Remote Pemberton-area communities are accessible only by helicopter or unpaved roads, which poses challenges to meeting patient health care needs. Having a team of health care providers working together to meet these needs has been integral to building resilience and capacity in these communities. The team includes:
- GPs, who share responsibility for patients and the whole community and share flying into Aboriginal reserves each week.
- Emergency nurses, who are integrated with GPs and also provide after-hours care through the RN (“Nurse”) First Call program, with the doctors supporting this and being available on call.
- MOAs, who embrace somewhat of a “social work role” helping patients to navigate health care and social services.
- Mental health care providers, who are located in the same building as, and are accessible to both doctors and emergency department nurses.
- A nurse practitioner, whose overhead is carried by the doctors.
- A chronic disease management nurse, who works well beyond this scope into palliative care, elder support, and care coordination across the team.
Community health nurses, elders, fire fighters, police, and search and rescue are all part of the team. Relationships run deep and are built on trust, respect for each other’s time, and flexibility around roles. Team members wrap around patients and the community and look after each other, which is particularly important when the going gets tough.
“My life is better in team based care, because I have these people wrapped around me, as well as wrapped around patients; we wrap around each other. We talk in the corridor, we meet each other, we see each other about, and we bump into each other in emerg. No electronic shared care plans, we just work together. Why? Because we like each other and we support each other.”
“Team-building is relationship building. That's what it's about, and that results in community building. And when you do community building you build capacity; people do more work when they are happy.”
— Dr Jel Coward, Rural and Remote Division of Family Practice, Pemberton chapter