Fraser Northwest Division Annual Report 2011

Annual Report 2011

Fraser Northwest

Fraser Northwest Division of Family Practice 2012 Annual Report2

Table of Contents

3 Message from Physician Lead

4 Message from Executive Lead

5 Fraser Northwest Division Milestones

6 Membership and Recruitment

7 Fraser Northwest Division Initiatives• PathwaysProject• LocumProject• SharedCareProject• DischargePlanningProject• GroupPurchasing• MemberInitiatedProjects• Website• PhysiciansDataCollaborative

13 CollaborativeServicesCommittee(CSC)

14 FinancialStatement

Vision StatementThe Fraser Northwest Division is a forum for physicians to improve health outcomes and the sustainability of the healthcare system by improving the experience of both patients and providers and strengthening primary care.

Fraser Northwest Division of Family Practice 2012 Annual Report 3

Message from the Physician Lead“A doctor and patient travelling the road of health and illness together through time, makes for happier doctors, healthier patients, and more sustainable healthcare systems.”- Dr. Tracy Monk

It has been an exciting inaugural first 16 months on the maiden voyage of the Fraser Northwest Division. Dr. Dee Mangin hoisted our sails at the Divisional launch, with an inspiring vision of how divisions have improved the lives of doctors and patients in New Zealand. Before there were divisions in NZ, powerlessness was pervasive. Putting doctors at the helm was the solution.

Onoursharedjourneywithourpatientsovertime,familyphysicianshavefirsthandexperiencewiththeproblemswhichplaguethesystem.Wehaveanimportantroletoplayindefiningthesolutions.Givingusthatopportunity has reconnected us to a sense of purpose, and rebuilt our connection to one another. It has made hope visible.

Our Division has two work streams: things we are doing to improve the practicing lives of doctors, and those we are doing for our patients and community. Although much of our first year has been occupied with building the ship and crew, we have also undertaken a number of member-specificinitiatives:successfulCMEs,abulkpurchasinginitiativeandalocumandrecruitmentworkinggroup.Wehavealreadyrecruitedthree new doctors to the area and have assisted in some locum placement and expect to be able to build on this preliminary work substantially in the coming year.

For our patients and community, we continue to develop the foundations foraprojecttosupportthefrailelderlyandareworkingontwoSharedCareinitiatives: one to improve the specialist referral process and another to addressdischargeplanning.OurPathwayswebsite(scheduledforlaunchSeptember2012),iscentraltoourSharedcareworktostreamlinethereferralprocess.Wehavecompletedhighlysuccessfulbetatestingofthesite and look forward to sharing it more broadly.

Withmanypotentialopportunitiesforprojects,theFraserNorthwestcrewwill continue to steer ourselves following the practical navigational advice of Dee Mangin: “Never do anything that won’t make the boat go faster.”

Greatthingsareonthehorizon.Thankstoallofyouforthewonderfulopportunity. It has been a privilege to be a part of this maiden voyage.

Dr. Tracy MonkInaugural Physician Lead

Ten geographers who think the world is flat will tend to reinforce each other’s errors. Only a sailor can set them straight. - John Ralston Saul

Never do anything that won’t make the boat go faster- Dee Mangin


Message from the Executive LeadWhenIjoinedtheFraserNorthwestDivisioninJanuary2011,wehadaboard of directors with lots of passion and ideas, me, a Document of Intent, a newly minted society – and little else.

From those humble beginnings, I am very pleased with the progress we have made. Together, we have learned to function as a team and have worked hard to develop a solid foundation for the Division. Over the course of this year, we have collaborated to put in place the underpinningsofallsuccessfulorganizations.We:

• Established the policies and financial and administrative systems requiredtocreateastrong,transparent,andwellrunorganization.

• Built positive relationships with our members through our member engagementmeetings, CMEDine& Learns andworkinggroups.Indeed, we now have 155 members and growing.

• Initiated strong, positive relationships with the Fraser Health Authority (FHA)andGeneralPracticeServicesCommittee (GPSC)viaourCollaborativeServicesCommittee(CSC),on-goingworkingrelationships with various‘Divisions Central’ staff andwith otherdivisions with whom we regularly share ideas and learnings. One of the real pleasures of being part of the divisions ‘movement’ is the strong senseofcollaboration,partnership&supportthatIexperienceonadaily basis.

