1. health and fitness

NANAIMO DIVISION
O F FA M I LY P R A C T I C E
2014 ANNUAL REPORT
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Our Constitution
The purposes of the Division are to:
1. Provide leadership, guidance, and support to family physicians in Nanaimo and on Gabriola Island in
order to enhance patient care in the community;
2. Provide a forum for family physicians to represent their expertise as it relates to issues affecting
community and patient health;
3. Provide a forum for innovative and collaborative approaches to healthcare with other stakeholders;
4. Participate in the planning of improvements, research and evaluation, in relation to patient care;
5. Develop and administer programs related to physician well-being; and,
6. Do all such other things as our incidental and ancillary to the attainment of the foregoing purposes
and exercise the powers of the Society.
Board of Directors
Dr. Sheila Findlay, Chair and Physician Lead
Dr. Gerry Vaughan, Vice-Chair
Dr. Melissa Oberholster, Secretary/Treasurer
Dr. Neil Rogers, Director-at-Large
Dr. Connie Woo, Director-at-Large
Dr. Sandy Barlow, Director-at-Large
Dr. Peter Metrowich, Director-at-Large
Dr. Aoibhinn Grimes, Director-at-Large
Dr. Steve Kulla, Director-at-Large
Division Staff
Leslie Keenan, Executive Director [email protected]
Erin Hemmens, Project Manager, A GP For Me [email protected]
Myla Yeomans-Routledge, Physician Recruitment and Retention Coordinator [email protected]
Bobbi Marcy, Administrative Assistant [email protected]
Katherine Henley, Administrative Assistant, A GP For Me [email protected]
Linda Kelly, Administrative Assistant, Shared Care [email protected]
Contract Staff
Sarah Whiteley, Project Manager, Shared Care [email protected]
Andrew Hume, Project Manager, Wound Care [email protected]
Lori Wagar, Evaluator [email protected]
Division Office
#17 -1601 Bowen Road
Nanaimo, BC V9S 1G5
T: 250-591-1200
F: 250-591-1205
www.divisionsbc.ca/nanaimo
www.fetchbc.ca
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Letter from Board Chair and Physician Lead
Dear Colleagues,
It is my pleasure to provide the Annual Report for the Nanaimo Division of Family Practice. I would like
to begin by giving thanks to our members, a collective of 173 Family Physicians, Emergency Room
Physicians, Hospitalists, and Family Medicine Residents. It is through your combined voice and efforts
that we have made significant strides over the past year. Our membership continues to grow with an
increase of 25 Physicians since our last AGM. We’re only 11 short of 100%!
I would also like to extend my wholehearted appreciation to my fellow Board of Directors: Dr. Gerry
Vaughan, Dr. Melissa Oberholster, Dr. Neil Rogers, Dr. Connie Woo, Dr. Sandy Barlow, Dr. Peter
Metrowich, Dr. Aoibhinn Grimes, and, Dr. Steve Kulla. Their collective wisdom, commitment and
passion have guided our work in helping to realize our mission of fostering a strong physician
community through effective representation, leadership, education and collaboration with partners to
promote and improve community-based health care.
Our vision is a fundamental shift in patient care where primary care physicians are full partners in a
health care system that communicates seamlessly, is fully integrated, has a shared purpose, and is
sustainable. Thanks to Island Health’s commitment to partnership, the development of shared working
values and collaborative planning towards integrating health services, we’re beginning to see our vision
come to fruition. This is evolving through their participation in a number of member working groups
and the Collaborative Services Committee. We have an upcoming strategic planning session for the
Collaborative Services Committee (Division, Island Health and GPSC) where we’ll further solidify an
action plan for our shared work. From our perspective, this is particularly important for A GP For Me,
Shared Care, Physician Recruitment and Retention, and Wound Care.
Our efforts combined with those of the other seven Island Divisions and other community partners has
helped to strengthen the Physician voice and provide a forum for the sharing of ideas and resources
towards improving the health care system for patients and providers in a sustainable way. We continue
to enjoy working with our Specialist colleagues to mutually improve relationships, communication, and
referral processes. Patient and family voices provide a key perspective and keeps us mindful of
centering our efforts around their improved experience. Thank you to all of our partners. Our work is
better together.
Over the last year, your contributions combined with community input have guided the GP For Me
initiative, the largest piece of work the Division has undertaken to date. The assessment and planning
phase concluded with a successful proposal to the GPSC (described by them as outstanding). The funds
provided will see the implementation of work focused on Physician recruitment and retention, mental
health and substance use and an attachment mechanism. The annual report details this work but in
brief, the funds are supporting a full time Physician recruitment and retention coordinator; a student
wellness centre at John Barsby Secondary School; a consulting GP for VIU which is developing an on-site
clinic for students, faculty and staff (and eventually the community of Harewood); and, an allied mental
health team, open to referrals from all GPs. The team will be situated in the Caledonian Clinic and offer
support to patients with mild to moderate mental health challenges.
