Victoria Division of Family Practice. 2014 annual report

Victoria

2014–15 ANNUAL REPORT

Report from the Co-chairs 4

Report from the Executive Director 6

Division Initiatives and Projects 8

Mission Statement and Purpose 18

Division Structure and Governance 19

Participation and Engagement 20

Financial Statement 24

Contents

Victoria Division of Family Practice 2014–15 Annual Report

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Report from the Co-chairs

T he past year has been an exciting one, as the Victoria Division of Family Practice continued to grow and reach

important milestones. The Victoria Division now counts 375 family physician members and 15 residents in its base. Members are engaged and active, with nearly one quarter participating in working groups and committees, and well over half attending events. You, the members, report that you benefit from opportunities the division offers, such as networking and connecting with colleagues, enjoying excellent local CME, finding support for your practice, and being part of efforts to re-design the health system. Along with the rest of your board of directors, we are proud to help guide an organization that brings value to our community and promotes excellence in local primary care.

Our members and our board have worked side by side with partners in the community—particularly other divisions and Island Health—to develop a range of programs and initiatives. Highlights from this year include the launch of four A GP for Me strategies designed to maximize patient access to longitudinal primary care: practice support, recruitment and retention, support of frail seniors, and support for patient matching. Our TORCH prototype will improve primary care in residential facilities, and our work in the community will increase quality of care for frail seniors. Our recruitment and retention strategy will encourage physicians to practice in our region and ensure physicians have coverage when they need time off. Our Transitions in Care program is improving communications with our hospital colleagues and the acute care system. Our emergency response group is promoting practice resiliency in the event of a crisis. We have built strategies to address the needs of both children and adults with mental health and substance use challenges.

Since our inception three years ago, your board and members remain as committed as ever to improving primary care and making Victoria “a great place to be a GP.” We believe that our physician colleagues are leaders in the province for developing and sharing our innovative prototypes and projects.

The board thanks you for your ongoing commitment, and invites you to participate at all levels of the Division’s work. In addition to regular calls for participation in committees and working groups and invitations to events, members are asked annually to run for the board of directors. A healthy succession of new directors to the board is essential in order to ensure that the board represents the community and that ideas remain fresh and directors energetic. To this end, we invite any member to attend a board meeting as a guest in order to learn about what we do and see if you would like to be involved—all you need to do is contact our office to set this up.

The Victoria Division board prioritizes open communication with members and partners. The work we do is truly collaborative: we need to combine many people’s insights and efforts if we are to

Dr. Steve Goodchild, co-chair

Dr. Katharine McKeen, co-chair

Members have built this organization—we want

you to feel welcome and we encourage you to share your

feedback and guidance.


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Celebration, left to right: Dr. David Harris, Dr. Tejinder Sidhu, Dr. Steve Goodchild

make critical systemic change. We make every effort to keep you informed about the division’s progress. At the same time, with a large and diverse community, it is sometimes challenging to speak in a way that resonates with everyone, and we welcome your comments on how we can improve how we listen to you. Members have built this organization—we want you to feel welcome and we encourage you to share your feedback and guidance.

We have a dedicated team of nine board members who provide excellent oversight in the governance of the Division. This year is bittersweet as we welcome a new director, Dr. Martha Macdonnell, to the board and also say goodbye to Dr. Aaron Childs, one of our founders and an inaugural co-chair. Aaron has played a crucial role in the Division’s work since incorporation in 2011. His good nature, sense of humour, and unwavering

determination to help his colleagues will be sorely missed at the board table.

Our operations team has grown this year to meet the ever-expanding demands of our initiatives. We are grateful to our executive director, Alisa Harrison, for continuing to lead a robust team that rises to new challenges with energy, creativity, and passion in building partnerships and programs to improve primary care in our community.

Your board and operations team know that the Victoria Division belongs to its members. We are stewards of your organization, and are here at your service. We look forward to another year of innovation and effort to improve the system of care, and to help you enjoy your work as GPs.

Dr. Steve Goodchild Dr. Katharine McKeen co-chairs


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Annual General Meeting, May 2014 (left: Dr. Daphne Fontaine)

Report from the Executive Director

Although our work has become increasingly broad and complex over the past year, the Victoria Division’s

primary goals are the same now as they were when we began operating in 2012. Mid-way through 2015, we can still say that nothing is more important than fostering a connected and resilient community of family physicians who support each other, and effect changes in the health system that enable doctors to enjoy fulfilling work and citizens to receive the best possible care. We do this by taking seriously our commitment to being responsible stewards of public resources who are accountable to both physicians and patients, and integrating evidence with experience so that we know the work we do is relevant, necessary, and effective.

Accountability and commitment to community are core values. Members have delegated responsibility for governance to a board of directors composed of colleagues who represent a cross-section of family practice—working in the community, facilities, walk-in-clinics, full-service and specialized practice, full- and part-time, in their own practices

and as locums—and members count on the day-to-day work of a skilled and committed operations team that is passionate about supporting physicians and improving the health system for everyone.

But leadership is bigger than that. Leadership in community comes from every physician who participates in a working group or committee, who champions a prototype or pilot project, who offers an idea for a change that might help a colleague or patient, who applies what

It is not an exaggeration to say that the Division’s members, including its governors, and

team, together with our partners across the community, are

co-creating the future of family practice, and influencing a new

direction for primary care.

Alisa Harrison, executive Director


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they learn at a CME event, who gives feedback so that the division can serve better, who keeps the faith that incremental change created together does make a difference and believes it is worth continuing to try.

It is not an exaggeration to say that the Division’s members, including its governors, and team, together with our partners across the community, are co-creating the future of family practice, and influencing a new direction for primary care. This annual report details some of the concrete strategies we have employed in the past year in order to do this. Family doctors in Victoria have led the implementation of new models of practice and new communications technologies, and are gradually removing barriers to critical health services. Although our work is still in its infancy, we pause for a moment to reflect and celebrate our achievements

thus far: we have yet to deliver on many of our most important priorities, yet the fact that we are still here together, asking hard questions, listening with humility to the answers, and taking the risk of trying ambitious potential solutions, is significant in itself.

