Victoria Division of Family Practice. 2013 annual report

Victoria

ANNUAL REPORT2013–14

Report from the Co-chairs 4Report from the Executive Director 6Division initiatives/projects 8Victoria physician survey 15Mission statement and purpose 19Highlights of the year 20Financial report 22

CONTENTS

VICTORIA DIVISION OF FAMILY PRACTICE

4

2013 ANNUAL REPORT

REPORT FROM THE CO-CHAIRS

During our second year of operation we focused on identifying and understanding the causes of gaps in care in our community. Division members spent many evenings working on root cause analyses of core problems and thinking of innovative ways to close the gaps. The division’s board and operational team have supported this process and focused attention on the challenge of maintaining member engagement, gathering information about our community, and analyzing corroborating evidence. Now, at the close of our second year, we are all moving forward together into the next stage of implementing potential solutions.

The division is still very young and has a great deal of work ahead, but we can already celebrate many accomplishments. We have started programs that promise to improve primary care for both patients and doctors. These programs are based on our members’ biggest concerns and priorities and supported by partnerships we are nurturing within the system. For example, members told us early on that they wanted to improve communications between GPs and the hospital in order to provide better patient care. Our Transitions in Care program, launched last fall, seeks to solve this longstanding and challenging problem and is off to a great start, engaging a range of physicians in the community and within Island Health, as well as Island Health administrators and allied health providers.

Members’ direction is also at the core of our growing involvement in the provincial A GP for Me initiative. We knew from physician surveys and working groups that local family physicians love their work, but they struggle to meet the demand for primary care and to cover their practices sufficiently to enable taking necessary time off. We also knew that members want to serve their patients more effectively, and need support to provide better care for frail elderly patients and patients with mental health and addictions issues. This guidance and more shapes our A GP for Me work, which brings a variety of partners to the table to work collaboratively to improve attachment and access to longitudinal primary care, and support a more sustainable health care system overall.

The division’s major initiatives to improve the health care system are complemented by smaller-scale projects designed to enhance our local family medicine community and support physicians’ professional development. Monthly Dine & Learns combine continuing medical education with networking and socializing, bringing family and specialist physicians together to learn from and get to know one another. Our Welcome & Transitions Mentoring program matches peers to help physicians new to Victoria get settled, and support physicians making career shifts. Tools like the Victoria Physician

Steve Goodchild and Valerie Ehasoo, Co-Chairs

Having completed our second full year of action, the Victoria Division of Family Practice continues to engage members from across the city’s diverse family medicine community. Members include family doctors in full-service family practice, locum physicians, hospitalists, GPs with focused practices, emergency room physicians, walk-in clinic physicians, military physicians, BC Cancer Agency physicians, family practice residents, and more. We are also making a concerted effort to reach out to new physicians and medical students to welcome them into Victoria’s family medicine community and to encourage their interest in family practice. Our membership continues to grow as more physicians hear about our work and the value of being involved.

2013 ANNUAL REPORT

5


Resource Booklet support clinical practice by providing a single point of access to contact information for community resources and specialist colleagues. We also collaborate with the Island Medical Program and the Family Medicine residency programs to strengthen our ties with potential and new family physicians and the dedicated people who train them.

Many more projects and programs are brewing, and we are excited to implement the solutions that members and partners have collaborated to develop. As a board of directors, we have worked hard in the last two years to learn who our members are, respond to their concerns, and shape an organization that provides support where it is needed most. We ask members to stay with us on this challenging path: keep talking, contributing, and guiding the division’s actions. The board stewards the organization, but the division belongs to the members, and members are in the driver’s seat.

This is a year of transition for the board as the remaining inaugural directors complete their term, and the majority of the board stands for election. We are grateful to all of the founding directors for their time, energy, and vision. The new board will work to balance continuity and change, always maintaining the division’s foundational commitment to grassroots action and local community development.

Thank you to all members and partners who have been a source of support and inspiration. We look forward to the future.

