The Shared Care Committee is a Joint Collaborative Committee, which is a partnership of Doctors of BC and the BC Government.

The Division supports family physicians and specialists to plan, implement, and evaluate projects focused on improving the flow of care between providers and care settings.

Shared Care projects require leadership from a family physician (FP) and a specialist (or FP with a specialty) and funding is available to support all stages of the project. 

 

The Division currently leads the following projects:

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

The goal of the Patient Flow project is to enhance patient flow processes and communication between physicians to reduce the burden on urgent care and improve patient health outcomes in the community. The project currently sees the engagement of North Shore family physicians, Lions Gate Hospital (LGH) Emergency Department physicians, LGH Diagnostic Imaging physicians, nurses, VCH representatives, and more.

 

The project focuses on:

1. Improving communications between LGH ED physicians and community family physicians to enhance and potentially streamline ED patient care.
2. Collaborating with LGH Diagnostics Imaging to understand and improve physician-to-physician communication and patient referral processes.
3. Enhancing patient flow processes, especially for unattached patients, who seek care at LGH ED in the absence of having a primary care provider in the community.

 

Some of the work currently underway:

• Creation of an ED Tips & Tricks resource for family physicians (adapted with permission from the Victoria Division of Family Practice).
• Development of a new referral process for sending patients from community into LGH's ED.
• Creation of a new urgent CT and ultrasound same-day access referral pathway for FPs.
• Determining solutions for improving the patient discharge process from LGH programs Community Patient in Acute Team (CPAT) and Rapid Access Follow-Up & Transition (RAFT) clinic back to family physicians.
• Exploring various messaging platforms to support communications between LGH specialists and community FPs.

 

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.

This project builds on a pilot project completed by the Division in which the objective was to train and educate family physicians and other primary care practitioners 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 specialist at the Adult ADHD Clinic. Additionally, 100% of the primary care practitioners who participated in the project agreed that they felt more confident in providing patient care. As ADHD is such a prevalent disorder, this work has been 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.

By creating a care pathway, the project team aims to spread ADHD knowledge and resources broader than the North Shore, allowing physicians and other primary care practitioners across the province to access necessary tools to provide care to their adult ADHD patients.

 

Medical Care for Short-Term Custody on the North Shore

The goal of the Care in 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 administering Opioid Replacement Therapy (ORT). In doing so, the project aims to improve medical care in cells, build community capacity, and reduce the burden on emergency services.

In partnership with West Vancouver Police Department (WVPD), North Vancouver (NV) RCMP, and Lighthouse (a Virtual Rapid Access Addiction Clinic at St. Paul's Hospital), an opioid replacement therapy (ORT) protocol was developed and is currently piloted in WVPD and NV RCMP cells.

The protocol allows detainees to speak to a clinician at Lighthouse about starting or continuing ORT while in custody. A prescription for Suboxone, Kadian, or Methadone is prepared by a pharmacist and administered to the detainee by police (WVPD) or by a pharmacist (NV RCMP). Upon release the detainee is connected with an outreach worker from VCH (Overdose Outreach Team) to support continuity of care.

In preparation for protocol rollout, a combined total of 91 police officers were trained by the physician lead on the project in opioid withdrawal and the ORT protocol. Feedback from the training sessions were overwhelmingly positive and many officers stated that the training would support them in their work. Additionally, the physician lead has presented on the topic to management and supervisors at WVPD, as well as the City of North Vancouver's Public Safety Committee with positive reception. 

 

If you are interested in learning more about these Shared Care projects or have an idea for one, please contact Alex Moroz-Witek, Project Coordinator, at HCI@nsdivision.ca.