facilitators: FEL support, administrative/ assistance, regional sharing, sessional payments

15. Provincial Evaluation
Across BC
Provincial Evaluation
Stage 2 Provincial Evaluation
Focus on site implementation and refinement of activities that meet the MOU’s aims, to 2019.

16. Some Key Provincial Activities – 12 Months
Funding guidelines improvements
Funding allocation review
2019/20 SSC review/ check-in
Rural strategy development
Co-sharing of successes and problem-solving
Regional meetings
Physician leadership/skills training needs assessment

17. What changes are we seeing?

18. Across BC
CHANGE Big picture
Revitalization of Medical Staff Associations
Physicians connecting with each other across sites + clinical areas
Increased teamwork between physicians, site leadership and and health authorities
Increased physician involvement and leadership

19. CHANGE EXAMPLES Relationships + Collaboration
Across BC
CHANGE EXAMPLES Relationships + Collaboration
Surgical services were saved for residents of Fernie through collaboration between two communities, surgeons, the regional health authority, site administrators and staff.
Patient flow and wait times were improved at the Lion’s Gate Hospital emergency room, thanks to a major physician-led collaborative effort to make space improvements.
The Providence MSA President was invited to interview the shortlisted CEO candidates, then present physician priorities to the new CEO.
Terrace physicians and Northern Health (NW) met to integrate their respective strategic goals.

20. CHANGE EXAMPLES Relationships + Collaboration
Across BC
CHANGE EXAMPLES Relationships + Collaboration
BC Cancer Agency physicians who serve patients through BC now have a way to connect with each other across regions to build relationships and discuss priorities.
Royal Columbian Hospital physicians are teaming up with frontline staff and administrators to build a culture of quality improvement across their site.
Facility Engagement opened the door to new relationships and solutions to smooth the transition to a new hospital campus in Comox / Courtenay.
East Kootenay physicians participated in the capital planning process to prioritize medical equipment needs.

21. CHANGE EXAMPLES Relationships + Collaboration
Across BC
CHANGE EXAMPLES Relationships + Collaboration
Communication between internists and family doctors, and support for patient care was strengthened through a new internal medicine unit at the UNBC in Prince George.
New booking protocols were introduced at Vernon Jubilee Hospital to the utilize the full capacity of the OR.
Child and youth psychiatrist outreach with virtual telemedicine support has been arranged in Lillooet.
With FE, health authority / physician collaboration took a big step forward when VCH implemented CST at its first two sites in 2018.

22. Our Change Examples (Optional - insert local examples)
Across BC
Our Change Examples (Optional - insert local examples)
Relationships + Collaboration

23. Physicians are saying…
Just knowing who these people are, how to speak to them, and what to speak with them about has been very meaningful – BC Cancer Agency
Our interactions with administration now are no longer an ‘us vs them’ mentality. It is a ‘let’s get together and tackle the problem.’
– Burnaby Hospital

24. Health Authorities are saying…
The voice of physicians is brought together much more proactively – rather than once a situation occurs – VCH Senior Leadership
The realization that we no longer need to have separate conversations is a great lead into the future.
– Interior Health West

25. We’re saying (Optional: insert local quotes)
Across BC
We’re saying (Optional: insert local quotes)
Physicians are saying:
Our health authority is saying:

26. Building our physician voice
and community
… To be continued.