Some of the members of the Princeton Health Care Team.


To: Sharon Mah, Rural Coordination Centre of BC

From: Edward Staples, President, Support Our Health Care (SOHC) Society of Princeton

Re: Nomination for an Award of Excellence in Rural Medicine in the Resilient Community category

The Support Our Health Care (SOHC) Society of Princeton would like to nominate the healthcare team at Cascade Medical Centre and Princeton General Hospital for a 2016 Award of Excellence in Rural Medicine in the Resilient Community category.

Background

As a direct result of a shortage of family physicians and healthcare professionals, Princeton and District has recently gone through a serious healthcare crisis. It reached a critical stage in April 2012, when we had only one doctor providing on-call service and our emergency department was closed four nights a week. Exacerbating the crisis was a critical shortage of nurses, medical office assistants, and laboratory staff.

At the peak of the crisis in January 2013, SOHC held a Health Care Community Consultation in response to community concerns over the shortage of health care professionals and the resulting erosion of services. This research based consultation was facilitated by Dr. Barbara Pesut, Associate Professor at the UBCO School of Nursing and Canada Research Chair in Health, Ethics and Diversity.

The results of the Consultation were summarized and published in a report that was released to the public. In response, the health care practitioners began working collaboratively with Interior Health, the Regional District of Okanagan Similkameen, the Town of Princeton, and local community groups to address the challenges and concerns identified in the report. This led to the formation of the Princeton Health Care Steering Committee in July 2013.

Over the course of the next several months, we were fortunate to have three doctors join the one remaining doctor at Cascade Medical and for a short time our community was enjoying a period of relative stability. However, this was not to last. Within the next few months one of the doctors left to be with his wife and family and to set up a practice in the lower mainland. And within a year it was determined that another doctor would be leaving upon completion of her two year certification requirement. Realizing the untenable situation, the two remaining GPs, Dr. Black and Dr. Monro, began working on recruitment. Their approach was to portray our community’s health care system as a positive, stable model staffed with young, energetic professionals working collaboratively to serve the community. The practitioners worked with SOHC to develop materials that could be used in their recruitment efforts. They also worked closely with Interior Health to take advantage of available recruitment programs.

Until permanent practitioners were recruited, Cascade Medical Group (CMG) needed to rely on locums to fill our community’s health care needs. Initially, there was some difficulty in attracting locums. In response, one of the physicians suggested a campaign to attract locums. The Love a Locum campaign was started, aimed at making locums feel welcome when they came to Princeton. SOHC organized a community-wide appeal, resulting in a large number of donations that included Save On Foods welcome baskets presented by our Mayor, home canned goods, home cooked meals, tickets to our local hockey team’s home games, and rounds of golf at the Princeton Golf Club. In addition, CMG requested accommodation support from Interior Health, resulting in provision of a furnished apartment close to the hospital and clinic. This program has now been in operation for over a year and has contributed to the successful recruitment and retention of locums.

Achievements and Successes
Over the past three years, the Cascade Medical Group has provided outstanding leadership and guidance in the formation and implementation of the Princeton Health Care Steering Committee Action Plan, successfully addressing many of the health care challenges that our community has faced. Central to this success has been the willingness of the entire team to work collaboratively to develop programs and initiatives aimed at providing sustainable solutions.

Today, as a result of collaborative recruitment efforts involving Cascade Medical Group, Support Our Health Care, and Interior Health we now have four full time general practitioners, two nurse practitioners (sharing one FTE), a full complement of nursing and laboratory staff, and a long list of available locums. This has contributed

to a more positive work environment for both practitioners and professional staff and, as a consequence, a much higher level of community satisfaction with our health care services.

One of the most significant developments to our health care model is the Princeton Access to Specialists program. The goal of this project is to improve health outcomes and quality of life of Princeton patients and to increase the likelihood of retaining Princeton family physicians. This project was spearheaded by the CMG under the leadership of Dr. Ella Monro and Dr. Colleen Black. The program was initiated in January 2014, involving an interdisciplinary project team that included representatives from Princeton family physicians, Penticton specialists, their MOAs, Princeton General Hospital management and staff, Community Integrated Health Services administration, and Shared Care project staff, that set out to:

• Develop, implement and test outreach clinic formats to provide appropriate specialist care in Princeton
• Provide Princeton physicians with customized education and relationship-building opportunities through on-site CMEs (Continuing Medical Education) with visiting specialists
• Engage feedback from physicians, healthcare providers and patients about their experience with the new approaches to care

From January 2014 to 2015, 46 specialist outreach clinics and 9 lunch hour CMEs were held at Princeton General Hospital. This represents approximately 450 patient appointments in 11 specialty areas.