Graphic recording – May 2013 mass working group meeting


6

2013 ANNUAL REPORT

REPORT FROM THE EXECUTIVE DIRECTOR

The Victoria Division’s first two years have moved at what often feels like lightning speed. When I started with the division early in 2012, our operational team consisted of just me and our administrative assistant, Nicole—both part-time. We worked directly with the seven active inaugural board members to create a new organization that would engage Victoria family physicians. I remember being surprised, at first, to learn how few family doctors in Victoria seemed to know one another, but I was immediately struck by the appetite for change within the board and our early-adopter members. We were all energized by the groundswell of interest in building doctor-to-doctor links and cooperating to improve physicians’ and patients’ experience of primary care. For all the challenges that were evident at the start, there was enormous hope and enthusiasm, and no shortage of already-busy people stepping up to build community and take the risks necessary to make things happen.

Fast-forward to the spring of 2014. At the end of our second full year of operation, membership in the Victoria Division has risen beyond all expectations, our infrastructure has developed and matured, the scope of our work has expanded in both breadth and depth, and our operational team has grown to meet ever-increasing demand. Member physicians continue to drive the division’s work, and we are proud to support an organized, connected community of family doctors striving on behalf of their patients and peers to improve the primary health care system.

In the Victoria Division, innovation is more than a buzzword: we are gifted with an opportunity to experiment and try new things. All of us are learning constantly, assessing and re-assessing, going out on a limb to see if we can make things better, if only by increments. We keep a trained eye on the division’s overall progress toward defined goals, but we are as committed to process as we are to product. As critical as it is to achieve intended results, it is also critical to be brave, to be open to the unexpected and untested, and to embrace nuance. In our first two years, this process has enabled us to influence health policy decisions and service delivery, and to support our members in developing their own leadership capacity as the engines of the division’s work.

The Victoria Division has no shortage of active members! It is exciting to see the division weaving itself into the fabric of family medicine in Victoria. When I listen to members—in one-to-one conversations, at committee tables, at engagement meetings, and beyond—I hear evidence that the division is becoming a critical source of support. Local family doctors now turn proactively to the division for assistance with problems they experience in their practices or in the system more generally, for professional development and peer support, and for opportunities to change the system of care.

Alisa Harrison, Executive Director

May 2013 mass working group meeting

2013 ANNUAL REPORT

7


Our partners are also starting to rely on the Victoria Division, looking to us as a representative voice for primary care. We are developing important relationships with other Divisions of Family Practice, Doctors of BC, the Ministry of Health, Island Health, and local NGOs. Through these relationships we can ensure that Victoria’s family physicians are active in decisions that impact their patients and practice, and we can help inform others about the ways in which understanding and working with community-based primary care providers enhances the health care system overall.

A combination of strong member engagement and working partnerships has fueled the division’s work on two major initiatives this past year: A GP for Me and the Transitions in Care program. We undertook this work in response to the core problems and priorities that members had already identified. As we have moved forward with the work, partnerships between organizations and

relationships between individuals—family physicians in Victoria and across BC, physicians in the community, and acute care, specialists, administrators, allies, and advocates—allow us to envision creative solutions that would not be possible if we were acting alone.

At the Victoria Division, we are committed to the notion that residents of this city—including those who are most vulnerable or in need—should have access to high-quality primary care, delivered by family physicians working in a sustainable model and collegial environment. Together, as a cohesive community and with our partners, we will continue working to make it so.

Graphic recording – Considering the work and experiences in the working groups, what are you most proud of?


8

2013 ANNUAL REPORT

DIVISION INITIATIVES/PROJECTS

The Victoria Division of Family Practice maintained its commitment to supporting physician-driven health system change. The committees and working groups that formed after members identified their initial priorities in 2012 remained active through 2013, deepening their analysis of problems, connecting with key partners and stakeholders, and beginning to plan locally-focused solutions. Overall, the division continued to support Victoria’s GPs to connect with one another to share knowledge, increase collegiality, and encourage community action.

COMMUNITY BUILDING COMMITTEE

The Community Building Committee (CBC) continued to host its extremely popular monthly Dine & Learn series at restaurants around town, with each event bringing 30-35 family physicians together with specialists for professional development and networking. The second annual Division Barbecue was similarly successful, attracting 135 members, families and friends to socialize and play in bouncy castles at Willow’s Beach. The committee also

developed two new initiatives: a Physician Resource Booklet to assist GPs as they navigate Victoria’s myriad medical specialists and related services, and a Welcome and Transitions Mentoring Program, designed to provide peer support for physicians new to Victoria or transitioning into subsequent career phases. Members of the CBC are working to develop welcome and recruitment materials—including print and video options—to show physicians why Victoria is “a great place to be a GP,” and help orient physicians who are new to the city.

