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This report highlights the progress and achievements of the Primary Health Care multi-year plan, focusing on improving health services and better managing chronic conditions. The report also outlines the challenges and risks faced in implementation, as well as the next steps and key initiatives for the upcoming year.
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Vision: Healthy people, families and communities. VP Quarterly Report on Strategies Q1 Report – 2015/16 June 23, 2015
VP Lead: Karen Earnshaw – Integrated Health Services Multi-year Plan: Primary Health Care Multi-year Plan
RQHR Primary Health Care Vision Right Service, Right Provider, Right Place… All the Time RQHR Primary Health Care Mission Primary Health Care is the everyday support for individuals and communities to better manage their own health. Our commitment is to provide coordinated health services that are client centred, community designed and team delivered.
Primary Health Care NEW NETWORK VISUALS
Portfolio Overview (Transitional Structure) Primary Health Care Service Line • Networks and Services • Urban Networks • Rural Networks • Home Care/ SWADD • Palliative Care/ Midwifery • Population & Public Health • Eagle Moon Health Office • Quality, Planning and Resource Management • KOT • Strategic Engagement and Decision Support • Program and Resources Management
VP is Leading on: Primary Health Care Multi-year Plan
Primary Health Care Multi-year Plan Provincial Health System Outcome By March 31, 2017, people living with chronic conditions will experience better health as indicated by a 30% decrease in hospital utilization related to 6 common chronic conditions.
Age and sex-adjusted hospitalization rates for 6 ACSCs per 100,000 population aged <75
Primary Health Care Multi-year Plan 2015-16 Provincial Improvement Targets • By March 31, 2017, there will be a 50% improvement in the number of people who say "I can access my PHC Team for care on my day of choice either in person, on the phone or via other technology" • By March 31, 2020, 80% of patients with 6 common chronic conditions (diabetes (DM), coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), depression, congestive heart failure (CHF) and asthma) are receiving best practice care as evidenced by the completion of provincial templates available through approved electronic medical records (EMRs) and the eHR viewer • By March 31, 2016, TBD% of patients with 4 common chronic conditions (DM, CAD, COPD, and CHF) are receiving best practice care as evidenced by the completion of provincial flow sheets available through approved EMRs and the eHRviewer
2015-16 Key Work/Initiative/ProjectTo Achieve Multi-year Plan Outcome & Targets
Status of Strategy ImplementationSuccesses • Successes / What’s Working? • A few examples…. • Regular Home Care Huddles – Urban and Rural • RPIW #81: Med Rec Acute Care to Home Care • Reassignment of all urban case managed clients complete in June • COPD A3 and Work plan created • Inventory of equipment, education and rehab services nearly complete • Practices selected for kaizen work • Health Promotion and Therapies staff transitioning to Rural • 5 Physicians soon at Meadow PHC Centre • Reorganizing payroll and budget system for better use and functionality
Status of Strategy Implementation – Challenges & Risks • Challenges/Gaps/Risks • Ongoing recruitment and retention of family physicians and other providers • Data/ Information Flow • Funding Models • Tight Budget Year • Rollercoaster of Change
Next Steps: 2015-16 Work Plan PHC Actions Improve accessibility to PHC; integrate Mental Health and PHC services Improve HIV testing and Immunization rates Safety: Hand Hygiene and Flu Shots Support seniors at home Recruit family physicians Strengthen Open Access in Moosomin Eliminate unfunded positions; establish a priority list of redeployed positions • Continue to Strengthen Home Care • Complete re-alignment of PHC leadership team and begin asking teams to work differently • Reduce ER waits and improve pt. flow
2015-16 Key Work/Initiative/Project • Strengthening Home Care • Roster Realignment • Establish Network Hubs and supply chain • Mobile Technology • Inter-disciplinary Case Conferences • Establish Network Production Boards • Clinical Standards Review • Medication Reconciliation on Admission
2015-16 Key Work/Initiative/Project Complete re-alignment of PHC leadership team and begin asking teams to work differently • PHC Center and Open Access Clinic in Moosomin • Redesign Home First, Connecting to Care and Seniors Home Visiting into single team focused on preventing ER visits and Acute Care Admissions. • Network Analysis • Home Care Transition • Public Health Transition • PHC Chronic Disease Teams • Business Admin and Support
2015/2016 Focus • Focus for PHC: • Complete alignment into Networks and start to build on our foundation • Support leaders in their new roles • Support staff in working differently • Continue work towards achieving improvement targets