Long Term Care Initiative
In 2014 the General Services Practice Committee (GPSC) recognized inconsistencies with patient care at Long Term Care facilities across BC. In particular, they identified five key areas for improvement, and they provide funding to each community. Divisions of Family Practice design local solutions to improve Most Responsible Practitioner (MRP) care in Long Term Care.
In Nanaimo, our Long Term Care Initiative (LTCI) welcomes all Family Physicians to join. If you feel you can meet or work with the LTC facilities and the Division to meet the 5 Best Practice expectations, you are invited to sign up to receive funding and support to care for your patients in LTC – whether it be one or many patients. Please fill out our Service Agreement Form.
Improving Patient Care
The Initiative supports Physicians who wish to ensure that the high standard of care they have provided to their patients, sometimes over many years, can continue. Family Physicians can benefit from the support of an annual payment of up to $320 per patient, CME opportunities, and tools for providing Geriatric care.
Alternatively, Family Physicians who may need to concentrate on their daily practice can be reassured that there is a Long Term Care Physician with the capacity and processes to accept their patient into the LTCI Community of Care and continue the quality of care every patient and family deserves.
The Nanaimo Division's LTCI assists MRPs in the community by providing access to peer support and groups, together with CME events, and collaboration with allied health providers to help achieve the GPSC 5 Best Practice Expectations.
Facility-Based Quality Improvement
Facility-Based Quality Improvement is encouraged, and funding is available for team initiatives at LTC centres in Nanaimo. If you are an LTCI MRP and would like to collaborate with colleagues to improve care, please email for more information.
We encourage our LTCI Physicians to continue to expand their repertoire of seniors knowledge. Superb education opportunities exist within the province, and we provide Education Bursaries to LTCI physicians who wish to extend their education in this field. Conference bursaries have supported Nanaimo Physician attendance at the following conferences:
- Leadership Program for Physicians and Leaders in Long Term Care
- UBC CPD Long Term Care Update - formerly "Residential Care Refresher"
Please contact us to learn more about applying for a bursary
We also provide valuable resources to help you with your practice in Long Term Care
Please contact the Division for updated documents in Nanaimo.
- Billing Guide for Physicians
- Billing Form for Physicians
- Geriatric prescribing booklet
- Help Guide for Visiting Facilities
Since 2015 the Division of Family Practice has been working alongside Family Physicians and senior management at LTC homes to address challenges faced by Physicians to provide care for LTC patients. These include the complexities of visiting patients across multiple sites, providing 24-hour care, and receiving support. Improvements and support implemented include:
PEAK On-Call Pilot
In 2019 we started a pilot study to support LTCI Physicians by providing peer on-call coverage at peak holiday times. We are continuing this pilot into 2020 and requesting that LTCI Physicians come together to support each other in providing on-call coverage. During the Spring Break, Summer, and Winter (end December) holiday periods, care coverage is available. NEW for 2020, we will be piloting PEAK on-call during Statutory holidays that fall outside of these dates.
You can receive $1980/wk or $500- $750/Stat for providing a period of call cover for your LTCI colleagues.* In return, you are free to plan vacation absences during the rest of the year. Reciprocity will allow all LTCI MRPs to benefit from on-call and ensure their LTC patients receive excellent care during their vacation absence.
Please note: Due to the LTCI best practice expectations and Physician agreement, PEAK on-call coverage is only available for planned vacations, not ad-hoc /regular relief from 24/7 care.
* Remuneration for PEAK on-call contributes to the GPSC funding cap of $45,000 per Physician per annum.
Embedded Video (Responsive).
Peak On-Call Pilot
- Peak On-Call All User Guide
- Peak On-Call Facility Staff Information
- Urgent On-Call Flowchart
- Peak On-Call Responsibilities
- SBAR Form
- SBAR Form Instructions
- Long Term Care Facility Record Sheet
- Physician Data Record Sheet
Meaningful Medication Review Process
A multi-disciplinary working group has created procedures and documentation to support Physicians and Pharmacists in providing meaningful reviews and reducing the risk of polypharmacy. Senior management at LTC facilities have been involved in this project and can support you in introducing this process into your medication reviews.
- Meaningful Medication Review Process
- Meaningful Medication Review Checklist
- Meaningful Medication Review Letter
ZOOM for Care Conferences
We have heard that care conferences are often challenging to attend due to other clinical demands. Working with LTC centres in Nanaimo, we have encouraged clustering of care conferences for MRPs so that the same Physician can attend up to three conferences in one session. While in-person attendance is preferred, we are also implementing remote conferencing alternatives to allow Physicians to provide input while not interrupting their patient flows at clinics. Remote care conferences can be beneficial if you have only a few LTC patients and cannot benefit from the clustered conferences. LTC staff will connect you to the conference for 15 minutes at the end of the conference, so your time is appropriately used for patients' medical care. For more information, please contact.
Admitting a patient to Long Term Care is often accompanied by time-critical requests for medical records. We recognize that sometimes this change in care location may also provide barriers to continuity of care for some clinic-based Physicians. We introduced two processes to support this transition.
LTC facilities in Nanaimo will contact you to ask if you wish to continue care for your patient. Indicating your preference on their faxed communication will allow the necessary actions to ensure your care is maintained or ensure your patient is assigned to an appropriate LTCI MRP.
Admission paperwork is burdensome. Did you know that most of the information can be printed directly from the EMR and attached to the admission paperwork?
Two types of admission forms exist:
Policies and process
In addition to the quality improvement actions above, the Nanaimo Division of Family Practice has also implemented policies and procedures to prevent the inappropriate transfer of care and ensure the sustainability of the future of MRP care in LTC.
- Best Practice Guidelines
- Sustainability Strategy
- MRP Transfer of Care Guidelines
- MRP Transfer of Care Form
If you have questions about the LTCI which have not been answered here, please do not hesitate to contact us.