Dr. Eugene Leduc and Dr. Jill Norris at the Division barbecue.

Dr. David Harrison, Dr. Doug McGhee and Dr. Jody Anzarut at the Welcome & Transitions Mentoring kick-off event.

2013 ANNUAL REPORT

9


WORKING GROUPS, STRATEGIC PLANNING AND A GP FOR ME

The division’s four working groups (Primary Care Access, Practice Coverage, Care of the Elderly, Mental Health and Addictions Care Access) met regularly through most of 2013, engaging more than 20 per cent of our members. The groups joined together in May for a mass meeting where approximately 60 members shared learnings to date and identified synergies. The mass meeting helped guide the board of directors in developing its three-year strategic plan in June, which in turn provides direction for the many ideas generated within the working groups.

During strategic planning, the board recognized that most of the issues and potential solutions identified by the working groups meshed with the goals and objectives of A GP for Me, a major new initiative of Doctors of BC and the BC Government that aims to help patients who want a family

doctor find one, and to increase capacity in the primary health care system. We therefore built our funding proposal around the results of the working group process, and launched Phase One of our A GP for Me work, Assessment and Planning, in early fall. The division’s Primary Care Access Working Group morphed somewhat organically into this initiative, to form the basis for a steering committee composed of member GPs, community partners (Island Health, Victoria Medical Society), and an MOA/Office Manager.

Phase One of our A GP for Me work has required the division to explore more fully the issues facing our community. While the division had already done an excellent job of learning about members’ concerns and supporting members to begin talking to each other and taking action, our Phase One work has enabled us to build our knowledge through deeper research into both physician supply and patient demand. As part of a

Graphic recording – What is keeping you engaged in the working group?


10

2013 ANNUAL REPORT

provincial working group, we developed and were one of the first divisions to roll out a comprehensive physician survey. With a response rate of approximately 50 per cent of our members, the physician survey generated a good snapshot of family practice in Victoria. This data has been corroborated in a variety of ways, including comparison with reported local, provincial, and national trends, and ongoing consultation with Victoria Division members and their MOAs. In collaboration with our neighboring South Island Division of Family Practice, we have also developed and deployed a patient survey to understand the population’s sense of its primary care needs.

In addition, we are in the midst of an in-depth community engagement process, through which we have identified and worked with key community partners to dialogue with vulnerable populations that show a particular need for better access to longitudinal family practice. In this context, we have held focus groups and/or consultations with organizations

including the Beacon Community Services, BC Cancer Agency, BC Schizophrenia Society, CFB Esquimalt, Citizen’s Counselling Centre, Cool Aid Society, Canadian Mental Health Association, University of Victoria Health Services, Island Sexual Health Society, and Patient Voices Network. We have made contact, and in many cases have focus groups pending, with the Capital Mental Health Association, First Nations Health Authority, Heart and Stroke Foundation, Midwives Collective, Intercultural Association of Greater Victoria, and Victoria Youth Clinic. We are also engaging key program areas within Island Health, particularly Home and Community Care, Mental Health and Substance Use Services, Integrated Primary and Community Care, Planning and Engagement, and Seniors Care, and sub-groups from within or connected with our own membership, such as physicians who currently provide maternity care, walk-in clinic physicians, locums, residents, and MOAs.

DIVISION INITIATIVES/PROJECTS CONT’D

Graphic recording – May 2013 mass working group meeting

2013 ANNUAL REPORT

11


3-Year Strategic Plan (above); mass working group meeting (right); Dr. Bill Cavers, A GP for Me billing event (left)


12

2013 ANNUAL REPORT

PRIORITY POPULATIONS: MENTAL HEALTH AND ADDICTIONS, CARE OF THE ELDERLY

Two of our key target populations are frail seniors and people with mental health and/or addictions concerns. Division members prioritized these populations in our first member survey in spring 2012, and multiple data sources affirm our commitment to improving primary care for these groups. The Care of the Elderly Working Group has focused its efforts on developing a new, evidence-based model for family practice involvement with long-term care to reduce the barriers preventing GPs from taking on nursing home patients, and to alleviate the problem of insufficient nursing home coverage. As of March 2014, the division’s board of directors and Collaborative Services Committee (CSC) have endorsed the new model and proposed prototype, and the working group is engaging with the A GP for Me steering committee and Island Health to plan implementation. The working group is also considering ways of mentoring and educating family physicians to increase their skills and confidence in caring for frail elderly patients.