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The Division also received project funding from the Doctors of BC for “Shared Care” initiatives that have
seen the improvement of relationships as well as improvements to communication and referral
processes between GPs and Specialists, specifically adult mental health and substance use, seniors
outreach, internal medicine and Emergency Room Physicians. We have also embarked upon the
improvement of transitions for seniors between acute and residential care and to improve the Physician
experience of those providing facility-based care. This work aligns nicely with the upcoming GPSC
Physician incentives for residential care.
The maternity care network is gaining strength. We had our first “Meet the Docs” event for pre-natal
patients and their families to meet the group of on call Physicians and help prepare them for what to
expect in hospital. Discussions are underway to create a defining vision for the network within the
context of other maternity services available in the community. We’re also working on increasing
awareness of the network and the option available for women seeking the involvement of a subspeciality GP.
There are two significant changes occurring in Island Health. First, the geographic realignment of health
service areas brings with it new leaders at the Collaborative Services Committee table and the inevitable
growing pains that come with the forging of new relationships. Second, Nanaimo Regional General
Hospital is the site selected for the initial roll out of electronic patient charting – iHealth. As with any
major shift in the use of technology, there will be an impact on Physician work flow and its effect on
efficiency and patient care. We remain mindful of the importance of the Physician voice in these
changes and the opportunity provided through the Division as a collective to provide feedback to Island
Health and work with them to resolve issues as they arise.
In closing, I’d like to thank our Executive Director, Leslie Keenan; Project Managers - Sarah Whiteley, Erin
Hemmens, and Andrew Hume; Physician Recruitment and Retention Coordinator, Myla YeomansRoutledge; Evaluator, Lori Wagar; and administrative support – Bobbi Marcy, Linda Kelly and Katherine
Henley. Their tireless efforts, creative ideas, and dedication have been the ballast in providing stability,
structure and momentum for the Division.
Sincerely,
Sheila Findlay, MD
Board Chair
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The remainder of this annual report provides an overview of each of the Nanaimo Division’s working
groups and committees along with the status of its financials per audited statements.
A GP For Me
This provincial initiative is aimed at increasing access to primary care services. The project is funded by
the Ministry of Health and Doctors and BC. It is founded upon research which demonstrates that
attachment to a GP improves the health outcomes of patients, increases provider satisfaction and
decreases health care spending.
The objectives of A GP for Me are to:
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Confirm and strengthen the GP-patient relationship and better support the needs of vulnerable
patients;
Increase the capacity of the local primary care system; and
Enable patients who want a Family Physician to find one.
According to the Canadian Community Health Survey, approximately 11% of the population in the
Central Vancouver Island does not have a Family Doctor.
Advisory Committee Membership
Dr. Melissa Oberholster – Board appointed Physician Lead; Lori Wagar – Evaluator; Leslie Keenan –
Executive Director; and, Erin Hemmens – Project Manager.
Accomplishments to Date
Dr. Oberholster presented the findings of the year-long Assessment and Planning phase to GPSC in
November 2014 resulting in a further $800,000.00 funding to carry out 5 Implementation projects:
1. Recruitment & Retention: See separate project update that follows.
2. Vancouver Island University Campus clinic (VIU): A GP for Me is funding a GP consultant, Dr. Dagny
Vaney, to work with the University to help establish a multi-disciplinary, campus-based health team
at VIU. University students represent a high proportion of unattached patients in Nanaimo and are
high users of the Emergency Department that could be appropriately handled in a primary care
setting. The clinic is set to open Spring 2015.
3. John Barsby Wellness Centre (JBWC): Led by Pediatrician Dr. Wilma Arruda and inclusive of more
than 19 community agency partners, including students and parents, the JBWC project will see the
creation of a school based wellness centre at John Barsby Secondary School in Harewood. The
project aims to provide services to some of Nanaimo’s most vulnerable youth. Opening date is
targeted for Spring 2015.
4. TEAM: Team Enhanced Access to Mental Health Services will see an allied mental health team
situated directly at Caledonian Clinic and offering support to patients with mild to moderate mental
health challenges. The TEAM, comprised of a Psychiatric Nurse, Clinical Counsellor and
Rehabilitation worker will be directly supervised by an Island Health Psychiatrist and accept referrals
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from ALL community based Family Physicians. Opening date of this year long demonstration project
is set for April 1st, 2015.
5. Attachment Mechanism: The Division will be canvassing Family Physicians to confidentially identify
those willing to take on unattached patients seen in one of the three patient centered A GP for Me
strategies: VIU, JBWC and TEAM. This is in response to both patient and GP feedback that the
current mechanism – the College of Physicians and Surgeons BC website – is not adequate.
In addition to the above projects, the Division has received funding from Doctors of BC, Shared Care to
support the development of a Child Youth Mental Health Substance Use Collaborative. This means that
funds will be available to ensure that students at the John Barsby Wellness Centre will have strong links
to CYMHSU services in the community. The Wellness Centre will be further supported by a Community
Developer, hired by Island Health who will also assess other CYMHSU needs and opportunities in
Nanaimo.
