Welcome to our new member

Welcome

A warm welcome to the newest member of the BC Rural Health Network:
East Shore Kootenay Lake Community Health Society.

ESKLCHS represents the following communities:
Riondel, Crawford Bay, Kootenay Bay, Gray Creek, Boswell, Sanca, and Twin Bays

To read more, please use the pull down Member Communities button.

Seniors Advocate – Residential Care Survey

To access the full report, click on https://www.seniorsadvocatebc.ca/osa-reports/residential-care-survey/

September 15, 2017

Seniors Advocate Isobel Mackenzie today released results of the Office of the Seniors Advocate’s landmark survey of people living in B.C.’s residential care facilities.

This is the most extensive survey of its kind ever conducted in Canada, targeting over 22,000 individuals in 292 residential care facilities.

“This project was a monumental undertaking and I am so very grateful to all of those who supported our efforts to ensure the voices of such an important part of our population in the province are heard,” said Mackenzie, adding the survey relied on the assistance of over 800 trained volunteers who donated 25,000 hours of their time to conduct in-person interviews with seniors. Residents’ most frequent visitors, usually a family member, were also mailed surveys.

Key positive responses from the survey include:

  • 50% of residents rated the overall quality of the care home as very good or excellent with 83% of residents believing the staff know what they are doing
  • 88% of family members report being involved in decisions about the care of their loved one
  • 80% of residents indicate they get the services they need
  • 65% of family members rated the facility 8 or higher when 10 was the highest possible score
  • 88% feel safe in the care home
  • 86% of residents feel staff treat them with respect
  • 88% of family members or most frequent visitors report that facility staff addresses their concerns always or most of the time

Key areas where residents and families said improvements are needed include:

  • 62% of residents say they do not get to bathe or shower as often as they want
  • One in four residents say they sometimes, rarely or never get help to the toilet when needed and 25% of residents report staff try to relieve physical discomfort sometimes, rarely or never
  • More than one-third of residents report they are not consistently getting the help they need at mealtimes
  • Almost 46% of residents report there is no one living in the facility that they consider a close friend and 45% report there is no one for them to do things with
  • Less than half (46%) of residents say staff regularly make time for friendly conversation
  • 49% of residents only sometimes, rarely or never have the same care aide on most weekdays
  • 4 out of 10 residents living in residential care do not want to be there
  • Only 57% of residents report that the care facility regularly feels like home

The Seniors Advocate has made a number of recommendations on the basis of the findings from this survey, including:

  • Increase flexibility around when and how care, services and activities are delivered
  • Foster greater engagement with family members
  • Examine opportunities to improve the meal time experience

“This report is not the “voice” but the “voices” of residential care as the diversity of opinions is apparent in the results. Together, these voices are telling us that our residential care system has some good aspects—even very good for some—but, taken as a whole, we need to do better and, in some cases, much better. You will read in the report of residents who are waiting too long to get the help they need, who are frustrated by the rigidity of fixed schedules and who want to have more to do and people they can talk to,” said Mackenzie.

Seniors Advocate – Quick Facts Report 2018

https://www.seniorsadvocatebc.ca/osa-reports/british-columbia-residential-care-facilities-quick-facts-directory-2018/

The British Columbia Residential Care Facilities Quick Facts Directory lists information for 293 publicly subsidized facilities in British Columbia. On January 31, 2018, we published our third annual Residential Care Facilities Quick Facts Directory. Highlights of new content include:

  • facility-level results from OSA’s Residential Care Survey
  • information on funded food costs
  • a broad range of demographic, care quality/service and facility information

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East Shore Kootenay Lake

East Shore Kootenay Lake Community Health Society (ESKLCHS)

Linda Cassidy – President  casss3@telus.net  250-223-8341 
Peggy Skelton – Vice President  skelton.peggy@gmail.com 250-227-2262  
Tom Wishart – Treasurer      tom.wishart@usask.ca       250-223-8455
Margaret Crossley – Secretary      mfocrossley@gmail.com    250-223-8455

ESKLCHS was created almost 30 years to support a private medical clinic in Riondel.  Following the closure of that clinic and the creation of an Interior Health Medical Clinic in Crawford Bay, the Society morphed into a community Health organization with the objective of supporting healthy living of East Shore residents along South Kooteneay Lake—which had become, in the main, a collection of retirement communities spread along approximately 70 kilometres of the lake.  In addition to aiding the Crawford Bay Medical Clinic, ESKLCHS has worked to establish a local Better at Home program, fostered intergenerational developments, and offers Focus On Health workshops in Boswell which promote disease prevention and health promotion.

ESKLCHS represents  the following communities:
Riondel, Crawford Bay, Kootenay Bay, Gray Creek, Boswell, Sanca, Sirdar, Kuskanook, Twin Bays

Perry Kendall: Free up money to solve doctor shortage

 

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PERRY R.W. KENDALL

AUGUST 1, 2018 12:15 AM

Re: “Weighing the value of family physicians,” comment, July 29.

Although I suggest that Dr. Chris Pengilly’s description that family physicians are paid a gross fee to provide medical care is perhaps not the best way to characterize the dominant fee-for-service model, I agree wholeheartedly with his critique of this payment mechanism as a highly inefficient way of delivering care to individuals with multiple complex chronic health conditions.

