Thousands of People Benefitting from Improvements in Primary Care Practices
Champlain Family Doctors & Nurse Practitioners Advancing Quality & Efficiency
March 29, 2016 - A new quality-improvement program spearheaded by the Champlain LHIN has cut down on the amount of time people spend waiting to see their family doctor or nurse practitioner. This innovative approach also helps more people get screened for diseases like cancer, and provides them with more support for chronic conditions like diabetes.
The Champlain Primary Care Quality Practice Facilitation Program – “Practice Excellence” for short - has been underway in the region since early 2014. The Champlain LHIN funds this three-year pilot project as part of its commitment to building a strong foundation of primary, home and community care. It is hosted out of Pinecrest-Queensway Community Health Centre.
WATCH - video clip - Wanda MacDonald
Dr. Elizabeth Brown, a family doctor at the Westend Family Care Clinic in Kanata, participated in the program last year. Now her patients get an appointment on the day of their choosing, often on the same day they call. Previously, there could be an 11-day wait for a non-urgent visit.
Dr. Brown accomplished this largely by changing her appointment approach from blocked (time saved specifically for physicals, well-baby, urgent visits, etc.) to open (depending on patient preference). She also worked on office efficiency, including having a printer installed in each exam room. This means she no longer loses appointment time walking to and from the main printer down the hall to retrieve her patients’ prescriptions and other printed materials.
WATCH - video clip - Elizabeth Brown
“What I learned is it isn’t really about working harder, it’s about working a lot smarter,“ said Dr. Brown. “I thought I was doing appointments really well, but I’ve made it easier for everyone. Now patients phone in and get an appointment whenever they want it, so they are a lot happier.”
Dr. Brown’s time commitment in the Practice Excellence program was about 2-3 hours weekly. “I spent less time doing it than I thought I would. It was a fun thing to do; it didn’t feel intrusive. Our facilitator took us through a step at a time, so she didn’t overwhelm us.”
Patients were also engaged in the Practice Excellence program, ensuring the voices of users were heard. To date, 40 family physicians and nurse practitioners have participated in the program to make improvements in their health clinics or centres. The number of people receiving care from these practices totals nearly 30,000 in the region – meaning these improvements are positively affecting patients personally, as well as the health system.
WATCH - video clip - Bernice Latrielle
An experienced Practice Excellence facilitator works with primary care providers (at no cost to them) to improve an area of their choosing. These areas may include patient access to appointments, preventive screening, and implementing emerging best-practices for chronic conditions. Data from the practice is gathered to inform the work. The duration of the program varies from 6 – 18 months, depending upon the needs of the practice and the improvement focus.
Liz Jackson, one of three Practice Excellence facilitators, explains: “We have some standard methods, principles and tools that we will bring to any situation, but it’s really about working with the team very carefully to understand the particular context, and then tailor the approach - and the changes that they might make to drive the improvement - so that we know it really will fit their setting.”
WATCH - video clip - Liz Jackson
The program also helped create a better experience for clients at Ottawa Public Health’s Sexual Health Clinic. Barbara Campbell, nurse practitioner and clinic director, explained that their walk-in clinic model is a “one-stop shop” for clients who often need more than one of their services that include assessment, testing, counselling, treatment, and/or medication. The aim is to ensure good client flow, minimizing clients’ wait between services. This led Ms. Campbell to participate in the Practice Excellence program.
The clinic’s quality improvement team of six included doctors, nurse practitioners, and public health nurses. They also engaged clients to help staff identify how long they were waiting, and where delays might be occurring between services. The Practice Excellence facilitator guided the team through a process where they developed solutions to reduce client wait time between services, like building flexibility around which staff are able to complete specific tasks with clients, and reorganizing staff at busier times of the day.
“We’ve been able to reduce the service time by about half with many of our client encounters,” Ms Campbell said. For example, many clients now wait 10 minutes or less between services, down from 20 minutes or more.
“When primary care is strong, the entire health system works better. This is why we are supporting this innovative program, and why we hope more family doctors and nurse practitioners take advantage of it,” said Chantale LeClerc, Champlain LHIN CEO.
WATCH - video clip - Chantale LeClerc
She added, “We’ll be evaluating what impact this initiative is having, both at the practice level, but also trying to look at ‘is it having an impact on the system?’ Then we will be in a position to determine whether this is something that we will want to continue, or whether we will want to grow these services across our region.”
Ottawa West-Nepean MPP Bob Chiarelli had positive things to say about the Practice Excellence program. “The system benefits when practitioners take an active role in creating efficiency that benefit both the patient and the system. The Champlain LHIN and Pinecrest-Queensway Community Health Centre are to be commended,” he said.
To learn more about the program, including how to participate, please visit the Champlain Primary Care Quality Practice Facilitation Program web page.