Partnerships
Island Health MHSU and CYMHSU, Public Health, Vancouver Island University, School District 68, Shared
Care: CYMHSU Collaborative, Tillicum Lelum Aboriginal Friendship Centre, First Nations Health
Authority, Ministry for Child and Family Development, Barsby Parent Advisory Council, The F.O.R.C.E.
Society, UBC Family Medicine Residents, RCMP, Snuneymuxw First Nation, and City of Nanaimo.
Next Steps
Please watch your emails for more information on all initiatives. The next 8 weeks will be a busy and
exciting time for A GP for Me as we embark on the next phase of work.
Please contact Dr. Melissa Oberholster or Erin Hemmens [email protected] or 250.327.8803
with any comments or questions.
A GP for Me Proposal Approved
Dr Melissa Oberholster wowed the GPSC yesterday with her presentation of our A GP For Me proposal.
Below are some of the committee’s comments following the presentation:
“It’s a love fest here. They just voted a unanimous yes!”
“Please let Melissa know that she hit it out of the park!”
“She told a story. It was so human. I wish we had taped it.”
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Physician Recruitment and Retention
Developing a Locum and Physician Recruitment and Retention Program is a defined goal of the Nanaimo
Division of Family Practice’s Strategic Plan and also an identified priority for the GP for Me Initiative that
confirmed over 25% of the Family Physicians in Nanaimo plan to retire or leave practice by 2017. A Local
Recruitment and Retention Working Group was refreshed June 2014 to oversee this project and drive
the development and implementation of a robust program that improves adequate practice coverage
for Nanaimo.
Membership
Dr. Sandra Barlow, FP and Physician Lead; Dr. Kerry Coates, FP and Co-Chair; Dr. Stuart Ockelford, FP and
Co-Chair; Dr. Beverly Pace, FP; Dr. Chris Collins, FP; Dr. Marcus Barron, FP; Dr. Kristy Williams, Family
Medicine Resident; Sheila Leversidge, Physician Recruitment Coordinator, Island Health; John Horn,
Social Planner, City of Nanaimo; Leslie Keenan, Executive Director; Erin Hemmens, Project Manager, A
GP for Me; Katherine Henley, Administrative Assistant, A GP For Me; and, Myla Yeomans-Routledge,
Physician Recruitment and Retention Coordinator.
Accomplishments
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Working with clinic Physicians and Managers, display booths at Physician conferences, journal and
online advertisements, developing relationships with local and distant Physicians, and partnership
with Island Health has led to a number of successful Locum placements;
Physician journey mapping of Doctors, new to our community, has helped inform the work of the
local, regional and provincial recruitment and retention working groups through the identification of
gaps and barriers in the process.
Strong partnership with UBC Family Medicine Residency Program through the Nanaimo’s Resident Mentorship Program; Residents participating in working groups; and, offering ongoing support and
education to Residents has engaged them and garnered their unique perspectives in our work;
Standardization and maintenance of a "Locum Need list” that is regularly updated by clinic managers
and distributed weekly to entire Locum pool has helped to secure Locum coverage for clinics;
Collaboration with Island Health's Physician Recruitment Program for knowledge sharing and
understanding of the licensing processes and credentialing/privileging requirements has led to an
improved partnership and sharing of key resources;
Regular maintenance and updates on the Recruitment and Retention portions of the Division
website provides at-a-glance information for Physicians wanting to practice in Nanaimo;
Information sharing/networking with other Divisions by offering templates and lessons learned as
our local program grows has been mutually beneficial in sharing resources and building towards an
island-wide Locum experience for those wanting to practice on the Island;
Collaboration with the Regional and Provincial Physician Recruitment and Retention working groups
through integration of tools/resources appropriate to local use ensures we’re focusing on local work
and communicating work that requires Regional and Provincial focus to assist local programs.
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Next Steps
The working group will continue to focus on recruitment and retention activities while also engaging in
the following: advertising; Red Carpet Welcome Package; social events; sponsoring general and complex
billing sessions for Family Medicine Residents; and, gathering information on those preparing to leave
practice to offer support with succession planning and gauging capacity and interest for Locum work
after retirement.
WHY WORK IN NANAIMO?
A Nanaimo Winter Day January 2015
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Shared Care Initiatives
Doctors of BC, Shared Care Committee provides funding and project support to Family Physicians and
Specialist Physicians to improve the flow of patient care from primary to specialist services. The Shared
Care portfolio of projects in Nanaimo, recognises the relationship between Family Physicians and
Specialists is fundamental to the delivery of effective health care, especially for more complex patient
populations. GPs and Specialists are working together to improve physician relationships, enhance
patient experiences and reduce fragmented care through improved communication and improved
referral processes. Shared Cared work is taking place in two distinct areas, Partners in Care and
Transitions in Care.
