Consultation Summary Report Final - Kaslo · COMMUNITY CONSULTATION SUMMARY REPORT HEALTH SERVICE DELIVERY VICTORIAN COMMUNITY HEALTH CENTRE at the OF KASLO 1 May 2013 . ... Health

COMMUNITY CONSULTATION SUMMARY REPORT

HEALTH SERVICE DELIVERY

VICTORIAN COMMUNITY HEALTH CENTRE

COMMUNITY CONSULTATION

SUMMARY REPORT


at the


OF KASLO

1




May 2013

COMMUNITY CONSULTATION

VICTORIAN COMMUNITY HEALTH CENTRE OF KASLO

Table of Contents

Executive Summary Background Consultation Design / Consultation Focus Group Summary Future State Workshop Summary Next Steps

Appendices

Appendix A: Public Service Announcement March 14, 2013Appendix B: Focus Group Questions Appendix C: Focus Group Summary PackageAppendix D: Workshop InvitationAppendix E: Workshop AgendaAppendix F: Workshop Discussion Summary Appendix G: Workshop Participant ListAppendix H: Steering Committee



at the

VICTORIAN COMMUNITY HEALTH CENTRE OF KASLO

Page Page

Consultation Process Page Page

Workshop Summary Page Page

Public Service Announcement March 14, 2013 PageFocus Group Questions PageFocus Group Summary Package Page

Invitation PageWorkshop Agenda Page

Discussion Summary Page 23Participant List Page

Steering Committee Membership Page

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Page 3 Page 4 Page 5 Page 7 Page 8 Page 9

Page 10 Page 12 Page 13 Page 21 Page 22 Page 23 Page 27 Page 28

Executive Summary An extensive community consultation process stakeholder interests in service delivery at the Victorian Community Health CentreHealth, the Village of Kaslo and the Regional District of The concept of broad community consultation Health proposed a plan to address frequent service delivery challenges at VCHC stable physician and nursing coverage. service from 24/7 coverage to weekday daytime service. There was widespread concern with a potential Area Health Care Work Group was formed determined a community consultation process was public in discussions around health-care services and service deliverysustainable plan for the future. A Steering Committee was formed to design the consultation process which imembers and a number of Interior Health staff. Linda Tarrant, an expert in collaborative strategic planning, and Dr. John Ross, a Canadian expert on rural emergency care. The consultation process involved over 2were held during March and April 2013 in Kaslo, the Lardeau Valley and Nelsonvaluable insight into community challenges, priorities and areas of potential service improvement. Over the coming months Interior Health as well as a report on emergency service delivecommunity health centre model that is sustainable in terms needs of area residents and can be used as a similar service delivery challenges. Interior Health recognizes the importance of ongoing community engagement and will keep the Area Health Care Work Group informed and involved as progress is made. brought back to this group for discussion and feedback

mmunity consultation process took place in the Kaslo area in the spring of 2013 stakeholder interests in service delivery at the Victorian Community Health Centre (VCHC)Health, the Village of Kaslo and the Regional District of Central Kootenay supported this process.

consultation stemmed from work that began in the fall of 2012 after quent service delivery challenges at VCHC due to difficulties in securing

The plan incorporated a reduction in Emergency Department hfrom 24/7 coverage to weekday daytime service.

potential reduction in emergency department hourswas formed to pursue discussions with Interior Health. Together it was

etermined a community consultation process was critical to engage various stakeholders and members of the care services and service delivery, which would assist in developing

A Steering Committee was formed to design the consultation process which included two Kaslo community members and a number of Interior Health staff. Interior Health also engaged the services of two consultantsLinda Tarrant, an expert in collaborative strategic planning, and Dr. John Ross, a Canadian expert on rural

The consultation process involved over 260 people in focus group sessions, meetings and in Kaslo, the Lardeau Valley and Nelson. The process produced

challenges, priorities and areas of potential service improvement.

will undertake a planning process using all of the information gathered, as well as a report on emergency service delivery options prepared by Dr. Ross. The o

sustainable in terms of fiscal and human resourcesbe used as a potential guide for other small and remote sites

Interior Health recognizes the importance of ongoing community engagement and will keep the informed and involved as progress is made. It is expected the model will be

for discussion and feedback in the fall of 2013.

3

in the spring of 2013 to explore (VCHC) of Kaslo. Interior

supported this process.

from work that began in the fall of 2012 after Interior due to difficulties in securing

The plan incorporated a reduction in Emergency Department hours of

hours. The Kaslo and with Interior Health. Together it was

various stakeholders and members of the assist in developing a

ncluded two Kaslo community engaged the services of two consultants:

Linda Tarrant, an expert in collaborative strategic planning, and Dr. John Ross, a Canadian expert on rural

meetings and a workshop that The process produced

challenges, priorities and areas of potential service improvement.

sing all of the information gathered, The objective is to develop a

and human resources, meets the health guide for other small and remote sites experiencing

Interior Health recognizes the importance of ongoing community engagement and will keep the Kaslo and It is expected the model will be

Background Kaslo is a relatively isolated community Nelson (one hour travel time). The villagpopulation is closer to 2,500 when includ The Victorian Community Health Centreand operates a 24/7 Emergency Department (ED)offices and after-hours on-call service, supported by RNs who staff the attached 20Kaslo is allocated funding for 2.0 physicians FTEphysicians on contract and locums. While this is considered adequate to meet the primary healththe population, 2.0 FTE is not considered The ED is a low volume site, reporting a total of 1,003 unscheduled visits in 2011/12.recurring human resource challenges in service interruptions (where the facility was either on diversion to Kootenay Lake Hospital in Nelson due to the lack of physician coverage, or where an RN During the spring and summer of 2012 several inability to provide ongoing 24/7 ED coverage group to examine the best way to provide quality emergency care to area residentsinformed by a thorough review of ED volumes, patient acuity and transport statistics. Emergency Services and Primary Care It was determined that a weekday ED servicemost appropriate means to provide consistent and reliable care to the community. about the reduced access to emergency services, and Health worked with BC Ambulance Service (BCAS) to developAttendants (ACAs) at VCHC who would combine the skill set of paramedics and nursing aidesperform as IH staff while on duty at VCHC, and be transfer duties as an employee of BCAS. On September 13, 2012 senior Interior HealthDistrict of Central Kootenay (RDCK) Director Andy Shadrack to reduce Emergency Department (ED) hours at 1, 2013. VCHC staff was informed the same day, and a The community was clearly concerned with should have engaged the community in discussions much earlier. Group was formed with community representativesWorking with Dr. Alan Stewart, IH Senior Medical Director, Community and Residential ServicesExecutive Medical Director) and Linda Basrancommunity consultation process was critical discussions that would assist Interior Health care. A Consultation Steering Committeeconsultation process. (See Appendix H:

Kaslo is a relatively isolated community in the Kootenay Boundary, approximately 70 kilometresge population is approximately 1,025 (2011), hoding the surrounding smaller communities.