Working together and building relation-ships within and beyond the health system is messy, complicated and slow. The division supports this painstaking work, and Victoria’s family physicians lead it by continuing to show up, to trust each other and partners despite challenges, and to demonstrate by example that a collective of committed individuals can change a seemingly intractable system.

Alisa Harrison executive director

Left to right: Dr. Elizabeth Grant, Dr. Martha Macdonnell


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Division Initiatives and Projects

This past year saw the Victoria Division of Family Practice begin to implement many initiatives and projects based on the work of member physicians and the operations team during 2012 and 13. Member engagement remained strong, with 22 per cent of members participating in ongoing working groups and/or committees, and 59 per cent overall attending Division events such as the AGM, billing sessions, the community barbecue, and Dine and Learns.

Community Building CommitteeThe Community Building Committee continued to organize popular events that brought members together for both social engagement and professional development.

Division members enjoyed the annual community barbecue at Willow’s Beach in the fall, as well as another year of local CME and opportunities to build relationships with family medicine and specialist colleagues. The Division’s monthly Dine & Learn events continued to be fully subscribed with sizeable waiting lists, featuring topics such as Emergency Medicine, Allergy and Immunology, Pediatrics, Cardiology, and more.

As part of its commitment to supporting physician health and wellness, the Division also launched an eight-week pilot in partnership with the BC Association for Living Mindfully (BCALM) to teach mindfulness skills to GPs.

Member engagement remained strong, with 22 per cent of members participating in

ongoing working groups and/or committees, and 59 per cent

overall attending Division events.

Community BBQ, September 2014


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A GP for Me Phase One: Assessment and PlanningThe Division completed the local assessment and planning phase of the provincial A GP for Me initiative in October 2014, and has since been working to implement the strategies that members developed to address the challenge of patient-GP attachment in Victoria.

The assessment and planning phase (November 2013 through October 2014) took direction from the findings of the working groups the Division had established in 2012, and then further engaged physicians, community partners, and other stakeholders to understand local needs more deeply. To this end, in addition to scanning research literature and examining the results of the previous year’s member survey, we held a variety of focus groups, and conducted several joint planning sessions with Island Health and targeted non-governmental organizations serving vulnerable populations such as frail

seniors and people living with mental health and substance use challenges.

Assessment and planning also included an exploratory Practice Coverage Pilot with locums.ca, which helped to inform the Division about the tools and supports that members and physicians need to ensure they have appropriate practice coverage.

Dr. Mark Sherman presenting on mindfulness at the 2014 AGM.

The Division has been working to implement the strategies that members developed to

address the challenge of patient-GP attachment in Victoria.


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Division Initiatives and Projects cont’d

A GP for Me Phase Two: ImplementationThe Division launched Phase Two of A GP for Me in December 2014, after receiving the General Practice Services Committee’s approval of four evidence-based strategies resulting from the assessment and planning process:

1. Supporting practices to take on new patients.

2. Coordinating recruitment and retention of family physicians.

3. Supporting frail seniors.

4. Matching patients and family physicians.

These four implementation strategies are a natural and welcome extension of the Division’s core work, and designed to work together to address Victoria’s capacity and attachment issues. They align with the provincial A GP for Me goals, and reflect the vision, mission and values of the Victoria Division of Family Practice. Each strategy has an advisory committee that guides the work, which is composed primarily of family physicians and includes community stakeholders and partners as appropriate.

A GP for Me implementation plan


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Practice Support

The practice support strategy is intended to help physicians address factors that make their practices difficult to manage and reduce their efficiency. Physician members and the operations team developed this strategy collaboratively with represent-atives from the South Island Division of Family Practice (SIDFP), Island Health Regional Support Team (RST), and Practice Support Program-Technology Group (PSP-TG). In February, we worked together on an MOA Breakout session at the RST Neurology Forum. That session introduced MOAs to a practice toolkit, and we have followed up with interested practices to assess their readiness to implement the toolkit and receive desired support.

As of this spring, the Practice Support Advisory Committee is well-established, with four community GPs and two MOAs, and it has finalized its strategic approach, timelines, and deliverables. Based on member feedback, we have developed a list of physicians who will receive in-practice support, and are beginning the first wave of visits. The MOA Network kick-off event was held at the end of May.

Recruitment and Retention

The Victoria Division has taken a coordinated local, regional, and provincial approach to addressing issues around recruitment, retention, and practice coverage. The Division has played an important role in developing a provincial recruitment and retention initiative, as well as a Vancouver Island recruitment and retention strategy, through which the eight Island divisions collaborate to attract family physicians to the region and then help them find the best fit among our various communities.

At the local level, with oversight from an advisory committee of member physicians, we are working hard to support physicians who have identified practice coverage as a top concern. Following our successful Practice Coverage Pilot in the fall and early winter of 2014, the Division hired a full-time practice coverage consultant to assist with matching locums and host physicians, and/or establishing cross-coverage arrangements. The consultant has continued to build on the pilot by helping members to implement contract templates and evaluation forms, supporting locums, and developing practice coverage policies and procedures.

In terms of recruitment and retention, the Division is building a stronger link with the Island Medical Program and Victoria residency program, and our practice coverage consultant is working directly with family practice residents to highlight opportunities that might help them stay and practice in Victoria. We have worked with physicians and partners to create a welcome package that shows why Victoria is a great place to live, work, and play, and we have continued to build our mentorship program, which offers peer support to physicians who are going through career transitions.