Wehaveawiderangeofinitiativesunderwaythatwill,overtime,improvethe way primary care is delivered. The Fraser Northwest Division Initiatives sectionofthisannualreportoutlinestheseprojects.

Underwayisindeedtheoperativeword.Youwillnoticemanyprojectsare in the beginning stage or working towards their first deliverables. As expected,ithastakentimetoestablishtheDivision.Eachprojectneedstimetobedevelopedasanidea,tofindGPstoworkonit,toidentifyexisting/newfundingandstafftosupportitand,ofcourse,togetonwiththe work. The past year truly has been about laying a solid foundation, both fortheorganizationitselfandtheworkoftheDivision.

Looking forward, I am excited about two things. One is that I am optimistic that2012/13willbetheyearinwhichourprojectsflourishanddeliverclear results for our members. The other is that divisions overall, and ours in particular, will be included as an important player in the delivery of primary care. Despite bumps in the road, it is happening already. Every day, more groups approach us to seek our engagement in their planning processes, events, and future work. If the core purpose of Divisions is to incorporate more family practice input and engagement in the delivery of health care, Ithinkweareofftoagoodstart.

Mary MillerExecutive Lead


Milestones

November 2010• Fraser Northwest Division of Family Practice Societywasincorporated.

January 2011• Fraser Northwest Division coordinator was

hired.• Pathwaysworkinggroupestablished&first

meeting was held.

March 2011• First member engagement event was held –90physiciansattended.

• Dee Mangin workshop was held, outlining the experiences of the New Zealand Pegasus Division.

May 2011• Pathways development contractor was

hired.

June 2011• FirstCollaborativeServicesCommittee(CSC)meetingwasheld.

• ControloftheDivision’sfundingwastransferred to the Division.

• Firstlocummeet&greetwasheld.

Sept 2011• Secondmemberengagementeventwas

held.• GloriaGibson,ourfirstparttimePathways

Administrator MOA was hired.

November 2011• FirstCME‘Dine&Learn’washeld,withPaulSobeyasthespeaker.

December 2011• First locum working group meeting was

held.• SharedCareProjectproposalwas

accepted.

January 2012• Third member engagement event was

held.• Kick-offmeetingforpotentialdischargeplanningprojectwasheld.

February 2012• WendyLeewashiredasprojectcoordinator.Websitedevelopmentbegan.

• Mary Anne Mattinson, our second part time Pathways Administrator MOA hired.

• Vivienne McMahon was hired as our Administrative Assistant.

March 2012• Member-InitiatedProjectsprogramand

funding was established.

April 2012• SecondCME‘Dine&Learn’washeld,withJamesMcCormackasthespeaker.

May 2012• LeslieRodgershiredasSharedCareandTransitionsinCareProjectCoordinator

Membership and RecruitmentThe Fraser Northwest Division now has 155 members. Attracting and engaging members is important to the Division’s success from several perspectives:

• Strongmembershipnumbersdemonstratelocalsupportforthedivisionconcept.Basedonmemberfeedback,itisclearthatourfamilyphysiciansareenjoyingtheopportunitytoconnectwitheachotherandarewillingtoofferinputonkeyissues(asrequestedviaavarietyofsurveys).

• The importance of member input cannot be overstated. Member priorities and participation drive board activities and decision-making.

• Numerousmembersarejoiningprojectworkinggroups.ThisiscriticaltotheworkoftheDivision, which is to drive systemic improvements in patient care and family physician support.

• The number of Division members directly correlates to the funding received: more members mean more dollars for the Division’s work.

The Fraser Northwest Division would like to thank those who have already become members. TheDivision’sgoalistohaveallfamilyphysiciansworkinginourareajoin.Pleaseencouragenon-member colleagues to consider becoming part of the Division and adding their perspective to the voice of primary care in this community.

BELOW - The Fraser Northwest Division celebrated its 1st anniversary in November 2011.


Fraser Northwest Division InitiativesIn the past year, the Fraser Northwest Division has undertaken several exciting initiatives which areprofiledbelow.NineteenGPsgaveoftheirtimeandexpertisethroughsittingoncommitteesand work teams over this past year, sometimes in multiple capacities. The importance of physician involvement cannot be overstated – from determining which issues are priorities to the progress made in addressing them. Members interested in becoming involved in the current or future work of the Division are encouraged to speak to a board member or the appropriate committee/ team chair.

