Possibilities through Partnerships

Victoria Power & Alison Mitchell Vancouver Island Health Authority

British Columbia

Discussion Overview

• VIHA – Who are We?

• Mount Waddington - Where the Heck is it?

• Partnership Journey 1.0 & 2.0

• Key Elements of a Successful Partnership Journey

• Results of the Journey to Date

• The Journey Continues

VIHA at a Glance

BUDGET $1.8 Billion POPULATION 765,849 (17% of BC) ABORIGINAL POPULATION 40,550 HEALTH CARE PROFESSIONALS 18,000 PHYSICIAN PARTNERS 1,900 FACILITIES 150+ ACUTE CARE & REHAB BEDS 1,500 RESIDENTIAL CARE BEDS 6,350 COMMUNITY ADDICTION BEDS 386 COMMUNITY MENTAL HEALTH BEDS 646 VOLUNTEERS 3,600 volunteers

260,000 hours per year

Mount Waddington (MW) Overview

• Approximately three hours from Campbell River • Many of its communities are more accessible by boat or plane

than by road • 14,000 population (23.9% Aboriginal) spread over 21,157 square

kilometres • Poor socio-economic indicators:

– 5% on income assistance (10% of children) / 10% unemployment /EI 3.4%

– 35% of children below standard in both reading and writing, – children in care 4x higher than BC rate (24.9/1000) – 17% of dwellings needing major repair – high percentage of multi-family households and crowded households – 2X higher rate of illicit drug deaths, more alcohol sales per capita

Mount Waddington Overview

• High rates of pediatric hospitalizations for respiratory illness, injury and poisoning

• Highest live birth rate in VIHA / second highest rate of teen mothers in VIHA

• Highest rate of death for 10 of the 18 major causes of death, and the second or third highest for an additional 5 compared to the other LHAs.

• 23.5% of residents have depression/anxiety • 18.5% of residents have hypertension • Proportion of residents receiving emergency services

is 2X VIHA average for all age groups

MW Health Services–

Partnership Journey 1.0 • 2006 - community engagement sessions that

highlighted significant gaps in determinants of health (transportation, housing)

• 2007 - Mount Waddington Community Health Network (MWCHN) created , consisting of a variety of organizations interested in health

• 2008 – MWCHN Annual Joint Public Forums with VIHA Board of Directors

MW Health Services–

Partnership Journey 1.0 • 2010 – MW moved from a program

management model to a geographic leadership model – 3 24/7 acute care hospitals, 1 urgent care centre,

2 residential care facilities, home care, mental health, addictions services, public health, primary care Addictions and public health.

• 2011 – Port Hardy loses 2/6 GPs = cascade affect of ↑ ER visits + ↓ PHC access = ↑ GP burnout + ↑ ER closures

MW Health Services–

Partnership Journey 2.0 • September 2011 Joint MWCHN / VIHA Board

Public Meeting – Mount Waddington Health System Stabilization

Local Working Group (LWG) formed

– MWCHN, Mayors, RHD, First Nations, GPs, VIHA local leaders

– Mandate to review current state and provide recommendations to stabilize health system by March 31, 2012

5 Key Elements of a Successful Partnership Journey

1. Executive Commitment (The Map) – Executive Charge

– Public Visibility

– Avoiding Triangulation – Letting Local Leaders be Source of Truth

– Responsive Forum for Barrier busting

5 Key Elements of a Successful Partnership Journey

2. Systemic Evaluation & Performance Monitoring (Food) – Digested + Nutritious

Information for Hungry Partners

– Quality Improvement Focus

– Dashboard Workplan

5 Key Elements of a Successful Partnership Journey

3. Frontline Leadership & Engagement (shelter) – SIT

– Current / Future State

– PDSA without Asking

4. Physician Engagement (Generator) – Early is not early enough

– Divisions of Family Practice

5 Key Elements of a Successful Partnership Journey

5. Community Engagement (GPS) – Shared Accountability (IAP2)

– Transparent Process (the WEBSITE)

– Communications Plan

– One meeting does not constitute collaboration

Journey Results

Journey Results

Journey Results

Results – ER Closures (In Hours)

Expanded

Care

Specialty

Care

Community

Care

“Results - Wellness Possibilities Through Partnerships

Core Primary Health Care

Client & Support

6/20/2013 20

Port Hardy (2) 1. Coal Harbour 2. Holberg 3. Quatsino 4. Old Quatsino 5. Winter

Harbour 6. Fort Rupert 7. Gwa'sala-

'Nakwaxda'xw

Alert Bay Port Alice Port McNeill

8. Gilford 9. Kingcome 10. Kyuquot 11. Rivers Inlet 12. Sointula 13. Woss 14. Zeballos

Proposed Hub – Satellite Locations

- VIHA Hub

- VIHA Satellite

- Non VIHA Hub

- Non VIHA Satellite

14

11

2

10

13

8 9

12 1

6/20/2013 21

5

7 3

4 6

- Services overlap with Namgis Health Centre

Hub/Satellite Communication Network

6/20/2013

Port Hardy Alert Bay

Port Alice

Coal Harbour

Gilford

Holberg

Kyuquot Zeballos

Woss

Rivers Inlet

Kingcome

Sointula

Port McNeill

22

Quatsino

Winter Harbour

Fort Rupert

Old Quatsino

Gwa'sala-'Nakwaxda'xw

- VIHA Hub

- VIHA Satellite

- Non VIHA Hub

- Non VIHA Satellite

- Services overlap with Namgis Health Centre

The Journey Continues

• Designate a dedicated Project Director for process coordination

• Establish stronger working relationships with First Nations partners sooner

• Expand public education on how health care system works

• Recalibrate service funding formula for remote communities to address local needs versus per capita allocation

• Explore Alternative Payment Plan for physicians

Contact Information • Victoria.Power@VIHA.CA

• Alison Mitchell@VIHA.CA • www.viha.ca/about_viha/community/mt_waddington • www.MountWaddingtonHealthNetwork.com • www.VIHA.CA/PHC_CDM