PARTNERS IN CARE
Enhancing relationships between GPs and Specialist partners through “Let’s Talk” events - an
opportunity for education, dialogue, and to prioritize key areas for improvement. Physician working
groups then develop and implement new processes to better coordinate patient care through
streamlining referral and consult processes, shared care planning and re-referral criteria, diagnostic
standards and communication, telephone advice protocols, and more. There are three working groups
under Partners in Care.
1. GP-Emergency Physician Working Group
Membership
Dr Peter Metrowich (ERP Co-Lead); Dr Tony Zuccaro (GP Co-Lead); Dr Neil Rogers, ERP; Dr Kevin
McMeel, ERP; Dr Melissa Gillis, GP; (Dr Lorne de Paoli, ERP); Gloria Bouchard, Manager Clinical
Informatics, IH; Lisa Holloway, Project Manager Community Integration, IH; Leslie Keenan, Executive
Director; and, Sarah Whiteley, Project Manager.
Accomplishments To Date
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GP-ERP group has met on 9 occasions to problem-solve issues around ED referral, discharge and
communication that members brought forward at April 2013 “Let’s Talk” event.
GP as MRP is now a ‘mandatory field’ within Cerner EMR, meaning GPs will receive their patient’s
results and reports.
Local GP’s provided with ‘best practice’ ER referral, in concert with new systems in ED to ensure
their pre-arrival summary is scanned into the electronic patient record.
New discharge processes in place, for patients requiring time-sensitive follow-up by their own GP.
Exploring ways to better support unattached and more complex patients at home on discharge from
NRGH ED using a team approach: Nurse Practitioner, Pharmacist, Registered Nurse, OT, Social
Worker, Behavioral Health, Clinician and Rehab Assistant.
Information and education for safe and consistent management of methadone seeking patients at
NRGH ED.
Group serving as conduit to shepherd GP and ED Cerner-related challenges to Island Health IM/IT.
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2. GP-Psychiatry/MHSU Working Group
GPs and MHSU working collaboratively improve: Communication: Phone consults; Referral Process referral acknowledgement, disposition notice, clarification of roles, contact information; Collaboration
through sharing patient care, GPs accessing MHSU guidance, MHSU inviting GP input, strengthening GPPsychiatrist relationships; and substance use through access and information. The focus has been on
adult mental health and the recent Let’s Talk Sequel indicated the need to focus now on improvements
in the area of substance use.
Membership
Dr. Angelique Goodhue (Psychiatry Co-Lead); Dr. Maciej Mierzewski (GP Co-Lead); Dr. Clarence Niles, FP;
Dr. Francis Nuamah, Geriatrician; Dr. Joris Wiggers, Psychiatrist; Dr. Sheila Findlay, FP; Dr. Kirsty
McIlwaine, FP; Dr. Sarah Smith, Psychiatrist; Dr. Emanuela Tura, FP; (Dr. Paddy Mark, FP; Dr. Liz DunstanAdams, FP); Leslie Keenan, Executive Director; Sarah Whiteley, Project Manager; Lisa Hoefer,
Coordinator, Practice Support Program, IH; Lisa Murphy, Manager, MHSU, IH; Karen Lorette, RN, Crisis
Counseling Clinic, IH; Kirsty Jane, Intake Nurse, MHSU, IH; Colleen Butcher, Manager Seniors and
Spiritual Health, IH; and, Patient Partners, Wendy South and Ron Plecas.
Accomplishments To Date
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Group has met on 8 occasions to problem-solve patient referral, communication and collaboration
issues that members brought forward at November 2014 “Let’s Talk” event.
Supported quality referrals through education and jointly developed form that MHSU will fax to GPs
if further patient information is required.
Referral acknowledgement and patient disposition notice becoming standard practice within adult
MHSU and seniors services.
Improved patient access to adult and seniors MH through their support for Psychiatry manpower
and recruitment needs (four new Psychiatrists recruited to Nanaimo).
GPs acquainted with new Psychiatrists in town through Division news, events and invitation to a
‘Welcome Gathering’.
Promoted collaborative GP-SP patient care: sharing clinic jumpline numbers, increasing access to
telephone consults, providing up to date contact information, strengthening information-sharing
with GPs.
Jointly supporting and integrating work with A GP for Me and proposals to the Specialist Services
Committee.
3. GP-Internal Medicine Working Group
Enhancing GP-IM relationships - improving collaboration and collegiality among GPs, Specialists and
other care providers; Standardised referral and consult process; Improving continuity of patient care;
Improving quality of and access to patient and physician information.
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Membership
Dr. J.P. Wallach (IM Co-Lead); Dr. Steve Kulla (GP Co-Lead); Dr. Hector Baillie, Internist; Dr. Connie Woo,
Hospitalist; Dr. Marc Paris, ERP; (Dr. Neil Rogers, ERP; Dr. Tony Zuccaro, FP), Leslie Keenan, Executive
Director; and, Sarah Whiteley, Project Manager.
Accomplishments to date
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Group has met on 6 occasions to jointly address issues that members brought forward in June 2013.
