We must build on SNHCC

Posted by Jamie Lee on Monday, April 23rd, 2012

Vance Badawey / Niagara This Week

The South Niagara Health Care Corporation was originally established to develop a response to the Hospital Improvement Plan and the ramifications of the plan on the residents of the City of Port Colborne. At that time, our community’s ER was downgraded to a UCC which meant our local physicians rarely communicated with each other as they did in the past, with no acute care beds. The SNHCC was a vehicle to empower them to develop our own Clinical Services Plan which would align itself with the Clinical Services Plan of the HNHB LHIN, with directives from the MOHLTC.

We focused primarily on rostering orphaned patients, and successfully rostered 3500 citizens to a primary care provider in Wainfleet and Port Colborne, and recruited many physicians and allied health and a myriad of complementary programs. This caught the attention of the LHIN and Dr. Karl Stobbe of the Michael G. DeGroote School of Medicine, and we were asked to pilot a project, the Inter-professional Care (IPC) Pilot Project, to basically come up with a new model of care with little resources. We hired on a physician lead, Dr. Jeff Remington, and together with the LHIN, DeGroote, Joanne Ferraccioli and all of our primary care providers, we have been able to successfully bring the following to our citizens.

• Local physician engagement; meetings held 3 times with over 80% attendance at all 3, positive feedback, Physicians are very willing to participate in clinical program integration and are enthusiastic to collaborate together.

• Community engagement; meetings held with Mayors and municipal reps from Port Colborne and Wainfleet, as well as presentation to Port Colborne City Council.

• In response to an invitation by the Township of Wainfleet, a presentation to Wainfleet Council took place in April 2012 to consider expansion of primary care service delivery to the underserved patients in that community (within our catchment area).

• Telepsychiatry program to be established in Port Colborne at 2 sites; streamlined referral process to ensure sustainability.

• CCAC Case Manager assigned to all practice providers in Port Colborne, the first such initiative in a non-FHT model of practice.

• A screening tool to identify high risk / frail seniors has been developed and implemented by the LHIN for use at all clinics in Port Colborne.  Data is carefully being managed by IPC stakeholders to ensure accurate uptake numbers. Initial feedback is extremely positive with 80% participation with providers expected.

• Initial project development of a Dementia screening program. Pfizer has partnered with us in further development, with implementation goals and working group established.

• Diabetes Mellitus Education Programs (DMEP) working group established to improve access, quality and efficiency of Diabetic Education programming, ensuring no duplication of services, with clear roles and shared accountability. Other goals are to improve self-management of Diabetes Mellitus, and reduce inappropriate demand for hospital / ER care of Diabetes Mellitus. The Diabetic Regional Coordinating Centre at Hamilton Health Sciences is working with the IPC in a collaborative capacity. • Initial consultation for inter-connectivity of the virtual FHT. Further discussions are necessary with Ontario MD, and Clinical Connect. Clinical Connect has been successfully implemented in the largest clinic in Port Colborne, a FHO practice model.

• Governance; through a not-for-profit corporation administered by the Municipality, further governance development for sustainable leadership and external fundraising for IPC projects is needed.

• Through a successful grant, Health Literacy program development has begun.

• Physician engagement with more learners being placed in Port Colborne for clinical rotations, and preceptor participation in ROMP Rural Medicine Week at an all time high of 70 per cent.

• Discussion with another community (Grimsby) to collaborate with the pilot project; they have indicated they are on board and will be meeting with the IPC again in the coming weeks.

After all that has been accomplished throughout the past few years for the benefit of the residents of the City of Port Colborne, some of which has been mentioned above, we are now extremely eager to work with our neighbouring South Niagara partners to consider expanding these and many additional established programs in their respective communities.

We have established a mandate to have the ability to replicate these projects throughout all of South Niagara and possibly beyond.

As we face further expected acute care bed cuts, we MUST develop an appropriate and equitable critical care pathway that meets best practice standards, STEMI protocols, and attracts physicians that will want to practice in Niagara. We have addressed the primary care needs, and have developed an excellent Clinical Services Plan that will meet the needs of all of Niagara, but we must collectively work on a plan to meet further needs of our citizens.

We must ensure that they convalesce close to home, meeting the needs of the LHIN Clinical Services Plan. One voice to the MOHLTC is critical, to develop a plan that addresses Chronic Disease Prevention and treatment, as well as a plan that encompasses the ever evolving health care needs here in South Niagara.

The IPC has all of our physicians engaged, excited and hopeful that we can provide excellent care in all of our communities without duplication of servicing, using our health care dollars in a fiscally responsible manner, and most importantly, finding programs that are already available that may not be at capacity, thereby using very little Capital Ministry funding. This funding will not be available to us individually, therefore we need to work together to develop a health care delivery system that works for all of us, hence the importance of working together. We hope to further engage the physicians in all of Niagara.

Moving forward, our entire team is focused on delivering equitable access to health care and ensuring it is done in an efficient manner. We look forward to working with representation from all South Niagara municipalities and their physician representation from those communities as well. We would like to develop a critical and acute care pathway that builds on the work we have already completed.



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