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Dr. Eric Cadesky: B.C. doctors working to improve care for residential-care patients

July 9, 2018

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Updated: June 30, 2018

The Vancouver Sun’s series on seniors’ care in B.C. brings to light challenges in how we care for people who bear the greatest burden of chronic disease. The provincial government has offered solutions such as hiring more care aids, opening additional long-term care beds and increasing support for seniors living at home. Readers should also be aware that B.C.’s medical doctors are working with the provincial government on the Residential Care Initiative.

Through non-profit organizations called Divisions of Family Practice (also funded by Doctors of B.C. and the provincial government), family doctors are creating local, grassroots residential-care solutions that reduce unnecessary hospital transfers, improve care experiences for patients and providers and reduce costs to the system while improving quality of care. All divisions have RCI projects, meaning that 99 per cent of the eligible 30,000 residential-care beds in the province now benefit from RCI work in some way.

RCI projects around the province provide residential-care patients with access to comprehensive care from their family doctor through regular visits, after-hours on-call coverage and care team meetings. Strong doctor/patient relationships play an important role in improving patients’ overall health and quality of life, especially when a patient has complex needs such as dementia, diabetes and heart and lung disease.

Providing patients with regular physician visits in local facilities has reduced unnecessary hospital transfers significantly in many regions. For example, transfer rates have been reduced in Mission by 33 per cent, in Kootenay Boundary by 34 per cent and 31 per cent in Salmon Arm.

Meaningful medication reviews are another component of RCI projects. Care teams — which can include doctors, pharmacists, nurses, care aids, family members and the patients themselves — review the goals of care and the current plan in order to avoid negative medication interaction, eliminate unnecessary prescriptions and investigations and reduce the number of patients prescribed antipsychotic medications (an issue outlined in the Vancouver Sun series’ fourth instalment, entitled, The problems with residential care.)

Physician-organized medication reviews in the Kootenay Boundary region have reduced the number of patients on antipsychotics without a diagnosis of psychosis by 28 per cent and reduced the number of patients on nine or more medications by 15 per cent. Medication reviews in Mission have also helped reduce the number of patients on nine or more medications by 18 per cent. Reviews in Abbotsford facilities have reduced the number of patients on multiple medications by 6.7 per cent and the number of patients being prescribed antipsychotics by 8.7 per cent.

These early data represent a small fraction of the results, as meaningful medication reviews are underway in facilities in Vancouver, Victoria, the Fraser Northwest and Shuswap-North Okanagan regions and in other communities around B.C.

To ensure value, RCI projects undergo in-depth evaluation and the early results are encouraging. While the RCI will not fix all of the systemic challenges facing our aging population, we commit to continuing to improve our patients’ quality of life through this work. Further evaluation of local RCI projects will identify which initiatives can be scaled to residential-care patients in communities around the province. It also shows that when we all work together — doctors, government, health authorities, health providers and patients — we can truly make a difference in the health of our patients and communities.

Dr. Eric Cadesky is president of Doctors of B.C.

Coming to Princeton!!!

June 27, 2018
Okanagan Men's Shed

Okanagan Men’s Shed

June 21, 2018

Men living in rural communities are at higher risk for loneliness and social isolation, factors that directly influence their health and wellbeing.  In a one year study, IHLCDP Associate Dr. Nelly Oelke, and her team are teaming up with the Okanagan Men’s Shed Association to deliver and evaluate a mobile Men’s Shed to rural communities in the Southern Okanagan Similkameen.  This project, the first of its kind, will also help to better understand the mental wellbeing needs of men in these rural communities and build capacity for supporting the development of local Men’s Sheds. Men’s Sheds are designed to bring men together in a space where they can connect with other men and participate in a range of activities. Research has shown that Men’s Sheds enhance men’s mental and physical wellbeing and improve quality of life. Other team members include IHLCDP Associate Dr. Carolyn Szostak, Dennis Jasper, and Art Post, President of the Okanagan Men’s Shed Association.  This research is funded by the SSHRC. Funding from the New Horizons program has enabled the Okanagan Men’s Shed Association to build a mobile shed and take it out to rural communities.

