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Shared System of Care (COPD) Prototype in Langley
Fraser Health Authority
May 2011 to April 2012
2
Dr. Ritta Wittman Dr. Andre Van Wyk Joanne Terry (RT) Kathy Payne (LPN)
Who are the team members?
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Three initial team meetings to plan for the learning sessions
COPD-6 devices were provided
Three 1 hour morning sessions were held at LMH with 23 physicians attending in total
What has been done?
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The sessions were delivered by Dr. Wittman and supported by Joanne and Dr. Van Wyk
What has been done (cont’d)?
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The sessions were only 1 hour long starting at 7:30am to minimize office disruption
Collaborated with GP Division in the invitation process
Invitation included WIC GPs & Hospitalists (subsequently in Burnaby and NW all WIC doctors and hospitalist were invited)
What did we do differently?
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To measure the progress of the shared care-COPD at the GP practices, an update form was created and used at the practice visits
Collaboration with other FH COPD initiative, BreatheWELL, in BBY and NW
To ensure that the two initiatives are aligned and minimize the duplication of the work
To engage GPs into both the PSP SC and BreatheWELL initiatives
What did we do differently (continued)?
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1. Established/enhanced local GP- Respirologist/RT relationship and improved their communication
2. Overall high satisfaction rate from the sessions (meeting their expectation, speakers, shared care, relevant info…)
Successes
Participants Feedback about the SC-COPD Sessions in Langley (May 28, 2011)
94% 94%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Overall Satisfied with the Session Pursuing Shared Care in This Way IsImportant
Agree & Strongly Agree
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3. Updates were obtained from 15 GPs during the practice visits from Jan to April 2012). The following charts show a summary of the findings:
Successes (continued)
Registry Development
87%
67%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Available COPD Registry Available Registry for Smokers
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Smoking Identification & Smoking Cessation (n=15)
93%100%
67%
100%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Have a regular Approachto Identify Smokers
In office Brief Consultationfor Smoking Cessation
Referral to Quit Now Tobacco Treatment
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Case Finding with COPD-6 Device (n=15)
73%
38%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
GPs Who Started Using COPD-6 GPs Who Used COPD-6 for ≥ 20 Patients
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Use of Exacerbation Plan (EP)100%
66%
80%
0%
10%
20%30%
40%
50%
60%
70%80%
90%
100%
Using EP for COPD Patients Using EP for All COPD Patients Have a Way of Finding Out WhichPatients Have EPs
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80%
100%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Adequately Access the Local RTs & Resp Services Interested in Participating in the Shared Care-CHFPrototype (n=13)
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Early Detection/Screening:Using COPD-6 device is time consuming (n=7); “it is difficult to incorporate it into a visit”; there is no fee code to compensate the time
Need for more information regarding the validity of COPD-6
Sustainability: need some mechanism to make sure that the changes made are sustainable & the suggested strategies will be carried out by stakeholders
Administration Support: Lack of an adaptable payment process for this prototype resulted in confusion and delay in the payments
Challenges
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Shared Care-COPD: Case Finding at Dr. Andre Van Wyk's Practice June 2011- March 2012
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9
45
6
3
12
32
7
10
10
2
0 0 0
2
6
10 0 0 0
4
0 01
0
2
4
6
8
10
12
14
June July Aug Sep Oct Nov Dec Jan Feb March
Month
# of Pateints who have beenscreened for COPD using theCOPD-6/ month
# of Screened Patients who have apositive COPD-6 Test
# of Patients who have a confirmedCOPD diagnosis
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Total Number of Patients Who Were Screened for COPD (using COPD-6) and Diagnosed with COPD by Kathy Payne at Dr. Van Wyk's Practice from June
2011 to March 2012
48
13 12
0
10
20
30
40
50
60
Total # of Patients who have beenscreened for COPD using the COPD-
6 device
Total # of Screened Patients whohave a positive COPD-6 Test
Total # of Patients who have aconfirmed COPD diagnosis
Q & A