Victorian Community Health Centre (VCHC) of Kaslo provides a variety of primary healtha 24/7 Emergency Department (ED). Physicians provide daytime ED coverage from their onsite

call service, supported by RNs who staff the attached 20-bed residential care facility. 2.0 physicians FTE (full time equivalent) which has typically been a mixture of

. While this is considered adequate to meet the primary health2.0 FTE is not considered sustainable for 24/7 ED coverage.

is a low volume site, reporting a total of 1,003 unscheduled visits in 2011/12. VCHC experienced recurring human resource challenges in 2012 (physician and nursing) which led to a significant number of

where the facility was either on diversion to Kootenay Lake Hospital in Nelson due to the an RN was on call but not on site at VCHC).

several discussions occurred with the Kaslo physicians regarding their 24/7 ED coverage due to workload concerns. Interior Health

group to examine the best way to provide quality emergency care to area residents. Discussions were ED volumes, patient acuity and transport statistics.

that a weekday ED service, together with a robust primary care service model,

onsistent and reliable care to the community. In order to address about the reduced access to emergency services, and the need for enhanced transport services, Interior

worked with BC Ambulance Service (BCAS) to develop a proposal to introduce Advanced Care would combine the skill set of paramedics and nursing aides

VCHC, and be released to BCAS to respond to 911 and ambulance as an employee of BCAS.

Interior Health staff held a meeting with Kaslo Mayor Greg Lay and Regional Director Andy Shadrack to outline current staffing challenges and hours at VCHC from 24/7 to daytime weekday service

informed the same day, and a community-wide public meeting was held th

concerned with the plan to reduce ED hours of service and felt Interior Health in discussions much earlier. The Kaslo and Area Health

community representatives selected by Mayor Lay and RDCK Senior Medical Director, Community and Residential Services

and Linda Basran, Community Area Director, IH East, the group critical to engage various stakeholders and members of the public

discussions that would assist Interior Health in developing a sustainable model of primary and ommittee was formed to oversee the design and implementation of the

Steering Committee Membership)

4

approximately 70 kilometres north of wever the area

(VCHC) of Kaslo provides a variety of primary health-care services Physicians provide daytime ED coverage from their onsite

bed residential care facility. (full time equivalent) which has typically been a mixture of

. While this is considered adequate to meet the primary health-care needs of

VCHC experienced a significant number of

where the facility was either on diversion to Kootenay Lake Hospital in Nelson due to the

ysicians regarding their nterior Health formed a working

. Discussions were

, together with a robust primary care service model, would be the In order to address concerns

need for enhanced transport services, Interior a proposal to introduce Advanced Care

would combine the skill set of paramedics and nursing aides. They would released to BCAS to respond to 911 and ambulance

held a meeting with Kaslo Mayor Greg Lay and Regional outline current staffing challenges and plans to

from 24/7 to daytime weekday service, effective October wide public meeting was held that night.

and felt Interior Health Kaslo and Area Health Care Work

Director Shadrack. Senior Medical Director, Community and Residential Services (now

group determined that a to engage various stakeholders and members of the public in

primary and emergency design and implementation of the

Consultation Design The Consultation Steering Committee met in Kaslo on March 11, 2013 process. Two guiding principles were agreed upon

1. opportunities for stakeholder and community2. the consultation discussion should

An extensive consultation process was developed groups, a transportation-focused meeting, and a followcommunity priorities in both emergency It was envisioned that the outcomes of the Kaslo consultation process could development of a new model of care, one that could experiencing similar service delivery challenges Consultation Process Eight two-hour focus groups were held Sunday March 24approximately 220 people. Specific sessions were held for:

• elected officials and business representatives• residents of the Lardeau Valley at the north end of Kootenay Lake• VCHC staff and physicians

The other five sessions were communityMembers of the public were notified by a Public Service Announcement to in the Pennywise publication, posters at VCHC In addition to attending the eight focus groups, physicians, and participated in a meeting with BCAS personnel, IH Transport Services and members of the Interior Health High Acuity Response Team (HA All focus groups began with an introduction by Maggie Wintersan overview of the consultative process by redesigning rural emergency care in Nova variety of topics such as expectations for local health services, access to those services, current challenges and future service sustainability. (See Appendix All discussion points were gathered in written formatsession. A dotmocracy exercise enabled developing sustainable health services in the area.

Steering Committee met in Kaslo on March 11, 2013 to plan and design the consultation were agreed upon:

opportunities for stakeholder and community-wide input should be maximized discussion should include the delivery of emergency and primary care

process was developed that included several community-wide and stakeholder focus focused meeting, and a follow-up workshop. Six questions were developed

emergency and primary care areas would emerge.

f the Kaslo consultation process could assist Interior Health in the , one that could potentially be used as a guide in other small

service delivery challenges.

s were held Sunday March 24th through Tuesday March 26th

and business representatives residents of the Lardeau Valley at the north end of Kootenay Lake

sessions were community-wide; area residents were able to attend more than one sessionwere notified by a Public Service Announcement to area media (see Appendix A)

, posters at VCHC, e-mail and telephone.

In addition to attending the eight focus groups, Dr. Ross met individually with a number of participated in a meeting with BCAS personnel, IH Transport Services and members of the

Team (HART) based in Trail.

All focus groups began with an introduction by Maggie Winters of the Kaslo and Area Healthcare Work Group, an overview of the consultative process by Linda Tarrant and comments from Dr. John Ross on his experience redesigning rural emergency care in Nova Scotia. Participants then broke into small groups to discuss

expectations for local health services, access to those services, current challenges (See Appendix B: Focus Group Questions)

were gathered in written format on flip chart paper and posted on the walls at each enabled participants to identify areas they felt critical to the success of

developing sustainable health services in the area.

5

to plan and design the consultation

primary care services

wide and stakeholder focus were developed to ensure

assist Interior Health in the in other small, rural sites

th attracting

area residents were able to attend more than one session. (see Appendix A), an ad

met individually with a number of VCHC staff and participated in a meeting with BCAS personnel, IH Transport Services and members of the

and Area Healthcare Work Group, Dr. John Ross on his experience

broke into small groups to discuss a expectations for local health services, access to those services, current challenges

and posted on the walls at each to the success of

Focus Group in Lardeau Valley Community Hall

March 24, 2013

Valley Community Hall Focus Group in Kaslo Legion Hall March 25, 2013

Dotmocracy Exercise

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Focus Group in Kaslo Legion Hall March 25, 2013

Focus Group Summary All written responses to the focus group questions were organized into themes. (See Appendix C Six major themes emerged:

1. Access to 24 hour emergency carea. Strong interest in seeing stable 24/7 emergency serviceb. Interest in exploring different staffing models i.e.c. Readiness to explore integration with BCAS,

2. Quality and continuity of primary care

a. Clinic hours should expand b. Need for collaboration with alternative healthc. Area residents need more information on clinic services

prevention d. Suggestions that lab and diagnostic imaging services be

3. VCHC and staff training/education

a. Increase training for advanced b. Increase training on communications and customer servicec. Consider how to use other healthd. Review staffing patterns

4. Community Engagement

a. Need to build trust and relationshipsb. Community wants to be involved in

5. Transportation

a. Need for improved ambulance serviceb. Need for Advanced Care Paramedicsc. Improve HART access to Kaslo d. Need for more transportation

6. Use of technology

a. More teleconference and video conference options with doctors and specialists b. More information should be

c. Lardeau Valley residents

All written responses to the focus group questions were transferred word-for-word into electronic formatC: Focus Group Consultation Summary Package)

24 hour emergency care Strong interest in seeing stable 24/7 emergency service Interest in exploring different staffing models i.e. physician accessible via telephone

integration with BCAS, with off-site physicians

Quality and continuity of primary care should expand to improve physician access

Need for collaboration with alternative health-care providers Area residents need more information on clinic services, health promotion

lab and diagnostic imaging services be more accessible

training/education for advanced clinical skills, make it ongoing

communications and customer service Consider how to use other health-care professionals

and relationships Community wants to be involved in planning and decision making

ambulance service – include Lardeau Valley Advanced Care Paramedics

Improve HART access to Kaslo transportation options

More teleconference and video conference options with doctors and specialists should be on the VCHC webpage on the Interior Health website

