May08 VS.indd - Calgary & Area Physician's Association

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Vital Signs May 2008 • Page 6 Member business alliance (MBA) update JustListedCalgary real estate team The JustListedCalgary real estate team is proud to partner with CAPA and offer its members substantial savings when buying and selling real estate. You will get all the benefi ts of an award winning team, extensive marketing plans, and most importantly, proven results well above the industry average. Savings in the 10-25% per cent range are being offered to all members who show their membership card. Please contact Mike Hannah with any questions or to obtain these substantial discounts. New collaborative care model planned for the Calgary Health Region By Janice Harvie, CHR communications Workforce shortages are wreaking havoc on the health care system. Some of the most visible effects are closed beds, dissatisfied patients and burned out, disillusioned staff. Aggressive recruitment and retention strategies are being implemented. In addition to ‘pumping up the volume’ with increased staff numbers, the Calgary Health Region will soon embark on a large scale system and culture change to deliver care via a collaborative care model that will ultimately take root in about 80 per cent of service areas. Dubbed the ‘workforce optimization initiative,’ the plan is to reorganize the workforce (where appropriate) to realize greater effi ciency and effectiveness in health services delivery. The initiative is fi scally neutral. “The literature supports this vision and we’ve brought a number of strategies and projects involving education, data profi ling, clinical leadership development, regulatory and HR changes and others under our umbrella to ensure the entire effort is coordinated and builds on existing good work,” says Dr. Jim Silvius, VP & associate chief medical offi cer responsible for patient care innovation and health technology, and a practicing geriatrician at Rockyview General Hospital. Dr. Silvius co-leads the initiative with Marilyn Visser, director interprofessional education and workforce utilization. The groundwork is about evaluating and addressing what’s preventing the system from working to the greatest benefi t of patients and providers. One of the key concepts within workforce optimization is collaborative practice, which represents (and requires) a major shift in thinking about our approach to patient care. “Collaborative practice is not just about practicing as a member of a team. Many of us would already say we are part of a team, but not many of us would say we work in the most effi cient system, particularly from the patient’s perspective,” says Silvius. Collaborative practice is a model in which everyone works to the full scope of their knowledge, skill and training in a process of continuous communication and shared decision-making that includes the patient and family, to achieve outcomes that could not be achieved by any one person working alone. What collaborative practice looks like in community care, in acute care and even for individual units or services is open for discussion. Because it is customizable to a certain extent in different settings, physicians are strongly encouraged to provide input when their units engage in the process and through unit councils. The implications of a new service model for physicians will be most evident in how and with whom they interact during the course of providing care. “We’ll still talk to the person most appropriate for giving or getting information about our patient, but that person may not always be the most senior nurse,” says Silvius. “We need to be part of the design in our areas because the number one principle of this is to better meet the needs of the patient. This process allows physicians to be part of developing how this is achieved in their area.” Admittedly, the collaborative practice model and other optimization strategies will not solve the region’s workforce issues. But it’s a vital step in the right direction. “Imagine how improved worklife could be if our system was functioning better, how much happier people would be if they were actually doing what they were trained to do and in a system that wasn’t so stressed,” says Silvius. The workforce optimization initiative will be piloted in six acute care units at the Foothills Medical Centre in the coming months with an enterprise-wide implementation strategy developed by the fall.
By Dave Lowery Actually, “form” and “bike . . . as in motorbike” are obviously four letter words. And a four-letter word usually has a negative connotation. But not these two four-letter words. To Dr. Connie Ellis, 42, they both elicit a lot of passion. A passion that she has had for motorbikes (she currently drives a Ducati) since she was a young girl growing up on the farm and the newly acquired passion she has for the project she has led for over two years, as liaison between the CHR department of medicine and family medicine, to condense between 3-400 forms down to maybe . . . uh . . . one! With a family practice in Bowness for the past 15 years, now specializing in travel medicine, Ellis recognized, along with numerous other family physicians over two years ago, that the number one problem back then was access to specialists in general. “We’re working on accessing specialists because it’s better patient care, specialists will be able to get the information they need and family physicians will get their patients seen in a timely fashion,” Ellis says. “Currently, the process isn’t changing for all specialties though we hope to have this someday. It will only effect specialists in the department of medicine.” The project hasn’t been cheap and initial time estimates were somewhat shorter, but Ellis says the end result will address much more than a form number reduction. “In initial meetings, we had everyone together who said ‘look at the larger issues,’” she says. “It soon became apparent that we could address them all through one form which would include triage and pertinent referral information.” And those issues included a “mess” of referral forms found in a family doctors inventory according to Shannon Erfl e, who joined the project as manager at the beginning of March after working as the CHR operations manager for living well with a chronic condition. “The family doctors had hundreds of referral forms in their offi ce and were operating in a referral system based on relationships as opposed to specialty areas,” Erfl e says. “That meant patients weren’t necessarily getting the treatment they needed and were having to wait longer. Together with family physicians, other health care providers and specialty services, we identifi ed those issues where we wanted to focus our attention. The result? We are getting the people and technical equipment in place, referral criteria have been generated and we’re committing to confi rming receipt of referral within two days and seven days for triaging. If it’s not done based on the package triage criteria, then the second triage will catch the mistake. An important change is that the specialty triage nurses will be contacting patients directly for appointments, family doctors to get more information if needed and going back to the specialist if there is anything that is questionable.” Ellis says the ultimate result will be better patient care but she is looking to expand the program. “Our next step is to include other specialties and departments,” she says. “Once they see it, I think they are going to jump on board. I would like to stress out departments and have them call us to make them part of the system. This is a plus . . . this is a good thing. We need to keep family doctors practicing and this will support good patient care.” Form is not a four-letter word What physicians need to know. 1. Starts May 1, 2008 2. The 30-page coil-bound instruction manual is for your staff. 3. The form isn’t important. The information is. • Erfl e: “If you prefer to use a dictated letter, as long as it contains the same information and supporting documentation, then we can move forward.” 4. The specialty will contact patients directly in order to confi rm and set up appointments. 5. Get the forms from data group or on line from department of medicine. • Erfl e: “As we move towards a more electronic system, we are hoping to make this an easier electronic process.” 6. Physician requests for a specifi c specialist will be honoured. • Erfl e: ”Most of the specialty groups haven’t made signifi cant changes in what they need, they have just put it in one place and they’ve given one central intake phone number.” For more information, please go to http://www.departmentofmedicine.com/ or contact Dr. Connie Ellis P. (403) 247-9797, E-mail: ellis@bowmont.ca or Shannon Erfl e, E-mail: shannon.erfl e@calgaryhealthregion.ca Presentations can be made to your clerical team on request. Dr. Connie Ellis outside her practice in Bowness. Vital Signs May 2008 • Page 7
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May08 VS.indd - Calgary & Area Physician's Association

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