Listen to webinar focusing on Men’s Sheds with Dr. Nelly Oelke, Dr. John Oliffe, and Art Post
June 19, 2018 – Men’s Shed presentation

For more information, please visit Okanagan Men’s Shed Association.

Ontario Family GP on the Benefits of Adding a PA to his practice

June 20, 2018

Published on May 9, 2018

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Anne Dang, CCPA
Vice President at Canadian Association of Physician Assistant


What benefit have you noticed since adding PA to your practice?

Dr. Dhalla:  A great benefit of having our PA, Deniece, join us is increased access. We see more patients, perhaps more importantly, the quality of service for each encounter is also enhanced . Patients often present with multiple complaints, we must triage the more important ones, while maintaining a patient centered approach.   With Denice, both access to care and quality have improved. In addition, she adds preventative care aspects to the patients care.

In my 15 years in practice, I realize that good communication is the foundation of great care. We follow guidelines and interpret tests, and implement recommendations. Sometimes, in the routine, we lose focus of the patient’s viewpoint. When we both see or review patients, we can better reframe our (clinician and patient) goals..

With our PA Deniece, we have better access for same day appointments. This reduces unnecessary ER visits, or walk in clinic use and allows early intervention in the course of an illness. More often, patients benefit from reassurance and counselling, along with health education.

As other physicians are retiring in our community, we have been able to take on new patients and provide care for those who would otherwise not have a family physician. In addition, having Deniece in my practice allows some patients to open up a little bit more than they would to a physician directly. Patients have a connection with Deniece and they feel they can confide their health concerns and worries, trusting that she will listen and help them.

Benefits of adding a Physician Assistant to a Family Practice – Deniece O’Leary, PA-C in Canada

How is it determined whether the patient gets to see a PA or MD? Read more »

Family-and-friend caregivers to receive much-needed relief with expanded supports

June 18, 2018

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News Release
Vancouver
Monday, June 18, 2018 11:45 AM

The Ministry of Health is investing $75 million to expand respite care and adult day programs, helping both seniors and their loved ones, announced Adrian Dix, Minister of Health.

“Many B.C. seniors count on their spouses, children and close friends to help them stay at home, and cope and manage chronic conditions,” said Dix. “Caregiving without adequate supports can impact the whole family, particularly a person’s ability to live at home, which is what most seniors and their loved ones want. Giving seniors better options and supporting unpaid caregivers to take time for themselves is a necessity.”
Over the next three years, the Province will improve and strengthen respite services and adult day programs to support seniors and their family-and-friend caregivers. The number of respite beds will be increased, and overnight care at home will be made more accessible. In addition, the number of adult day program spaces will be increased, and the hours of operation will be expanded to provide services on evenings and weekends. As part of the work, health authorities are developing plans to meet localized needs of family-and-friend caregivers and seniors in their regions.

“The August 2017 report from the Office of the Seniors Advocate estimates that 31% of seniors had a primary caregiver in distress,” Dix said. “According to the report, the number of clients accessing adult day programs and the number of hours per client decreased in recent years. Over the past five years, there were also a significant cut in the number of respite beds. Under the direction of Premier Horgan, we are changing direction by expanding respite care and adult day programs. This plan will provide more direct care for seniors and afford family-and-friend caregivers time for themselves to reduce stress and exhaustion.” Read more »

B.C. should allow physician assistants

June 7, 2018

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Times Colonist

MAY 27, 2018 12:05 AM

The B.C. government should be applauded for launching a renewed approach to primary care. Patients in B.C. deserve faster and improved access to primary care, which is a key pillar in any successful health system. A focus on team-based care will be critical to this success.

There simply aren’t enough providers to care for everyone in B.C., especially those in remote communities. Recruiting more family doctors and hiring more nurse practitioners will most certainly help.