Lardeau Valley residents should be eligible for more telephone consults

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word into electronic format and : Focus Group Consultation Summary Package)

physician accessible via telephone

health promotion and disease

more accessible

More teleconference and video conference options with doctors and specialists on the VCHC webpage on the Interior Health website

more telephone consults

Future State Workshop Summary A day-long workshop was held on Monday April 22themes identified in the focus groups. Pinterests, VCHC service areas, partners such as BCAS and physicians, and key IH staff. were invited; 40 were able to attend. (See Appendix G After presentations from the consultants and Interior Health, according to their interests, moving between groups as they wished. challenges, think creatively and develop services in Kaslo. (See Appendix E: Workshop Agenda) The six groups then reported back presenting theircare services at VCHC. A number of valuable Discussion Summary)

long workshop was held on Monday April 22nd in Kaslo to pursue further discussion on the Participants were selected to ensure a cross section of community

interests, VCHC service areas, partners such as BCAS and physicians, and key IH staff. (See Appendix G: Workshop Participant List)

After presentations from the consultants and Interior Health, participants self-selected into small groupsbetween groups as they wished. Participants were asked to identify

develop suggestions to assist in developing consistent, quality Workshop Agenda)

The six groups then reported back presenting their suggestions to enhance both primary valuable ideas were brought forward. (See Appendix

Future State Workshop April 22, 2013

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in Kaslo to pursue further discussion on the six major articipants were selected to ensure a cross section of community

interests, VCHC service areas, partners such as BCAS and physicians, and key IH staff. Forty-one participants

into small groups Participants were asked to identify

consistent, quality health-care

enhance both primary and emergency See Appendix F: Workshop

Next Steps Over the next several months Interior Healthgathered through community consultation The objective is to develop a community health centre modelresources, meets the health needs of arearemote sites experiencing similar challenges Interior Health recognizes the importance of ongoing community engagement and will keep the Area Health Care Work Group informed and involved as progress is made. It is expected the model will be brought back to the and feedback in the fall of 2013.

Interior Health will undertake a planning process informed by gathered through community consultation, and a report from Dr. John Ross on emergency service delivery

community health centre model that is sustainable in terms area residents and can be used as a potential guide for other small and

experiencing similar challenges.

Interior Health recognizes the importance of ongoing community engagement and will keep the informed and involved as progress is made.

It is expected the model will be brought back to the Kaslo and Area Health Care Work Group

9

informed by the information emergency service delivery.

sustainable in terms of fiscal and human guide for other small and

Interior Health recognizes the importance of ongoing community engagement and will keep the Kaslo and

are Work Group for discussion

APPENDIX A

PUBLIC SERVICE

For Immediate Release

Kaslo Community Consultation Sessions

KASLO – Interior Health will hold a number of community consultation sessions March 24engage area residents in productive dialogue around sustainable healthCommunity Health Centre.

Area residents are invited to attend the sessions outlined below: Sunday March 24th North Kootenay Lake residents Lardeau Valley Community Hall in Meadow Creek5 p.m. – 7 p.m. Please pre-register to ensure adequate seating is available. Phone: 250-366-4452 Monday March 25th

Kaslo Legion Hall

10 a.m. – 12 p.m. 12:30 p.m. – 2:30 p.m. 7 p.m. – 9 p.m. Please pre-register: E-mail: [email protected]

Phone: 250-353-2083 Focus groups will also be held with elected officials, physicians and health centre staff. “We are pleased to see the community consultation process moving forward,” Director for Community and Residential Services. physicians and staff about their priorities, their values and how we can ongoing human resource challenges we are facing.”

PUBLIC SERVICE ANNOUNCEMENT

For Immediate Release | March 14, 2013

Kaslo Community Consultation Sessions

will hold a number of community consultation sessions March 24th through March 26engage area residents in productive dialogue around sustainable health-care services associated with the Kaslo Victorian

Area residents are invited to attend the sessions outlined below:

unity Hall in Meadow Creek

register to ensure adequate seating is available.

Tuesday March 26th Kaslo Legion Hall 7:30 a.m. – 9:30 a.m. 10 a.m. – 12 p.m. 2 p.m. – 4 p.m.

[email protected]

Focus groups will also be held with elected officials, physicians and health centre staff.

We are pleased to see the community consultation process moving forward,” said Dr. Alan Stewart, Senior Medical Director for Community and Residential Services. “This is a terrific opportunity to learn from the community, our physicians and staff about their priorities, their values and how we can best meet Kaslo’s health

challenges we are facing.”

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through March 26th to care services associated with the Kaslo Victorian

said Dr. Alan Stewart, Senior Medical is a terrific opportunity to learn from the community, our

best meet Kaslo’s health-care needs given the

Linda Tarrant, an expert in collaborative strategic planning, will facilitate the focus group discussions. Dr. John Ross, a Canadian expert on rural emergency care, will also consult with healthdeveloping a sustainable model of emergency care Kaslo residents Maggie Winters and Maggie Crowe have been instrumental in designing the consultation process which will include a full-day workshop in April when elected officials, community representatives, physicians and Interior Heastaff will come together to clarify priorities and develop suggestions for “Our goal is to provide Kaslo residents with consistentthe focus group discussions and how they will

The community will be kept informed and involved

strategic planning, will facilitate the focus group discussions. Dr. John Ross, a will also consult with health-care professionals and assist Interior Health in

emergency care.

Kaslo residents Maggie Winters and Maggie Crowe have been instrumental in designing the consultation process which day workshop in April when elected officials, community representatives, physicians and Interior Hea

clarify priorities and develop suggestions for sustainable health-care services in Kaslo

is to provide Kaslo residents with consistent, sustainable, quality care,” said Stewart. “will inform our decisions moving forward.”

The community will be kept informed and involved as the consultation process unfolds.

-30-

11

strategic planning, will facilitate the focus group discussions. Dr. John Ross, a assist Interior Health in

Kaslo residents Maggie Winters and Maggie Crowe have been instrumental in designing the consultation process which day workshop in April when elected officials, community representatives, physicians and Interior Health

care services in Kaslo.

Stewart. “We look forward to

APPENDIX B

Community Consultations: Victorian Community Health Centre of

External Focus Group Questions

1. Identify 2-3 key expectations that you have for health services in Kaslo and area.

2. Thinking of how you and/or your family have accessed both scheduled and unscheduled health

services of VCHCK in the past, what

3. There are challenges to keeping the health centre

address those challenges?

4. How can we improve the community’s understanding of how to best access primary care and

emergency services?

5. What are your main concerns about changes to future health services?

6. After all of the comments that you have heard, what factors will be key to the success of developing

sustainable health services in this area?

Community Consultations: Victorian Community Health Centre of

External Focus Group Questions

3 key expectations that you have for health services in Kaslo and area.

Thinking of how you and/or your family have accessed both scheduled and unscheduled health

services of VCHCK in the past, what worked well? What could be improved?

There are challenges to keeping the health centre open 24/7. How do you think we could best

How can we improve the community’s understanding of how to best access primary care and

What are your main concerns about changes to future health services?

After all of the comments that you have heard, what factors will be key to the success of developing

sustainable health services in this area?

