First Nations/Aboriginal/Métis

The First Nations Health Authority offers a variety of virtual health care services to First Nations people in BC who have limited access to health care services in their communities, who must travel long distances for appointments or whose access to health care has been disrupted by the COVID-19 pandemic. 

About these Serv​​ices

The FNHA works with health care professionals to ensure that services are aligned with the principles and practices of cultural safety and humility and trauma-informed care. The FNHA also actively recruits specialists with Indigenous ancestry.  

Maternity and Babies Advic​​e Line 

The Maternity and Babies Advice Line​ provides services to expectant mothers and new parents, guardians or caregivers of newborn babies in rural and remote First Nations communities in BC. Family members and healthcare providers can also receive support.

Mental Health Cou​​​nselling

First Nations Health Benefits provides coverage for clients to attend virtual and in-person counselling sessions. See Mental Health in Health Benefits (or view a list of approved mental health providers). 

Telehe​​alth

Your appointment with your doctor or specialist is done through video conferencing. You do not need to travel away from your home. See Telehealth.

Virtual Doctor of th​e Day

Doctors are on call seven days a week to provide medical advice, prescriptions and referrals. See Virtual Doctor of the Day.  

Virtual Substance Use & Ps​ychiatry Services

Specialists in addictions medicine and psychiatry are on call weekdays to support individuals and their family members with more complex mental health needs. The service requires a referral from a health care provider such as a doctor, nurse, mental health counsellor or traditional healer, or through the First Nations Virtual Doctor of the Day service. See Virtual Substance Use and Psychiatry Services

The British Columbia Patient-Centred Care Framework

[Excerpts]
INTRODUCION
Providing patient-centered care is the first of eight priorities for the B.C. health system as articulated the Ministry of Health’s strategic plan, Setting Priorities for the B.C. Health System (February 2014). Under the strategic plan, the province will strive to deliver health care as a service built around the individual, not the provider and administration. This is not an overnight change, but a promise of a sustained focus that will drive policy, service design, training, service delivery, and service accountability systems.

What is patient-centered care?
Patient-centered care puts patients at the forefront of their health and care, ensures they retain control over their own choices, helps them make informed decisions and supports a partnership between individuals, families, and health care services providers. Patient-centered care incorporates the following key components:
– self-management
– shared and informed decision-making
– an enhanced experience of health care
– improved information and understanding, and
– the advancement of prevention and health promotion activities

Patient-Centered Care Practices
Four patient-centered care practices are presented in this framework to help guide health care organizations in the pursuit of patient-centered care.
1. Organization Wide Engagement
Support for patient-centered care principles should be demonstrated by an organization’s leadership through both words and actions. At the same time, health care providers should demonstrate support for patient-centered care principles at the patient care level, pushing up in a true partnership with leadership.

To read more, click on:


Citizen-Patient-Community Participation in Health Care Planning….

To: British Columbia Ministry of Health & Health Authority Decision-Makers
From: Rural Evidence Review Project, Centre for Rural Health Research, UBC

BACKGROUND
The importance of involving patients in health care activities is widely recognized and prioritized through British Columbia’s Patient-Centred Care Framework. Although BC’s framework is focused on patient participation in their own care, the framework does not recognize the role for patients, family and caregivers to participate in quality improvement and health care redesign.

The challenge of citizen-patient-community (CPC) involvement in health care activities in British Columbia predates the Patient-Centred Care Framework and can be traced to the B.C. Royal Commission on Health Care and Costs (1991) (i.e., the Seaton report) which highlighted the importance to include CPCs in health system decision-making.

Despite multiple iterations of health care restructuring following the Commission, the vision of enhanced involvement in health care activites as articulated in the Seaton report remained into the early 2000s through CPC participatin on hospital boards. The disbandment of hospital boards in the 2000s alongside further health care restructuring that resulted in the current Regional Health Authorities, the Provincial Health Services Authority and what became the First Nations Health Authority, was met with the promise that the new structure would ensure local CPC engagement and involvement. There is a widespread agreement, however, that a robust replacement to local hospital boards has bot yet been achieved and consequently, CPC voices in health care activates have been diminished.

For Key Points from the Evidence, and Recommendations read the full report at:

https://med-fom-crhr.sites.olt.ubc.ca/files/2019/09/RER-Policy-Brief-Community-Health-Boards-September-2019-V2.pdf

Contracting-Out Care in Nursing Homes

Contracting-out care: The socio-spatial politics of nursing home care at the intersection of British Columbia’s labor, land, and capital markets

CS Ponder, Florida State University, USA
Andrew Longhurst, Canadian Centre for Policy Alternatives, Canada
Margaret McGregor, The University of British Columbia, Canada

First Published September 22, 2020 

[Abstract] The provincial health services labor market was fundamentally altered in 2002 with the introduction of a series of legislative and policy changes enabling the contracting-out, or subcontracting, of care workers in nursing home facilities in order to encourage private sector investment in nursing home infrastructure and provision. 