Register of IM sub-speciality interest areas was developed and distributed to GPs.
Designed and launched ‘GP Access to Non-Urgent Telephone Advice’ service.
Working with Internal Medicine on the process of re-referrals for patients needing 6 and 12 monthly
reviews.
Increased rapid access to Holter monitors for patients needing them who have been discharged
from the Emergency Department.
TRANSITIONS IN CARE
Family Physicians, Specialists, Island Health and others working together to reduce barriers for seniors
transitioning between acute care and Residential Care. Lessons learned will be applied to transitions
between acute care and Assisted Living and/or the patient’s own home.
Vision
A seamless transition for seniors between acute and residential care supported by: clear clinical
pathways; effective and efficient communication and coordination; team based care; robust Physician
engagement; Physician incentives and support; continuous FP-patient relationship; clear decision
making processes and accountability; and, a platform for regular inter-professional communication.
Membership
Dr. Gerry Vaughan (Board Lead); Dr. Colin Forrester (FP Lead); Dr. Anysia Rusak, Geriatrician; Dr. Eric
Grantner, Hospitalist; Dr. Diane Wallis, FP; Dr. Erfan Javaheri, FP; Dr. Tom Bailey, Medical Director,
Seniors Health, IH; Dr. Susanne Voetmann, FP; Dr. Mike Morris, Hospitalist; Dr Kyle Bourne, Family
Medicine Resident; Timothy Orr, Director Residential Services, IH; Leslie Keenan, Executive Director;
Sarah Whiteley, Project Manager; Marci Eckland, NRGH Site Director, IH; Janet James, Manager,
Medicine and Ambulatory Care, IH; Marie King, Social Worker, Activation Care Unit, IH; Sonya
Robertson, Residential Clinical Lead, Nanaimo Seniors Village; David Forbes, Manager, Clinical Pharmacy
Programs, IH; Faye Liem, Clinical Pharmacist, Dufferin Place, IH; Wendy Carmichael, Manager, Health
Services, Kiwanis Village Lodge; Marjorie Kamp, Residential Care Administrator, Dufferin Place, IH; Catrin
Brodie, Clinical Coordinator, Nanaimo Seniors Health, IH; Lisa Holloway, Project Manager, Community
Integration, IH; Lydia Swift, Director of Care, Malaspina Gardens; and, Kim Slater, Patient and Family
Representative.
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Accomplishments To Date
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Successful Physician engagement, issue identification and visioning event, September 2014.
Member feedback used to design two concurrent arms of activity aimed at improving patient
transition and reducing barriers for GP practice in residential care facilities: Physician Engagement
and Communication and Team Based Care.
The two following working groups have started meeting and will plan, implement and test new
strategies through 2015-16.
Communication and Building Collaborative Teams Working Group
Identified tasks: Engage care teams in safe and effective discharge planning and patient transitions, by
introducing pre-hospital care plans; standardizing warm handovers; understanding patient’s FP (or
alternate) is central to care planning; engage facilities and teams in supporting planned, coordinated FP
visits and standardized documentation processes.
Physician Engagement and Capacity Working Group
Identified tasks: Cultivate Physician interest and engagement in developing and designing a network
that supports quality care for facility-based patients by addressing the Physician “hassle” factors; and,
reducing unnecessary readmissions/ER transitions, through a strong collaborative team approach to
promoting successful aging in facilities. This work aligns well with the recently approved GPSC
Residential Care incentives and the Ministry of Health’s strategic direction in improving resourcing at
facilities to allow for care at facilities, including end of life.
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Wound Care Working Group
Background
The Wound Care Working Group is mandated under the Collaborative Services Committee comprising
representation from the Nanaimo Division of Family Practice and Island Health. The project funding for
the group comes through Doctors of BC, Shared Care. The group’s work is moving into the important
final steps of Assessment and Planning phase to set the stage for an application for Implementation
funding through Doctors of BC, Shared Care.
Membership
Members include: Dr. Sheila Findlay, Co-Chair, FP; Lois Cosgrave, Director, Home and Community Care,
Co-Chair, IH; Dr. Osas Igbinosa, FP; Dr. Clarence Niles, FP; Dr. Richard Robinson, Plastic Surgeon; Andrew
Hume, Project Manager; Leslie Keenan, Executive Director; Cheryl Beach, Project Director, Community
Care Initiatives, IH; Christine Shaw, Clinic Manager; Teresa Stone, Wound care/Ostomy Nurse, IH; and,
Cathy Clackson, Director, Surgical Services, IH.
The following are highlights of key activities that will be completed over the next few months.
Physician Survey
To date, 78 Physicians have completed a survey designed to identify issues faced by Physicians related
to the assessment and treatment of complex wounds. Preliminary results show that over 30% of
Physicians see a patient with a complex wound for 10 or more visits with an average of 16-25 minutes
per visit. The results demonstrate that treatment and assessment of complex wounds has significant
negative impacts on patient flow, Physician satisfaction and financial implications for Physicians. The
results also clearly indicate a need to increase awareness among Physicians on community and hospitalbased patient services available to Family Physicians. The Working Group is making continued efforts to
increase the number of Specialists participating in the survey which is expected to close shortly.