The Mental Health and Addictions Care Access Working Group has confronted a variety of complex issues. Developing the capacity to provide high-quality primary mental health and addictions care is vital as demand and acuity increase. Following cross-jurisdictional research and a local environmental scan, the working group determined last spring that it could not solve this problem on its own, and hosted an interdisciplinary mental health providers’ roundtable to build partnerships, recognize shared concerns, and begin identifying potential collaborative solutions.

Since then, members of the group have investigated a variety of themes, most of which point toward the value of integrated, shared care models. Through this process, the working group has built an effective

partnership with Island Health’s adult mental health services. GPs from the division have worked with Island Health clinicians and staff to revise the referral form, which is set to roll out in spring 2014, and the division sits on the committee developing Island Health’s proposed South Island Crisis Clinic, developing mechanisms to support GPs treating mental health patients in the community and assist with attaching clients to family physicians once they are discharged from the clinic. In addition, the division has endorsed Island Health’s proposal for a collaborative Shared Care initiative focusing on local issues in child and youth mental health services.

RECRUITMENT, RETENTION AND PRACTICE COVERAGE

There is, perhaps, no issue more significant for Victoria’s family physicians than recruitment, retention and practice coverage. With an existing GP shortage and approximately one-third of the city’s GPs set to retire within the next decade, recruiting new physicians is crucial, as is ensuring that current GPs are able to avoid burnout and continue to practice. The division has examined the full suite of coverage issues from a variety of angles, and developed a practice coverage strategy that coordinates local, regional and provincial approaches.

Locally, the Practice Coverage Working Group brought more than 50 members together in April 2013 to test the idea of cross-coverage through a ‘speed dating’ event aimed to help match like practices so that physicians can support each other to take time off. Helping members explore cross-coverage as an option is important in a community where most GPs are in solo practice, and is one component of the division’s developing program to facilitate coverage.

Another important component is ensuring that members have access to the technological tools (such as an effective website) that


2013 ANNUAL REPORT

13


may help them find coverage, whether between GPs or utilizing locums, as well as a person who can help them use the tools effectively and assist with administrative pieces such as using contracts, identifying an appropriate billing split, orienting a locum to a practice, and giving/receiving quality improvement feedback.

Research that we co-led with the Fraser Northwest Division of Family Practice for the provincial Recruitment, Retention and Practice Coverage steering committee demonstrates that the human component is critical for success in any practice coverage system. The provincial group, composed primarily of GPs and executive directors representing 11 divisions, received innovation funding from the General Practice Services Committee to perform cross-jurisdictional research into all locum matching programs in Canada in order to understand best practices and make recommendations for how to address this issue in BC. The most significant recommendation was to recognize technology as an enabler and human beings

Speed Dating for Practice Coverage – postcard invitation

as the centre of a successful program. For this reason, the Victoria Division is currently developing a short-term pilot program to test web resources that can support both locum and cross coverage, and build a staff support role to help facilitate coverage arrangements.

The division will share the results of this pilot and all of our practice coverage work with others across the province, and in particular with other divisions on Vancouver Island, with whom we are collaborating to develop a regional recruitment and retention strategy.

TRANSITIONS IN CARE

Collaboration is a strong theme throughout the division’s work, and nowhere more than in our Shared Care initiatives. Victoria has been a partner in the South Island Division’s Partners in Care initiative for the past two years, and as of September 2013, South Island joined our Transitions in Care (TIC) program.

The TIC program originated with a member working to improve communications between acute care and community GPs, and has


14

2013 ANNUAL REPORT


grown into a major project involving GPs and executive directors from Victoria and South Island, as well as a project manager, hospitalists, ERPs, and administrators from Island Health. We began with a large GP engagement session to explore the issues at stake by developing several patient scenarios, which we then took to a multi-partner and stakeholders’ meeting in November. The latter meeting drew clinicians and administrators from throughout Island Health, as well as patient representatives from the Patient Voices Network, and helped us to further identify priorities for action. The steering committee has since been focusing on improving admissions processes, including developing an e-Notification pilot program with Island Health and Excelleris to alert GPs when their patients are admitted to hospital, methods to ensure hospitals have accurate GP contact information, and collaborative problem-solving with the emergency department. We intend to apply for additional Shared Care funding for a second phase, which will address critical communications issues in discharge planning.

