BC Children's Hospital Foundation 2013 Report on Giving presented to Scotiabank

2013 REPORT ON GIVING Regional Subspecialty Clinics Supported

by Child Health BC

P RES ENT ED TO

Scotiabank

Thanks to Scotiabank and its employees’ leadership and generosity, Child Health BC has made tremendous progress this past year in realizing its vision of achieving the best health for infants, children and youth in BC. Thousands of BC’s children and families have benefited from the program through the creation and/or expansion of pediatric clinics throughout the province, the development of provincial standards of care and many other initiatives. It is heartening to know that children and their families are benefiting from the innovative enhancements that have resulted from Scotiabank’s philanthropy.

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MOVING FORWARD

Dr. Maureen O’Donnell

Since Dr. Maureen O’Donnell became the executive director of Child Health BC in October 2010, the vision and work plan for Child Health BC has evolved, leading to an aggressive set of strategies that include comprehensive service planning and complex partner initiatives. The program’s activities now cross the full continuum of health services – from health promotion and injury prevention to primary and subspecialized care – to meet the acute, chronic and end-of-life care needs of children.

One of the key strategies in meeting this vision is to support the delivery of regional specialty and subspecialty services. We are proud to report the many ways that Scotiabank’s support has accelerated the activities of regional subspecialty clinics this year.

The development of regional pediatric clinics is at the heart of ensuring children have access to specialized care as close to their home community as possible. Since 2007, with Child Health BC funding, five pediatric ambulatory care facilities in Richmond, Vernon, Prince George, Prince Rupert and Nanaimo have been either expanded or created. These clinics enable children and families to see subspecialists in or near their communities, sparing them the inconvenience of having to travel to BC Children’s Hospital in Vancouver for care and ensuring children, who would otherwise not be seen, receive proper care. These clinics also play a big role in enhancing the skills of regional caregivers through the building of collaborative relationships between local providers and BC Children’s clinical teams.

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ONGOING OUTREACH VISITS BY CLINICIANS In addition to the expansion of regional clinics, Child Health BC continues to support physician visits from nine clinical areas of BC Children’s Hospital to communities across BC, and helps to cover travel expenses for nurses, dietitians and therapists.

BC Children’s care teams visit many communities throughout the province, including Prince George, Terrace, Kelowna, Trail, Nanaimo, Victoria, Surrey and Abbotsford. They provide care in areas such as endocrinology and diabetes, respirology, rheumatology, neurology and gastroenterology. In 2012 a total of 1,699 visits were made to communities in five regional health authorities – the majority of which were in the northern and interior regions of BC. The following table outlines all of the clinics and the number of visits to each health authority.

BC Children’s Hospital outreach clinics supported

by Child Health BC Jan 1 – Dec 31, 2012

Health Authority and Health Services Delivery Area Vancouver Coastal Total

Vancouver Island Total

Northern Total

Interior Total

Grand Total

–

–

12

7

19

504

–

–

94

13

611

Ear, Nose & Throat

1

47

1

99

4

152

Gastroenterology

1

1

65

37

–

104

330

4

–

Cystic Fibrosis Diabetes/Endocrinology

Neurology

Fraser Total

–

104

127

565

Ophthalmology

3

–

2

40

45

Renal

1

65

4

70

Rheumatology/Arthritis

3

121

9

133

839

56

68

532

204

1,699 3

EXPANDING THE CARDIOLOGY OUTREACH PROGRAM IN THE FRASER VALLEY Plans are underway to expand cardiology outreach services to Surrey Memorial Hospital in the Fraser Health Authority. This involves building the organizational infrastructure required to support the services – ensuring there is appropriate space and clinical equipment, and that a booking appointment procedure, clinical protocols, medical record keeping, clinician training and education, and other relevant components are in place.

Along with program development, Child Health BC will support a nurse clinician who will accompany the subspecialist on the Surrey clinic days.

The nurse clinician will participate in the ongoing development of the provincial cardiology program, working closely with Child Health BC and the regional health authorities. Duties will include: Facilitating discussions about outreach and other provincial service planning; Collecting information for quarterly reporting on cardiology outreach; Providing patient care and clinical education for nurses provincewide; and Developing provincial pediatric cardiology resources.

The expanded clinic began with biweekly clinic days in March and has become a regular weekly clinic as of May 2013.

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LAUNCHING PEDIATRIC DIABETES SERVICES IN THE OKANAGAN Plans to expand the Interior Health Authority’s diabetes outreach program to Kelowna are also underway. Working with the area’s pediatric medical and nursing leadership to address a recent gap in local service for children and youth with diabetes, Michele Fryer, Child Health BC’s provincial lead in Regional Specialty and Subspecialty Services, is organizing the addition of a Kelowna-based clinic to the BC Children’s Hospital diabetes outreach program.

This extension of clinical outreach services will be highly beneficial for families with children living with diabetes in and around Kelowna. The concept of a shared-care model is being considered in which local family physicians, pediatricians and subspecialists from BC Children’s Hospital share responsibility in caring for a diabetic child. This model will also contribute to growing the knowledge of local pediatric health-care professionals. The first diabetes outreach clinic in Kelowna was held in May 2013. Logistical work is ongoing.