Physicians who participate on the board or working groups are compensated at the sessional rate for their committee time.

Pathways Project Pathwaysisaweb-basedapplicationdesignedforGPstouseonareal-timebasisintheexaminingroom to facilitate efficient, optimal specialist/ clinic referrals. Its usefulness lies in the speed with which searches can be conducted, it’s richness of data and the fact that it is designed to align with thetypicalgeneralpractitionerreferralprocess.Release1willlikelybeavailableinSeptember2012and will be used to:

1. Determine the optimal specialist/clinic referral for the patient.

2. Provide the patient with a simple, one-page information sheet with specialist/ clinic details such as contact/ address information, a map showing the location of the specialist or clinic, information the patient needs to take to the specialist or clinic, and cancellation policies.

3. Provide,asappropriate,shortbutusefuleducationalmaterials(eitheronpaperorviashortvideoclips)aboutapatient’smedicalcircumstances.

Over time, Pathways will also become the natural repository of the Division’s shared care work. Forexample,asthedivisionworkswithspecialiststodocumentredflagsymptomswarrantingurgent consultation, workups for specific presenting complaints, pearls, and clinical pathways, this information can be captured in Pathways. The goal is to provide a carefully selected set of informationwhichsupportsGPsmakingrealtimediagnosticandreferraldecisions;itisnotmeantto replace other more detailed databases.

Pathways Leadership Team

Dr.RonWarneboldt(Chair)Dr. Tracy MonkDr.JohnYapMary Miller

Locum Project The locum working group has been exploring ways the Fraser Northwest region can attract locums, and beyond that, how the Division can create innovative ways for family practitioners to taketimeoff.Todate,thefocushasbeenoninitiatingalocumwebsiteproject,wherebothfamilyphysicians and locums can advertise needs/availability and technology can support appropriate matchesbeingmade.Thegroupisalsoorganizingameetandgreetwhereresidents,locumsandnewgradscanmeetlocalphysiciansandlearnmoreaboutspecializedareasofpracticessuchasobstetrics, palliative care and geriatrics and so on.

Locum Working Group

Dr.JoelleBradley(Chair)Dr.SarahBromilowDr.PeterChungDr.GaryHayesDr.KathyJonesDr. Meghan KellyDr.ShawnTullyDr.CarolynYeungMary Miller

BELOW - Fraser Northwest Division board members thinking hard at the board retreat on January 7, 2012.


Shared Care Projects

TheSharedCareCommittee,whichisajointcommitteeoftheGPServicesCommitteeandtheSpecialistServicesCommittee,providestwofundingstreamswhichwehaveappliedtoforthefollowingprojects:

1. Partners in Care

OurPartnersinCareprojectwillbegininspring2012.AsteeringcommitteehasbeenestablishedandasofMay2012hashiredLeslieRodgersasprojectcoordinator.TheFraserNorthwestDivision’sPartnersinCareprojectwillfocusonorganizingaseriesoffamilyphysician/specialistconversationsgeared towards improving patient care across the family physician/specialist interface and the efficient use of physician time and health care resources.

WiththespecialtiestheDivisionchoosestoengagewithitwill:

• Striveto improvethemechanicsaroundGP/SPreferralsaswellas the informationflowbetween family physicians and specialists.

• Addressmutuallyagreeduponworkflowissuesandbarrierstotimelyreferralsraisedduringthis series of dialogues.

• Whereappropriate,determinestandardinvestigationprotocolsforspecificconditions,carepathways and agreed upon criteria for urgent referral.

Steering Committee

Dr. Tracy MonkDr. Kathleen RossDr.RonWarneboldtMary Miller

The Partners in Care steering committee is seeking an additional family physician.

2. Transitions in Care

TheobjectiveoftheFraserNorthwestDivisionTransitionsinCare:Dischargeplanningprojectistopromote continuity of care as patients are admitted into the hospital and then discharged back into the community. To achieve this, the advisory committee is focusing on the communication stream from community family physician to hospitalist and back to the community physician upon patient discharge.

TheadvisorycommitteeleadingthisprojecthassubmittedafundingproposaltotheTransitionsinCareprogram.Itishopedfundingwillshortlybeforthcomingandthisexcitingprojectcangetunderway.


