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Health Innovation Award for Patient-Centred Care – Northern Health Region

Northern Health Region 2019 Award Winners

Hope North Recovery Centre for Youth – Thompson

The Hope North Recovery Centre for Youth is a mobile crisis team, crisis stabilization unit and youth substance stabilization unit located in Thompson. In 2016, Hope North began piloting the implementation of a Protocol for the Assessment and Discharge of Suicidal Children and Youth. The goals of this protocol were to reduce youth suicide attempts and death, facilitate the coordination of services between health settings and encourage meaningful involvement of the youth and their caregiver(s) in safety and wellness planning. The results have been impressive; when surveyed, 96 per cent of youth felt welcomed at Hope North and 80 per cent of youth felt Hope North services were right for them. In addition, youth increased their knowledge about places to go for help, and who to call in a crisis. This increased their feelings of hope for the future. Caregivers also increased their capacity to manage a crisis.

As this project is a Province of Manitoba funded initiative with the Northern Health Region, (in particular the Hope North Recovery Centre for Youth and the Discharge Project team), the plan is to roll out the protocols provincially with evidence to support the efficacy of these initiatives. Work is currently being done with Healthy Child Manitoba and Province of Manitoba to make this happen.

Needs Based, Preference Informed Scheduling – Thompson Primary Care Clinic

To improve access to care, continuity and quality of care, client experience and provider satisfaction/retention, the Thompson Primary Care Clinic has developed and implemented a needs-based, preference-informed scheduling process. This process is a proactive scheduling approach that has not only reduced chaotic scheduling practices and related impacts to access and client experience (i.e. canceled appointments) but has also improved the engagement and retention of primary care providers by incorporating, where possible, the individual preferences of physician and nurse practitioners.

Notable outcomes include the reduction of overall client complaints related to access, a significant reduction in the number of rescheduled appointments related to scheduling, a reduction in physician sick time and travel refusals, and an overall improvement in provider engagement.

This initiative has provided us with many lessons about developing processes to meet operational needs while still balancing the needs of providers/staff.

The engagement framework pilot developed as a byproduct of this process also has the potential to deepen the understanding of meaningful engagement through evaluation of engagement activities.

Primary Care in Long Term Care and Home Care

This initiative established a Nurse Practitioner (NP) position to become a part of the Primary Care Program to provide services within personal care homes and the home care program in Flin Flon. This service allowed same day access to primary care, as well as comprehensive clinical assessments, medication reviews, home visits, and resulted in a high level of engagement with patients and families. The patients received care from a dedicated NP in their homes/place of residence or in a dedicated space within Home Care. Truly an example of right care, right place, right provider.

Benefits include reduced patient falls and lower pharmaceutical costs. Primary care visits of the elderly to the Flin Flon Clinic have also greatly reduced as they receive their primary care through this initiative, which has increased community access to the Flin Flon Clinic.

Northern Health Region 2019 Award Nominees

Northern Patient Transportation Program– Regional

The hiring of a Patient Care Coordinator for the Northern Patient Transportation Program (NPTP) in July 2017 was a response to the increased need and expense of travel for appointments with specialists. It was felt that some patients could be seen locally and that more of the care could be coordinated with better selection of travel mode. This practice would not only save expenses but improve access to care. The challenges with generalist to specialist referral are compounded in the North given our geography, physician turnover and service gaps. Overcoming these growing issues would require NPTP to improve customer service, review provider and patient concerns and adapt to the modern expectation levels for care.

The physicians and the program had a common interest in improving the number of patients seen locally. A gap found that medical services did not have a Service Menu that could be updated and utilized as a source of what each provider offered. NPTP created this document with the participation of 25 service providers that details what they regularly see, occasionally see or never see. This document will be updated twice a year and serve as a catalogue guide.

The improved engagement with physicians by participating in the Service Menu development is a major success. The enthusiasm that this document would improve communication and reduce a barrier to referrals has led to more contact, so patients are better served. It is anticipated that the Service Menu will assist planning and recruitment, complement medical knowledge of local options and reduce the complexity of orientation for new physicians to their colleague’s expertise.

Final Product Verification for Pharmacy Technicians

With recent changes to the regulations of pharmacy technicians in Manitoba, the Northern Health Region has implemented a “Final Product Verification for Pharmacy Technicians” program. This program has increased the patient’s access to their medications by allowing pharmacy technicians to verify the final product/medications to be dispensed to nursing staff. This program alleviates the workload of the pharmacist, increasing the quality of care the pharmacist can provide when reviewing medication orders. Similarly, this allows the pharmacist more time to engage with patients and other health-care providers to provide education on specific areas such as diabetes counselling, and pain and symptom management among palliative patients.

The result of the initiative has led to an increase in clinical pharmacy services to include a pharmacist-driven comprehensive medication reconciliation review to limit the number of medication errors made upon admissions, transfers, and discharges. This has led to a decrease in medication errors made by pharmacy and nursing staff, and a decrease in the number of calls received from community pharmacies regarding errors on discharge prescriptions. This initiative has allowed the pharmacist in The Pas to engage in a more comprehensive role to reviewing the evidence-based medicine and has led to an increase in the development of different preprinted order sets in Northern Region Health via the Pharmacy and Therapeutics Committee.

This initiative has led Northern Region Health to increase the roll-out and implementation of the best evidence-based medicine to patients and care providers in our region.

Virtual Health Information Management

In 2018 a regional process was developed between The Pas, Flin Flon, Snow Lake and Thompson clinics to utilize the shared instance of EMR to maximize the capacity and scope of the health records staff to ensure client information requests are managed in an appropriate and timely manner. As a result of vacancies in both Flin Flon and The Pas, client requests were occasionally delayed, and in some situations, incorrect information was being provided for more complex requests.

This initiative was in response to significant recruitment challenges and the recognized need for the expertise/support of health information management practitioners in client information releases. This initiative has improved the timeliness and quality of information releases regionally, has demonstrated cost savings by maximizing existing capacity, and has demonstrated the ability to virtually manage client care needs.

The outcome of this initiative was improved quality of care for clients related to requests for information release despite a reduction in capacity. In addition, the initiative created a collaborative process to guide clear expectations, communication and outcomes that will support the sustainability of the tool.

This initiative has also created the foundation to further explore virtual service delivery opportunities.

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