EMERGENCY RESPONSE AND BUSINESS RESILIENCY FOR FAMILY PHYSICIANS

Finally, the division has initiated a project to help family doctors respond at the individual practice and collective system levels to an emergency, disaster or other surge in demand for primary care. Member feedback following Dr. Graham Dodd’s keynote speech

on this topic at our first AGM in February 2013 encouraged the board to pursue the issue with an emphasis on developing clear and concrete guidance for local physicians.

In addition to member support and interest, there are strong practical justifications for this project. According to provincial authorities, Vancouver Island is unlikely to receive timely assistance from the mainland should a disaster occur, so it is critical for residents to be prepared and self-sufficient. Primary care physicians can play an important role in ensuring the continuity of health service delivery, and from the individual GP’s perspective, advanced preparation can help to increase business resiliency and mitigate the disruption to an individual practice.

After some initial scoping work in fall 2013, the division convened a member engagement session in January with 47 GPs and representatives from the Ministry of Health’s Emergency Management Unit (EMU). EMU staff provided information about emergency services in BC and how primary care might fit into a coordinated health system response. After the session, 16 members formed a working group to move the project forward. As the division continues building relevant partnerships with the EMU and Island Health, the EMU will support members to develop practice resiliency and continuity plans targeted to community primary care in Victoria.

The Victoria Division is excited to be an innovator in this area. Although considerable evidence supports the value for a community when family physicians are disaster-ready, we are not aware of any other group of primary care physicians in Canada organizing in this manner. We have an opportunity, therefore, with our partners, to break new ground with a strong potential benefit across the province and possibly the country, as we will spread any knowledge, tools or mechanisms that we develop as widely as possible.

Dr. Nicole Bennett-Boutilier, speaking at Transitions in Care physician engagement event

2013 ANNUAL REPORT

15


VICTORIA PHYSICIAN SURVEY — A COMMUNITY SNAPSHOT

In the summer of 2013, almost half of the Victoria Division’s member physicians and their MOAs completed a comprehensive survey designed to provide a snapshot of Victoria’s family medicine community. The survey helped the division understand who is in the community and how people practice, and to identify some trends in physician supply. It has become a key source of information about family practice in the city, and along with a variety of other sources of qualitative and quantitative evidence, provides direction for the division’s work.

The survey covered many aspects of practicing as a family physician. This brief report highlights selected results that are particularly significant for the community’s future and/or have had a specific impact on the division’s work. Please contact the division if you wish to see a more comprehensive report.

TRENDS IN FAMILY PHYSICIAN SUPPLY AND PRACTICE COVERAGE

The Victoria Division is exploring ways of improving patient attachment, both in terms of quantity and quality. In this context, it is important for us to understand how many family physicians are practicing in the city, how and where they practice, and in what ways that might change. Survey responses indicated that the supply of family physicians in Victoria is expected to decrease, with 32 per cent stating that they will retire in the next ten years.

Many will phase into retirement, with an initial period of semi- or partial retirement. When asked, 13 per cent of participants indicated they expect to do locum work on retirement, and an additional 64 per cent responded “maybe.” As we build a recruitment and retention strategy, we are exploring how semi-retired physicians might contribute to practice coverage, and how the division can support physicians to consider succession planning as part of their work-up to retirement.

Finding ways to improve coverage is important, as access to reliable, high-quality coverage has a direct impact on physicians’ professional fulfillment, personal health and wellness, and capacity to care for patients.

Expected Time to Retirement

What Retirement is Expected to Look Like


16

2013 ANNUAL REPORT

VICTORIA PHYSICIAN SURVEY — A COMMUNITY SNAPSHOT CONT’D

Almost half of survey participants said that it is difficult or extremely difficult to find coverage, and 35 per cent stated that their ability to find locum coverage has affected their retirement plans. When asked to describe in their own words what they needed to improve their satisfaction, better coverage was among the top four answers.

an additional 47 per cent worked in clinics with a walk-in component. Walk-in providers must be part of the conversations taking place about improving coverage and care.