12

Community Consultations: Victorian Community Health Centre of Kaslo


Thinking of how you and/or your family have accessed both scheduled and unscheduled health

24/7. How do you think we could best

How can we improve the community’s understanding of how to best access primary care and

After all of the comments that you have heard, what factors will be key to the success of developing

APPENDIX C

CONSULTATION SUMMARIESKASLO AND AREA

FOCUS GROUPS

MARCH 24

CONSULTATION SUMMARIESKASLO AND AREA

FOCUS GROUPS

MARCH 24 – 26, 2013

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CONSULTATION SUMMARIES

APPENDIX C

Question #1 Identify 2-3 key expectations that you have for health services in Kaslo and area. Theme 1: Services delivered locally (58 responses)

• Lab/x-ray (14); more frequent, mobile service• Specialists come to Kaslo • Alternate/complementary providers; NP. PA, working with doctors• Ability to stay in the community for services: Home care, palliative, extended care

Theme 2: Emergency room coverage (50)

• Does not have to be an MD; skilled, qualified personnel, NP, paramedic; revisit Nurse First Call, nurse call doctor; Dr. on call or on site

• Stable, reliable hours • 24 hours – we are isolated, remote and nothing less will do (20 r

doctor needed to be on site) Theme 3: Continuity of care (39)

• Be able to see the same doctor, develop a personal relationship • Continuity of doctors • Access to care sooner, in person or by phone or technology• Evening & weekend clinics; reasonable times for clinics, be able to see a doctor in 2• Better communication between doctors and alternative care providers

Theme 4: Training & Education (22)

• Increase training of staff; we need high quality, competent staff• Cross training for greater efficiency• Educate the public – prevention, nutrition, know the limitations of the Centre, when to use ED

Theme 5: Community & Interior Health (22)

• Enhance two-way communication between the community and the health system; listencommunity and act on our suggestions; transparent dialogue

• Fewer administrators; big bureaucracy; spend money on services not admin• Need local leadership, autonomy and funding control• Need an effective network of regional services; better coordinat

Theme 6: Transportation/Ambulance/First Responders (18)

• Need reliable public transportation; medical services bus NKL to Kaslo• Need well trained ambulance staff, more/improved services• Integrate ambulance services with the rest• Better communication between community, emergency, fire, police, first responders• Use telehealth/video to access expanded services


Services delivered locally (58 responses) frequent, mobile service

Alternate/complementary providers; NP. PA, working with doctors Ability to stay in the community for services: Home care, palliative, extended care

Emergency room coverage (50) e an MD; skilled, qualified personnel, NP, paramedic; revisit Nurse First Call, nurse

call doctor; Dr. on call or on site – doctor does not need to be the gatekeeper,

we are isolated, remote and nothing less will do (20 responses but only one specified that a

Be able to see the same doctor, develop a personal relationship

Access to care sooner, in person or by phone or technology & weekend clinics; reasonable times for clinics, be able to see a doctor in 2

Better communication between doctors and alternative care providers

Training & Education (22) Increase training of staff; we need high quality, competent staff

ross training for greater efficiency prevention, nutrition, know the limitations of the Centre, when to use ED

Community & Interior Health (22) way communication between the community and the health system; listen

community and act on our suggestions; transparent dialogue Fewer administrators; big bureaucracy; spend money on services not admin Need local leadership, autonomy and funding control Need an effective network of regional services; better coordination; stable health services

Transportation/Ambulance/First Responders (18) Need reliable public transportation; medical services bus NKL to Kaslo Need well trained ambulance staff, more/improved services Integrate ambulance services with the rest of the health-care services Better communication between community, emergency, fire, police, first respondersUse telehealth/video to access expanded services

14


Ability to stay in the community for services: Home care, palliative, extended care

e an MD; skilled, qualified personnel, NP, paramedic; revisit Nurse First Call, nurse

esponses but only one specified that a

& weekend clinics; reasonable times for clinics, be able to see a doctor in 2-3 days

prevention, nutrition, know the limitations of the Centre, when to use ED

way communication between the community and the health system; listen to the

ion; stable health services

Better communication between community, emergency, fire, police, first responders

APPENDIX C

Question #2 Thinking of how you and/or your family have accessed both scheduled health services of VCHCK in the past, what worked well? what could be improved? What’s working well:

• Access to male and female physicians• Physicians available to discuss test results over the phone • Team work at VCHC, including physiothera• Teleconferences and videoconferences with other health care providers outside of Kaslo• Community Pharmacist now providing more services

What could be improved? Theme 1: Clinic/physician access (37/163 comments)

• Extend clinic hours/ walk-in clinic ho• Physicians are pulled from clinic appointments to the ED, patients are left waiting when they had a

scheduled appointment • Reception staff could benefit from additional training in scheduling, customer service as they

ones deciding on urgency when someone needs to see a physician • Should be greater flexibility in terms of who patients can see for follow

more) • More x-ray service (can nurses be trained to do x

Theme 2: Transportation (12 comments)• Need assurance ambulance is always available• BCAS needs to know their way around• First responders need better training and equipment• HART in Trail is too far away • Need medical services bus serving north end of lake and even

Theme 3: Lab concerns (11 comments) • Appointment cancellations without notice are a problem• Logistics around lab processes should be looked into (requisitions & results)• Better access needed (can nurses take blood samples?)

Theme 4: Consistency of care (6 comments)• Need consistent coverage to build relationships• Different doctors have different ideas about care plans/treatment • Consistency would allow for more telephone consults

Theme 5: Communications (4 comment• Phone book listing for VCHCK needs to be easier to find• More local info needs to be provided regarding services available such as baby clinics, flu shots etc.

front desk staff need more information too

Thinking of how you and/or your family have accessed both scheduled and unscheduled health services of VCHCK in the past, what worked well? what could be improved?

Access to male and female physicians Physicians available to discuss test results over the phone Team work at VCHC, including physiotherapist Teleconferences and videoconferences with other health care providers outside of KasloCommunity Pharmacist now providing more services

Theme 1: Clinic/physician access (37/163 comments) in clinic hours (takes too long to see a physician)

Physicians are pulled from clinic appointments to the ED, patients are left waiting when they had a

Reception staff could benefit from additional training in scheduling, customer service as theyones deciding on urgency when someone needs to see a physician Should be greater flexibility in terms of who patients can see for follow-up appointments (use nurses

ray service (can nurses be trained to do x-rays?)

tation (12 comments) Need assurance ambulance is always available BCAS needs to know their way around First responders need better training and equipment

Need medical services bus serving north end of lake and even Nelson/Trail

Appointment cancellations without notice are a problem Logistics around lab processes should be looked into (requisitions & results) Better access needed (can nurses take blood samples?)

Consistency of care (6 comments) Need consistent coverage to build relationships Different doctors have different ideas about care plans/treatment – leads to conflictsConsistency would allow for more telephone consults

Theme 5: Communications (4 comments) Phone book listing for VCHCK needs to be easier to find More local info needs to be provided regarding services available such as baby clinics, flu shots etc. front desk staff need more information too

15

and unscheduled health services of VCHCK in the past, what worked well? what could be improved?

Teleconferences and videoconferences with other health care providers outside of Kaslo

Physicians are pulled from clinic appointments to the ED, patients are left waiting when they had a

Reception staff could benefit from additional training in scheduling, customer service as they are the

up appointments (use nurses

leads to conflicts

More local info needs to be provided regarding services available such as baby clinics, flu shots etc. –

APPENDIX C

Question #3: There are challenges to keeping the Health Centre open 24/7. How do you think we could best address those challenges?