Patient Journey Mapping
In addition to important data gathering already completed such as an environmental scan, an IH audit of
acute, residential and home and community wound care and hospital related data, the working group
will obtain information directly from patients related to their experience. This ‘Patient Journey Mapping’
will help to better understand what is working well, what is not working well and ideas to improve
access and navigation of the care system.
Once the survey and patient journey mapping is complete, results will be collated and add to the
complete picture of where the working group’s planning should focus.
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Understanding Community-Based Services
The Working Group is continuing to look at wound care services currently available in Nanaimo to
improve awareness among the broader care community, support better patient access and referrals,
and, to identify care gaps. A communications plan will be developed to accomplish this.
Next Steps
Several more meetings of the Working Group are anticipated over the next few months. Once the
Assessment and Planning Phase is complete, the Working Group will develop a Shared Care funding
proposal application to implement specific initiatives. Sustainability will be a
key aspect of any implementation strategy as well as adhering to the Triple
Aim principles:
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Improving the provider and patient experience of care (including
quality and satisfaction);
Improving the health of the population; and,
Reducing the per capita cost of health care
The Working Group anticipates having the Shared Care Implementation funding proposal completed by
this summer.
Wound Care at Caledonian Clinic
Dr. Pieter Boshoff, FP, has obtained his IIWC designation (International Interprofessional Wound Care)
through the University of Toronto and is currently pursuing his Diploma in Dermatology. Below are
some statistics related to patients Dr. Boshoff has seen with complex wounds referred by other GPs.
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1600 visits in the past 12 months (140 patients)
Sees an average of 5 patients/day
75% of patients seen have healable wounds
Most patients are seen within a few days of referral
85% of wounds seen are preventable
Dr Boshoff has agreed to initiate a "Referral Acknowledgement" and "Follow Up Consult" letter back to
referring GPs to help facilitate better communication, awareness and GP relations.
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Continuing Medical Education (CME)
Background
The focus of this working group is to address relevant and topical concerns for Nanaimo and Gabriola
Island Physicians, focusing on local resources and inviting other members from the community, as
needed, to provide education about local resources and to assist Physicians in tackling local health care
issues. We do this through non-industry-sponsored continuing medical education events that provide a
forum for GPs to represent their expertise as it relates to issues affecting community and population
health. The CMEs are accredited by the Canadian College of Family Physicians for Mainpro M-1 Credits.
Membership
Dr Melissa Oberholster, Physician Lead; Leslie Keenan, Executive Director; and, ad hoc members. With
Dr. Oberholster’s work as the Treasurer of the Board and GP For Me Physician Lead, the Division is
seeking a GP for the role of Physician Lead for the CME working group. Time requirements for the role
are minimal. If you are interested, would you please contact Leslie Keenan [email protected]
2014-2015 CME Events
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Wound Care, March 11, 2014, presented by Dr. Richard Robinson, Plastic Surgeon and Teresa Stone,
BScN, IIWC.
Preconception and Prenatal Care, May 20, 2014, presented by Dr. Bill Ehman, Family Physician. A
video recording of the CME can be found at https://www.divisionsbc.ca/nanaimo/Videolibrary
Heads Up – What You Really Need to Know About Concussions, presented June 24, 2014 by Dr. Steve
Martin, Sports Medicine Physician, UVic; and, Adam Kleeberger, Canadian Rugby Union Player. This
CME was held to support Physicians and allied health care providers volunteering for the BC 2014
Summer Games.
Evidence Based Medicine, November 20, 2014, presented by Dr. Chris Collins, Family Physician. A
video recording of the CME can be found at https://www.divisionsbc.ca/nanaimo/cme
Simulation-Assisted Emergency Medicine Procedures Course for ERPs, conducted on site at NRGH in
September, October and December with others anticipated in 2015. The labs use high and low
fidelity simulation dolls, task trainers, interactive smart board technology and videotaping
capabilities.
Oncological Emergencies, March 12, 2015, presented by Dr. Michele Dunn, GP in Oncology at the
Nanaimo Cancer Clinic.
Other Events 2014-2015
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Splash Into the New Year engagement events to celebrate new GP and Specialist Physicians to the
community, new relationships with Specialists, new parents, and new graduates. These were held
January 31, 2014 and January 22, 2015 at the Nanaimo Golf Club.
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Summer BBQ and engagement event, August 21, 2014 at the home of Dr. Robin and Dierdre Love,
sponsored by the Division. We are planning to hold another BBQ this summer and want to
incorporate the famous “chicken jump”.
