Mount Waddington Health Services: Where are we in April 2008?

1. Mount Waddington Health Services: Where are we in April 2008? Presentation to: Mount Waddington Health Network April 4, 2008

2. Framework for Change

3. Principles of Integrated Services • Comprehensive • Seamless • Locally accessible • Network of provider teams • Integrated into a regional system

4. That supports our population to: • stay healthy (prevention, promotion) • get better (acute, urgent) • manage illness and disease (chronic) • cope with the end of life (palliative)

5. Mount Waddington Redesign for Integration Change the way we plan and provide services “Identify the best supports to ensure success and sustainability of this work”

6. Strategies to Achieve Integration….&Results to Date

7. Vision of Integrated Services Developed in 2007 Holberg Port Hardy Cluster of Services Kwakiutl FN (Fort Rupert) Gwa’sala-nakwaxda’xw Quatsino Cormorant Island Service Cluster ‘Namgis Health Services Mt Waddington’s VIHA Area Services Kwicksutaineuk/Ak-Kwa-Mish (Gilford) Gwawaenuk (Hopetown) Tsawataineuk (Kingcome) Woss Port McNeill Cluster of Services Sointula Nursing Centre Port Alice Health Centre

8. Integrating VIHA’s management team in Mount Waddington- a big accomplishment! • Established Service Integration Team with direction from Rural Services and including all managers responsible for area programs • Agreement to plan as a team and implement a shared vision • Supported by VIHA’s Learning & Development to create an integrated team culture both for operations decision-making and to begin implementing key change strategies • Drafted Implementation Action Plan for 2008-9

9. “Together, let’s focus on meeting patient's needs - crossing program boundaries as necessary to creatively overcome barriers to health.” • Six primary health care nurse lead positions in place by December 2007 • Leadership group establishes weekly telephone conferences to problem-solve and share information in February 2008 • Tackling discharge planning issues across VIHA sites ongoing

10. Focus on health of aboriginal people • VIHA developing a partner relationship with Sacred Wolf Friendship Centre by funding cultural safety education for Port Hardy and Port McNeill VIHA staff • Visioning and population health needs review for urban and village populations around Port Hardy in 2008 • ‘Namgis partnership initiated in Alert Bay through support for health needs review • Physician outreach now to Quatsino & Promising Babies • Recruiting for Nurse Practitioners for Port Hardy

11. Cultural Safety • Aboriginal Liaison Nurse and Elder for VIHA give ongoing cultural safety information to staff • Elder Sally Williams presents to VIHA Board advocating for continued cultural education. VIHA Board visits First Nation communities • Cultural education for health providers building on Kingcome and Hopetown camp experience • Port Hardy staff attend cultural orientation sessions held by Sacred Wolf Friendship Centre • Discharge planning initiative locally

12. Physician engagement • Review by consultant Dr. Bob Burns; report submitted to VIHA on physician retention and recruitment issues in Mount Waddington • MW physicians engage in Practice Support Program for chronic disease management Toolkit and office redesign • The two Port Hardy clinics agree to partner with VIHA for services of nurse practitioner focused of moms and babes. Recruitment underway.

13. “VIHA programs are based at 13 different settings in five local communities. We need an inclusive process for staff to raise issues and a collaborative process for leaders and management to resolve problems locally.” Staff engagement: • Management/staff meetings to distribute Plan in 2007 • Communication/change management strategy being developed with Human Resources support • Meeting with unions to share redesign plans and strategies (charters) since November 2007 • Six week consultation process at Cormorant Island facility in early 2007 for team building • Team-building process with managers & nurse leads

14. Integrated Specialized MHAS Housing Project Resources confirmed Partnership with Salvation Army and cooperation with Sacred Wolf Renovations underway for …..spaces! Seniors Supportive Housing Initiative RFP from BC Housing Communication to all interested seniors groups No proposals received Increases in supportive housing for specialized populations

15. Integrated specialty services • New Social Worker position created (funding from both MHAS and SHC) for navigation and supporting medical/social needs of patients/clients • Still need to find audiologist source, enhance regional physiotherapy, find new approaches to lab and diagnostics for small communities, spiritual care

16. Port Alice as Primary Health Care Centre • Community needs assessment completed by Population Health Observatory and VIHA Planning Fall 2007 • Primary Health Care needs clarified • Next job is to establish local Steering Group with community reps to implement changes, sort out resources for physician support and capital improvements

17. Healthy Families • Physicians and integrated team engaged for Promising Babies • Family Place services enhanced with support of MCFD • Nurse lead for Reproductive Care working between CYF and Rural Health • Women’s Health Fair being offered by integrated services in all communities Spring 2008 Will continue to strengthen the Mount Waddington Reproductive Network, confirm roles of physicians, facilities and community supports, to ensure a safe continuum of perinatal care for all communities

18. “Equitable access to services for remote populations with poor health status requires special consideration beyond what works for people in larger communities” • Using VIHA Quality Council process to improve discharge planning for Mount Waddington residents • Use of agency nurses to keep facilities operating • Successful use of outreach servicesand teams

19. Other ways we’d like to operate… “Realigning front line resources to make a difference in rural health” • Primary Health Care teams to provide enhanced services in community or facility while being on-call to provide emergency services; a ‘workplace without walls. “Integrating interdisciplinary services between facilities and homes supports the complex care needs of the elderly in the community and in residential care.” • Utilizing Seniors health care staff, whether in facilities or community, where their expertise makes a difference to quality of life for the elderly.

20. Finally…how to continue to support our common commitment to a healthier Mount Waddington population?