ANNUAL LEADERSHIP DINNER

Every person in the long-term care field deserves our thanks, so the theme of this year’s Leadership Dinner was gratitude. A special thanks to all those who submitted and/or participated in our gratitude video, your stories were inspiring to hear. We are looking forward to next year already! See a summary of the event here.

COMMUNITY OF PRACTICE

The Community of Practice Working Group, spearheaded by our own Dr. Ian Bekker, is a dynamic environment where new physicians can come to learn, and experienced physicians can come to share (and likely learn some new things too!) The meetings are lighthearted and fun, while supporting the vision of continual improvement of long-term care for all. Most recently, the group has produced some insightful documents on common challenges in LTC.

The following documents that have come out of these COP meetings are all available on our website:

• Community of Practice Guideline: Supportive Care Visits
• Community of Practice Guideline: Approaches to Resident Behaviours
• Community of Practice Guideline: Goals of Care
• Community of Practice Guideline: Hip Fractures in Frail LTC Residents
• Community of Practice Guideline: Polypharmacy Reduction

SIDNEY CARE WEDDING

It is not often that we receive emails as heartwarming as this. Joan Smyth, Director of Care at Sidney Care Home reached out with a link to their story, as featured on CTV News. Highlighting the best of long-term care on the Island, Joan and her team pulled together a beautiful wedding ceremony for two of their residents. I can’t imagine there was a dry eye in the room at this event! See the video here.

LTCI WELCOME BBQ

In light of all of the recent recruitment into LTC, we decided to bring together new and experienced LTC physicians for a social event. Many brought their significant others and children along, and fun was had by all in the beautiful sunshine!

NURSE-MD COMMUNICATION TOOL

In an attempt to address some of the challenges that come with communication between physicians and care home staff, the LTCI team has been working on streamlining the process with a communication cheat sheet. Glengarry is the first care home to have the communication tool being put into use. Please reach out to an LTCI coordinator if you would be interested in developing something similar for your care home. View the template we created for Glengarry on our website here.

REMINDER: LACERATION REPAIR KITS AVAILABLE FROM ISLAND HEALTH

When LTC homes have laceration repair supplies readily available, physicians can make in-home suturing a standard practice and unnecessary transfers to hospital can be avoided.

Laceration Supplies for Island Health Owned-and-Operated Homes and IH Affiliate Homes:

Laceration repair kit supplies are available for Island Health owned-and-operated and affiliate sites* via the following steps:

• Site Manager/DOC sends an email to Laurie Gnam to request 1+ kits (order placements to be limited to once per month or quarter)
• Laurie records orders and notifies The Summit Stores team of the requests
• Laurie notifies sites when kits are ready for pick-up
• Sites are responsible for picking up the kits from reception at The Summit

* Affiliate sites will be billed by Island Health for kits purchased through this process.

Laceration Supplies for Private Care Homes:

Unfortunately, private care homes unaffiliated with Island Health are unable to access laceration repair kits via Island Health and will need to use their own procurement processes. The LTCI website has a list of laceration repair kit supplies and contact details for the Stevens Company, who assisted the LTCI with previous procurement of supplies in 2020. Please contact the LTCI to problem-solve any procurement issues that may arise at your site.

TRUTH AND RECONCILIATION

On September 30^th, Canadians everywhere honoured the annual day for Canadian Truth and Reconciliation. In the spirit of continuing the conversation year round, we wanted to share some resources that have been particularly helpful or informative.

• Indigenous Tourism BC has an event section highlighting upcoming cultural or educational events in our province. See the full list here.
• We Were Children is a film that explores the deep impact of residential schools through the perspective of two children suffering through the system. Watch it here.
• 5 Things You Need to Know about Reconciliation is a short, informative video by Len Pierre about the key points you should understand about Reconciliation in Canada. View it here.  

MAINTAINING YOUR LTC HOME'S COORDINATED MEDICAL PRACTICE MODEL

A key aim of the Victoria-South Island Long-Term Care Initiative (LTCI) is to create sustainable medical practice models, which support family physicians (FPs) and care home teams to meet the provincial LTCI best practice expectations (BPEs), improve team communication and coordination, and foster continuous quality improvement. Since 2015, most Victoria and South Island care homes have put medical practice model in place, resulting in the following improvements:

• 300% increase in physician attendance at care conferences
• 89% increase in proactive physician visits to residents
• 52% reduction in residents prescribed 9 or more medications
• 71% reduction in transfers to emergency

PRACTICE MODEL COMPONENTS

A coordinated medical practice model has the following key elements:

• A small group of FPs who agree to work with an LTC home, led by a site-based Medical Coordinator
• Clustering, where each FP agrees to be MRP for a group or “panel” of residents at the site
• Collaboration between FPs and care home staff to meet the LTCI’s BPEs
• Funded regular meetings (one or two a year) between the FPs and care home leaders to discuss how the practice model is working and identify areas for improving quality of care, communication, and coordination.

FPs who participate in the LTCI are eligible to receive funding. Please reach out to the LTCI team if you’d like help setting up a meeting!