Learn for Life: partnered with the NRGH Hospital Foundation holding two education events for the
public – Heart Health presented on March 31 and April 9, 2014 by Dr. Hector Baillie, Internal
Medicine; What You Should Know About Skin Cancers presented on April 2, 2014 by Dr. Gabriele
Weichert, Dermatologist; and, Palliative Care presented on April 7, 2014 by Jill Gerke, Regional
Manager, End of Life, IH.
Walk With Your Doc – Doctors of BC promotes this event in May in BC communities each year. In
Nanaimo, the initiative is led by Dr. Derek Poteryko, FP and Dr. Kelvin Houghton, FP. Physicians that
joined the walk last year also included Dr. Barbara McLeod, FP; Dr. Betty Bartleman, Pediatrician;
and, Dr. Kelly Cox, Pediatrician. Following the event in May 2014, Dr. Poteryko and Dr. Houghton
have continued the initiative by leading walks in the community each month. This year, the annual
event will be held on Saturday, May 9, 2015, 1000 – 1500 hrs (walk is 1 hour at starts at 1100 hrs) in
Maffeo Sutton Park. Posters and sign-up sheets will be circulated to clinics.
Be Active Every Day – Doctors of BC promotes this annual event in October throughout BC. Dr.
Susanne Voetmann led the initiative with students at Aspengrove School and Dr. Derek Poteryko led
the initiative at North Cedar Intermediate School. The event uses health promotion to help school
age children become more active and make healthy choices. A month-long challenge was held with
each school that encourages one hour of activity and play time every day throughout October. It
provides an opportunity to start young people on the right track at the beginning of the school year,
and help keep them there for the rest of their life.
2015 Splash into the New Year Event:
L-R: Dr. Peter Metrowich, Dr. Melissa Oberholster, Dr. Connie Woo, Dr. Gerry Vaughan. Nanaimo Division Board Members
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Hospital Support Working Group
Background
The initial focus of this group was to improve the working environment, communication, and
engagement for the group of GPs providing active hospital care, enabling them to better support each
other and improving working relationships within the hospital setting. The initiatives put into place to
this group included free hospital parking, centralized on-call line and call maps with photo/signature
posters, dedicated computer use in the nursing stations, and active engagement with the Family
Medicine Residents.
The focus for this group in the past year has been maintaining the above and moving on to further
develop the Maternity Care Network. These focus of the latter is identified below.
Membership
Dr. Chrisen Moonsamy, GP Lead; Dr. Sheila Findlay, FP; Dr. Aoibhinn Grimes, FP; Dr. Francis Chan, FP;
Dr. Colin Walker, FP; Dr. Duda Uchman, FP; Dr. Melissa Gillis, FP; Dr. Renier van Rensburg, FP; Dr. Ryan
Kurytnik, FP; Dr. Steve Beerman, FP; Dr. Tony Zuccaro, FP; Dr. Bill Ehman, FP; Dr. Laura Barron, FP
Locum; Dr. Sharon Chan-Yan, FP Locum; and, Leslie Keenan, Executive Director.
Accomplishments To Date
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Increased awareness of the Maternity Network of Family Physicians accepting referrals for
comprehensive pre/post natal screening and care through clinic posters, brochures, listing on
www.fetchbc.ca, and email communication with the rest of the Physician community
First Meet the Docs event on February 26, 2015 held with the network Physicians, expecting
parents/partners and their children with total of 38 people in attendance. It was an opportunity for
prospective parents to meet the FPs in the call group and discuss what to expect just prior to and
post hospitalization.
Held a network visioning session meeting to articulate a shared purpose, short and long-term goals
informed by evidence-based research and current state of maternity care in Nanaimo.
Partnered with our OB/GYN colleagues to lend support for their impending manpower shortage.
Next Steps
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Complete the visioning work.
Two other Meet the Doc events are planned for May 28 and October 9, 2015.
Further work on increasing awareness of the network and enhancing the Physicians work through
community education.
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Healthy Communities Working Group
Background
As part of the strategic plan, the Division aims to contribute to a health community through
collaboration with other partners. We’re partnering with Island Health, Ministry of Social Development
and Innovation, United Way, City of Nanaimo, VIU, and other community agencies to agree on the best
strategy to accomplish this.
Membership
Dr. Sheila Findlay, FP; Leslie Keenan, Executive Director; Analisa Blake, Project Lead, Food Security and
Healthy Living Initiatives, IH; Jeannine Bousquet, Community Relations & Service Quality Manager,
Ministry of Social Development and Social Innovation; Diana Davison, Senior Manager, Island Savings;
Marc Dinelle, Manager, Field Services, Ministry of Social Development and Social Innovation; John Horn,
Social Planner, City of Nanaimo; Signy Madden – Executive Director, United Way Central and Northern
Vancouver Island; Maggie Kennedy, Community Health, VIU (retired); Trevor Davis, Associate VP,
Scholarship and Community Engagement, VIU; Robin June Hood, Director, Community Based Research
Institute, VIU; Lisa Marie Barron, Project Development, Nanaimo Women’s Centre; Geri Bemister,
Criminology Instructor, VIU; Bruce Wright, Staff Sergeant, RCMP.
