South Okanagan Similkameen

Child and Youth Mental Health Collaborative

South Okanagan Similkameen

Local Action Teams

Local Action Teams (LATs) are a key component in the structure of the Child and Youth Mental Health and Substance Use (CYMHSU) Collaborative. They provide the foundation for improving timely access to support and services for local children, youth and families experiencing mental health and substance use challenges.

Teams are comprised of a diverse cross-section of mental health and substance-use service providers, stakeholders, and youth and families from the local community.

How it works

Each Local Action team commits to tackling one or two key objectives within a particular timeframe to address barriers in their community. A Collaborative Coach supports the team to help them successfully achieve their goals and measure their outcomes.

Click the link below to see details of who’s involved in your community, their improvement objectives, and how they’re planning to measure success.

South Okanagan Similkameen Local Action Team

 

Transitions in Care Initiative

South Okanagan Similkameen

Acute Exacerbation of COPD Acute Pathway

An interdisciplinary team came together to focus on acute exacerbation of COPD (AECOPD) patients in hospital and their optimal transition back to the community. It soon became apparent that the best way to facilitate the transition was to provide the patient with quality in-hospital and community education and support.

Together the team identified gaps in care and then used a quality improvement model to develop, test and implement solutions based on clinical best practice.

An AECOPD acute pathway was developed to standardize best practices in the hospital and connect patients to support and education in the community. It is based on an optimal COPD model of care.

Early results indicate this model of care is having a positive effect – with a 32% reduction in COPD admissions in the South Okanagan in the past three years.

Primary Maternity Care

Primary maternity care in the South Okanagan Similkameen is provided by a combination of obstetricians, family physicians, midwives and paediatricians.

In the past few years, birth numbers in the region have declined at the same time that midwife capacity has increased. This has resulted in a decreased caseload for family physicians working in the primary maternity clinic at Penticton hospital and threatens the long-term sustainability of the clinic. Family physicians are a critical component of primary maternity care in the South Okanagan Similkameen.

The project brings together the four care provider groups and Interior Health staff to find ways of working together that allow each provider group to maintain a sustainable practice.

ON TRAC Youth Transitions

Youth with chronic complex health conditions and disabilities are often referred to BC Children’s Hospital for treatment. During that time, youth often have little connection to local physicians.

At age 18, youth are expected to transition to adult care, usually with a family physician and specialist(s) in their local area. The ON TRAC youth transition project is designed to identify local transition issues and improve this transition for youth and their families.

Emergency Department Transitions

Emergency and family physicians have engaged in ongoing dialogue about patient transitions to and from emergency. Information transfer, appropriateness of emergency use, and patient transitions are all issues identified as having potential for improvement. This project is scheduled to start late in 2014. A multidisciplinary team will be engaged to identify the scope of the project and develop improvements.

 

Polypharmacy Initiative

South Okanagan Similkameen

South Okanagan Similkameen physicians have been engaged in Polypharmacy Risk Reduction and have been provided with tools and resources to support meaningful medication reviews within the context of the GPSC Residential Care Initiative. 

South Okanagan Similkameen has Polypharmacy Risk Reduction physician mentors who are skilled in mentoring their physician colleagues in meaningful medication reviews in residential care. 

Family and Specialist physicians in the South Okanagan Similkameen are working with pharmacists and Health Authorities to embed meaningful medication reviews in acute care and developing processing for communicating with community care providers.  

 

Partners in Care Initiative

South Similkameen

Princeton Access to Specialist Care
Princeton is a small rural community located 115 km west of Penticton. With a population of just over 5000, the community has a three family physicians and a nurse practitioner. Like other isolated communities, the town struggles with doctor recruitment, retention and access to specialists.

In an effort to support family physicians(FPs) and to provide better access for Princeton patients, a Shared Care project was initiated in the Fall of 2013. Penticton specialists started holding outreach clinics in Princeton, eliminating some patient travel and providing family physicians with lunchtime CME learning opportunities.

The first phase of the project is focused on outreach clinics and supporting Princeton physicians. The second phase of the project, to start early in 2015, will focus on efficiencies for patients when they travel to Penticton for appointments and tests.

Palliative – Oncology Improvements
The palliative care program in Penticton includes many patients who are also undergoing active oncology treatment. Better communication processes among palliative and oncology staff, and family physicians improve patient care and reduce duplication of services. A small working group was established in the Fall of 2012 to identify, develop and implement process improvements.

The group is currently investigating the feasibility of a half-day palliative symptom management clinic staffed by a palliative doctor to develop detailed patient care plans. The goals of the clinic are to improve patient care, increase family physician knowledge around palliative care, and reduce reliance on the emergency department for symptom management.

Advanced Care Planning
In the South Okanagan Similkameen there is increasing discussion and awareness about the importance of early advanced care planning. Local specialists and family physicians have started to engage around how to increase the number of patients with an advanced care plan, who should take the lead on initiating advanced care planning, and how to share plans among care providers.

This project is in an early stage of identifying issues.

Diagnostic Imaging Improvements
South Okanagan Similkameen physicians are interested in adapting newly created Central Okanagan diagnostic imaging tools and processes.  Several physicians have seen the improvements that come from using the Diagnostic Imaging form developed by the Central Okanagan Shared Care Diagnostic Imaging Project and have asked that it be spread in our region.

The Central Okanagan project resulted in reduced wait times for family physicians to contact radiologists; reduced wait times for patients requiring urgent imaging, and increased family physician satisfaction.