PRACTICE CAPACITY AND STYLES

Finding solutions to challenges around practice coverage and access to excellent primary care are at the core of the division’s work. Victoria family physicians are working hard to provide the best care possible for as many patients as they can, in a context where 74 percent of survey respondents reported an increase in the complexity of patients’ problems. While most respondents did not prioritize seeing more patients, 70 per cent said they are accepting new patients into their practice: of that total, 13 per cent are doing so generally, and 57 per cent under specific circumstances. Physicians familiar with A GP for Me billing codes were more likely to report taking on new patients.Physicians may not have the resources to

implement alternative coverage solutions on their own. For instance, while 68 per cent of survey participants said they would consider cross-coverage as a solution, and 53 per cent are already involved in cross-coverage arrangements, logistical challenges remain. One of the central challenges is the high proportion of solo practitioners: 32 per cent of respondents reported working in a solo practice, and 28 per cent in a group practice without shared patients. The division has included cross-coverage as a key component of our recruitment and retention strategy, with an aim to provide opportunities for relationship-building and logistical support for finding and sustaining a cross-coverage practice match.

The division is also considering the role of walk-in clinics in practice coverage solutions. Walk-in clinics bridge gaps in care for patients who are unattached, and there may be creative ways to link with longitudinal practices to enhance coverage. As of the survey date, 12 per cent of respondents indicated working at exclusively walk-in offices, while

Family physicians’ capacity depends in part on where and how the physician practices, and there is great variety in our community. Just under half of survey respondents maintain a full-time office practice, with an additional 11

Top Answers for What Would Improve Physician Satisfaction

Physician’s Type of Practice

2013 ANNUAL REPORT

17


per cent working full-time in other settings, and 35 per cent practicing part-time.

While less than half of survey participants provide inpatient care, 75 per cent of survey participants did report hospital privileges of some kind.

health professionals who can complement and support family practice. Indeed, nearly a quarter of survey participants already consistently practice team-based care utilizing non-physician team members in patient care.

Survey participants said that they want better access to multidisciplinary colleagues. For instance, when asked what kind of supports they needed, 41 per cent of participants said better relationships with specialists, 31 per cent specified needing better connection with mental health practitioners and addictions counselors, and 25 per cent would like better links with social workers.

The survey and other data suggest a strong interest in team-based approaches to care, and the division is exploring ways of doing this in the context of the A GP for Me and Shared Care initiatives.

CARING FOR VULNERABLE PATIENTS

Interdisciplinary care offers particular value to physicians caring for vulnerable patients. While most respondents indicated that they are already confident in providing care to patients with mental health concerns and at the end of life, members participating in division working groups on mental health and addictions, and care of the elderly have provided anecdotal evidence that their confidence levels could increase even further if they knew they had multidisciplinary support and were part of a team.

The division is examining ways to support and mentor family physicians working with frail elderly patients in order to attract more physicians to work in long-term care (LTC). Less than half of respondents (47 per cent) indicated having patients in LTC, and only 13 per cent indicated that they will accept new patients in LTC. Physicians taking LTC patients tend to be older themselves and nearing retirement, pointing toward a serious future shortage of physicians providing this type of care.

Physician Hospital Privileges by Type

A variety of issues have resulted from the ways in which family physicians’ roles in the hospital have changed over time, and the division is working in a variety of ways, including the Transitions in Care program to restore good communication between acute and community-based primary care, and strengthen the relationships between physicians practicing in different environments.

One message heard through the survey, which has been corroborated in working groups and other interactions with members, is the desire to provide better care by connecting with other


18

2013 ANNUAL REPORT

VICTORIA PHYSICIAN SURVEY — A COMMUNITY SNAPSHOT CONT’D

The most frequently cited barriers to practicing in LTC included geographical distribution of patients (39 per cent), coverage (32 per cent), and remuneration (31 per cent). In response to this information, as well as the fact that 56 per cent of respondents reported that they would see more LTC patients if the barriers were removed, the division developed a prototype for changing the way family physicians engage with LTC, with implementation expected for this fall.

PHYSICIANS ENJOY WORKING IN FAMILY PRACTICE!

Despite identified challenges, family physicians in Victoria are highly satisfied with their work

lives. The vast majority of survey participants enjoy working as family physicians in the city. They were most satisfied with local opportunities for CME (91 per cent), and with their relationships with other family practitioners (88 per cent). By contrast, they indicated that they struggle with practice coverage, administrative responsibilities, practice efficiency, and future career prospects. These findings reinforce the division’s commitment to building community and collegiality, and supporting family physicians’ ongoing personal and professional development through programs such as the Dine & Learn series, annual barbecue, and Welcome & Transitions Mentoring.

