Burnaby Division of Family Practice. 2014 annual report

Burnaby

2014–15 ANNUAL REPORT

Strengthening Primary Care in Burnaby

Message from the Board Chair 3

Message from the Physician Lead 4

Message from the Treasurer 5

Message from the Executive Director 6

A GP for Me 7

Integrated Home Health Network Report 8

The PATHWAYS Report 9

Global Family Care Clinic Update 9

Continuing Medical Education (CME) 10

Raising Health Literacy 11

Board of Directors 12

Contents

Our Vision:

Patients and Physicians Achieving Health and Happiness.

Our Mission:

To engage, support and mobilize family physicians in co-creating a network that will support the

well-being of all members of the Burnaby community.

Our Values:

Patient-Centred, Transparency, Respect, Excellence, Ethical, Collaboration (teamwork/community),

Equal Access, Equity/Equality, Education/Knowledge, Optimal Health and Physician Health.

Burnaby Division of Family Practice 2014–15 Annual Report

3

Message from the Board Chair

It has been an exciting year for us at the Burnaby Division of Family Practice (BDFP).

By far our biggest achievement this year has been around our work in the provincial A GP for Me initiative. With help from you, our members and community partners, we prepared the Burnaby Division A GP for Me implementation proposal and presented it to the General Practice Services Committee (GPSC) on December 16, 2014. Dr. Baldev Sanghera (A GP for Me Physician Lead) skillfully depicted Burnaby’s story: an urban city on the border of two health authorities with a complex population to serve and a lower GP-to-population ratio compared with other BC cities. In attendance support-ing Dr. Sanghera were Dr. Karimé Mitha (co-chair, A GP for Me Advisory Committee), myself and other project team members and partners.

In the letter informing the Division of the proposal’s acceptance, the GPSC wrote: “The GPSC was particularly impressed with your knowledge of and involvement with your community, and the way that it was reflected in your proposal. As well, the committee appreciated the clarity and creativity of your presentation, and looks forward to seeing you go forth and prosper.

We want to acknowledge Burnaby’s challenges in dealing with Health Authority borders and access to resources, and look forward to the learnings that may come around this issue.”

The funding has now come through. We are poised to begin implementing our strategies to further improve primary health care in Burnaby.

The five streams of the A GP for Me initiative are all aimed at improving community health through education, enhanced office efficiency, physician recruitment, and targeted community services for vulnerable patients. These interwoven streams align with the Division’s Strategic Direction, and will complement the work that we are doing in our offices. Burnaby’s A GP for Me work will build on and enhance some of the other Division projects including the Global Family Care Clinic, Pathways, the Empowering Patient education series and the upcoming residential care initiative, to name just a few.

Another change this year is in our staff. We are very fortunate to have Valery Dubenko, our new Executive Director, join us. In addition to being an RN and having an MBA degree, she has extensive experi-ence in leading teams and spearheading successful projects. With her help, we are hiring additional staff for the implementa-tion of our A GP for Me work, and we are further solidifying our infrastructure to support our ongoing work and growth at the BDFP.

This report is a snapshot of some of the work we have been doing at the BDFP. We have a lot to accomplish in the coming year as we roll out our A GP for Me work. I hope that you will all see the value in what we are trying to accomplish, and work with us to make the Burnaby community stronger than ever!

Dr. Charlene Lui, Chair

By far our biggest achievement this year

has been around our work in the provincial

A GP for Me initiative.


4

Message from the Physician Lead

Dr. Davidicus Wong, Physician Lead

Our A GP for Me proposal has been funded by the GPSC and

we successfully launched a bold public education campaign

to raise public health literacy.

As you will notice in this Annual Report, the Burnaby Division has accom-plished much in the past year. I would

like to thank Joanne Granek for serving as our interim Executive Director, getting our ship in order and steering us in the right direction, Valery Dubenko for taking the helm as our new Executive Director and investing much thought, consideration and time into strengthening our organization and Leona Cullen, the kind voice of our Division to the public and an invaluable support to the Board and our members.