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VIDEO CLINICS – DELIVERING SERVICE THROUGH TELEHEALTH Last year the regional subspecialty clinics expanded to include neurology clinics, which make use of telehealth and videoconferencing.

These clinics represent a new kind of expansion in the use of technology – something the future will hold more of as the development of a comprehensive telehealth-supported system is underway.

The telehealth pilot with the Neurology Division at BC Children’s Hospital is led by Dr. Mary Connolly. The purpose of the pilot is to test the feasibility of doing a provincial telehealth follow-up clinic for children and youth with epilepsy. Through video conferencing, telehealth facilitates the sharing of information and dissemination of best practices, and brings rural and remote health-care providers closer to colleagues around the province. It serves as a teaching tool, helping BC Children’s specialists share their knowledge with medical students, patient families and the public.

Telehealth is also used to evaluate patients at a distance to determine if they need to visit BC Children’s for further evaluation and treatment.

For children requiring neurology care, a child and his or her family first have an initial face-to-face meeting with Dr. Connolly at BC Children’s Hospital. Subsequent visits are then organized in which Dr. Connolly meets with her patients, their family and care provider at a scheduled time via telehealth, enabling these patients to remain in their home communities while being connected to Dr. Connolly and her team at BC Children’s. To date, 17 epilepsy follow-up clinical sessions have been held for patients and local providers in the province, primarily in Prince George and Kelowna.

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BENEFIT OF TELEHEALTH SUBSPECIALTY CLINICS TO CHILDREN AND COMMUNITIES Thanks to the telehealth neurology clinics, families experience less disruption in their lives and are spared the cost of visiting Vancouver.

From the local clinicians’ perspective, they have an opportunity to increase their clinical competency through their direct connection with Dr. Connolly, and are able to provide some monitoring and ongoing care to children in their local community between visits. Child Health BC is considering opportunities to expand this model of service delivery in other clinical areas such as asthma, diabetes, endocrinology and cystic fibrosis.

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MORGAN’S STORY Long drives are no big deal for Vernon resident Eric Olsen, but one trip that Eric, and his wife, Tracey Reade, would rather not make is the five-hour, 450-kilometre trek to BC Children’s Hospital where their fiveyear-old daughter Morgan receives care for epilepsy.

Eric drives a truck for a living and is often on the road so he and Tracey try to keep their trips to BC Children’s to two days, but this still comes with its share of inconvenience. There’s the cost of travel, missed days of work, and the issue of accommodation.

“It’s stressful on the family,” says Tracey, noting that the earlier trips were traumatic for Morgan. “She loves travelling now, but the trips were not part of her routine and she didn’t like hospital settings.”

Routine is important for Morgan, who also has autism. Not only does she have to deal with frightening seizures caused by her epilepsy, she is upset by noise and sometimes “melts down,” Tracey says.

Morgan and her parents have made four trips to BC Children’s Hospital since she was diagnosed in 2007. Fortunately, Child Health BC has made life easier for the family. Since 2008 Morgan has seen BC Children’s Hospital neurologist Dr. Mary Connolly five times without having to travel further than Kelowna. Dr. Connolly has met with Morgan twice in Kelowna, where she holds a pediatric neurology clinic three times a year, and three times at a video-conferencing facility in Vernon.

Tracey says Morgan is happy to be able to attend kindergarten and visit with friends and staff at the NONA Child Development Centre in Vernon, where she spends her afternoons. “She’s just a very bubbly, loving fiveyear-old who loves to dance, colour and do puzzles. We’re grateful to Dr. Connolly and BC Children’s Hospital that she can enjoy these simple things in life.”

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ENSURING EXCELLENCE THROUGH PROVINCIAL STANDARDS OF CARE Another way Child Health BC ensures the best health for children is through the development of provincial standards of care for child health conditions.

Informed by literature reviews, research and international best practices, province-wide standards of care are highly beneficial for regional caregivers. The standards will allow caregivers to refer and treat children with specific conditions with the confidence that they are following accepted and agreed-upon protocols. In Canada, Child Health BC is a unique organization that develops provincial standards with implementation strategies that help to ensure their use. So far standards have been created for cystic fibrosis, childhood diabetes and cerebral palsy.

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I’m grateful for the support provided by Scotiabank in enabling my team to see children right in their home communities. A visit to BC Children’s Hospital in Vancouver often poses great financial and time challenges for these families. Through the travelling clinics we are able to take this burden away from families and ensure that their children get the specialized care they need. This makes a big difference in their health and improves their quality of life significantly. On behalf of the patients we serve, thank you.

– Dr. Jean-Pierre Chanoine,

clinical professor and head of the Endocrinology and Diabetes Unit at BC Children’s Hospital

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YOUR GIFT IS CHANGING LIVES Thank you, Scotiabank and Scotiabank employees, for your inspiring generosity and support of Child Health BC. Through your donation you are safeguarding the well-being of BC’s children and enabling families to access the specialized care their children need, while being able to stay closer to the comforts of home.

Every day, positive and groundbreaking changes in child health care are being made throughout the province because of you.

We look forward to continuing to partner with you as we transform the delivery of health care to children across our province.

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BC Children’s Hospital Foundation 938 West 28th Avenue, Vancouver BC V5Z 4H4 Tel: 604 875 2444

Toll Free: 1 888 663 3033

Fax: 604 875 2596

www.bcchf.ca