Type of Practitioner Physicians Would Benefit from Better Relationship with Outside of Office

2013 ANNUAL REPORT

19


MISSION STATEMENT AND PURPOSE

VISIONPromoting healthy communities through excellence in local primary care.

MISSIONThe Victoria Division of Family Practice is a physician-led non-profit society that strives to improve patient care and population health by:

• ensuring access to excellent primary care,• increasing family physicians’ influence and

impact on health policy development and health care delivery decisions,

• building partnerships that facilitate an effective and sustainable health system, and

• enhancing physician collegiality and professional fulfillment.

VALUESThe Victoria Division of Family Practice conducts its operations with the following values in mind:

• compassion and patience• inclusivity• collaboration• grassroots democracy• transparency• respect• timely, respectful communication• fair process• accountability• stewardship and responsibility• ongoing and meaningful input and engagement• building real relationships• local responsiveness• evidence-driven.

Sue Davis facilitating the mass working group meeting

Dr. Kathy Dabrus presents a Community Building Award to Dr. Peter Innes at the 2013 AGM


20

2013 ANNUAL REPORT

HIGHLIGHTS OF THE YEARFEBRUARY

• 1st AGM – Fairmont Empress: three new board members elected, Dr. Graham Dodd speaks about emergency preparedness for family physicians

• Dine & Learn: Musculoskeletal 1

• Collaboration begins between Island Health and the Division’s Mental Health and Addictions Care Access Working Group

MARCH

• Dine & Learn: Cardiology

OCTOBER

• Kick-off event for Division’s Welcome and Transitions Mentorship Program

• Transitions in Care kick-off physician engagement event

• Division participates in Shared Care Committee Showcase, Vancouver

• Dine & Learn: Infectious disease

• Care of the Elderly working group begins developing new model for family practice in long term care

• Division begins community stakeholder/partner engagement as part of A GP for Me – Phase One

• Dr. Steve Goodchild assumes the role of board co-chair after Dr. Aaron Childs steps down

NOVEMBER–DECEMBER

• Division participates in the provincial A GP for Me conference, Vancouver

• Dine & Learn: Physician Health Program

• Division disseminates Medical Resource Manual referral resource

• Victoria joins other Island Divisions of Family Practice to form a regional recruitment & retention working group

• Transitions in Care multi-stakeholder and partners meeting

• A GP for Me – How is it working for you? discussion and billing event for physicians and MOAs

• Transitions in Care working group (Division and Island Health) begins developing an e-Notification pilot for family physicians to improve communication around patient admissions to acute care

• Division begins publishing twice-monthly e-Newsflash

APRIL

• Speed Dating for Practice Coverage event

• Division report, Increasing Capacity of Primary Care Providers in Accessing Mental Health and Substance Use Services

• Dine & Learn: Cancer screening

2013

JANUARY

• Dine & Learn: Foot and leg ulcer management

• Board development retreat

• Division collaborates with the Ministry of Health, Emergency Management Unit, to host 1st working session on emergency preparedness for family physicians

• Division joins the newly-formed Island EMR Collaborativ

FEBRUARY

• Collaborative Services Committee approves Care of the Elderly working group’s proposed new model for family practice in long term care

• Dr. Kathy Dabrus, board member, joins Dr. Robin Saunders (SIDFP board) for a discussion on CFAX 1070 about A GP for Me

• Division evaluation framework in development

• Dine & Learn: Specialists’ top tips

2014

2013 ANNUAL REPORT

21


MAY

• Working groups and committees mass meeting: report-back and next steps

• MOA dinner and planning session: Working Together to Improve Family Practice

• A GP for Me introductory billing event

• 1st residents’ Dine & Learn

• Dine & Learn: Musculoskeletal 2

JUNE

• Division’s physician practice survey rolls out

• Division participates in provincial Divisions of Family Practice Roundtable, Vancouver

• Division participates in Shared Care Committee retreat, Victoria

• Dine & Learn – Gynecology

• Division hosts adult mental health interdisciplinary providers’ roundtable

• Division board of directors strategic planning retreat

• Collaboration begins with Fraser Northwest Division to lead research on locum programming for the Provincial Recruitment and Retention Working Group