Theme 1: Staff Professional Development (34 out of 230 comments)

• Leverage staff already in Kaslo by providing targeted additional training. Use all professionals including community Pharmacist to their full scope of practice

• Enhance paramedic training and roles• Training should also focus on team development, relationships, communication• Offer incentives for local people to be trained in

Theme 2: Use technology (21)

• Provide dynamic web page with upcommunication with the public (9)

• Teleconferencing to connect remote physician with Health protocols and liability managed; consider a sister hospital elsewhere in a different time zone to reduce problem of night call

• Consider linking Lardeau Valley, others for regular teleclinics and follow Theme 3: More community-based input and design of Health Centre services (18)

• Understand the specific rural area; try to keep people close to home• Create and deliver services specific to the needs of the community• More evening or weekend clinics to red• Consider providing a small residence for part

Theme 4: Add a Nurse Practitioner to the Health Centre staff (12) Theme 5: Simplify employee contracts (8)

es to keeping the Health Centre open 24/7. How do you think we could best

Staff Professional Development (34 out of 230 comments)

Leverage staff already in Kaslo by providing targeted additional training. Use all professionals including community Pharmacist to their full scope of practice Enhance paramedic training and roles Training should also focus on team development, relationships, communication Offer incentives for local people to be trained in the helping professions; bursaries

Provide dynamic web page with up-to-date information; e-mail notices of important issues; better communication with the public (9) Teleconferencing to connect remote physician with Health Centre staff when needed protocols and liability managed; consider a sister hospital elsewhere in a different time zone to reduce

Consider linking Lardeau Valley, others for regular teleclinics and follow-up (see theme 3)

based input and design of Health Centre services (18)

Understand the specific rural area; try to keep people close to home Create and deliver services specific to the needs of the community More evening or weekend clinics to reduce ED demand (9) Consider providing a small residence for part-time, casual, and locum staff

Add a Nurse Practitioner to the Health Centre staff (12)

Simplify employee contracts (8)

16

es to keeping the Health Centre open 24/7. How do you think we could best

Leverage staff already in Kaslo by providing targeted additional training. Use all health-care

the helping professions; bursaries

mail notices of important issues; better

Centre staff when needed – establish protocols and liability managed; consider a sister hospital elsewhere in a different time zone to reduce

up (see theme 3)

APPENDIX C

Question #4: How can we improve the community’s understanding of how to best access primary care and emergency services?

Theme 1: People want more information about what’s available (87)

• Many people understand the difference between the clinic and ER• Improve understanding with posters, local press, BC nurse line, update web site, newsletter from IH

• Fact sheets to homes re: hours, services available & phone numbers

Theme 2: Need to repair trust (7)

• Better communication between health centre & community

• Lots of work to build trust, with IH and doctors

• Confidentiality

Theme 3: Integrate services and use technology (7)

• Need a regional ombudsman to help navigate the system• Better coordination between local and distant providers• Satellite services, more authority to support staff, regional doctor field calls from RNs & others

a) use internet for appointments (Skype)

b) better referral to alternative services by doctors

Theme 4: Access to doctor and clinics (6)

• Use doctors in expanded hours, not emerg• Primary care and doctors appointments more available• People know how to use emerg but if we can’t see a doctor for 6 weeks, we go to emerg• No one knows about the Rapid Access clinic

Other interesting comments about using local volun

• Need maps of rural roads, fire numbers, names of first responders• Encourage people to know how to use fire numbers and access first responders• More training for 911 and dispatchers

improve the community’s understanding of how to best access primary care and

People want more information about what’s available (87)

Many people understand the difference between the clinic and ER understanding with posters, local press, BC nurse line, update web site, newsletter from IH

Fact sheets to homes re: hours, services available & phone numbers

Need to repair trust (7)

Better communication between health centre & community & IH and everyone Lots of work to build trust, with IH and doctors

Integrate services and use technology (7)

Need a regional ombudsman to help navigate the system Better coordination between local and distant providers Satellite services, more authority to support staff, regional doctor field calls from RNs & others

use internet for appointments (Skype)

better referral to alternative services by doctors

Access to doctor and clinics (6)

anded hours, not emerg Primary care and doctors appointments more available People know how to use emerg but if we can’t see a doctor for 6 weeks, we go to emergNo one knows about the Rapid Access clinic

Other interesting comments about using local volunteers and 911 operators:

Need maps of rural roads, fire numbers, names of first responders Encourage people to know how to use fire numbers and access first respondersMore training for 911 and dispatchers – know our geography

17

improve the community’s understanding of how to best access primary care and

understanding with posters, local press, BC nurse line, update web site, newsletter from IH

Satellite services, more authority to support staff, regional doctor field calls from RNs & others

People know how to use emerg but if we can’t see a doctor for 6 weeks, we go to emerg

Encourage people to know how to use fire numbers and access first responders

APPENDIX C

Question #5: What are your main concerns about changes to future health services? Theme 1: Positive comments about the future

• We want a coordinated team (docs, nurse, admin, EMS, holistic medicine) not MD focused. Teamwork is key.

• More access to primary care, prevention and staying healthy.• We want to maintain/grow home• Changes are good as long as they improve our services.• We want confidence in the system to provide our medical needs.

Theme 2: Patient quality and accessibility of care in Kaslo (102 comments)

• Aging population requires access to care; baby boomers overwhelming our taxed system. • Losing our ER – closure of services• Not now having a “golden hour” for stroke care • Not having enough home care (nu• Loss of chronic care services • It is too far to go to Nelson, Trail, Kelowna and Vancouver. Transportation is costly and a hardship on

an ill person. We pay the same for benefits and get less access to Theme 3: IHA/Communication and trust (110).

• Will IH listen? Fear that our public input may fall on deaf ears. • Need a higher level of transparency (reporting) and accountability (commitment).• Need annual reporting process? • There are concerns about government in power, priorities, oppositions, relationship between

gov/IH/unions and health-care stakeholders being open and accurate. • Can IHA cull its overlarge bureaucracy? Admin must be streamlined.

Theme 4: Staff and paramedics, recruitment,

• We want money to go into training, not admin. • Lack of reliable ambulance service, “paramedic pay is abysmal!!” • RNs and staff are working part time now, not being hired full time, is IH really saving money in the long

run? • Already we have volunteers doing work that skilled employees should be doing.

Theme 5: Keeping and attracting seniors, families and industry (27)

• Our seniors will leave the community in the future due to the current and future condition of services• The current care needs to be maintained and or improved so that people want to stay living here from

cradle to grave; industry won’t come without services• Young families are not wanting to and will not want to move to our community without an ED.

What are your main concerns about changes to future health services?

Positive comments about the future We want a coordinated team (docs, nurse, admin, EMS, holistic medicine) - client/patient centered

Teamwork is key. More access to primary care, prevention and staying healthy. We want to maintain/grow home care. Changes are good as long as they improve our services. We want confidence in the system to provide our medical needs.

ity and accessibility of care in Kaslo (102 comments) Aging population requires access to care; baby boomers overwhelming our taxed system.

closure of services Not now having a “golden hour” for stroke care Not having enough home care (nursing, housekeeping, socialization & palliative care)

It is too far to go to Nelson, Trail, Kelowna and Vancouver. Transportation is costly and a hardship on an ill person. We pay the same for benefits and get less access to care?

IHA/Communication and trust (110). Will IH listen? Fear that our public input may fall on deaf ears. Need a higher level of transparency (reporting) and accountability (commitment).

government in power, priorities, oppositions, relationship between

care stakeholders being open and accurate. Can IHA cull its overlarge bureaucracy? Admin must be streamlined.

Staff and paramedics, recruitment, retaining and respect of staff (40) We want money to go into training, not admin. Lack of reliable ambulance service, “paramedic pay is abysmal!!” RNs and staff are working part time now, not being hired full time, is IH really saving money in the long

Already we have volunteers doing work that skilled employees should be doing.