Transitions in Care Advisory Committee

Dr.DianaStancu(Co-chair)Dr.JenniferYun(Co-chair)IreneStreet(FHArepresentative)DaveHarrhy(TransitionsinCarerepresentative)Mary Miller

Group PurchasingNegotiating group purchasing rates for Division members on commonly purchased medical and office supplies makes good financial sense. Over the last several months, Fraser Northwest Division has participated in discussions with other divisions and selected preferred medical supply companies.WendyLee,theprojectcoordinator,willannouncephaseoneofagrouppurchasingprogramnolaterthanMay2012.

Advisory Physicians

Dr.ShawnTullyDr.IanWoods

Contribution to the Creation of an RCH Family Practice Call Room OncallfamilypracticesleepspaceatRCHhasbeenanunmetneedforoveradecade,especiallyforfamilydoctorsdoingobstetrics.Thishasaffectedthephysicianswhoprovidematernitycareto all patients, and has impacted recruitment and retention in the area. Therefore, Fraser Northwest DivisionmadeacontributiontotheRCHFoundationtobespecificallyusedtoestablishoncallfamilypracticesleepspaceatRCHfortwofamilypracticeobstetriciansandalsoaddedthatthefundscanbeusedforanadditionalsleepspaceforanRCHhospitalist.

Member Initiated ProjectsTypically,Divisionprojectsareundertakenattheboardlevel,asdirectedbyourmembers.However,individual physicians or small groups of physicians may also wish to pursue smaller yet innovative initiatives on their own. To support these, members are encouraged to use a program called MemberInitiatedProjects,whichincludestheopportunitytoaccessfundingofupto$5,000perproject.TheDivisionispleasedtostrengthentheabilityofitsmemberstoimprovepatientcarethrough this program and looks forward to receiving applications.

Visit www.divisionsbc.ca/frasernw/memberprojects for more details.

WebsiteThe Fraser Northwest Division website is an important resource for Division members and others who wish to become more familiar with Division initiatives. It houses key information and documentsaboutthedivision,memberresources,andlinkstootherresources.WithWendyLee’ssupport, the site is evolving to become a robust repository for information, for example, upcoming eventsandhowtoaccessfundingformemberinitiatedprojects.Memberswillalsosoonbeableto access information on obtaining group purchasing rates for medical and office supplies.

To access the Division’s website visit www.divisionsbc.ca/frasernw

“Data is a campfire around which organizations huddle for heat and light. The irony is in the fact that neither the heat nor the light yield a solution. The solution emerges out of the huddling.”

- Anonymous, Ontario Ministry of Health

LEFT - Listening to James McCormack (Therapeutic Education Collaborative (TEC) at division CME Dine & Learn on April 19, 2012.

Physicians Data CollaborativeFraserNorthwestisoneofover20DivisionswhichhavecontributedtotheformationofthePhysiciansDataCollaborative(PDC),anot-for-profitsocietymadeupofDivisionsworkingtogetherto enable the collaborative use of clinical data. A core principle of its work is ensuring data is used in a manner that protects physician and patient privacy.

ThePDCwillcreateafrontlinephysician-driven,divisionallyownedandcontrolledinfrastructurewith the potential to achieve the following:

• EnableclinicalqualityimprovementactivitiesandCMEreflectivepractice.• Answer research questions of interest to frontline practicing physicians.• Answer population health questions that may assist in health system management and

improved patient care.• Produce data to drive and evaluate Divisional initiatives.

The New Zealand divisional experience has shown that putting frontline doctors in control of these activities leads to significant positive changes that improve the lives of doctors and patients while also improving the sustainability of the health system. A central element of this work is building relationships and trust.


Fraser Northwest Division Collaborative Services Committee (CSC)TheCSCisaforumforopendialoguebetweenrepresentativesfromtheDivision,FHA,theGeneralPracticeServicesCommitteeandtheDivisionsprovincialofficeinordertoco-designsolutionstoissues brought to the table.

Theopportunitytounderstandpatientcareproblemsfromavarietyofdifferentperspectivesandto share information, advice and resources from all the partners increases the chances of achieving improved delivery of services.