What was not included in this important announcement was the introduction of physician assistants into B.C. PAs work independently under the supervision of a physician and are able to diagnose, develop treatment plans and work closely with patients throughout their care.

PAs practice in Alberta, Manitoba, Ontario, New Brunswick and in our Canadian Armed Forces. They are also critical members of the health-care team in the U.K., the Netherlands, the U.S. and elsewhere.

They’re used in all of these jurisdictions because evidence proves that PAs reduce wait times, improve care and save money. It’s time for B.C. to introduce PAs so that patients and families can benefit from their skills as part of the health care team.

Trevor Stone

President

Canadian Association of Physician Assistants

How Ontario’s next government could relieve overcrowded hospitals

June 3, 2018

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By THERESA BOYLE Health Reporter

Sun., June 3, 2018

The number of patients who occupied hospital beds even though they no longer required hospital care hit a record level in Ontario this past winter, the Star has learned.

As a result, emergency room wait times also hit an all-time high.

Women’s College Hospital is performing knee replacement surgery as an ambulatory procedure, in which patients are sent home the same day. (LUCAS OLENIUK / TORONTO STAR)

Women’s College Hospital is performing knee replacement surgery as an ambulatory procedure, in which patients are sent home the same day. (LUCAS OLENIUK / TORONTO STAR)

Almost 5,000 patients, most of them frail and elderly, were stuck in hospital beds because long-term-care homes were full or because it was unsafe for them to return home without more support, according to newly audited data from the Ontario Hospital Association (OHA) and the province’s Health Ministry.

This caused a bottleneck for patients admitted to hospitals through emergency departments. The 90th-percentile wait time for transfer to an in-patient bed was 40.9 hours, meaning 90 per cent of patients waited less than that time before being admitted.

It’s not surprising then that “hallway medicine” has become a major theme in the June 7 provincial election. There has been a lot of talk on the campaign trail about hospitals housing patients in “unconventional spaces” such as bathrooms and storage rooms. Health care always ranks as a top concern among voters, but rarely gets this kind of attention. Read more »

Cities & States Sue Big Pharma, Targeting the Firms Who Profited from Peddling Addictive Opioids

June 3, 2018

opioids

New York Mayor Bill de Blasio announced earlier this year that the city would sue manufacturers and distributors of prescription opioids to account for their part in the city’s ongoing deadly opioid epidemic. Firms named in the suit include Purdue Pharma, Johnson & Johnson and McKesson Corporation. The Guardian reports that more than 60 cities are suing Big Pharma over opioids. An explosive New York Times report has revealed that manufacturers of the drug OxyContin knew it was highly addictive as early as 1996, the first year after the drug hit the market. 

MAYOR BILL DE BLASIO: This is a man-made crisis if ever there was one, fueled by corporate greed, fueled by the actions of big pharmaceutical companies that hooked millions of Americans on opioids to begin with. And some of them still are addicted to prescription drugs, and others have migrated to heroin. But we know where it began for so many people. And, bluntly, it was so a very few people could profit, and, obviously, the horrible actions of criminals who sell drugs and profit in death, as well. That combination has led to where we are today. We need to remember that those origins at the root of this problem means it’s a problem that can be defeated. We can fight back against the big pharmaceutical companies. We can fight back against the criminals who peddle drugs. We can change in so many ways, including changing the entire culture around this issue, so we can help people.

To read the full article, click on 

https://www.democracynow.org/2018/6/1/cities_states_sue_big_pharma_targeting?utm_source=Democracy+Now%21&utm_campaign=2d4c38c3e2-Daily_Digest_COPY_01&utm_medium=email&utm_term=0_fa2346a853-2d4c38c3e2-191686713

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SOHC Discussion Paper

Developing an Improved and Sustainable Health Care Model for Princeton, B.C
Support Our Health Care has released a discussion paper in order to get feedback from the community, politicians and professionals about the state of local healthcare and what the long term solutions should be.
Download PDF Here