Welcome and Recruitment material

L I V EW RKP L AYVICTORIAWELCOMESVICTORIAWELCOMESNEW FAMILY PHYSICIANS

VICTORIAA GREAT PLACE TO BE A GP

INSET IMAGES COURTESY TOURISM VICTORIA2014 - 12 - NEW PHYSICIAN'S WELCOME RACK CARD.indd 1

20/01/2015 11:53 AM


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Supporting frail seniors

This strategy has two parts: Towards Optimal Residential Care Health (TORCH), which supports seniors living in residential care, and a pilot with Island Health to support seniors living in the community.

After over a year of rigorous research and planning, directed by a working group of family physicians and in partnership with Island Health, the Division built and launched the TORCH prototype at four residential care facilities in Victoria. TORCH has been active since the end of January, with 18 member physicians directing the primary care of approximately 300 seniors, and overseen by an advisory committee of physicians, facility representatives, patient/family advisors, and Island Health and division leads.

TORCH is a new model for family physician practice in residential care, which emphasizes team-based care within the facilities, builds a network of GPs, and brings GPs and facilities together to focus on quality improvement. TORCH includes a program of clinical training sessions, developed by GPs with expertise in caring for seniors and residential practice. These sessions are open to groups of 30 physicians, prioritizing current TORCH physicians but also welcoming other physicians from the community to learn about topics such as goals of care and advance directives; dementia, complex/chronic medical care; polypharmacy risk reduction; infections; terminal care and

symptom care, and pain management; Parkinson’s and neuro-degenerative disorders; and insulin/DM management. The prototype will run for the duration of the implementation phase, and depending on the results of our program evaluation, may ultimately spread to other facilities in the city.

Physicians supporting frail seniors living at home benefited from a short pilot in collaboration with Island Health, through which Island Health seconded two clinicians (a 0.4 FTE RN and a 0.4 FTE physiotherapist) to work with physicians to build a community resource list, accessible via the Division’s website (https://www.divisionsbc.ca/victoria/frailelderly). The clinicians designed and conducted an educational session in February for 25 GPs and 18 MOAs/clinic staff to learn about community resources available to frail seniors, and how to use the online community resource list. In addition, five GPs received in-office support from the Island Health clinicians. The GPs selected patients, and the clinicians and GPs conducted frailty assessments and collaborated on care plans. The clinicians provided advice on appropriate community supports/resources and supported office

TORCH has been active since the end of January,

with 18 member physicians directing the primary care of approximately 300 seniors.


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staff to use the tools at hand. The in-office component of the pilot improved the quality of attachment for 66 patients, as the GP and patient emerged with a better understanding of the patient’s level of frailty, put a care plan in place, and are prepared to track follow-up. This pilot ended on March 31, 2015, and an evaluation report is in development.

In order to continue addressing the primary care needs of frail seniors living in the community, the Division re-convened the Care of the Elderly working group in January 2015. This working group, which has engaged a total of 30 members thus far, met regularly throughout the first half of the year to share physicians’ perceptions of what is needed and direct a review of the best practice literature on providing care for fail seniors living in their own homes. The Division engaged Impact BC to conduct this review, and recommendations are currently before the board of directors for consideration.

Patient Matching

The final strategy of our A GP for Me work focuses on building mechanisms to match patients and family physicians, once there is capacity to do so within community-based primary care. Following the Division’s commitment to evidence-informed practice, the Division began by commissioning a research study on best practices in patient matching, which includes a literature review and cross-jurisdictional scan. The report will be ready for sharing beyond the steering committee in late spring, and will guide the establishment of this strategy’s advisory committee and concrete next steps.

Education session – frail seniors community resources, February 2015


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Shared Care Programs

Transitions in Care (TIC)

The Victoria Division continued to collaborate with the South Island Division of Family Practice and Island Health around improving transitions in care, focusing largely on enabling better communication between hospital and community GPs. We completed the first phase of work in 2014, which focused primarily on eNotification. The first phase of TIC brought the partners together to develop an automated electronic notification of patient admissions, discharges, and deaths in hospital. This system is designed to be interoperable so that GPs can receive notifications regardless of what EMR they are using. Notifications are transmitted via Excelleris, the vendor that provides lab results to community GP offices, and physicians without an EMR can access the notifications via Excelleris’ Launchpad application. After a three-month pilot in summer 2014 involving 42 physicians, evaluations showed that the vast majority

of GPs believed eNotification would be an asset to their practice and it would help them provide better care for patients.

Island Health, therefore, rolled eNotification out across the province in January 2015 with nine EMRs reaching 74 per cent of physicians in the region, and over 2000 users across BC. Anyone in BC who uses the participating EMRs and who has had a patient admitted to an Island Health acute care facility will receive notification. Excelleris continues working to bring other EMRs into the program, and there is great interest in spreading this mechanism to other regional health authorities. As a testament to its innovative nature and value in the health system, eNotification has been written up in Canadian Healthcare Technology, has had a poster presentation at the Information Technology and Communications in Health conference in Victoria (February-March 2015), will be the subject of a workshop at the BC Health Leaders Conference in October 2015, and has been nominated for a Health Employers Association of BC Health Care Award.

TIC also began to address the issue of contact between hospital and community GPs, in situations that warrant a provider- to-provider conversation. TIC has been bringing GPs and Island Health together to find ways of ensuring that hospital providers can access community GP contact information. To date, TIC has worked with Island Health IT to include the primary care provider’s name on the PowerChart banner so that it is visible regardless of what page a provider is looking at. Providers can “click through” to bring up the individual’s contact details. We continue to work with Island Health to improve the details that are available and find ways to keep this information current and accurate.

Dr. Lisa Veres


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TIC has been bringing GPs and Island Health together to find ways of ensuring that hospital

providers can access community GP contact information.

Now in its second phase, TIC is building on the success of eNotification and our communications work thus far by beginning new pilot projects around discharge planning in the summer of 2015. TIC is also beginning work to improve communication and collaboration between community GPs and emergency room physicians.

