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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PEI Health Careers Directory

Last spring the Health Sector Council released the PEI Health Careers Directory, outlining 62 health occupations practiced on the Island. The booklet scratches the surface really; there are so many options for people interested in pursuing a career in health.

Each career gets a brief write-up including a job description, salary range, high school preparation and post-secondary requirements, and a list of schools offering programs leading to a job in the career profiled. So, for example, the entry for Medical Laboratory Technologist looks like this:

Health Profession: Medical Laboratory Technologist

Job Description: Medical Laboratory Technologists perform sophisticated laboratory tests that help diagnose and treat disease

Approximate Salary: $40,000 - $57,500

High School Preparation: Academic high school diploma with an emphasis on biology, chemistry, computer science and math

Academic Requirements: Post-secondary studies in medical laboratory science – usually a 2- or 3-year program at the community college level

Schools in Atlantic Canada: College of the North Atlantic, NL (3-year program); New Brunswick Community College Saint John Campus, NB (2.5-year program)

Each of the careers fits into a loosely defined category – Cancer Care, Clinical Laboratory Science, Dentistry, Diagnostic Imaging, Health Information and Communication, the Medical Profession, Mental Health, Nursing, Pharmacy, Public Health, Special Technologies and Services, Therapy and Vision Care. The categories make it easy to look up careers that you might be interested in. If you’re curious about nursing, for example, open up the section on Nursing and you’ll see that there are seven nursing-oriented jobs listed. If you enjoy science and lab work, check out Diagnostic Imaging or Clinical Laboratory Science for jobs that lean in that direction, like medical laboratory technologist.

Check out the booklet; let me know what you think. We have hardcopies at the office for anyone interested (our contact info is on the PEIHSC website). Also, we’ll probably revise the booklet in the future, so if you work in any of the occupations listed and notice something that should be changed or updated (like the salary ranges) please get in touch with me.

Cheers,

Mark

Recruiting the ‘Facebook Generation’

Julie Murphy, Administrative Assistant with the Health Sector Council, sent me the following article on recruitment strategies for Gen Xers and Yers. The article points out that recruitment strategies highlighting job benefits and salary through the use of traditional media (newspaper ads, for example) do not resonate with the 18-32 age bracket, and how the most successful recruitment campaigns are turning to new venues (social media like Facebook, blogs, and Youtube) to send a different message (social responsibility and personal values versus job security and salary) about what it means to work with a particular organization. I think a good example of this recruitment style is the recent Canadian Forces campaign – you’ve probably seen some of the grainy, edgy, documentary-style recruitment ads on TV. You can also check out individual videos on the Canadian Forces website and on Youtube (like the Fight Chaos and Fight Distress/Chaos/Fear videos). I probably wouldn’t last a day in the forces, but these videos make me want to join and make a difference in the world...for a few seconds at least.

So what does this mean for the health sector on PEI? Can it learn something from recruitment strategies that emphasise changing the world, making a difference, and personal growth over salary range and mission statements? Certainly people working in the health sector are often drawn to the field out of a desire to ‘do good’ and change lives. But this aspect of health sector careers is rarely (if ever) stated in the job postings I see on the job board.

What do you think? Would a shift in focus in health sector recruitment to a more youthful, tech-savvy demographic with an emphasis on values and ethics serve to entice more health workers to the Island? In my opinion, yes, a different recruitment approach probably would serve to generate more interest in the PEI health sector. I’m not sure what that approach would necessarily look like; imagine the Canadian Forces videos but instead focusing on medical careers, nursing and so on. But there’s another piece to that puzzle, which is ensuring that once we attract the so-called ‘Facebook generation’ to the PEI health system we keep them there. That’s the key component really. If the workplace doesn’t live up to the expectations of a new recruit, they probably won’t stick around, and ensuring that we have an exemplary workplace here on the Island goes hand-in-hand with recruitment, whatever the approach.

Wooing Facebook Generation with Meaning, Spirit

By Carly Foster
June 1, 2008

In the 70s, it was stability. The 80s: Money. The 90s: Balance. Now, some analysts say employee recruiting and retention is about communicating the meaning and purpose of work, even more so than the value of benefits and total rewards.

The path to recruiting and retaining the so-called Facebook Generation is not through fancy gimmicks and traditional advertising - it's through meaning, spirit and tech-savvy company promotion, says Tod Maffin.The broadcaster, blogger and social media strategist was the keynote speaker at EBNC's recent sold-out Canadian Benefits Summit, discussing "Recruiting the Facebook Generation: How to Win the War on Talent."

read more of the article here...

More survey results...oh, and Happy Friday!

