1. DRAFT
Informing Provincial Supports for Team-based Care GPSC Summit June 19, 2017

2. Presenter Disclosure Presenters:
Dr. Joanne Young, Family Physician, Doctors of BC member to the GPSC
Shana Ooms, Executive Director, MOH member to the GPSC
Relationship with commercial interests:
Grants/Research Support: none
Speakers Bureau/Honoraria: none
Consulting Fees: none
Other: none

3. Managing Potential Bias

4. Session Objective & Overview
1. Vision - Why team based care?
2. GPSC Team-based Care Task Group – What supports exist provincially?
3. Abbotsford Division of Family Practice –
What are the lessons on advancing team based care?
4. Small Group Discussions –
Where am I on the spectrum of team based care implementation?
What will it take to move to the next level, practice, community, provincially?
5. Closing and Next Steps
Shana
Objectives of the session
To introduce team based care as an essential building block of the patient medical home and overall vision of the transformed primary and community care system
To introduce the newly formed GPSC team based care task group and role
To share lessons about team based care experiences (Abbotsford Division of Family Practice and Fraser Health Authority)
To provide a forum for sharing and learning about how to advance to the next level of team based care in practice (co located/virtual) or linked to the practice (networked)
Reminder – mention concurrent PSP session – Applying team-based care competencies in a primary care setting

5. Why Team-Based Care?
“Health care teams are an essential part of a strong and responsive primary health care system”
Service providers can focus on service provision and care planning rather than administrative work
When teams are optimized in terms of skill mix and size, interprofessional teams can offer work-life balance by reducing excessive work burden on any one type of health service provider.
And beyond the health care system, interdisciplinary teams have the potential not only to improve the health outcomes for populations, but also to impact the overall economy.
An example cited by the Conference board of Canada estimated that full coverage of interprofessional teams for diabetes type 2 adult patients (teams involving three or more types of care and service providers, a physician, nurse, pharmacist);
could have saved ~ $260 million in direct health care costs and ~$390 million in indirect costs due to productivity losses in the economy

6. Triple Aim Evidence Increased: Reduced:
Patient and provider satisfaction and experience
Quality, especially for people with complex care needs
Time with providers and primary care capacity
Support to provide comprehensive care
Access to community resources and self management supports
Opportunities to learn new skills/approaches through the collaborative experience
Sustainable practice model with all team members working to optimized scope
Efficiency and cost savings potential beyond health to the economy overall
Reduced:
Clinician burnout (stress and workload)
Use of emergency and hospital
Per capita costs
A number of benefits have been articulated through the variety of team models being implemented that speak to the value proposition for working in teams from both the patient and provider perspective as well as the for the system (triple aim).
For GPs/practices:
Reduced stress and workload
Supports provision of comprehensive care
Opportunities to learn new skills/approaches through the collaborative experience
Supports a sustainable practice model
For patients:
Improved patient satisfaction
Improved coordination, continuity and comprehensiveness of care
Increased time with providers and improved quality of care for patients with complex needs
Improved access to community resources and self-management education
For the health system:
Expanded primary care capacity and increased attachment of unattached patients
Optimized scope of practice of team members based on patient needs
Potential for increased efficiency and cost-effectiveness of primary care delivery
Potential for improved sustainability of health care system, including decreased burden on acute care facilities
From multi-jurisdiction evaluations regarding impacts of various interprofessional team models, e.g. Thompson Division’s Nurse in Practice Pilot, Nova Scotia’s Family Practice Nurse Program, Canadian Medical Association’s National Physician Surveys, Western Canadian Interprofessional Health Collaborative reports, Canadian Nurses Association.
References:
Can team-based care improve patient satisfaction? A systematic review of randomized controlled trials.
Primary health care teams and their impact on processes and outcomes of care. Statistics Canada.
The group health medical home at year two: cost savings, higher patient satisfaction, and less burnout for providers.

7. GPSC Vision and Goals
The GPSC's vision is to enable access to quality primary health care that effectively meets the needs of patients and populations in BC, using the patient medical home to form the foundation for care delivery within  a broader, integrated system of primary and community care.
The four goals that the GPSC is aiming to achieve are to:
Increase access to appropriate, comprehensive, quality primary health care for each community.
Improve support for patients, particularly vulnerable patients, through enhanced and simplified linkages between providers.
Contribute to building a more effective, efficient, and sustainable health care system in order to increase capacity and meet future patient needs.
Retain and attract family doctors and teams to work together in healthy and vibrant work environments.

8. Team Based Care – A critical building block
Belief that the team based care attribute of the BC PMH model needs to be a key area of focus in order to advance toward that future state.
Team-based care is a priority area for GPSC and foundational building block of the BC PMH and system of care
Shana
When we look at the current state in BC and compare that with the future state that we are trying to achieve, and when we consider the evidence and experience of health care providers both in BC and in other jurisdictions, the GPSC BELIEVES that the team based care attribute of the BC PMH model needs to be a key area of focus to advance toward that future state.
It is seen as a critical building block to the integrated system of primary and community care, both at the practice level and at the community level (in practice teams and linked networked teams).

9. GPSC Team-based Care Task Group
Purpose is to support the implementation of TBC in the province as part of GPSC’s PMH strategic direction
In building this support we will be focusing on 5 areas:
Creating a learning system
Helping to build the business case
Supporting early adopters
Helping to build the change management supports
Exploring Governance models
Joanne

10. GPSC Team-based Care Task Group Members
Ministry of Health Staff:
Joanna Richards
Health Authority Representatives:
Darlene Arsenault
Vanessa Salmons
Division Representatives:
Dr. Jel Coward
Dr. Adam Thompson
College of Family Physicians:
Dr. Christie Newton
GPSC Members: Shana Ooms (MOH) Dr. Joanne Young (DoBC) Dr. Khati Hendry (DoBC) GPSC Staff: Angie Chan Darcy Eyres Alana Godin Lucy Kirby Petra Lolić Afsaneh Moradi
Joanne

11. Team-based Care Landscape
Examples of TBC work being done by other groups in BC:
GPSC
Incentive Working Group simplifying and redesigning GPSC incentives
PSP developing small group learning sessions focused on TBC
Funding for initiating change management for PMH (up to $250,000 per division)
PMH Assessment tool and Panel Assessment tool
Ministry of Health
Policy refresh on Primary Care in BC
UBC Health
Survey of TBC initiatives in BC
College of Family Physicians of Canada
TBC Best Advice Guide
Joanne

12. Presentation from the Abbotsford Division of Family Practice
Anne Marie to introduce Abbotsford presenters

13. Gauging the TBC Experience in the Room
Contemplating
Initiating
Underway
Anne Marie

14. Group Discussion
Anne Marie

15. Time Remaining: 40 mins

16. Time Remaining: 30 mins

17. Time Remaining: 20 mins

18. Time Remaining: 10 mins

19. Time Remaining: 5 mins

20. Share any Emerging Ideas
Anne Marie

21. Closing and Next Steps
How will the feedback from this session be used?
Ideas board near the registration area of the foyer for additional feedback
Joanne or Shana

22. Thank You
Contact