Keeping and attracting seniors, families and industry (27) Our seniors will leave the community in the future due to the current and future condition of servicesThe current care needs to be maintained and or improved so that people want to stay living here from cradle to grave; industry won’t come without services Young families are not wanting to and will not want to move to our community without an ED.

18

client/patient centered –

Aging population requires access to care; baby boomers overwhelming our taxed system.

rsing, housekeeping, socialization & palliative care)

It is too far to go to Nelson, Trail, Kelowna and Vancouver. Transportation is costly and a hardship on

Need a higher level of transparency (reporting) and accountability (commitment).

government in power, priorities, oppositions, relationship between

RNs and staff are working part time now, not being hired full time, is IH really saving money in the long

Already we have volunteers doing work that skilled employees should be doing.

Our seniors will leave the community in the future due to the current and future condition of services. The current care needs to be maintained and or improved so that people want to stay living here from

Young families are not wanting to and will not want to move to our community without an ED.

APPENDIX C

Question #6: After all of the comments that you have heard, what factors will be key to the success of developing sustainable health services in this area? Note: Each participant in each focus group was given three dots to identify their top parentheses represent the total number of dots that each theme received. Theme 1: Need for dedicated staff to be working to their full scope of practice (130)

• nurse practitioners • doctors who understand the community• paramedics • full time nurses/doctors who are happy and want to work here

Theme 2: Be willing to try new ways (65)

• Be creative, innovative, look at new ways of doing things, open to new alternatives, let go of the past• be open to different staffing patterns, be flexi• break down barriers to silos, use alternative care providers

Theme 3: Sustainable funding (64)

• Put the funds into patient care not administration• incentive programs for doctors and staff• restore programs that have been cut or reduced (home care)• keep services in Kaslo, stable ER

Theme 4: Community Involvement/Education (60)

• keep the community involved in decision• good communication, inform us of up• emphasize prevention and education about

Theme 5: Training/Education (46)

• continuous professional development• train medical staff • train home care staff

Other comments: a. We need to work together better, teamwork b. We need to work more cooperatively with IH c. We need good transportation & ambulance serviced. We need to use technology to deliver better care

After all of the comments that you have heard, what factors will be key to the success of developing sustainable health services in this area?

Note: Each participant in each focus group was given three dots to identify their top priorities. The numbers in parentheses represent the total number of dots that each theme received.

Theme 1: Need for dedicated staff to be working to their full scope of practice (130)

doctors who understand the community

full time nurses/doctors who are happy and want to work here

Theme 2: Be willing to try new ways (65) Be creative, innovative, look at new ways of doing things, open to new alternatives, let go of the pastbe open to different staffing patterns, be flexible break down barriers to silos, use alternative care providers

Put the funds into patient care not administration incentive programs for doctors and staff restore programs that have been cut or reduced (home care)

services in Kaslo, stable ER

Theme 4: Community Involvement/Education (60) keep the community involved in decision-making affecting our services good communication, inform us of up-coming changes, collaboration emphasize prevention and education about how to best use services (ED)

continuous professional development

We need to work together better, teamwork We need to work more cooperatively with IH – they need to listen to us, respect us, honest communicationWe need good transportation & ambulance service We need to use technology to deliver better care

19

After all of the comments that you have heard, what factors will be key to the success of

priorities. The numbers in

Be creative, innovative, look at new ways of doing things, open to new alternatives, let go of the past

need to listen to us, respect us, honest communication

APPENDIX C

At the end of each focus group session participants were asked to note anything that had previously arisen in the conversation.

Question #7: One last thing you’d like to say… Theme 1: Quality and access to care (29)

• We need more services: home support, extended care, transportation, respite, short term acute, end of life, lab services in Meadow Creek

• Longer clinic hours – evenings and weekends• Real food, bought locally, exercise• Coordinated bookings, follow-up care• Shorter wait time for specialists • Doctors make house calls

Theme 2: Be willing to change and work together (25)• Current model doesn’t work, need a shared vision, short and long• Distinguish our area for excellent health care; package Kaslo to attract people of all ages• Integrate traditional and alternative/holistic medicine• Too much administration • Is the money going to the right place• Need to work together with unions, IH, listen to the community, not a heavy hand of control• Doctors need to treat us with respect, come and stay in the community

Theme 3: Staff scope & training (11)• Expand scope of service, cross-train• Less part-time, more money • Staff need more training to do more things (nurses do x

Theme 4: Community involvement (14)• We care; the future of Kaslo depends on our health services• We want to be involved in budgeting, local control in decision• Reduce administration and put it into care• Help us find what’s available • We want to look after ourselves and stay healthy

Other comments: • We should be creative about using space in the centre • A 72 year old gentleman thought he should pay more because he needs more service

At the end of each focus group session participants were asked to note anything that had previously arisen in the conversation.

Question #7: One last thing you’d like to say…

Quality and access to care (29) We need more services: home support, extended care, transportation, respite, short term acute, end of

n Meadow Creek evenings and weekends

Real food, bought locally, exercise up care

Be willing to change and work together (25) model doesn’t work, need a shared vision, short and long-term plan

Distinguish our area for excellent health care; package Kaslo to attract people of all agesIntegrate traditional and alternative/holistic medicine

g to the right place Need to work together with unions, IH, listen to the community, not a heavy hand of controlDoctors need to treat us with respect, come and stay in the community

Staff scope & training (11) train

Staff need more training to do more things (nurses do x-rays), NP

Community involvement (14) We care; the future of Kaslo depends on our health services We want to be involved in budgeting, local control in decision-making Reduce administration and put it into care

We want to look after ourselves and stay healthy

We should be creative about using space in the centre - don't just use it for one thinghought he should pay more because he needs more service

20

At the end of each focus group session participants were asked to note anything that had not

We need more services: home support, extended care, transportation, respite, short term acute, end of

Distinguish our area for excellent health care; package Kaslo to attract people of all ages

Need to work together with unions, IH, listen to the community, not a heavy hand of control

don't just use it for one thing hought he should pay more because he needs more service

APPENDIX D

INVITATION

You are invited to attend a

FUTURE STATE WORKSHOP

To discuss health

Kaslo Victorian Community Health Centre

Kaslo Golf & Country Club

INVITATION You are invited to attend a

FUTURE STATE WORKSHOP

health-care service delivery options

for the


APRIL 22, 2013

8 a.m. – 3:30 p.m.

Kaslo Golf & Country Club 418 Pine St.

250-353-2262

21

options


APPENDIX E

Kaslo Victorian Community Health CentreFUTURE STATE WORKSHOP

8:00 Coffee and networking

8:30 Welcome and introductions

Outline of consultation process & participation

Summary: Focus Groups & Individual interviews

• Review Major Themes & Recommendations

• Q & A

• Observations/Insights

10:15 Break

10:30 Review “Charting The Course”

& decision-making principles

11:00 Breakout sessions

• Identify options for sustainable service delivery

• Barriers/How to overcome them

• Short-term wins (within our control & resources)

• Longer-term solutions: process &

12:00 Lunch

12:45 Continue breakout sessions

1:15 Report out: (10-15 min/group)

• Each theme group reports

• Q & A and comments from all participants

• Priority options identified in large group

3:30 Next steps, closing remarks, thanks to all

AGENDA

Kaslo Victorian Community Health Centre FUTURE STATE WORKSHOP

April 22, 2013

Maggie Winters Kaslo and Area Healthcare Work Group

& Karen Cairns IH Community Engagement Lead

ocess & participation Linda Tarrant, Consultant

Individual interviews Dr. John Ross, Consultant

& Linda Tarrant

Themes & Recommendations Group

Group

“Charting The Course” Karen Omelchuk

IH Director Health System Planning

Group

Identify options for sustainable service delivery

Barriers/How to overcome them?

our control & resources)

process & who needs to be engaged?