• A GP for Me billing session for MOAs

• Division begins working with Island Health to develop a South Island Crisis Clinic

SEPTEMBER

• 2nd annual VDFP community BBQ at Willow’s Beach

• Dine & Learn: Hematology

MARCH

• Division participates in planning Island Health’s Mental Health and Substance Use integration planning day

• Emergency preparedness working group meets to identify methods of supporting GP office/practice resiliency

• The Practice Coverage working group approves the Division’s draft recruitment, retention and practice coverage strategy

• Division and Island Health produce a redesigned referral form for adult mental health services

• Division endorses Island Health’s proposal to the Shared Care Committee for a collaborative Vancouver Island Service Plan for Children/Youth with Mental Health and Substance Use Issues

• Dine & Learn: Dermatology

APRIL

• Division hosts ‘meet and greet’ with candidates for board of directors election

• Online voting period for the directors’ election

• Dine & Learn: Residents & medical students

MAY

• 2nd AGM – Delta Victoria Ocean Pointe: Six new board members elected, presentations on physician health and wellness

JULY–AUGUST

• Division launches A GP for Me community development work, Phase One – Assessment & Planning

• Division launches Transitions in Care program


22

2013 ANNUAL REPORT

FINANCIAL REPORT

Apr 13 – Mar 14 Apr 12 – Mar 13

FUNDING SOURCES GPSC – Infrastructure $ 925,182.86 $ 622,586.40 Provincial Retention & Recruitment $ 46,116.54 $ — Transitions in Care $ 66,642.23 $ — A GP For Me $ 255,959.05 $ — Other funding $ 4,466.00 $ — Bank Interest $ 5,812.69 $ 662.70Total Funding Received $ 1,304,179.37 $ 623,249.10 EXPENDITURES Administration Administration Wage Expense $ 284,329.49 $ 135,868.81 Administration Office Expenses $ 32,996.49 $ 37,976.63 Total – Administration Expenses $ 317,325.98 $ 173,845.44 Working Groups, Projects and Events Physcian Member Payments $ 254,189.45 $ 163,866.63 Contractors $ 185,913.68 $ 17,710.75 Working Group / Project / Event Expenses $ 112,922.34 $ 86,911.07 Working Groups / Project / Event Travel Expenses $ 7,952.20 $ 1,655.15 Total – Working Groups, Projects and Events $ 560,977.67 $ 270,143.60 Board Costs Board Member Payments $ 178,874.78 $ 148,472.78 Board Travel $ 10,536.59 $ 10,457.19 Board Education / Training $ 5,403.60 $ 8,799.06 Board/Committee Meeting Costs $ 17,626.35 $ 11,003.78 Total – Board Costs $ 212,441.32 $ 178,732.81Total Expenditures $ 1,090,744.97 $ 622,721.85 FUNDING LEFT OVER AT FISCAL YEAR END $ 213,434.40 $ 527.25

Victoria

The Divisions of Family Practice Initiative is sponsored by the General Practice Services Committee, a joint committee of the BC Ministry of Health and Doctors of BC.

www.divisionsbc.ca/victoria


Contact information:PO Box 2588 Cowichan Bay, BC V0R [email protected]/victoria

BOARD OF DIRECTORS

Dr. Steve Goodchild — co-chairDr. Valerie Ehasoo — co-chairDr. David Harris — treasurerDr. Lorne Verhulst — secretaryDr. Ian BekkerDr. Aaron ChildsDr. Kathy DabrusDr. Katharine McKeenDr. Tejinder Sidhu

CORE OPERATIONAL TEAM

Alisa Harrison — executive directorCatriona Park — project coordinator and A GP for Me leadChristine Tomori — community engagement lead, A GP for MeKristin Atwood — project manager, Transitions in Care, and data analyst, A GP for MeNicole Dehoop — administrative assistantSarah Tudway-Cains — administrative assistantCindy Storie-Soth — bookkeeper

Photographs of the Victoria area courtesy of:Picture BC: front cover — Beacon Hill ParkHeather Armstrong Photography: mass working group meeting, Alisa Harrison headshotVictoria Division operational teamGraphic recordings by Get the Picture

Victoria Division of Family Practice. 2013 annual report

Documents

Transcript of Victoria Division of Family Practice. 2013 annual report