As reported elsewhere in this Report our A GP for Me proposal has been funded by the GPSC and we successfully launched a bold public education campaign to raise public health literacy. Through the Practice Support Program, we have been teaching Advanced Access/Office Efficiency to two cohorts of Burnaby family physicians and their staff. The goals of these programs were to empower physicians to take control of their work lives, reduce stress, strengthen their relationships with their medical office assistants and support a better experience for their patients.

We have enhanced the core content of these modules with important discussions on Physician (and Staff) Health – including work-life balance and stress management and Facilitating Positive Change (with our patients and with ourselves).

Through PSP and our Division, we will continue to share these important topics with our members. We must attend to our own health to be our best for our patients and the other important people in our lives.


5

Dr. Jennifer Moore, Treasurer

D uring the last year the Board has expanded its scope of work, not only focusing on member engagement,

but also on planning and developing a strategy for A GP for Me.

The Division has undertaken a number of financial improvement strategies including the development of new and updated financial policies, a new chart of accounts, and a strong budgeting process with the Board. During implementation of our work within the provincial A GP for Me initiative we will have two separate budgets, since separate funds are allocated for general Division projects and work specific to A GP for Me.

Message from the Treasurer

We have hired an accounting firm to work with us in improving a number of financial processes. This will help us remain finan-cially transparent to our members. Looking ahead to the fiscal year of 2015/16 we will once again produce a balanced budget that is consistent with our aims and strategic plan.

Audited financial statements are available to members on request.

The Division has undertaken a number of financial improvement

strategies including the development of new and updated

financial policies, a new chart of accounts, and a strong budgeting

processes with the Board.


6

T he Burnaby Division of Family Practice has experienced a fair bit of change over the last year. Change is the one

certainty we can rely on in primary care going forward in the next few years! In 2014, the Division underwent a number of changes including completing our A GP for Me assessment and planning phase and moving into the implementation phase. This project brings a significantly expanded scope of work to the Division, membership and community. We also had a change in executive staff leadership with the departure of Anneke Rees who provided solid leadership during the Division’s founding years. Lastly, we are working hard to get ready for an influx of new opportuni-ties, such as Residential Care.

As the new Executive Director, I am stepping into the role with excitement and alertness, as I have worked in a number of health sectors over the past ten years that were expanding just as I entered into a new role. I know the hard work and perseverance it takes to keep a focused vision, when there are many competing and exciting visions in the landscape.

I see the Division’s mandate is increasing as well. Initially the Division provided a vehicle to bring together our members to promote collegiality, build partnerships with health authorities and community and we focused on smaller projects. Today the Division is being asked to play an increasing role in implementing primary care structural and system change. As we expand our scope, we are working to better understand our members’ needs so we can continue to improve the quality and responsiveness of our programs.

Over the next year, we have some “big rocks” to move. To meet these challenges we will build on our strengths including: a strong Board; our members’ individual and collective strengths; strengthening our organizational capacity, our partnerships and the success we have had with our projects (A GP for Me, Empowering Patients, and Pathways).

To achieve a shared vision we will all need to work together using our combined resources to improve the quality of care, and strengthen primary care. As I write this message, we are well into this challenge! I look forward to meeting more of you and working together to reach our shared goals.

To achieve a shared vision we will all need to work together

using our combined resources to improve the quality of care, and strengthen primary care.

Message from the Executive Director: Focusing Forward and Embracing Change

Valery Dubenko, Executive Director


7

A GP for Me – Working With Our Members – Why Your Input Matters!

Working with our members is critical to achieving our mission

and ensuring we hear their voices as the strategies unfold.

I n 2014, the Division, our members, and partners worked together to develop a proposal for our work in the provincial A

GP for Me initiative. The proposal focuses on five strategies to improve primary care in Burnaby. In January 2015 our proposal was approved by the GPSC and we transitioned into the implementation phase.