Group

15 min/group) Linda Tarrant

Q & A and comments from all participants

Priority options identified in large group

osing remarks, thanks to all Dianne Kostachuk IH Director, Strategic Initiatives

22

and Area Healthcare Work Group

IH Community Engagement Lead

Consultant

Consultant

IH Director Health System Planning

Director, Strategic Initiatives

APPENDIX F

WORKSHOP

SUMMARYAPRIL 22, 2013

WORKSHOP DISCUSSION

SUMMARY APRIL 22, 2013

23

DISCUSSION

APPENDIX F

24 hour Emergency Care Foundational Work

• Reassess staffing and utilizationemergency and residential care

• Examine night staffing rotations to determine • Implement practice and training

team building • Explore options for physician call, how to provide nurses with appropriate physician support

Longer Term

• Provide advanced training for BCAS and nurses (including Nurse 1• Explore potential for a Nurse Practitioner• Maximize use of technology to communicate with physicians• Develop a new name/description for small EDs to reduce restrictions created by the term “Emergency

Department”

Quality and Continuity of Primary CareFoundational Work

• Improve communication around available VCHC services (i.e. urgent access clinic)• Stabilize the group of physicians providing service in Kaslo• Increase training for clinic reception staff• Explore options that maximize office efficiency and • Evaluate and consider adjusting the primary

Longer Term

• Explore alternatives that optimize physician contracts• Explore options for providing out• Investigate option of using a Nurse Practitioner or alternative care providers • Consider establishing nurse or physician

and disease prevention) Health Centre and Staff Foundational Work

• Set up better internal communication• Implement a team-building process

a) monthly education strategy (use technology, simulator) to improve confidence and competenceb) monthly strategy/operations meetings to address operational and site issues, and improve

teamwork across the site c) develop a strategy that will build on the enthusiasm of team members for quality improvement

• Discuss opportunities for physicianthe emergency department; a focused approach to teams learning and working together

staffing and utilization of nurses (including the number of full time nursing positions), in both to determine the best configuration of available resources

practice and training sessions to optimize the care of high acuity patie

Explore options for physician call, how to provide nurses with appropriate physician support

Provide advanced training for BCAS and nurses (including Nurse 1st Call) Explore potential for a Nurse Practitioner Maximize use of technology to communicate with physicians Develop a new name/description for small EDs to reduce restrictions created by the term “Emergency

Quality and Continuity of Primary Care

Improve communication around available VCHC services (i.e. urgent access clinic)Stabilize the group of physicians providing service in Kaslo

clinic reception staff Explore options that maximize office efficiency and effective team work (best provider for specific task)Evaluate and consider adjusting the primary care clinic hours of operation and system of scheduling

Explore alternatives that optimize physician contracts options for providing outreach service (lab) at the north end of the lake

ption of using a Nurse Practitioner or alternative care providers or physician-led group education sessions (public health

Set up better internal communication building process, framed by the staff, to include:

monthly education strategy (use technology, simulator) to improve confidence and competencestrategy/operations meetings to address operational and site issues, and improve

develop a strategy that will build on the enthusiasm of team members for quality improvementDiscuss opportunities for physician-led monthly teaching/learning sessions (with PHC Nurse partner) in the emergency department; a focused approach to teams learning and working together

24

(including the number of full time nursing positions), in both

available resources to optimize the care of high acuity patients and engage in

Explore options for physician call, how to provide nurses with appropriate physician support

Develop a new name/description for small EDs to reduce restrictions created by the term “Emergency

Improve communication around available VCHC services (i.e. urgent access clinic)

effective team work (best provider for specific task) clinic hours of operation and system of scheduling

led group education sessions (public health, chronic disease

monthly education strategy (use technology, simulator) to improve confidence and competence strategy/operations meetings to address operational and site issues, and improve

develop a strategy that will build on the enthusiasm of team members for quality improvement learning sessions (with PHC Nurse partner) in

the emergency department; a focused approach to teams learning and working together

APPENDIX F

Health Centre and Staff cont’d Longer Term

• Investigate a strategy for staff to enhance skills by doing a “workemergency centres

• Engage with local education leaders to develop a strategy to engage high school students in a health career (a “grow your own” approach)

• Investigate opportunity to develop a regional casual float pool • Seek opportunities for increased use of UBC physician “rounds” (available on

Community Engagement and Interior HealthFoundational Work

• Make it easier to find Kaslo information on I• Offer IH “Living Well” columns to the local papers• Include Lardeau Valley LINKS and the Village of Kaslo

of relevant IH news on their websites• Expand information in the annual IH Health Services Guide regarding using EDs • Kootenay Boundary Connected Communities • Include community representatives on physician

(Note: community representatives now participate on outcome of the Kaslo and Area Health

• Establish ongoing Kaslo community/IH liaison (Note: Ongoing liaison continues to be the Kaslo and Area Health

Longer Term • Explore funding options to assist IH in communicating with communities (ex. advertising dollars)

Transportation and Ambulance Foundational Work

• BCAS to explore 9-1-1 geo-mapping of community • Health Connections Bus (establish local working group to improve coordination of BC Transit bus

service with local health-care services• Explore opportunity to integrate local paramedics into VCHC operations (rationale: retention of pa

paramedic by offering regular work; providing costavailability of paramedics to respond to 911 community responses; opportunity to develop clinical skills). Precedence already set in Kelowna/KamlScotia. Requires MOU between BCAS and IHA for release of paramedic to attend to 911.

• BCAS public engagement opportunities (Open Houses, speaking to community groups about 9services, including the new helicopter program based in Kamloops )

Investigate a strategy for staff to enhance skills by doing a “work exchange” with staff in larger

education leaders to develop a strategy to engage high school students in a health career (a “grow your own” approach) Investigate opportunity to develop a regional casual float pool among neighbouringSeek opportunities for increased use of UBC physician “rounds” (available on-line, via video?)

Community Engagement and Interior Health

ake it easier to find Kaslo information on Interior Health website and in the phone directoryto the local papers

Lardeau Valley LINKS and the Village of Kaslo on IH e-mail distribution list to facilitate posting of relevant IH news on their websites Expand information in the annual IH Health Services Guide regarding using EDs Kootenay Boundary Connected Communities – determine Kaslo representation on this group

community representatives on physician recruitment panels ntatives now participate on physician interview panels

outcome of the Kaslo and Area Health Care Work Group)

ngoing Kaslo community/IH liaison liaison continues to be the Kaslo and Area Health Care Work Group)

Explore funding options to assist IH in communicating with communities (ex. advertising dollars)

mapping of community to minimize response times (establish local working group to improve coordination of BC Transit bus care services—to involve the community, IH and BC Transit)

Explore opportunity to integrate local paramedics into VCHC operations (rationale: retention of paparamedic by offering regular work; providing cost-effective nursing assistance to VCHC staff; improve availability of paramedics to respond to 911 community responses; opportunity to develop clinical skills). Precedence already set in Kelowna/Kamloops and in rural communities in

Requires MOU between BCAS and IHA for release of paramedic to attend to 911.BCAS public engagement opportunities (Open Houses, speaking to community groups about 9

helicopter program based in Kamloops )

25

exchange” with staff in larger

education leaders to develop a strategy to engage high school students in a health

among neighbouring communities line, via video?)

and in the phone directory

mail distribution list to facilitate posting

Expand information in the annual IH Health Services Guide regarding using EDs determine Kaslo representation on this group

s; this is a direct

are Work Group)

Explore funding options to assist IH in communicating with communities (ex. advertising dollars)

(establish local working group to improve coordination of BC Transit bus

to involve the community, IH and BC Transit) Explore opportunity to integrate local paramedics into VCHC operations (rationale: retention of part time

effective nursing assistance to VCHC staff; improve availability of paramedics to respond to 911 community responses; opportunity to develop clinical

oops and in rural communities in Alberta and Nova Requires MOU between BCAS and IHA for release of paramedic to attend to 911.

