Long Term Care Initiative
In 2014 the General Services Practice Committee (GPSC) recognised there were inconsistencies in patient care at Long Term Care centres across BC. In particular they identified 5 key areas for improvement, and they provide funding to each community, and Divisions of Family Practice design local solutions to make improvement to MRP (Most Responsible Practitioner) 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 centres 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 patient in LTC – whether it be 1 or many patients. Please fill out our Service Agreement Form.
Improving Patient Care
The Initiative supports physicians who wish to ensure 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 may be reassured that if they need to concentrate on their daily practice, there is a Long Term Care Physician with capacity and processes in place to accept their patient into the LTCI Community of Care and continue the quality of care which 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
This is encouraged and funding is available for team initiatives at LTC centres in Nanaimo. If you are a 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 ate the following conferences:
- Leadership Program for Physicians and Leaders in Long Term Care
- UBC CPD Long Term Care Update - formerly "Residential Care Refresher"
- UBC Care of the Elderly Intensive Review Course
Please contact to learn more about applying for a bursary
We also provide useful resources to help you with your practice in Long Term Care
Please contact the Division for updated documents in Nanaimo.
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. Care coverage is available during the Spring Break, Summer, and Winter (end December) holiday periods; and 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.
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
Procedures and documentation have been created by a multi-disciplinary working group to support Physicians and Pharmacists in providing meaningful reviews and reducing risk of polypharmacy. Senior management at LTC centres 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 up to 3 conferences can be attended by the same Physician in one session. Whilst in person attendance in preferred, we are also implementing remote conferencing alternatives to allow Physicians to provide input whilst not interrupting their patient flows at clinics – this can be particularly useful 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, and we recognize that sometimes this change in location of care may also provide barriers to continuity of care for some clinic based physicians. We introduced 2 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.
2 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 inappropriate transfer of care, and ensure 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.