We have known for 20 to 30 years that complex primary care is delivered more effectively, and more efficaciously, with more satisfied patients and more satisfied physicians, through team-based group practices with allied and complementary health-care professionals and appropriate practice supports.

In B.C., we are facing the prospect of significant numbers of family practitioners entering the retirement-aged cohort. Pengilly is one such. The outcome will likely be even more British Columbians who are unable to find a primary-care attachment.

We also see that these retiring physicians are unable to sell their practices and recruit successors. As Pengilly notes, most newly graduating family-medicine specialists do not, on the whole, wish to be small-business owners. They would prefer alternative ways of being remunerated; they would also prefer to work in team-based practices.

I also agree that the Doctors of B.C. (formerly the B.C. Medical Association) needs a fundamental change of heart.

While being engaged with government in attempts to reform primary care and meet population health needs, they are still, as Pengilly notes, wedded to the fee-for-service payment model, which rewards piecework and impedes appropriate complex chronic care.

I therefore propose a modest solution to assist in the long-delayed transition to full-service primary care. A solution in which no physician is forced into a payment system that she or he might find distasteful, that rewards anticipatory team-based care for individuals with chronic care needs and that optimizes the skill sets of other health-care professionals.

Government and the Doctors of B.C. should get together to agree that the fee-for-service dollars that are “freed up” as older family practitioners retire should be “retired” from the fee-for-service “pot” and redirected to a variety of alternative payment plans that can be used to support new family-practice specialist graduates and ancillary health-care professionals entering the primary-care arena.

This reallocation could be close to cost-neutral for government, be politically acceptable to the body that represents physicians, be better for British Columbians and, as Pengilly suggests, “the productivity should increase enough to ameliorate or even obviate the family-physician shortage.”

Dr. Perry R.W. Kendall served as B.C.’s provincial health officer.

 

Chris Pengilly: Let’s declare a family-practice emergency

 

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SEPTEMBER 28, 2017 12:27 AM

I read with interest the op-ed from Joanne Hamilton concerning her parents who are now “orphan patients.” The responses from Vanessa Hammond and Dr. Robin Saunders suggest solutions that offer a realistic and optimistic future. (“Physician shortage is now a crisis situation,” comment, Aug. 31; “Physician shortage doesn’t have to be a crisis,” comment, Sept. 5; “Victoria’s doctors strive to improve patient care,” comment, Sept. 19.)

The declaration of an “opioid emergency” enabled expedited remedial measures to be put into place. I suggest that a “family practice emergency” should be declared to enable similar accelerated interventions. The ideas of the Victoria Health Co-Op are very welcome, but will take time to institute. One of my late mother’s favourite expressions was: “While the grass is growing, the horse is starving.”

I am particularly sensitive to the subject of orphan patients at the moment because I retired from family practice early in 2015. After great difficulty, I found a physician to continue the care of my patients, but because of a serious medical condition she was unable to continue.

She and I spent a long time trying to find physicians in the community to undertake the care of her sickest patients.

Unfortunately, family practice and/or Victoria were insufficient to retain one young female physician who had adopted several of my orphans, so they are re-orphaned.

One patient is a young woman who is wheelchair-bound with cerebral palsy. She does not let this hold her back in any way. She has a full-time job and is mother to two little girls whom she and her husband care for completely. She lives a full and active life, contributing to her community in many aspects.

She is diligent in maintaining her strength and health through regular exercise and physical therapy. Still, she is in desperate need of a family physician to assess and co-ordinate her multiple needs, which is essential to her ongoing quality of life.

The other patient who worries me is a youngster of about five years old who has a cancer of the kidney. This was detected early and he is doing well. He requires the sort of care that cannot be delivered in a fragmented form, as in an urgent-care clinic. Currently, he is being followed by a pediatrician, but this is not the appropriate role for that specialist, who then is delayed from seeing more urgent new referrals.

I have approached several colleagues asking them to adopt these patients, but they really are full. They think, quite appropriately, it would be unsafe to take on more than their current patient (over)load.

I have already called in so many favours around town that my credence is exhausted.

We are not going to be able to get more physicians any time soon. It will take many years to graduate a significant number of practice-ready doctors.

What we need to do now is to make the current physicians more productive, and less burdened by unnecessary paperwork and bureaucracy — until the community health centres are up and going.

These suggestions could begin to be effective by the end of this year:

• Provide each physician with a typist service, as has long been provided to hospital physicians.

• Compensate family physicians a quarter of an office-visit fee for the responsibility and time involved in repeating prescriptions of their own patients; these are more safely prescribed by the family physician who has access to the medical record, and not infrequently the patient might not need to come to the office.

• Encourage physicians to form groups of four or more doctors (which are proven to be more effective and more efficient) by offering a one-time grant to cover the cost of amalgamating and moving offices.

• Integrate and co-ordinate public-health nurses to work in close liaison within group practices.

• Eliminate, or at least simplify, the form-filling needed for a patient to access “special authority drugs.”

It will not be cheap — but it will be less expensive than graduating more and more physicians who might even then fail to embrace family practice. Most family physicians want to reduce the number of “orphans,” and they can do it if bureaucratic barriers are smoothed out, and out-of-date patterns of practice and remuneration are energetically reviewed.

Chris Pengilly, formerly of Tuscany Medical Clinic, is a part-time family physician.

https://www.timescolonist.com/opinion/columnists/chris-pengilly-let-s-declare-a-family-practice-emergency-1.23047980