Shared Care Projects

Shared Care projects require leadership from a family physician (FP) and a specialist (or FP with a specialty) and funding is available to support both project activities and physician leadership time. 

The Division currently leads the following projects:

Adult ADHD Care Pathway for Primary Care in BC

The goal of the ADHD Care Pathway project is to develop an ADHD care pathway for family physicians and other primary care practitioners in BC to support them with point-of-care resources to identify, diagnose, and treat uncomplicated ADHD in adult patients.

The project builds on a pilot project completed by the Division that trained and educated 7 family physicians and 1 nurse practitioner on identifying, diagnosing, and treating uncomplicated and/or previously diagnosed adult ADHD in their primary care clinics.

One of the main outcomes of the pilot project was that 37 adults with uncomplicated ADHD were able to be managed in a primary care setting versus being referred to a psychiatrist. Additionally, 100% of participants in the project agreed that they felt more confident in providing patient care. This work was very valuable in demonstrating that uncomplicated ADHD can be managed in a primary care setting, which can help reduce barriers to care. More information on this project found here.

The adult ADHD care pathway will be launched in early 2026. Stay tuned for more details.

Opioid Replacement Therapy (ORT) for Police Custody in BC

The goal of the opioid replacement therapy (ORT) in police custody project is to improve care for those in short-term custody who are at risk of opioid withdrawal by establishing a care protocol for prescribing, delivering, and administering ORT which is safe and effective medication used to reduce opioid withdrawal symptoms. It involves partnering with police, virtual ORT prescribers, and pharmacists in BC communities.

This provincial project builds on the North Shore pilot with West Vancouver Police Department and North Vancouver RCMP where at least 41 people have received ORT while in custody through this program (from Dec 2023 to August 2025). The ORT care pathway is now standard practice on the North Shore.

See highlights of the North Shore project in a succinct two-page overview here.

Watch project partners share the impacts of this project in this short video: 

If you are interested in learning more, please contact: HCI@nsdivision.ca.

Strengthening Pediatric Care on the North Shore: Enhancing Collaboration between Family Physicians and Pediatricians

The goal of this project is to improve collaboration and communication between pediatricians, family physicians, and community partners who support children and youth with complex neurodevelopmental, behavioural, and mental health needs.

Goals of Care Initiative

The Goals of Care Initiative (GOCI) is a province-wide effort to ensure that patients’ values and preferences are consistently documented, accessible, and integrated into their healthcare journey. The initiative is exploring conducting a pilot project with oncology patients who are aged 65 and older with non-curative intent cancer.

The pilot project would serve as the foundation for phased expansion to long-term care, primary care networks, and chronic disease clinics throughout British Columbia. Through a multidisciplinary team model, standardized processes, and digital health integration, GOCI aims to build a scalable framework that advances provincial priorities, improves patient outcomes, and supports provider wellbeing.

The Division has also completed the following projects:

Enhancing Patient Flow between LGH Emergency Department and Primary Care on the North Shore

The Patient Flow project (2023–2025) aimed to enhance communication and patient flow between Lions Gate Hospital’s Emergency Department (ED), Diagnostic Imaging, and community family physicians (FPs). The project brought together FPs, ED physicians, and radiologists in collaboration with Vancouver Coastal Health to improve patient care coordination and reduce unnecessary emergency visits.

Key achievements:

• PrevEd Resource: Co-created by FPs and ED physicians to help FPs manage common urgent presentations in the community.
• ED Referral Form: Improved the consistency and quality of clinical information sent with patients. 62% of FPs (58) and 56% of ED physicians (16) reported better communication between healthcare settings.
• Urgent CT and Ultrasound Pathway: Enabled FPs to directly access same-day imaging for urgent cases, preventing an estimated 120 ED visits annually.
• Diagnostic Imaging Messaging: Introduced direct messaging between FPs and radiologists through Pathways BC, providing a quick accessible way for FPs to get answers to questions about test results. 84% of FPs (58) reported improved communication with radiologists. 

If you are interested in learning more about these Shared Care projects or have an idea for one, please contact: HCI@nsdivision.ca.