Other programs implemented by the healthcare team include the following:

• establishment of a Rapid Access system – for patients with uncomplicated appointments attached to Cascade Clinic
• renovation of facilities at Cascade Clinic – the addition of two consultation rooms and a shared practitioner office space
• sponsorship of student practicums for medical, nurse practitioner, and nursing students
• weekly health care clinics for students at Princeton Secondary School

In addition, the team was involved in the initiation and implementation of the following projects:

• expansion, promotion, and removal of barriers to e-health options: telehealth, telemedicine, home monitoring programs
• Art for Health program: creating a more welcoming and aesthetically pleasing visual environment through various art installations at the hospital and clinic
• Community Paramedicine program: working in conjunction with BC Ambulance Services to establish procedures for the implementation of this program
• Community Worker program: psychosocial patient support provided collaboratively with CMG and Princeton Family Services Society

Future initiatives include:

• development of a public education program focusing on health promotion and use of available health care services and resources
• linkage with planned Residency Program in Penticton

Key Players
Although the transition from the survival stage to our present stable situation involved a team effort, credit is given to deserving individuals who provided the resilience and leadership needed to guide the team through the most difficult months. They include the following:

Dr. Colleen Black began her practice at Cascade Medical Centre in August, 2013. She is presently the head of the Cascade Medical Group and has provided exceptional leadership to the entire team.

Dr. Ella Monro joined Cascade Medical at the same time as Dr. Black and together they have formed a partnership characterized by cooperation, collaboration, initiative, and perseverance.

NP Tanya Ter Keurs has been serving the Princeton community for seven years. Her experience and understanding of the community has provided the team with important continuity. As the community saw long serving doctors retire and many other doctors come and go, she has been an important key to our present day stability.

It is also important to recognize the contribution made by the nursing staff at Princeton General Hospital. The following individuals have been key players:

Dorothy Westfall retired in April of this year after serving the Princeton community for over 30 years. As acting Patient Care Coordinator during the most critical months of the crisis, she provided expertise and leadership to the entire team.

Cherie Whittaker joined Princeton General Hospital in September, 2004 as a member of the nursing staff. In 2009 she became the nursing manager of the hospital. Her contribution as an administrator provided stability through very challenging times.

Erin Traverse joined the nursing staff at PGH in August 2013. She is the current Patient Care Coordinator at the hospital.

Special mention is made of registered nurses Cathy MacDonald, Catherine Alexander, Michael Anne Miller, and Barb Nyman and licensed practical nurses Colleen Lueke, Kathleen Bedard, Michelle Nyland, and Trina Adams who were often the only source of emergency care when there were no doctors available to provide on call service.

Medical Office Staff provided outstanding support during the transition from a system struggling to provide basic care to a more stable model of health care. This “front line” team often had the difficult job of providing a buffer between frustrated patients and primary care providers struggling to keep up, a task they completed with professionalism and skill. Recognition is given to the following individuals for their part of the overall team effort:

Michelle Leduc began work as a Medical Office Assistant at Cascade Medical in 2013 and was involved in the transfer of over 3000 patient records (on paper) from retiring doctors onto the MedAccess electronic medical record system at the clinic.

Rachelle Sanderson joined Cascade Medical as an MOA in 2013 contributing to the professional stability being developing at the clinic.

Laboratory Services personnel were important team members who provided 24/7 on-call service in addition to their regular duties. Lab technicians Gail Debnam, Sharon Elko, and Chris McMahon and Diagnostic Imaging technician Steve Ball deserve to be recognized for their contribution.

It is also important to recognize the contribution made by Susan Brown, Health Service Administrator with Interior Health. She presently serves as the manager of the professional staff at the hospital and clinic and is co-chair of the Princeton Health Care Steering Committee. Her ongoing role as a facilitator and advisor provided the team with the support needed to see them through the darkest times.

In Conclusion
Due to the tireless efforts of the entire team at Cascade Medical and Princeton General Hospital, our community now enjoys a much improved and more stable health care model. The past four years have been very difficult and at times very stressful, especially for our healthcare practitioners and professional staff. Throughout this time, our health care team remained resolute in their commitment to provide the best possible service to our community and at the same time initiated many new programs aimed at improving access to services for all Princeton and Area residents.

For this, we owe our team of health care professionals a great debt of gratitude.

Sincerely,

Edward Staples, President
Support Our Health Care (SOHC) Society of Princeton