We are excited about the opportunity this project provides us to work more closely with our members. Working with our members is critical to achieving our mission and ensuring we hear their voices as the strategies unfold.

During the first few months of implementa-tion we undertook a number of tactics to seek our member’s opinions and expertise on how the project could unroll. We sent out a survey to capture valuable real time data on our member’s practices, and also held a dinner and work planning event capturing valuable feedback on four of our five strategies. These tactics also helped us identify members who are interested in being involved in the next phase of the work.

The survey was sent to 174 members on March 25th, 2015. In total, the Division received 38-responses. Some of you might wonder what exactly we do with all this information we collect... Below is an example of how we are using these recent survey results in this project.

We have one strategy focusing on recruit-ment and retention – and a sub-strategy to work with GPs who plan to retire soon. Burnaby has a shortage of GPs, and we have learned that supporting retiring GPs may enable them to continue practicing in our community, albeit in a different capacity.

The information we collect provides us with the means to know who to contact and offer support to. Potential strategies for this group of GPs include supporting them to hand

over their practice to a younger GP, develop-ing a transition plan, and extending their practice by partnering them with a GP who can take on some of the heavier workload. A number of our retiring GPs may be interested in transitioning to locum work.

We believe focusing downstream on our retiring GPs can reap benefits for them, our greater GP community, and our community members who rely on Burnaby having a sufficient supply of doctors to provide care.

Why is your input so valuable? It is critical that our design of strategies be informed by your lived experience of practicing in our community. Also, we have limited time and resources and so identifying the issues or gaps, and which members wish to work with us helps us target our efforts more effectively.

Thank you to all of our members who contributed to our A GP for Me surveys and planning events over the past year. We are using the information you provided in multiple ways!

Dr. Karimé Mitha,Co Chair, A GP For Me Advisory Committee,BDFP

Dr. Baldev Sanghera, A GP For Me Physician Lead, BDFP


8

Integrated Home Health Network Report Dr. Baldev Sanghera

T he goal of this initiative was to integrate Home Health care delivery with primary care being delivered by

GP practices, with a vision to support “frail” seniors to live at home. Multiple meetings were held by Burnaby Division with Fraser Health Authority (FHA) Home Health to create a framework that enables physicians and Home Health case managers to provide collaborative care to patients with long-term care needs in their homes. Burnaby GPs were represented by Drs. Marzieh Shafie and Baldev Sanghera.

Home Health will identify GPs with a significant case load of “frail” seniors requiring extra support. A connection will be established by dedicating a specific case manager (CM) for that practice’s patients. Conferencing can occur face to face in the GP office or via telephone at regular scheduled intervals. The GP and CM will collaboratively monitor patient function, provide self-management support, arrange access to available community services and programs and facilitate access to allied care providers to achieve optimal health outcomes. Allied care providers can provide direct reports to the GP or via the CM. Patients and caregivers will benefit by having an organized collaborative care plan and easier navigation of services. GPs may bill for consultation with the CM using the Community Client Conferencing Fee (billing codes 14016 and 14077).

Future plans are to continue to strengthen and test the robustness of this collaborative system, with hopes to expand it to all GPs requiring this service for their “frail” senior patients. This will be done in a step wise manner, with high caseloads being a priority.

Future plans are to continue to strengthen and test the

robustness of this collaborative system, with hopes to expand it to all GPs requiring this service for their “frail” senior patients.

Dr. Baldev Sanghera


9

Leona Cullen,Pathways Administrator

The PATHWAYS ReportLeona Cullen

Global Family Care Clinic Update: A Burnaby Division and Fraser Health Partnership

The implementation of Pathways in 2014 was an exciting step forward for the Burnaby Division and its

members. This web-based resource provides a comprehensive, searchable database of specialists and specialty clinics as well as a wide variety of physician resources, patient education materials and more to assist our members in making informed decisions regarding patient care.