This legislation was intended to shrink provincial expenses and replace aging facilities through partnerships with the private sector that would keep debt off provincial books.

Through in-depth interviews with front-line workers and provincial and Health Authority administrators, this research foregrounds care as a political relationship by mapping how these legislative changes related to provincial budget concerns splintered a specialized labor market, eroding both working and caring conditions, and exposing eldercare in British Columbia, Canada to the speculative dynamics of finance.

https://journals.sagepub.com/doi/full/10.1177/2399654420960489

Priorities for BCRHN

With many thanks to Dr. Jude Kornelsen, Co-Director for the Centre for Rural Health Research at the University of British Columbia’s Department of Family Practice, Co-Principal Investigator of the Rural Maternity Care New Emerging Team and  assistant professor in the Department of Family Practice at the University of British Columbia.
June 5, 2020 

Hospital at Home program – Victoria

Cindy E. Harnett / Times Colonist
November 15, 2020

Dr. Shauna Tierney, left, and Dr. Elisabeth Crisci are the two medical leads for the Hospital at Home pilot program that is based at Victoria General Hospital, with plans to roll out province-wide next year. Story, page 2 DARREN STONE, TIMES COLONIST

[Excerpts} Dr. Elisabeth Crisci says when she first saw a man getting a blood transfusion in his living room as part of a home-based hospital-care program in Australia, she felt disoriented, but that quickly turned into a “lightbulb moment.”

Crisci is one of two physicians in charge of a new pilot program that launched with its first patient on Monday at Victoria General Hospital. It will allow eligible patients to receive treatment at home, rather than in hospital, with support from hospital-based doctors, acute-care registered nurses, and special equipment and technology.

The Hospital at Home program is based on similar programs in Australia and the United Kingdom.

“They’re in their own bed, they can eat their own food, and it just makes sense,” said Crisci, who saw the Hospital at Home model while training in Australia, where it is an established form of acute care. “I went into people’s homes and I saw patient after patient receiving the type of care that, here in Canada, we can only get when admitted to the hospital, and it was a true revelation.”

The voluntary program is targeted at acute-care patients who have been assessed by a doctor as being appropriate for the program, who have a caregiver at home, who require only a brief hospital stay, and who live within a short drive of the hospital. The catchment areas will vary from region to region. Only designated doctors will work in the program, which is billed as providing patients with in-person and virtual around-the-clock care.

In 2018, the B.C. Care Providers Association recommended the model to improve care for seniors, saying older adults with an acute illness would opt for “safe, high-quality, hospital-level care” in their homes rather than hospital, and similar programs have shown older acute-care patients cared for at home are less likely to experience clinical complications such as delirium and functional decline.

To access the full article, click on: https://www.timescolonist.com/news/local/creating-hospital-beds-out-of-thin-air-hospital-at-home-program-launches-in-victoria-1.24239644

Family Councils in Long Term Care

Family Councils in Long Term Care
Exploring the potential benefits and constraints of family councils in long-term care

BCCPA Newswire, Family Councilslong term careResidential CareSenior Care
Aug. 14, 2017 Our understanding of how care should be delivered to seniors depends greatly on applied research
Through research, we know that family plays an integral role in senior care. We also know how the involvement of individual family members can determine quality of life for residents in care.

What we need now is a greater understanding of how family councils function, and their impact on long-term residential care in B.C.

The role of family councils

Composed of family and friends of long-term care home residents, a family council meets regularly to identify and resolve issues affecting all residents, plan activities, and support each other. A family council must be organized, self-led, self-determining, and democratic.

Family councils typically work with a staff liaison appointed by the care home to assist the council.

Family councils aim to facilitate communication, and promote partnerships between staff, residents, as well as families of residents not actively involved in the council.

“Care providers work very closely each and every day with family councils and individual family members of residents in care facilities,” said Daniel Fontaine, CEO of the BC Care Providers Association.

“Family members play a very critical role in helping maintain and improve the quality of life of seniors living in a care setting. A fully functional and effective family council has proven to make a difference in the lives of many of B.C.’s senior population.”

