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Attachment Update

Attachment Update. Divisions Provincial Roundtable May 31, 2012. Timeline. Innovations to share. Practice Assessment Survey Integrated practice supports Practice payments and PIA M ultidisciplinary grants Community survey of patients C ommunity level gaps analysis

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Attachment Update

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  1. Attachment Update Divisions Provincial Roundtable May 31, 2012

  2. Timeline

  3. Innovations to share • Practice Assessment Survey • Integrated practice supports • Practice payments and PIA • Multidisciplinary grants • Community survey of patients • Community level gaps analysis • Community engagement • Primary care clinic with distribution focus • Patient engagement • Definition of attachment • Patient confirmation process– primary care provider

  4. Evaluating the Issue: Unattached Patients • Prince George • Estimated unattached patient population: 15,000 • variation according to life circumstance and chronic conditions • White Rock–South Surrey • 5 to 35% of population unattached: • Hospital discharges: 5-20% • ER: 10-35% • Cowichan Valley • 5% (4,143) Unattached Patients • 40% (33,148) Poorly Attached Patients

  5. Attachment Strategies: • Enhancing capacity of the local primary care system: • Practice coaching • Recruitment and locum coverage • Making coordination of care easier – technology, Integration • Recognizing and rewarding longitudinal care provision • Creating multidisciplinary care models • Stand-alone clinics with assessment and distribution functions • In-practice enhancement of non-physician providers • Enabling access to phychiatrist, pharmacist, other providers • Improving health of population overall to reduce demand • Community-level collaboration with public health, municipalities

  6. PGDoFP Strategic Directions

  7. Prince George - Attaching Patients • Current activities • Unattached patient clinic – opened May 2008 • Inpatient Primary Care Program (for unattached patients) • Managing ‘retirements’ • Analysis of Practice Assessment Survey Data • Recruitment • Supporting practice effectiveness • Next Steps • Primary health care clinic (will incorporate UPC) • Opening July 2012 • Increase support for practice effectiveness and capacity

  8. Cowichan Initiatives Family Practice Hospital Support Program Cowichan Maternity Clinic Current Initiatives: Aboriginal Health Working Group Chronic Pain Working Group Provincial Attachment Working Group CVDFP Attachment Working Group Practice Coaching Locum Coordinator Warmland Health Services: Unattached Patient Services Proposed Initiatives: End of Life/Palliative Care Working Group

  9. Cowichan - The synergistic effect of taking a mixed approach… … allows the community to develop an overall vision and then implement portions of the vision as funding and resources allow.

  10. White Rock-South Surrey - Attachment Strategies

  11. White Rock-South Surrey

  12. Results to Date • WRSS: 2500 patients attached • 900 through 2 new doctors • 600 through PCAC • PG: 3771 patients attached • Recruitment (3192) • Residential care (114) • IPC (465) • Cowichan: 575 patients attached • Maternity clinic (133) • Hospital support program (21) • Locum program (421)

  13. Risks and Challenges • No Physician Master Agreement, resulting in funding uncertainty • Administrative stability (staff turn-over) • Hospital care pressures • Physician burnout • Patient inflow • Unrealistic stakeholder expectations • Accommodating patient choice • Physician office space limitations • Difficulty recruiting new physicians to some communities • Difficulty staffing clinics

  14. Thank you....Questions?

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