TheFraserNorthwestCSChasestablishedtermsofreferenceoutliningeachpartner’srolesandresponsibilities.OneofthedefiningfeaturesofourCSCisthefollowingclause:

“InkeepingwiththeWHOframeworkdefiningprimarycareasperson-focussedandpatientneeds-driven, rather than disease-focussed[1], the partners will support collaborative initiatives that will increasetheprimarycareorientationofthehealthsystembyincreasingthedeliveryofStarfield’s[2]person-focussed key attributes of primary care”

OurCSCwasinstrumentalinaddingfamilyphysicianofficenumberstotheemergencyroomadmissionsheetsandopeningcommunicationchannelsforourdischargeplanningproject.It continues to identify gaps and discuss potential initiatives, such as discussions around the establishmentofafrailelderlyand/orvirtualwardproject.

CSC MembersDr. Tracy Monk – FNW Division representativeDr. Kathleen Ross – FNW Division representativeDr.IdaGallo–FNW Division representativeDiane Miller – FHA representative, Executive Director, Primary Health Care & Aboriginal HealthDr.GracePark–FHA representative, Medical Program Director, Home HealthDr.JeanClarke–GPSC representativeAfsaneh Moradi – Divisions provincial office representative

[1]WorldHealthOrganization.TheWorldHealthReport2008:PrimaryHealthCare–NowMorethanEver.Geneva,Switzerland,2008.[2]StarfieldB.PrimaryCare:BalancingHealthNeeds,Services,andTechnology.Rev.ed.ed.NewYork,NY:OxfordUniversityPress;1998.


Financial StatementThis financial statement is based on an unaudited internal statement. Audited financial statementswillbeavailableattheMay24,2012annualgeneralmeeting.

Revenue

Infrastructurefunding $ 548,495.75

Carryoverfunding $ 37,995.75

SharedCarefunding $ 149,995.75

TOTAL $ 740,567.77

Expenses

Administration/Management $ 124,201.49

Board $ 27,869.36

Member/CMEEngagements $ 36,964.59

DivisionPartnerships,includingCSC,InterdivisionalCouncil, $ 44,202.01

PhysiciansDataCollaborative

Pathways $ 138,678.81

LocumWorkingGroup $ 14,998.24

SharedCare $ 5,949.53

TOTAL $ 392,864.03

Note: UnspentSharedCarefundingof$144,046.22remainswithFraserNorthwestDivisionforspendinginthe2012/13financialyear.However,attheendofeachfinancialyearunspentinfrastructure and carryover funds revert to the central division office Innovation Fund. Divisionsmayapplytothisfundforinnovativeprojectswhichcannotbefundedoutoftheirinfrastructure dollars.


Expenses Expressed as a Percentage

Admin / Management - 32 %

Board 7 %

CME & Member Events - 9 %

Division Partnerships 11 %

Pathways 35 %

Locum Working Group - 4 %

Shared Care - 2 %

Fraser Northwest

The Divisions of Family Practice initiative is sponsored by the General Practice Services Committee, a joint committee of the BC Ministry of Health and Services and the BC Medical Association.

www.divisionsbc.ca/frasernw

Fraser Northwest Board of Directors

Dr. Tracy Monk – Physician LeadDr. Kathleen Ross – ChairDr. Joelle Bradley – TreasurerDr. Nora Tseng – SecretaryDr. Anne Buie – Member at largeDr. John Edworthy – Member at largeDr. Ida Gallo – Member at largeDr. John Yap – Member at large

Staff

The sole full time employee of the division is Mary Miller - Executive Lead.In addition, the following part time contractors are essential to the work of the division:Vivienne McMahon – Administrative AssistantWendy Lee – Project Coordinator (currently working on our website and group purchasing)Leslie Rodgers – Project Coordinator (currently working on our Shared Care projects)Russell Warneboldt – Pathways developerGloria Gibson – Pathways MOA AdministratorMary Anne Mattinson – Pathways MOA Administrator

Fraser Northwest Division of Family Practice

[email protected]:778.294.1964C:604.818.2422

Photographs courtesy of:

S. Mitrovic Cover: FraserRiverSunset–Coquitlam,BC

Mary MillerPage 8: Fraser Northwest Division board retreatPage 12: DivisionCMEDine&Learn

Dr. Kathleen RossPage 6: The Fraser Northwest Division 1st anniversaryinNovember2011Page 11: Lindsay Lake Loop trail at Belcarra Regional Park

Tracy MonkBoats in France

Ben GabrielPage 11: CanadaGoosephototakenatRocky Point Park

Documents

Fraser Northwest Division Annual Report 2011