Mental Health – Seen as one of the priority initiatives in 2013/14, mental health efforts currently focus around child and youth mental health. CVDFP has joined Island Health in a Child and Youth Mental Health and Substance Use Collaborative. Seven local action teams will be put in place on Vancouver Island, with Cowichan serving as one of the first. The action team will look at implementing components of the strategic plan developed by the Ministry of Child & Family Development.
In addition to Island Health and the Ministry of Child & Family Development, the collaborative will likely include participation by the local school district, First Nations, adult mental health, psychiatrists, pediatricians, and other community groups.
Aboriginal Health – With the largest First Nation community in the province located in the region, CVDFP recognized early that collaborations with First Nations partners would be an important component to all aspects of its work. CVDFP created an Aboriginal Health Liaison position as part of its board of directors, a position that focuses on communications and relationship building.
Such efforts have included community consultations, planning of Aboriginal Health educational opportunities, facilitation of GP coverage for a community in need, promotion of culturally safe practices, and hosting of engagement events. First Nations partners are an important part of the Collaborative Services Committee and their community needs are considered as part of each CVDFP initiative.
Palliative Care – CVDFP participates in a Shared Care-funded palliative care collaborative that has been working closely with physicians, the health authority, Home and Community Care, the Cowichan District Hospital, and Cowichan Valley Hospice to look at how to bring a comprehensive palliative and end-of-life care program to the region. With no new funding available at this time, focus has been on ways to build a program within existing capacity.
To that end, a Community Palliative Consultation Team comprised of a GP-Oncologist, a local hospice worker, and a palliative care nurse has been formed to support GPs in their care of patients with challenging palliative or end of life symptoms. The team offers patient assessment and GP consultations, as well as Pain and Symptom Management Clinics for patients, either in hospital or in community for those who are non-ambulatory.
Specialist Collaborations – CVDFP strives to engage specialist physicians in Division initiatives and conversations as appropriate to the issue at hand. The community is fortunate to benefit from a high level of interaction and collegiality between GPs and specialists. Efforts are currently being made to create a more structured engagement mechanism for specialist participation at the Collaborative Services Committee level.
IT – CVDFP is one of a number of divisions that contribute to the Physicians Data Collaborative. The PDC is a not-for-profit society working to develop a community and electronic infrastructure that are trusted by family physicians.
The Cowichan Division is also a member of the Island Health Informatics Committee that looks at improvements in electronic communications and functionality.
The Cowichan Community of Practice has been highly successful during its term, having achieved close to 100% of EMR uptake for the region.
Practice Coaching – In 2013/14, CVDFP collaborated with Island Health Regional Support Team/Practice Support Program and the Physician Information Technology Office to bring integrated practice coaching to its GP members.
Comprised of a Practice Automation Coach and PSP Coordinator, the practice coaching team offered supports in EMR use and clinical efficiencies (implementation of PSP modules). The program was well received by the participating GPs as well as the coaches themselves, producing positive results and a successful, replicable model for improving clinical efficiency and EMR capability, and ultimately increasing practice capacity.
Of the 35 GPs who participated in the practice coaching program, 97% ultimately achieved or exceeded EMR meaningful use level 3. Of those participating in the practice coaching program, 68% undertook a review and clean-up of their patient panel, with an overall average reduction in patient panel size of 38%. Specifically, 14 GPs saw a reduction of 500 or more patients; 10 saw a reduction of 1000+; 7 saw a reduction of 1500+; 6 saw a reduction of 2000+; 5 saw a reduction of 2500+; and 3 saw a reduction of 3000+.