Accomplishments to Date
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Agreed that Mental Health Substance Use is the priority population, beginning with child youth
mental health as it crosses all sectors of work represented in the membership above.
Reviewed a number of resources and other successful Healthy Cities models.
City of Nanaimo provided a community grant in November 2014 to an agency focusing on improving
services for CYMHSU. Part of the proposal process identified a number of community agencies
providing CYMHSU services. Our working group’s next focus is to identify the gaps in service (from
the proposals) and act as a review body for other agencies, e.g., United Way, to screen grant
applicants and recommend funding proposals that fill the gaps identified.
Next Steps
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Review proposal materials from the City and identify gaps in service.
Agree on criteria for screening tool to evaluate proposals against above gaps.
Agree on process to raise awareness of group’s work with funders.
Identify other opportunities for collaboration in promotion of a healthy community.
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Collaborative Services Committee
Background
The Collaborative Services Committee (CSC) formed in 2012 through a process led by the Provincial
Divisions of Family Practice. A document of intent was signed by the Division, Island Health, GPSC and
Ministry of Health dedicated to the improvement and access of primary care. Primary care is where
most people, most of the time, encounter the health care system. As the 2009 Hollander report cited,
“it is the greatest leverage point for improving population health, the patient experience and reducing
pressure on the overall system.” By signing the Document of Intent, the partners affirmed their belief
that a sustainable primary care system is one where there is the least possible distance between
clinicians who deliver care and the policy makers. The CSC provides a table at which shared issues can
be identified, agreed upon, acted upon, and evaluated.
Membership
Dr. Sheila Findlay, Co-Chair; Allison Cutler, Community Program Services Director, Co-Chair, IH; Dr.
George Watson, GP, GPSC representative; Dr. Connie Woo, Hospitalist; (Dr. Neil Rogers, ERP); Dr. Drew
Digney, Executive Medical Director, IH; Suzanne Fox, Executive Director, IH; Lisa Hoefer, CSC Staff
Support; Julie Holder, Physician Engagement Lead, Provincial Divisions; Leslie Keenan, Executive
Director; Jan Tatlock, Director, Public Health, IH.
Accomplishments To Date
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Agreed on collaborative working values.
Agree on shared work with an upcoming strategy planning session to further solidify this and agree
on areas of focus and an action plan going forward.
Successful vehicle for communication and problem resolution in areas impacting primary care, e.g.,
shortage of Psychiatrists in Nanaimo; concerns re: implementation of iHealth at NRGH; progress of
wound care working group ultimately raising it to become a CSC working group with greater
accountability; assigning executive leads to working groups; sharing results of GP/ERP survey re:
level of satisfaction with Cerner roll out in ER; streamlining process to access IH stats for shared
projects; engaging Specialists for wound care working group; streamlining acute/community
working groups on Seniors Transitions work; provide recommendations to GPSC to improve A GP For
Me proposal approval process.
Mutual sign off/support for Division-led initiatives – A GP For Me and Shared Care proposals and
subsequent IH staff support for the initiative projects.
Evaluation of CSC work, leading to strategic planning session March 10, 2015.
Inter-Division Collaborative Services Committee (IDC)
Twice per year, all of the 8 Island Division Co-Chairs, IH CSC Co-Chairs and Executive Directors meet to
discuss issues pertinent to a regional approach. Two regional working groups have formed from the IDC:
Physician Recruitment and Retention, and, Primary Care Informatics Working Group. The following are
the highlights from the IDC work.
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Proposal for an island-wide recruitment and retention strategy ratified by the IDC lending a
strong voice of support for an Innovation Proposal for funding to support this work. The
proposal will be submitted to GPSC this month.
A strong, cohesive working group, Chaired by Dr. Aaron Childs (Victoria Division), has formed
from the above with membership from the 8 Island Divisions and Island Health. Dr. Sandy
Barlow is the FP from the Nanaimo Division represented on this group along with Leslie Keenan,
Executive Director. We’ve seen the fruits of this collaborative through shared booths at
Physician conferences; clarification of roles to avoid duplication; sharing of resources and
templates; a commitment to supporting an island-wide network to make the island more
attractive to visiting Locums and FPs to practice in Nanaimo. Four new FPs have been recruited
and are now working in our community through partnering on the recruitment efforts of Island
Health, Health Match BC, and the island Divisions.
The Primary Care Informatics Group was set up to inform the IH implementation strategies of
iHealth (Cerner). Representatives from Nanaimo include Dr. Chris Collins, FP and Leslie Keenan,
Executive Director. The group meets monthly by teleconference with GP reps from each Island
Division and Chaired by Dr. Mary Lyn Fyfe. The group provides a venue for GP voice re:
integration of EMRs with IH Cerner; scanning FP summaries into Cerner (a work in progress); and
discussing concerns related to iHealth. A full day face to face is planned for April to review the
working group’s model, establish a Co-Chair role, and outline a plan for work going forward.
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