Partners in Care – Mental Health and Substance Use

The Division’s assessment and planning work for A GP for Me—which included focus groups and deep engagement with GPs, specialists, allied health providers, Island Health, community agencies, and patients with lived experience—further supported the findings and recommendations of the Division’s mental health and substance use (MHSU) care access working group that indicated we need a focused initiative to address the concerns of patients and care providers around MHSU. In response, therefore, we worked with our partners to develop a proposal to the provincial Shared Care Committee (a joint committee of Doctors of BC and the Ministry of Health) to implement the following three strategies:

• Improve MHSU care in GP offices by developing a learning series that provides clinical skills training in key areas of practice. The series will be developed and delivered in a way that builds the collaborative relationship between GPs and other providers—particularly psychiatrists—and enables spread beyond the city.

• Develop a collaborative model of care where psychiatrists and GPs co-facilitate group medical visits teaching CBT skills to patients with mild-moderate anxiety and depression.

• Create a phone line within Island Health’s new MHSU Crisis Service that provides GPs with rapid access to information they require to support patients with MHSU problems, including consultation with a psychiatrist or other MHSU provider, support with patient referrals or MHSU service navigation, and more. This work will build off of the Rapid Access to Consultative Expertise (RACE) model currently active around the province for a range of specialties.

The steering committee—composed of GPs from both the Victoria and South Island Divisions of Family Practice, psychiatrists, Island Health leaders, and division team supports—is now in place and active. Shared Care has approved funding for the first and third strategy; the second (CBT group visits) has provisional approval, pending a decision on complementary funding for which the psychiatrists have applied through the Specialist Services Committee.


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Child and Youth Health Collaborative

The goal of the provincial Child and Youth Mental Health Collaborative is to increase the number of children, youth, and families receiving timely access to integrated MHSU services and supports. The Collaborative began in the Interior Health region and is now rolling out in other parts of the province through Local Action Teams (LATs). Island Health began this work on Vancouver Island, introducing its proposal to the region’s Divisions of Family Practice at the Interdivisional Collaborative Services Committee last spring. The Victoria Division sits on the regional leadership committee, which oversees the Collaborative’s work on Vancouver Island, and co-chairs the Victoria LAT with Island Health and the Ministry of Children and Family Development (MCFD). The Victoria LAT includes GPs, MHSU service providers, patients and families, and representatives from the school district, MCFD, Island Health, RCMP, community-based NGOs, and more. Victoria’s LAT is currently determining its priorities and will then move to develop a work plan.


Emergency response and business resiliency for family physiciansThe Division has continued a project to help family doctors respond at the individual practice and collective system levels to an emergency, disaster or other surge in demand for primary care. We have pursued two main streams of activity that collectively will lead to a coordinated, locally-based health system response, designed by GPs, which helps all providers efficiently and effectively respond to an emergency, disaster, or other surge in demand for primary care.

Building individual physician/practice resiliency

A 16-member working group supported the development of a guide that assists GPs to create their own essential level practice continuity plan and build individual physician/practice resiliency. The Practice Resiliency Guide and Workbook are currently being distributed to all interested members.

Creating a detailed plan of action for GPs in an emergency or increased demand situation

Work began with a multi-stakeholder meeting in December 2014, involving all of our key partners: Island Health, municipalities, the Ministry of Health Emergency Management Unit (EMU), and Doctors of BC. Participants struck the Health Emergency Management Primary Care Integration Working Group to develop a Concept of Operations document that will “provide guidance on integrating GPs into the disaster plans of the regional health authority and the community. It is a strategic document offering options for inclusion and information on coordinating

The goal of the provincial Child and Youth Mental Health

Collaborative is to increase the number of children, youth, and families receiving timely access to integrated MHSU

services and supports.


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between varied agencies. It will be augmented by operational plans detailing the specific arrangements agreed to by the relevant parties.” The Division will then translate this strategic document to a detailed emergency management plan for members.

New working groups: Health IT, Walk-in-Clinic engagement, GPSC Residential Care FundingThe Victoria Division pursued two new areas of work in 2014-15, around Health IT and walk-in-clinics (WIC). In both cases, we began by holding reasonably large facilitated engagement sessions (in November and January, respectively) with a cross-section of interested members to hear family physicians’ thoughts and understand their top concerns and priorities. The initial larger engagement sessions enabled GPs to strike working groups for each topic in order to explore these issues more deeply and make recommendations for action. The Health IT working group will continue meeting into the summer and fall, and the Division is exploring next steps for the WIC group. Physicians from both working groups are linking with existing work in the Division’s A GP for Me and Shared Care initiatives.

Divisions across BC are also tasked with determining how to implement new GPSC funding to support GPs working in residential care. To this end, we have struck a collaborative working group of physicians from both the Victoria and South Island Divisions of Family Practice, and Island Health leaders to develop a strategy that is appropriate and meets the needs of patients, physicians, and facilities in our region.

We welcome your interest, questions, and comments.

Get involved!

Please contact the Division’s office if you are a member of the Victoria Division of Family Practice and would like to get involved or deepen your engagement with any of the Division’s work, or if you are a potential partner who would like to link with us. We welcome your interest, questions, and comments.


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Mission Statement and Purpose

VISION Promoting healthy communities through excellence in local primary care.

MISSION The VDFP supports the community of physicians to improve patient care and population health by: • Fostering physician collegiality and professional fulfillment. • Influencing health policy and delivery decisions. • Partnering to facilitate an effective and sustainable health system. • Increasing access to excellent primary care.