The beauty of this resource, developed by the Fraser Northwest Division, is that it was created ‘by family physicians for family physicians’.

The BDFP ‘Pathways Leadership Team’ developed an implementation plan and an ongoing strategy to ensure that Pathways continues to effectively serve the needs of

the membership. The team consists of Dr. Baldev Sanghera, Dr. Lindsay McCaffrey, Dr. Khai Phan, Dr. Arthur Vasquez and BDFP staff member Leona Cullen.

The official launch of Pathways to our membership took place at a member event September 24, 2014. On November 6, 2014, we hosted a ‘Tapas & Pathways’ event for MOAs and office support staff. The attendees left excited to engage with this new tool.

Next steps for our Division include surveying all members for the new ‘Family Practice’ specialty, which will allow each physician the opportunity to highlight details about their practice, including up-to-date contact information, areas of practice and other details which make their practice unique.

2014-15 was a busy year at the

Global Family Care Clinic. Referrals increased with approximately 200 new referrals. The service priority is people living in Burnaby, and in fact, many patients live within one kilometre of the Clinic. Co-location with the New Canadian Clinic is invaluable in providing some service continuity. Clinic staff appreciate the family physicians who support the nurse practitioners and their patients. Their participation is critical to enabling the Clinic to provide good service and doctors now have a billing code to reflect this valuable work they do.

Patients have come from many different countries including but not limited to Iran, Iraq, Eritrea, Congo, Colombia, Mexico and Russia. The Fraser Health language service has been very helpful in providing in-person interpreters when needed. The Division is funding a research project to provide translation services to Division members. Many who come to the Clinic require a lot of case management time beyond specific health concerns. They often need letters of support and resources regarding housing, food, furniture and other basic necessities of daily living.

This year Clinic staff are working with the Burnaby Division to develop a process to transition patients to Burnaby family physicians.

“ I have to thank the organization for

the tremendous amount of work that

has gone into this (Pathways) project,

and tell you that every day, my nurse

practitioner and I turn to each other

and say “I love pathways”, at least once! It has made

a tremendous difference to our

practice.”– Dr. Rosemary

D. Baird, Member of the Burnaby Division of Family Practice.


10

Continuing Medical EducationDr. Mike Look

D r. Mike Look, the Burnaby Division’s CME Committee Chair, in consulta-tion with our membership, planned

and implemented a number of continuing education sessions. We hosted five such events in 2014/15. Advertised on our website and through emails to members, events include dinner, updates and announcements regarding Division business, and events and guest speakers. A brief summary of last year’s CME events:

• The April 2014 CME event provided an opportunity for physicians, their MOAs and seven local specialists to discuss ongoing challenges and concerns with the GP/specialist referral system. Approximately 50 members and 25 MOAs attended.

• 26 members attended the May 2014 Polypharmacy CME with Dr. Peter O’Connor, the Program Medical Director, Older Adult Program, Fraser Health Authority.

• In September we launched Pathways at a CME with Dr. Ron Warneboldt, Pathways Lead with Fraser Northwest Division. 47 GPs, two NPs and 11 MOAs attended.

• Dr. Jordan Leith presented in October on Clinical Pearls for Managing Labral and Meniscal Tears, a CME co-sponsored with Fortius Sport and Health. 16 members attended.

• The March CME included both a presentation by Dr. Michelle Murti, Medical Health Officer with Fraser Health Authority, presenting on the Burnaby GP workforce survey results on immuniza-tion as well as a discussion on the

Burnaby Division’s newly funded A GP for Me implementation plan. This session was attended by 45 GPs, one NP, three MOAs and partners from Fraser Health Authority, HealthLinkBC, Ministry of Health and Burnaby Hospital.

Members have suggested some topics for future CMEs including chronic disease management, MSK and psychiatric topics (depression and anxiety). We hope to see you at this year’s events.

