Best Practices in Interprofessional Care Case Study

This Health Council of Canada video presents a brief case study of a successful collaborative practice facility in Twillingate, a small community of about 2,500 people on the northeast shore of Newfoundland. The chronic disease care team described in the video exhibits qualities that I think we can consider best practices in collaborative care – namely, that collaborative care is a team-based approach where practitioners from different occupations and levels of the health system come together to discuss an individual client’s case. The approach is client-centred, includes the patient as a team-member, and promotes the sharing of knowledge between disciplines. Seems like a no-brainer, I know. That collaborative care is a somewhat revolutionary health care delivery model may be a revelation to some, but the degree of collaboration exhibited by the chronic disease team in Twillingate is not the norm. However, collaborative practice facilities and teams are becoming more prevalent. We have good examples on PEI which I will be profiling in future blog posts. Stay tuned!

Embedding of this video is disabled, so you'll have to link directly to Youtube to view it. Sorry about the extra step!

http://www.youtube.com/watch?v=PADGp1I34is&feature=channel

PEI Family Medicine Residency Program

The Department of Health released a press release last week announcing that five family medicine residents will be starting their two-year residency at the QEH and Prince County Hospital. The idea behind the residency program is to encourage family doctors to establish practices on the Island following their training. Recruiting family doctors is becoming a challenge everywhere, let alone in a rural setting like PEI, so with any luck the program will be successful and we will see more family doctors setting up practice here. Incidentally, there is some evidence (like this study from Canadian Family Physician) to suggest that providing training in rural medicine to medical students increases the chances that they will go on to set up practices in rural areas.

For Immediate Release March 12, 2009
Five Residents Identified for PEI Family Medicine Residency Program

CHARLOTTETOWN, PEI -- The province announced today that five family medicine residents have been identified to begin their two-year training program on the Island this July.

“This is tremendous news for Islanders and I’m extremely pleased that we now have five talented medical school graduates identified and ready to start their training on Prince Edward Island this summer,” says Premier Robert Ghiz. “Establishing the PEI Family Medicine Residency Program has been a top priority for my government, and it will help significantly in the recruitment of additional family physicians for the province.”

The five medical school graduates were identified by Dalhousie University. Four of the students are graduates of Canadian medical schools and one is a graduate of an international medical school.

To train as a family physician, a medical school graduate must complete two years of residency training under the guidance of a practising, credentialed physician – also known as a preceptor.
“I’m very excited about five exceptional medical school graduates who will receive their two-year training across the Island,” says Health Minister, Doug Currie. “Medical residents who train here have the highest potential to stay, plus second-year residents can work as qualified physicians under the supervision of a licensed physician, which will help with patient workload. This will enhance our current recruitment initiatives and assist in ensuring we have an adequate number of family doctors into the future.”

During the past two years, Island physicians have been part of curriculum and faculty development, and have been receiving training in integrating medical students into their clinical practice.

“This is the result of several years of planning for the implementation of the program, says Dr. George Carruthers, site director. “Currently there are about 30 preceptors on the Island who provide training at the post-graduate level. Island preceptors are looking forward to having the residents train here, which will result in enhancements to the Island medical community overall, and to patient care.”

The PEI Medical Residency Program will be based and operated from a site at the Queen Elizabeth Hospital with rotations at Prince County Hospital and throughout communities across the Island.

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CUPE Article on RPNs' Scope of Practice in Ontario

The article reproduced below (find the original here) gives another perspective on an issue that’s very similar to the one affecting health facilities in rural communities on PEI. What’s your take? Do you think that some of the pressures facing rural hospitals and their emergency rooms in particular could be eased by expanding LPNs’ scope of practice as this article suggests? Are we even at a stage where we can consider expanding LPNs’ scope of practice when they are limited by their scope of employment?

RPNs can ease ER crisis at Huron Perth’s Seaforth – Another rural hospital cuts services as McGuinty government turns its back

January 28, 2009 11:09 AM

LONDON, Ont. – Expanding the scope of practice for Registered Practical Nurses (RPNs) can ease the Emergency Room (ER) crisis at Seaforth Community Hospital, says Michael Hurley, President of the Ontario Council of Hospital Unions OCHU/CUPE, which represents 40 workers at Seaforth. “We have to respond to the shortage of nurses,” Hurley says. “But cutting emergency room (ER) services is not an acceptable way to respond to inadequate resources or staffing.”

Hurley encouraged hospitals to expand the scope of practice of RPNs, graduates of a two-year program, to better serve the public.

“By realigning nursing duties across the Huron Perth Healthcare Alliance and using RPNs appropriately, we can address the nursing shortage at Seaforth,” Hurley says.
As of February 7, Seaforth Community Hospital will cut its 24-hour ER down to 12 hours, and remain open only from 8:00 AM to 8:00 PM. Hospital officials say that ambulances will be diverted to other hospitals during the shut-down times.

But Hurley warned that it is the chronic underfunding of the health system underlies ER closures at Seaforth, and elsewhere, and not just the nursing shortage.

“Cutting ER services is a direct response to the financial pressures on the health care system,” Hurley says. “This is yet another example of a rural hospital losing services in a wave of underfunding and restructuring that the McGuinty government is forcing onto hospitals.”

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Contact:
Michael Hurley, President, OCHU/CUPE, cell: 416.884.0770

David Robbins, CUPE Communications, cell: 613.878.1431