VALUES The Victoria Division of Family Practice conducts its operations with the following values in mind: • compassion and patience • inclusivity • collaboration • grassroots democracy • transparency • respect • timely, respectful communication • fair process • accountability • stewardship and responsibility • ongoing and meaningful input and engagement • building real relationships • local responsiveness • evidence-driven


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Division Structure and Governance

The Victoria Division of Family Practice is an independent non-profit society under the umbrella of the provincial Divisions of Family Practice initiative. The Victoria Division is governed by a board of directors, which is composed entirely of family physicians practicing in the community, and supported by the Division’s executive director. The board delegates some governance responsibility to its executive, finance, HR, evaluation, and communi-cations committees. It further delegates governance for initiatives and programs to steering committees (e.g., Transitions in Care steering committee, Partners in Care – Mental Health & Substance Use steering committee, A GP for Me steering committee), which are guided by advisory committees and working groups responsible for implementing specific strategies and projects (e.g., recruitment and retention, TORCH, Practice Supports, etc.). Steering and advisory committees are composed of family physicians and partners as appropriate, including representatives from Island Health, specialists, MOAs, and others. The Division also supports ad hoc working groups of family physicians and partners exploring particular issues or addressing specific short-term work (e.g., emergency response, community building, General Practice Services Committee (GPSC) residential care funding, etc.).

The Division engages in collaborative work within its own committees and working groups, as well as several partnership tables. The most central is the Collaborative Services Committee (CSC), which brings executive and medical leaders in the Victoria Division, Island Health, and GPSC together on a monthly basis to identify and work on shared priorities and projects. The CSC is a member of the Interdivisional CSC (IDC), which meets quarterly and includes delegates from each CSC on Vancouver Island, as well as partners from the GPSC, provincial Divisions of Family Practice office, Shared Care Committee, and Doctors of BC. The Division plays a key role in the IDC’s regional recruitment and retention working group, as well as the GPSC’s Provincial Recruitment and Retention Steering Committee.

The eight divisions on Vancouver Island meet regularly to work on a variety of issues together. The Victoria and South Island Divisions work particularly closely, collaborating on local Shared Care programs, among other initiatives.


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Participation and EngagementParticipation and Engagement

Core Operations and Governance

Executive Director: Alisa Harrison, PhDProject Coordinator: Catriona ParkAdministrative Coordinator: Nicole DehoopCommunications & Design: Crystal SawyerEvent Support: Becky Litt, Sara Healing

Board of Directors

Dr. Steve Goodchild (co-chair)Dr. Katharine McKeen (co-chair and treasurer)Dr. Lorne Verhulst (secretary)Dr. Jody AndersonDr. Ian BekkerDr. Aaron ChildsDr. Kathy DabrusDr. Valerie EhasooDr. Lisa Veres

General Division Committees, Working Groups and Pilot Projects

Community Building CommitteeDr. Jody AnzarutDr. Sarah ChritchleyDr. Kathy Dabrus (board liaison)Dr. Jessica FryDr. Caitlin HarmonDr. Doug McGheeDr. Tara Mogentale

Care of the Elderly Working GroupProject Support: Chrissy TomoriTORCH Development: Juna CizmanDr. Ian Bekker (physician lead)Dr. Lisa Veres (physician lead)Dr. Sarah ChritchleyDr. Joyce CouttsDr. Herbert DomkeDr. Fil EdoraDr. Valerie EhasooDr. Ron EsteyDr. Taryl Felhaber

Dr. George ForsterDr. Steve GoodchildDr. Ben HowDr. Naomi HwangDr. Geoff InmanDr. Christine JonesDr. Jim LaingDr. Janet MakDr. Fiona ManningDr. Margaret ManvilleDr. Douglas McGregorDr. Mike MilesDr. Dale NicollDr. Philip PendergastDr. Duncan RobertsonDr. Ted RosenbergDr. Tejinder SidhuDr. Tracy TresoorDr. Michael VaughanDr. Jennifer Whyte

Frail Seniors in the Community: In-Office Clinical Support Pilot – Team and ParticipantsProject manager: Chrissy TomoriDr. David BrookDr. Murray BrownDr. Rhonda HauserDr. Meeta PatelDr. Tejinder Sidhu

Thank you to the family physicians who participated in the Division’s committees and working groups, partners who worked with us, and the Division team members who provided project management and support over the past year (May 2014 to May 2015).

The Board of Directors, from left to right: Dr. Lorne Verhulst, Dr. Kathy Dabrus, Dr. Jody Anderson, Dr. Steve Goodchild, Dr. Aaron Childs, Dr. Ian Bekker, Dr. Lisa Veres, Dr. Katharine McKeen, Dr. Valerie Ehasoo

Left to right: Dr. Mike Miles, Dr. Peter

Houghton, Dr. Dean Kolodziejczyk

of Frail Seniors in the Community team.


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Dr. Lisa VeresKirn Collins (MOA)Erica Kovacs (MOA)Nada Manhas (MOA)Tetje Thistlethwaite (MOA)Kim Webb (MOA)Megan Bond (Island Health)Mary Catherine Collins (Island Health)Valerie Houghton (Island Health)Karla Marshall (Island Health)Jody Parent (Island Health)Lorna Ross (Island Health)

Mental Health & Addictions Care Access Working Group & Planning SessionsDr. Abeer AbedDr. Parvinder BirdiDr. Paul BrigelDr. Bill BullockDr. Joyce CouttsDr. Lauren DakeDr. Herbert DomkeDr. Valerie EhasooDr. Haydeh ErfanifarDr. Naomi HwangDr. Kristin KorolDr. Eugene LeducDr. Martha MacdonnellDr. Tara MogentaleDr. Matthew MoherDr. Barbara RobackDr. Stephen RoomeDr. Robert ShepherdDr. Mark Sherman Dr. Tejinder SidhuDr. Trish Snozyk

Dr. Lorne VerhulstDr. Jennifer Whyte

Practice Coverage Pilot Working Group

Project Manager: Gina DelimariMedical Consultant: Dr. Sandra LeeDr. Aaron Childs (physician lead)Dr. Daphne FontaineDr. Steve GoodchildDr. Jody Young

Emergency Response Working GroupDr. Ian Bekker (physician lead)Dr. Herbert DomkeDr. Haydeh ErfanifarDr. George ForsterDr. Carol JenkenDr. Hana MasataDr. Peter MeyerDr. Tejinder SidhuDr. Ioana SmirnovDr. Lorne VerhulstDr. Jody YoungShawn Carby (Ministry of Health)Katja Magarin (Ministry of Health)Sue Munro (Island Health and Provincial Health Services Authority)