Advertised on our website and through emails to members,

events include dinner, updates and announcements regarding

Division business, and events and guest speakers.

Dr. Mike Look, CME Committee Chair


11

Raising Health LiteracyDr. Davidicus Wong

Between October 2014 and April 2015 the Burnaby Division presented a public education program in a number

of community venues including Burnaby community centres, Metrotown Library, public schools and Burnaby Family Life. The goals of the Empowering Patients public health education program are to:

1. Increase people’s health literacy, encour- aging healthy living (proactive, preven-tive self-care; healthy eating; healthy home, work and social relationships; and physical activity) as the new norm;

2. Reduce the of burden of chronic disease;

3. Enhance the patient-doctor relationship;

4. Improve patients’ self-care in general and in the management of chronic diseases, including diabetes, chronic lung disease and hypertension.

Participants at each presentation received a Key Points summary sheet to keep and share with friends and family. I led all the presentations and promoted them through my Healthwise column in the Burnaby Now. This program was supported by our community partners who donated their meeting space and publicized the events. Burnaby Division staff provided coordina-tion to support the work.

The topics included:

• Healthcare is Self Care: Achieving Your Potential for Health

• Patient-Doctor Relationship: Making the Most of Every Visit

• Healthy Eating

• Healthy Relationships

• Emotional Wellness

• Healthy Physical Activity

• Making Sense of Symptoms and Screening Tests

• Surviving Your Hospital Stay

• What You Should Know About Medical Ethics

The Division has produced videos on these and several related topics. They will be available soon for public viewing through our Division’s website. The following three posters, designed to increase public health awareness and direct people to the online videos and health information on our website, will also soon be available on the Division website to display in your practice.

• Poster 1 10 THINGS YOU CAN DO FOR YOUR HEALTH

• Poster 2 WE WERE MADE TO MOVE

• Poster 3 REAL HEALTH CARE IS SELF-CARE

We would like other Burnaby Division family physicians to present one or more of these commu-nity education sessions. We have PowerPoint presentations, Key Points handouts, posters and videos you can use, and of course, you may want to add some of your own content. We are especially interested in members who can present the material in languages other than English.

Interested? Great! Let’s talk. Send me an email at [email protected]

Be active. Exercise every day.

Get a good night’s sleep.

Eat a variety of fruits and vegetables.

Avoid butter, hard margarine, lard and shortening.

Limit salt and alcohol.

If you smoke, quit.

When you feel a strong emotion, pause and ask, “What am I feeling, thinking, saying and doing?”

Choose positive thoughts. Actively manage stress.

Accept what you cannot change; take responsibility for what you can.

Be kind to others and yourself.

1

2

3

4

5

6

7

8

9

10

10 THINGS YOU CAN DO FOR YOUR HEALTH

To learn more about working with your family doctor for your best health:

www.divisionsbc.ca/burnaby

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

www.divisionsbc.ca/burnaby

Burnaby

Burnaby Division of Family Practice

Contact Information

Box 60364 Fraser PO,6417 Fraser Street,Vancouver, BC V5W 4B5www.divisionsbc.ca/burnaby

Valery DubenkoExecutive Directore-mail: [email protected] CullenProject Coordinator / Pathways AdministratorTel: 604-259-4450Fax: 604-227-3575e-mail: [email protected]

Board of Directors

Dr. Charlene Lui – Chair Dr. Karimé Mitha – Vice Chair Dr. Davidicus Wong – Physician Lead Dr. Baldev Sanghera – Vice Physician Lead Dr. Jennifer Moore– Treasurer Dr. Lindsay McCaffrey – Secretary Dr. James Hii – Director

Staff

Valery Dubenko – Executive Director Leona Cullen – Project Coordinator

Photo credits

Cover and interior photos – Burnaby Division of Family Practice

Documents

Burnaby Division of Family Practice. 2014 annual report