The Campbell River and District Division of Family Practice is working with Island Health, the First Nations Health Authority, and the Campbell River Hospital Foundation to improve access to care for maternity patients through the Campbell River Maternity Clinic. The clinic’s collaborative, team-based approach to maternity care has filled gaps in care for many vulnerable patients in Campbell River and remote communities on the North Island.
The clinic launched as a pilot project at the Campbell River Hospital in November 2015, and moved to a permanent home in the Wellness Centre of the new Campbell River campus of the North Island Hospital in September 2017. The clinic operates four half-days per week, with family physicians providing antenatal, post-partum, and well baby visits. Resident teaching is a priority—family practice residents from the UBC Strathcona Site (three of whom are now practising obstetrics within the community) attend the clinic throughout their obstetrics rotation.
Dr Jennfer Kask, a family doctor in Campbell River, started the journey toward creating the maternity clinic with her colleagues by identifying five main goals:
- Access to quality maternity care
- Cultural competency
- Provider satisfaction
- Sustainability of family practice maternity services
- Residency teaching
Project partners started the clinic planning process by bringing together a number of elements that were already in place and realigning them to improve care. According to Dr Kask, “[It took] great effort and creativity to make something new using only the pieces we’ve already got.”
The division has supported the process by preparing business plan documentation, facilitating discussions with stakeholders, providing administrative and project support, and identifying opportunities to apply for Shared Care funding.
Patients seen on site receive support from an MOA arranged by Island Health, who provides intentional and culturally safe support that includes appointment booking, reminder calls, and keeping information in patient charts up to date. Clinic patients also have access to radiology and lab services, nutrition and fitness advice from the co-located Diabetes Education Clinic, support from the hospital social worker, and links to support from community programs. Public health nurses attend the clinic weekly on Tuesdays, and nurses from the Healthy Beginnings Program provide breastfeeding advice or meet antenatally if a patient has identified needs.
The Campbell River Maternity Clinic hasn’t only improved access to care for patients in the Campbell River area—as part of the services provided by the clinic, maternity GPs also visit the Port Hardy Clinic to see North Island patients who may not be able to travel to Campbell River to receive prenatal care before giving birth. “Women have attended the clinic from 32 communities from A (Alert Bay) to Z (Zeballos),” says Dr Kask. “20.8% of our visits are with women from communities other than Campbell River. We have been able to offer telehealth visits, supported by the Mobile Maternity Project (MOM), since summer 2017. Utilizing telehealth means even less travel for women from remote communities like Cortes Island, which is two ferries away from Campbell River.”
Providing culturally safe care to all patients is one of the clinic’s main priorities. Physicians have participated in the San’yas Indigenous Cultural Safety Training, the Island Health “For the Next Seven Generations for the Children” Program and the “Building Bridges Through Understanding the Village” Workshop. Health Coaches from the Kwakwaka’wakw Maternal Child Health Project are available to assist patients with travel and access to appointments and services. Approximately 36% of the individuals currently seen at the clinic are from First Nations families, and the number continues to grow.
Christine Colbert, Executive Director for the Campbell River and District Division of Family Practice, describes the collaborative effort to create the clinic as “having the patience to walk the path together. And patience doesn’t necessarily mean just sitting back and waiting. It’s being active and engaging but allowing space for others to come alongside when they’re ready.”