Health Emergency Management Primary Care Integration Working GroupDr. Ian Bekker (physician lead)Dr. Graham Dodd (Doctors of BC)Shawn Carby

(Ministry of Health)Kelli Kriyzanowski (Ministry of Health)Melia Walker (Ministry of Health)Deborah Cracknell (Island Health)Krystal Hanson (Island Health)Courtney Addis (Island Health)Dr. Omar Ahmad (Island Health)Rob Johns (Victoria)Eileen Grant (Oak Bay)Maegan Thompson (Saanich)

Health IT Working Group Dr. Ian Bekker (physician lead)Dr. David AtwellDr. Ernie ChangDr. Kathy DabrusDr. Adrian FanatDr. Geoff InmanDr. George ForsterDr. John KimDr. Eugene LeducDr. Linda OttleyDr. Eric ShafonskyDr. Jennifer Whyte

Walk-in Clinics Working GroupDr. Katharine McKeen (physician lead)Dr. Ian BridgerDr. Ernie ChangDr. Michael PutlandDr. Jack SturmwindDr. Chris WattDr. David Warnock

Dine & Learn Presenters

GPs:Dr. Jody AnzarutDr. Bruce CampanaDr. Sarah ChritchleyDr. Brian FarrellDr. Eunice FastDr. Jessica FryDr. Caitlin HarmonDr. Simon HoogewerfDr. Suzi LeggattDr. Anna MasonDr. Doug McGheeDr. Nancy McLeodDr. Chris MorrowDr. Darcy NeilsonDr. Rob SealyDr. Jody Young

Specialists:Dr. Andrew AttwellDr. Jennifer BalfourDr. Chasta BascuDr. Vanessa Bernstein Dr. Laurence BosleyDr. Karlina BreikksDr. Scott CameronDr. Amanda ColemanDr. Krystal CullenDr. Cliff DuncalfDr. Peter Lee

Top: Dr. Matthew Moher

Middle: Dr. Jody Anzarut

Bottom: Dr. Krystal Cullen


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Participation and Engagement cont’d

Dr. Iain McAuleyDr. Jeff McCrackenDr. Imad NadraDr. George PawliukDr. Leo QuonDr. Jim SacamanoDr. Karan ShettyDr. Elaine WaiDr. Kristi Zinkiew

A GP for Me

Operations Lead: Catriona ParkAdministrative Assistant: Pasqua Terrone

Steering CommitteeDr. Lorne Verhulst (chair)Dr. Steve GoodchildDr. Valerie EhasooDr. George ForsterDr. Barbara RobackVictoria Power (Island Health – Primary Care)Stephen Reichert (Reichert & Associates – Evaluator)

Recruitment, Retention and Practice Coverage Advisory CommitteeRecruitment & Retention Consultant: Helen WelchDr. Aaron Childs (chair)Dr. Daphne FontaineDr. Jessica FryDr. Steve GoodchildDr. Doug McGhee

Towards Optimal Residential Care Health (TORCH) Advisory CommitteeProject Manager: Juna CizmanTORCH coordinator: Carolyn BrandlyDr. Ian Bekker (co-chair)Dr. Tom Bailey (Island Health) (co-chair)Dr. George ForsterDr. Margaret ManvilleDr. Mike MilesTimothy Orr (Island Health)Fiona Sudbury (Kiwanis Pavilion)Donna Murphy (Gorge Road Hospital)Shelley Gurvey (Glengarry Hospital)Catherine Ryan (Glengarry Hospital)Lorraine Pardy (The Heights at Mount View)Maria Stefanyk (The Heights at Mount View)Cathy Murowinski (Resident/Family Experience Advisor)Norma Jean Hickin (Resident/Family Experience Advisor)

TORCH pilot physiciansDr. Ian BekkerDr. Uma BelgaumkarDr. Joyce CouttsDr. Fil EdoraDr. Joseph HaegertDr. Naomi HwangDr. Geoff InmanDr. Carol Jenken

Dr. Magnus MacnabDr. Janet MakDr. Margaret ManvilleDr. Rod McFadyenDr. Mike MilesDr. Chris MullerDr. Dale NicollDr. Emily PaiDr. Lorne VerhulstDr. Jennifer Whyte

Practice Supports Advisory CommitteeProject Manager: Terry O’BrienMOA Coordinator: Leslie Rogers-WarnockDr. Heera Bindra (chair)Dr. Jody AndersonDr. Sarah ChritchleyDr. Tara MogentaleJo-Anne Beeren-Parsons (MOA)Sheila Walker (MOA)Jean McKinnon (Island Health)

Transitions in CareProject Manager: Kristin Atwood, PhDAdministrative Assistant: Liana KennedyDr. Lisa Veres (chair and physician lead)Dr. Laura Phillips (physician lead)Dr. Margaret BesterDr. Jill NorrisDr. Jason WaleDr. Carley CooperDr. Linda Wilson (South Island Division)Dr. Ulana Farmer (South Island Division)Kathy Ilott (South Island Division)Val Stevens ( Island Health)Marko Peljhan (Island Health)Nancy Falconer (Shared Care)Lois Cosgrave (Island Health; information-only)

Dr. Jill Norris, Transitions in Care


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Clay Barber (South Island Division; information-only)Dr. Morgan Price (Information-only)

Discharge Planning Working GroupDr. Laura Phillips Dr. Lisa Veres Dr. Jill Norris Dr. Margaret Bester Dr. Tejinder Sidhu Dr. Ulana Farmer (South Island Division)Dr. Matt Billinghurst Dr. Parvinder Birdi Dr. Herbert Domke Dr. Rikus De LangeJo-Anne Beeren-Parsons (MOA)Dr. Sean Spina (Island Health – pharmacy) Jehiah Chalifour (Island Health)Robyne Maxwell (Island Health)Val Stevens (Island Health)Kirsten Hagen (Island Health)Gloria Bouchard (Island Health)Bev Merrifield (Island Health)Kathy Norman (Island Health)Nancy Falconer (Shared Care)