Family councils in British Columbia

B.C.’s Residential Care Regulation supports family councils by stating that long-term care facilities must provide an opportunity for family members to form a council which promotes the individual and collective interests of residents in care, and involves them in decisions that affect their day-to-day.

Gerontological Education, Research and Outreach (GERO) at the UBC School of Nursing released a province-wide report on family councils in the province.

Out of the 222 long-term care sites surveyed across B.C., 151 had family councils. Most of these sites were privately-owned, and located in urban areas.

Facilities with successful family councils reported improved peer support, constructive attitudes, and learning opportunities at their sites.

The report also highlighted challenges to initiating and sustaining a family council, including a lack of interest, poor understanding of a family council’s purpose, and an inconsistency in family attendance.

Findings over the years

Previous research tackling the subject shows the benefits of family councils on long-term care significantly outweigh its drawbacks.

A 2007 study that set out to determine the presence, characteristics and impact of family councils on long-term care in U.S. found they “provide mutual support, empower its members, and advocate change to improve the residents’ quality of life.”

The study, published in the journal Geriatric Nursing, also mentioned family councils contribute to a culture of mutual respect within a long-term care facility.

One of the greatest challenges of maintaining an active council, researchers found, is the fluid nature of membership. Family members are busy with work and their personal lives. And when a resident in long-term care passes away, their family withdraws from the council in most cases.

The study called for increased efforts to identify the role of the facility in supporting family councils, and stated that the involvement of family councils has the potential to improve relationships between family, residents and staff, reduce and address complaints, and improve quality of life for seniors.

https://bccare.ca/2017/08/exploring-the-potential-benefits-and-constraints-of-family-councils-in-long-term-care/

Family Councils

Interested in starting a Family Council?
Find out how to Organize a Family Council, Learn about the Guiding Principles, Communicate Information About the Resident and/or Family Council and much more, by downloading the guide.

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Family and Residence Councils

https://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care/accountability/family-and-resident-councils

A family and/or resident council is a group of persons who either live in a residential care facility or are the contact person, representative or relatives of care facility residents, and who meet regularly for a common purpose related to the care facility. A family and/or resident  council is also self-led, self-determining and democratic. Councils exist to engage the resident community in collaborative activities which will advance the quality of life for residents

A staff liaison from the residential care facility may be appointed to support and facilitate the council.

One of the key roles that a family and/or resident council can play is to promote improved communication and collaboration between family members and facility staff, and management.  This may involve working collaboratively on projects that enrich the lives of persons in care, making recommendations to decision makers, communicating common concerns and ideas for improvements.

This website will:

– Orient you to what a council might look like
– Provide some tips on starting and maintaining a council
– Outline how the Residential Care Regulation supports councils
– Facilitate understanding of residential care services and standards

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Drug Delivery by Drone

By Simon Little  Global News
Posted August 29, 2019 

Drug delivery by drone?

No, it’s not the latest strategy from 21st-century drug dealers but, rather, the possible future for Canadians who live in remote areas and require medication.

Earlier this month, Canada Post, London Drugs and InDro Robotics successfully flew pharmaceuticals by drone from Vancouver Island to multiple locations on Salt Spring Island as a part of a test program.

The trial — in which the drugs were flown six kilometres over the Pacific Ocean in 11 minutes from Duncan on Vancouver Island to Salt Spring Island — is the first time medication has been delivered beyond visual line of sight (BVLOS) by drone in Canada, according to the companies involved.

Youth Poverty Solutions

Community: Powell River

Overview:
Community works together to have grassroots conversations around youth poverty and what can be done to solve important issues.

“The other challenge that we have is around child/youth mental health, youth poverty, youth that are hungry.

In November, the child youth advocate of BC released a report that was talking about (youth poverty), and it’s called Time to Listen.

I read the report and I wanted to know, what learning can we have from that report for Powell River and I just brought together a few VCH, employees that are working with that population and it started to raise a lot of questions about what’s happening here so, they said, well, we need to bring other people (in) so that small group of conversation has become quite large and now we have Tla’min, we’ve got physicians, we’ve got the school district, we have MCFD (Ministry of Children and Family Development).

We’ve been looking at population health around child/youth mental health, substance use, and we’ve discovered a few things that, that we want to, learn from the youth that are drinking quite young, violence with youth, and, the drinking, the using of drugs, a lot of marijuana.

So now we are working with the division that maybe will have some project management and shared care project to help us shape where we want to go.

So, this is the type of work that really excites me because it comes from the grassroots conversations, it brings many partners and we are determined to focus on solving some, important issues.”

To find a contact, visit the https://ruralsitevisits.rccbc.ca/innovation/youth-poverty-solutions/ page