A couple of weeks ago I posted results from the Health Sector Council’s grade 12 exit strategy survey showing that parents are the strongest influence on students’ education and career plans. I’d like to point out a few other results from the survey in this post.

One of the things we found was that many students were interested in the health sector as a career option (33% of students indicated interest). When asked about specific occupational groups within the health sector that they were interested in pursuing, the majority indicated nurse (22.3%), doctor (18.2%) and pharmacist (9.5%). Either students are not interested in other health careers, or (more likely) are not aware of the variety of health careers available.

Later in the survey students were provided a list of 62 health occupations that are practiced on PEI – jobs like medical lab technologist, addictions counsellor, emergency medical technician, resident care worker, nuclear medicine technologist, and so on – and were asked to indicate which careers looked interesting. Each entry included a small amount of information on the occupation, including salary range and education requirements, so that students could make an informed decision. Not surprisingly, many students were interested in other health careers, in addition to nurse, physician and pharmacist. Interest was strong in higher salaried positions like medical physicist, dentist, family doctor, specialist physician and psychiatrist, but was also strong in occupations with much lower remuneration – jobs like addictions counsellor and child development worker – suggesting salary wasn’t the sole factor influencing students’ expression of interest. In fact, the most popular jobs were those that included a high degree of social interaction and whose practitioners might be viewed as helping clients ‘better’ themselves (addictions counsellor, child development worker, psychiatrist, psychologist, social worker, dietitian and physiotherapist, for example).

Overall interest in health careers increased dramatically (from 33% to 53.6%) after the students reviewed the 62 occupations, suggesting that the more health career information students have at their disposal, the more likely they are to find a job that matches their interest. Not rocket science, obviously, but the simple fact is that many students don’t have access to this information. As I mentioned in an earlier post, we have a directory of PEI health careers available for download. Let me know if you want a hard copy.

Cheers,
Mark

A Family Health Team model

The article below describes a community’s response to pressures affecting its health human resources and its ability to deliver effective, quality health care. Many of the issues raised in the article are ones that we share in PEI – physician recruitment challenges, shifting demographics among the medical profession whereby more medical school graduates are choosing to specialize rather than enter family medicine, physician retirement, and so on.... Granted, there have been some good news stories, including some recent success recruiting physicians, but the times are changing and recruitment is just one piece of the puzzle.

The article outlines the development of an interprofessional, team-based health delivery system for the Peterborough region of Ontario, adhering to the ideals of collaborative, patient-centred care outlined in one of my previous blog posts. The Peterborough region currently has five interprofessional family health teams (two in the city of Peterborough), consisting of family doctors, nurse practitioners, receptionists (yes...they are an integral part of the health team concept), registered nurses, dietitians, social workers and so on. In 2008 the Peterborough Regional Health Centre was opened with the intention of expanding the interprofessional care concept to include outpatient services and bring specialist physicians into the mix.

It’s an interesting concept and one that appears to be working. Fourteen thousand people have been taken off the waiting list for a family doctor in the Peterborough region in the last two years and wait times have decreased. We have family health teams on PEI and I’m not sure how they compare to those in Peterborough, but the two jurisdictions are strikingly similar. Peterborough and Prince Edward Island are almost exactly equivalent in population (139,818 in PEI as of 2008 vs. 133,080 in Peterborough as of 2006). Both jurisdictions are also largely rural and comparable in overall area and population density (23.9 people per square kilometre in PEI vs. 35 per square kilometre in Peterborough).

I think it’s something that bears watching. If successful, some of the concepts that drive the Peterborough model might be worth adopting on PEI. For one thing, I’m curious to know how many people the Peterborough health teams count as patients compared to PEI teams. I’ll keep you posted if I find out. What are your thoughts?

The Perfect Storm

How a community calmed the rough waters of health care
By Gordon Gibb

You’ll have to forgive Dr. Don Harterre for choosing a winged warthog as his office mascot. The diminutive porker suspended above his desk serves as a delicious metaphor in view of recent success implementing family health teams in Peterborough, Ont., — something one local physician predicted would only happen "when pigs fly."

In Peterborough, an idyllic city of 75,000 located 90 minutes northeast of Toronto, health care is something people love to talk about these days.

Little wonder. The sprawling, state-of-the-art Peterborough Regional Health Centre (PRHC) is slated to open in June, consolidating two outdated hospitals into one meticulously planned facility. The Peterborough Clinic has just moved into a new building adjacent to the PRHC, with its orphaned facility downtown tagged to house expanded vascular health services. Five family health teams are flourishing. And upwards of 14,000 people have come off the waiting list for a family doctor in the past two years.

read the rest of the article here...

Happy humpday!

Some comic relief is in order after the last number of serious and reflective posts. Here's a bit of satire to lighten the mood.