IHealth CommitteeDr. Laura PhillipsDr. Lisa VeresDr. Ian BekkerJohn Forbes (Island Health)Dr. Mary Lyn Fyfe (Island Health)

Communications/Tech CommitteeDr. Lisa Veres (physician lead)Val Stevens (Island Health)Gloria Bouchard (Island Health)Jehiah Chalifour (Island Health)Sergio Duran (Island Health)David Sie (Island Health)Michael Reece (Island Health)

ER Advisory CommitteeDr. Laura Phillips Dr. Jason WaleDr. Carly CooperDr. Tina WebberDr. Brendan Irvine (South Island Division)Jackie Beaulieu (Island Health)Jessica Johnson (Island Health)

eNotification Pilot Participants Dr. Amy AtchisonDr. David BellDr. Marc BosenburgDr. William BullockDr. William CaversDr. Walter ChowDr. David Clinton-BakerDr. James CoxDr. Sarah CritchleyDr. Kathy DabrusDr. Nicole del Bel Dr. Andre du ToitDr. Felipe EdoraDr. Dennis Francis

Dr. Steven GordonDr. Dorothy HamiltonDr. Telen HarperDr. Lindsay HawkinsDr. Geoff InmanDr. Judith JonesDr. Draga JovicDr. Paul KachanDr. Eugene LeducDr. Azaria MarthymanDr. Anna MasonDr. Chuck MedhurstDr. James MellingDr. Mike MilesDr. Kelley MinishDr. Dale NicollDr. Gary NielsonDr. Anthony NielsonDr. Amarjit NirwanDr. Laura PhillipsDr. Bev RutherfordDr. Walter SalmaniwDr. Tejinder SidhuDr. Galina SmushkinDr. Murray StanwoodDr. Konia TroutonDr. Lisa VeresDr. Carole Williams

Partners in Care – Mental Health & Substance Use

Project Manager: Chrissy TomoriAdministrative Assistant/MOA: Tetje Thistlethwaite

Steering CommitteeDr. Bill Bullock (co-chair)Dr. Valerie Ehasoo (co-chair)Dr. Jeff Pocock (South Island Division)

Dr. Erin Burrell (psychiatrist)Dr. Helen Campbell (psychiatrist)Dr. David Yaxley (psychiatrist)Kelly Reid (Island Health)Kathy Ilott (South Island Division Project Manager)Katharine Coatta (Reichert & Associates – Evaluation)

CBT Skills Working GroupDr. Marjon BlouwDr. Bill BullockDr. Lauren DakeDr. Oona HayesDr. Erin Burrell (psychiatrist)Dr. Joanna Cheek (psychiatrist)Dr. Wanda Crouse (psychiatrist)Dr. Melissa Gansner (resident psychiatrist)Dr. Karen Palmer (psychiatrist)

Child & Youth Mental Health Collaborative – Victoria Local Action TeamVictoria Division delegates:Alisa Harrison (co-chair) Dr. Valerie Ehasoo (physician lead)Dr. Naomi HwangDr. Jenn Lee


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Other Funding Sources1 Provincial A GP For Me Transitions in Care Recruitment and Retention Phase 1 Phase 2 Phase 1 Phase 2 Apr 2013 – Sept 2014 Apr 2013 – Nov 2014 Nov 2014 – Mar 2015 Apr 2013 – Nov 2014 Nov 2014 – Mar 2015

FUNDING SOURCES Provincial Recruitment and Retention $ 72,099.00 Phase 1 – A GP For Me $ 499,983.50 Phase 2 – A GP For Me $ 550,000.00 Phase 1 – Transitions in Care $ 183,929.00 Phase 2 – Transitions in Care $ 156,071.00 TOTAL FUNDING RECEIVED $ 72,099.00 $ 499,983.50 $ 550,000.00 $ 183,929.00 $ 156,071.00 EXPENDITURESAdministration Administration Wage Expense $ 17,444.55 $ 21,769.61 $ 15,484.81 $ 41,342.82 $ 34,815.81 Administration Office Expenses – $ 11,810.16 $ 14,929.58 $ 1,930.08 $ 1,572.30 Administration Travel / Meeting Expenses $ 3,318.63 $ 1,645.83 $ 1,464.28 – $ 98.03 Total – Administration Expenses $ 20,763.18 $ 35,225.60 $ 31,878.67 $ 43,272.90 $ 36,486.14 Working Groups, Projects and Events Physician Member Payments $ 142,817.24 $ 34,443.22 $ 46,360.11 $ 12,355.09 Contractors $ 42,899.12 $ 158,457.85 $ 94,671.09 $ 73,534.09 $ 15,879.00 Working Groups / Project / Event Expenses – $ 61,296.63 $ 8,377.66 $ 8,399.47 $ 3,308.30 Working Groups / Project / Event Travel Expenses – $ 4,160.60 – $ 206.53 Total – Projects and Event Expenses $ 42,899.12 $ 366,732.32 $ 137,491.97 $ 128,500.20 $ 31,542.39 Board Costs Board Member Payments $ 941.52 $ 50,135.89 $ 15,250.80 $ 6,884.52 $ 7,365.51 Board Travel – $ 4,096.19 – $ 66.30 Total – Board Costs $ 941.52 $ 54,232.08 $ 15,250.80 $ 6,950.82 $ 7,365.51

TOTAL EXPENDITURES $ 64,603.82 $ 456,190.00 $ 184,621.44 $ 178,723.92 $ 75,394.04 FUNDING LEFT OVER $ 7,495.18 $ 43,793.50 $ 365,378.56 $ 5,205.08 $ 80,676.96

Financial Statement

1. The amounts shown here reflect Division’s fiscal year, April 1, 2014, to March 31, 2015. Phase One of both A GP for Me and Transitions in Care (April 2013-–Nov 2014) is now complete. Phase Two of both A GP for Me and Transitions in Care (November 2014 to March 2016) is currently in process. The numbers here reflect the time period ending March 2015.