ACHIEVING THE LTCI BEST PRACTICE EXPECTATIONS

SUPPORTING PRACTICE MODEL SUCCESS

Care home leaders and staff can contribute to medical practice model success, coordination, communication, and efficiency by:

• Providing physician parking and access to workstations
• Clustering physicians’ patients together, i.e., unit or floor-based assignments
• Scheduling care conferences and medication reviews well in advance
• Clustering a few care conferences /or medication reviews together
• Ensuring nursing staff have clear information about how to communicate with their home’s MRPs and their usual visit schedule
• Triaging the level of urgency of resident issues
• Using standard order sets, SBARs and other templates as appropriate
• Making time for regular team and physician learning and engagement

Physicians can contribute by:

• Establishing a regular visit schedule
• Communication to staff in advance about their expected time of arrival
• Using the care home’s EHR to document medical care

The benefits of a healthy model include improved team-based care, a reduction in unnecessary transfer to hospital, increased resident and family satisfaction, and higher physician and staff satisfaction.

The Victoria and South Island LTCI is committed to helping all LTC homes to achieve strong medical practice models. If you would like our help, please contact us for assistance, or visit our website to view the many tools and resources available to support physicians and care home teams in their work.

We like hearing from you!

CURRENT OPPORTUNITIES

The below LTC sites are seeking an MRP, please get in touch if you are interested:

• Aberdeen
• Amica on the Gorge
• Glenwarren Lodge
• Gorge Rd LTC
• Sunset Lodge
• The Heights at Mt View
• The Summit
• The Priory

Do you know any family physicians looking to wind down their practices within the community but aren’t quite ready to retire? Or do you know any recently graduated family physicians looking to gain experience? Please spread the word about the rewarding experience that long-term care can provide and have them reach out to the LTCI at victoriasouthisland.ltci@victoriadivision.ca for more information!

MISSED IT?

Have you missed any of our virtual learning series events? Recordings and notes on our most recent Learning Series Event, “Common Dermatological Conditions in Long-term Care” with Dr. Matt Galas on November 1st can be found on our website here.

THE LIGHTER SIDE OF LONG-TERM CARE

Do you have a funny, unusual, or touching story of your time in long-term care that you wish to share with your colleagues and community? Submit a story to an LTCI coordinator to be shared anonymously in our next newsletter.

RESOURCES

You can find a newly added Dementia Care best practice resource on our website.

This Effect of Cryoneurolysis on Pain and Positioning in Patients with Wrist and Hand Contracture poster from Island Health can be found here.

Physician Education Pathways Addiction Medicine: Island Health is offering continuing medical education in addiction medicine. Click here to learn more about your options for upskilling.

Updates to the Suture Kits can be found here.

View the LTCI COP Guideline: Type of Vehicle for Type of Wound and Location by Dr. Matthew Galas from a previous LTCI Learning Series here.

Find the link for each region’s After-hours Call Group poster and the most recent after-hours SBAR on our website here.

The Medical Education and Resource Committee (MERC) has endorsed these three following required learning modules required learning modules for medical staff.

• Mental Health Act training
• Confidential Information Management training
• Violence Prevention training

EVENTS

November 20, 2023: @5:00-7:00PM Community of Practice Working Group Meeting at the RJH Woodward Room. Join us for a delicious catered dinner and robust conversation on LTC topics in a casual and fun environment. Physicians are renumerated at the current sessional rate. If you wish to join, RSVP here with any dietary restrictions.

November 28-29, 2023: : The Restorative Leadership Symposium at the Vancouver Marriot Pinnacle. This symposium is designed to be an opportunity to gather social sector leadership, with an emphasis on health leadership, to develop and enhance systems understanding and support of restorative approaches at the governance, executive and management levels. For more information and to register, head here.

November 30, 2023: @5:00-6:30PM LTCI Virtual Learning Series Event “Medical Ethics in Long-term Care” with Jillian Boerstler, a Bioethicist at Island Health. For more information, or to RSVP to this event, reach out to the LTCI here.

December 03, 2023: @11:00AM-2:00PM VDFP Family Holiday Social. Drop in event featuring face painting, a photo booth, cookie decorating and more. RSVP to the VDFP team here.

December 14, 2023: @11:30AM-1:00PM Reimagining LTC BC Collaborative: Appropriate Use of Antipsychotics, a virtual event organized by Health Quality BC. To view details and enroll, head here.

LOCAL CULTURAL EVENTS

November 18, 2023-March 17, 2024: Kali Spitzer: Bodies of, Bodies Within at the Art Gallery of Greater Victoria. Kali Spitzer’s work embraces the stories of contemporary BIPOC, queer and trans bodies, creating representation that is self-determined, with her collaborative process being informed by the desire to rewrite the visual histories of Indigenous bodies beyond a colonial lens. To learn more, head to their website.

November 26, 2023: @2PM Oak Bay Christmas Festival. Activities include a bouncy castle, street games, craft stations, lighted trucks, onstage entertainment, a visit from Santa and more. Get more info here.

December 1, 2023-January 6, 2024: Magic of Christmas at Buchart Gardens. Get your tickets for this beautiful and popular event here.

April 17, 2023-January 7, 2024: One month left to see Dinosaurs of BC Exhibit at The Royal BC Museum. See more info and get your tickets here.