BCAS public engagement opportunities (Open Houses, speaking to community groups about 9-1-1

APPENDIX F

Transportation and Ambulance cont’d Longer Term

• Increase access to Critical Care Responders Acuity Response Team (HART). Include patients.

• Establish and implement BCAS bypass protocols fordeployment of BCAS helicopter and

• Explore advanced scope of practice for local paramedics and VCHC staff to support the short term management of emergency/critical care patients

• Investigate possible use of the residential bus/school bus to connect rural residents with healthservices

• Explore volunteer driver programcare services

Background information

• Annual cost to hire one dedicated paramedic crew 24/7: • Recruitment challenges – difficult to

(PCPs) earn $2/hour when on call • Challenges in skills maintenance/competencies

Technology Foundational Work

• Facilitate connecting with other health professionals • Move VCHC video conferencing equipment to a more accessible location • Explore potential for dedicated Interior Health space in the Lardeau Valley to provide

and web-based clinics Longer Term

• Investigate an interactive website for VCHC with current infodoctors are working, who is on call, educational courses

• Explore the potential to book appointments • Explore the option of a 1-800 phone number with recorded messages (tap into the existing 1

number in Nelson?) • Use webinars for community and personal education at the convenience of the user

cont’d

Increase access to Critical Care Responders - supported by BCAS helicopter/ Interior Health H. Include early deployment and rendezvous protocols for critical

Establish and implement BCAS bypass protocols for emergency patients (supported by early BCAS helicopter and HART rendezvous protocols)

Explore advanced scope of practice for local paramedics and VCHC staff to support the short term management of emergency/critical care patients Investigate possible use of the residential bus/school bus to connect rural residents with health

program such as Kootenay Ride Share to connect rural residents with health

hire one dedicated paramedic crew 24/7: $600,000 difficult to compete with the oil fields when Primary

when on call skills maintenance/competencies in rural areas

ith other health professionals on-line via telehealth, Skype etcvideo conferencing equipment to a more accessible location in the building

dedicated Interior Health space in the Lardeau Valley to provide

website for VCHC with current information on availabledoctors are working, who is on call, educational courses Explore the potential to book appointments and obtain test results on-line (lab work for example)

0 phone number with recorded messages (tap into the existing 1

Use webinars for community and personal education at the convenience of the user

26

supported by BCAS helicopter/ Interior Health High and rendezvous protocols for critical

upported by early

Explore advanced scope of practice for local paramedics and VCHC staff to support the short term

Investigate possible use of the residential bus/school bus to connect rural residents with health-care

such as Kootenay Ride Share to connect rural residents with health-

rimary Care Paramedics

Skype etc. in the building

dedicated Interior Health space in the Lardeau Valley to provide on-line services

rmation on available services, which

(lab work for example) 0 phone number with recorded messages (tap into the existing 1-800

Use webinars for community and personal education at the convenience of the user

APPENDIX G FUTURE STATE WORKSHOP PARTICIPANT LIST Andy Shadrack, RDCK Director

Brent Hobbs, IH Director, Patient Transport

Chris Mason, BCAS Superintendent

Danielle Newson, VCHC Public Health Nurse

Deb Borsos, VCHC Lab Services

Dianne Kostachuk, IH Director Strategic Initiatives, Community Integrated Health Services (CIHS)

Dr. Fen Smit

Dr. Lauren Rodgers

Dr. Annemarie de Koker

Elizabeth Scarlett, VCHC Physiotherapist

Georgie Humphries, VCHC RN

Greg Lay, Mayor of Kaslo

Heather Cook, IH Chief of Professional Practice & Nursing

Heather Gates, community representative

Ingrid Hampf, IH Acute Health Service Administrator, Kootenay Boundary

Jane Ballantyne, community representative North Kootenay Lake Community Services Society

Jessie Renzie, VCHC RN

Karen Omelchuk, IH Director Health System Planning

Kaslo Consultation Steering Committee

Kate O’Keefe, North Kootenay Lake resident

Larry Badry, BCAS Kaslo Unit Chief

Lorna Staten, IH Human Resources

Mark Anderson, IH Manager Lab Operations

Mary Ballon, community representative

Molly Seminoff, community representative

Rhonda Addison, VCHC RN

Sandra Morrow, IH Residential Services Manager

Terri Domin, IH Administrator, CIHS

Thalia Vesterback, IH Diagnostic Imaging Director

Therese Rosner, IH Manager, Administrative Services,

FUTURE STATE WORKSHOP PARTICIPANT LIST

Brent Hobbs, IH Director, Patient Transport

Danielle Newson, VCHC Public Health Nurse


Physiotherapist

Heather Cook, IH Chief of Professional Practice & Nursing

Heather Gates, community representative

Acute Health Service Administrator, Kootenay Boundary


Karen Omelchuk, IH Director Health System Planning

North Kootenay Lake resident

Manager Lab Operations

Molly Seminoff, community representative

Sandra Morrow, IH Residential Services Manager

Diagnostic Imaging Director

istrative Services, CIHS

27



APPENDIX H KASLO CONSULTATION STEERING COMMITTEE

Catherine Anderson VCHC admin

Linda Basran IH Community Integrated Health Services (CIHS

Dr. Curtis Bell Community Medical Director

Karen Cairns IH Community Engagement Lead

Nicola Candy Clinical Lead, V

Maggie Crowe Kaslo resident, retired nurse

Suzanne McCombs IH Site Manager

Dr. Michael Purdon Executive Medical Director, Community & Residential

Dr. John Ross Physician consultant

Dr. Fen Smit Kaslo physician

Dr. Alan Stewart Executive Medical Director, Acute Services

Linda Tarrant Healthcare consultant and facilitator

Cheryl Whittleton Acting CIHS Administrator, Kootenay Boundary

Maggie Winters Kaslo resident, retired nurse

KASLO CONSULTATION STEERING COMMITTEE

VCHC administrative staff

IH Community Integrated Health Services (CIHS) Area Director

Community Medical Director

Community Engagement Lead

Clinical Lead, VCHC Residential and Emergency

Kaslo resident, retired nurse

Site Manager- Kaslo, Nakusp, New Denver, Edgewood

Executive Medical Director, Community & Residential

hysician consultant, Rural Emergency Care

Kaslo physician

Executive Medical Director, Acute Services

Healthcare consultant and facilitator

Acting CIHS Administrator, Kootenay Boundary

Kaslo resident, retired nurse

28

Director

Kaslo, Nakusp, New Denver, Edgewood

Documents

Consultation Summary Report Final - Kaslo · COMMUNITY CONSULTATION SUMMARY REPORT HEALTH SERVICE DELIVERY VICTORIAN COMMUNITY HEALTH CENTRE at the OF KASLO 1 May 2013 . ... Health