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Other Funding Sources1 Provincial A GP For Me Transitions in Care Recruitment and Retention Phase 1 Phase 2 Phase 1 Phase 2 Apr 2013 – Sept 2014 Apr 2013 – Nov 2014 Nov 2014 – Mar 2015 Apr 2013 – Nov 2014 Nov 2014 – Mar 2015

FUNDING SOURCES Provincial Recruitment and Retention $ 72,099.00 Phase 1 – A GP For Me $ 499,983.50 Phase 2 – A GP For Me $ 550,000.00 Phase 1 – Transitions in Care $ 183,929.00 Phase 2 – Transitions in Care $ 156,071.00 TOTAL FUNDING RECEIVED $ 72,099.00 $ 499,983.50 $ 550,000.00 $ 183,929.00 $ 156,071.00 EXPENDITURESAdministration Administration Wage Expense $ 17,444.55 $ 21,769.61 $ 15,484.81 $ 41,342.82 $ 34,815.81 Administration Office Expenses – $ 11,810.16 $ 14,929.58 $ 1,930.08 $ 1,572.30 Administration Travel / Meeting Expenses $ 3,318.63 $ 1,645.83 $ 1,464.28 – $ 98.03 Total – Administration Expenses $ 20,763.18 $ 35,225.60 $ 31,878.67 $ 43,272.90 $ 36,486.14 Working Groups, Projects and Events Physician Member Payments $ 142,817.24 $ 34,443.22 $ 46,360.11 $ 12,355.09 Contractors $ 42,899.12 $ 158,457.85 $ 94,671.09 $ 73,534.09 $ 15,879.00 Working Groups / Project / Event Expenses – $ 61,296.63 $ 8,377.66 $ 8,399.47 $ 3,308.30 Working Groups / Project / Event Travel Expenses – $ 4,160.60 – $ 206.53 Total – Projects and Event Expenses $ 42,899.12 $ 366,732.32 $ 137,491.97 $ 128,500.20 $ 31,542.39 Board Costs Board Member Payments $ 941.52 $ 50,135.89 $ 15,250.80 $ 6,884.52 $ 7,365.51 Board Travel – $ 4,096.19 – $ 66.30 Total – Board Costs $ 941.52 $ 54,232.08 $ 15,250.80 $ 6,950.82 $ 7,365.51

TOTAL EXPENDITURES $ 64,603.82 $ 456,190.00 $ 184,621.44 $ 178,723.92 $ 75,394.04 FUNDING LEFT OVER $ 7,495.18 $ 43,793.50 $ 365,378.56 $ 5,205.08 $ 80,676.96


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BCMA Funding Doctors of BC Doctors of BC Apr ‘14 – Mar 15 Apr ‘13 – Mar 14 Unaudited Audited

FUNDING AMOUNT Doctors of BC – Infrastructure $ 1,000,000.00 $ 870,994.60 Carryover from Previous Fiscal Year $ 98,600.00 $ 57,000.00 Bank Interest $ 7,791.40 $ 5,812.69 TOTAL FUNDING RECEIVED $ 1,106,391.40 $ 933,807.29 EXPENDITURESAdministration Administration Wage Expense $ 309,427.80 $ 275,595.03 Administration Office Expenses $ 51,801.65 $ 29,198.28 Administration Travel Expenses $ 7,173.77 $ 1,947.09 Administration Meeting Costs $ 10,994.84 —Total – Administration Expenses $ 379,398.06 $ 304,793.31 Working Groups, Projects and Events Physician Member, MOA’s and Resident Payments $ 92,317.58 $ 132,878.17 Contractors $ 122,573.11 $ 69,841.60 Administration, Promotion and Design $ 42,113.84 — Working Groups / Project / Event Expenses $ 50,784.52 $ 62,127.07 Working Groups / Project / Event Travel Expenses $ 2,942.47 $ 4,074.72Total – Projects and Event Expenses $ 310,731.52 $ 268,921.56 Board Costs Board Member Payments $ 160,647.34 $ 155,249.08 Board Travel $ 10,956.12 $ 8,841.84 Board Education / Training $ 15,949.61 $ 6,653.60 Board / Committee Meeting Costs $ 11,443.76 $ 17,626.35Total – Board Costs $ 198,996.83 $ 188,370.87

TOTAL EXPENDITURES $ 889,126.41 $ 762,085.74 FUNDING LEFT OVER AT FISCAL YEAR END $ 217,264.99 $ 171,721.55

Financial Statement

The Divisions of Family Practice Initiative is sponsored by the General Practice Services Committee, a joint committee of the BC Ministry of Health and Doctors of BC.

www.divisionsbc.ca/victoria

Victoria

Victoria Division of Family Practice

Contact information

PO Box 2588 Cowichan Bay, BC V0R [email protected]/victoria

Board of Directors

Dr. Steve Goodchild – co-chairDr. Katharine McKeen – co-chair and treasurerDr. Lorne Verhulst – secretaryDr. Jody AndersonDr. Ian BekkerDr. Aaron ChildsDr. Kathy DabrusDr. Valerie EhasooDr. Lisa Veres

Core operations team

Alisa Harrison, PhD – executive directorCatriona Park – project coordinator and A GP for Me leadKristin Atwood, PhD – project manager, Shared CareChrissy Tomori – project manager, Shared CareNicole Dehoop – administrative coordinator

Photo credits

Cover photo: Tulips in Spring – Deanne Gillespie, Tourism Victoria

Interior photos – Terrance Lam, Andrew Dodd (Dodd’s Eye Media), Syd Woodward

Alisa Harrison headshot – Heather Armstrong Photography

Documents

Victoria Division of Family Practice. 2014 annual report