Healthier You Interior Summer 2016 by Glacier Specialty Publishing

Healthier You Summer

2016

flavour

summerf ! Page 22

ROAD TO RECOVERY

A family shares their story about finding help

REGIONAL OR New approach means shorter waits for surgery

New communication tool

culture of care

Working to enhance health care for Aboriginal patients Page 10

makes the MOST of tough situations â&#x20AC;&#x201C; p. 6

Volume 1, Issue 4

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#Itstartswithme

Summer

2016

Building cultural safety and cultural humility in health care The First Nations Health Authority and Interior Health work together to provide high quality culturally safe care for all people.

By FNHA CEO Joe Gallagher and IH President & CEO Chris Mazurkewich

p.28 above: Interior Health Board Chair Erwin Malzer and Aboriginal Health Program Director Brad Anderson during recent tours of Secwepemc and Tsilhqot’in communities.

Important numbers every senior should know

inside Making the MOST of a tough situation �� Page 6 When patients are at end-of-life, it’s vital all care providers understand their wishes. Quick and delicious recipes page �� Page 13 Quinoa is a great tasting, nutritious base for a salad this summer. Building a better road to recovery �� Page 14 A mother’s personal story underscores the need to enhance access to mental health and substance use treatment.

Working together for better primary care �� Page 18 Engagement is the first step in developing new primary care homes. THE SIGHTS, SOUNDS, SMELLS AND FLAVOURS OF SUMMER �� Page 22 Summer is the time for fresh, colourful, flavourful foods. GO OUTSIDE AND PLAY! �� Page 24 We all benefit from time spent outdoors playing – especially our little ones. NEW REGIONAL OR �� Page 26 An operating room in the Interior Heart and Surgical Centre helps long-waiting patients get surgery sooner.

Cover photo: Kelowna’s Aboriginal Patient Navigators

Nicole Big Sorrel Horse (left) and Jayne Taylor.

summer 2016

Healthier You

WELCOMEmessage

Welcome from Interior Health

Chris Mazurkewich, President & CEO Interior Health

Throughout Interior Health, we’ve made a lot of improvements in how we care for frail seniors. More detailed discharge planning is helping us transition patients with the right supports from hospital to home. We are seeing more information sharing and collaboration between ourselves and physicians, through our work with local Divisions of Family Practice. But the fact is, we still have a lot of work to do.

One of the five key strategies we introduced earlier this year, our strategy to improve care for frail seniors with complex chronic conditions, has the potential to impact many people. More than 22 per cent of residents within Interior Health are over 65 year old, and that number is on the rise. Many of us have aged parents and, of course, we all keep getting older. Take me, for example. I’ve now had cataract surgery on both eyes (with excellent care at Kelowna General Hospital, I should add). And I have been watching my own mother slow down significantly in the last few years. She remains active and enjoys a busy social life, but she is using her walker more and more these days. One of the most important ways we can improve care for this important population is by supporting them to stay at home, to live independently, and to maintain that quality of life for as long as possible. That in-home support extends to end-of-life care. Our family said goodbye to my mother-in-law last spring after caring for her in her home during her final stages of illness. She did not want to die in a hospice or a hospital. She was clear that when it was her time to go, she wanted to do so at home, surrounded by those she loved. This is what happened. I encourage everyone to have conversations with your loved ones and your care team about your wishes for end-of-life care. Read more about these important conversations and steps we are taking to incorporate quality end-of-life care into clinical practice in our feature on page 6. Also in this issue, learn about the First Nations Health Authority and how we are working together to improve the health of Aboriginal people; read a personal story about substance use and our plans to develop 73 treatment beds; we have a story about our new regional operating room that is helping to address surgical waits; and we share a glimpse of a care model in the Kootenays that is making great strides in building capacity for primary care. You’ll also find ideas for fresh summer meals, and lots more. Enjoy the read!

4 Healthier You

summer 2016

Healthier You Volume 1, Issue 4 – Summer 2016

Published by:

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PUBLISHED BY interior HEALTH & GLACIER MEDIA

Contributors / Healthier You is produced by the Interior Health communications team with contributions from public health staff, in partnership with Glacier Media. Interior Health Corporate Office #220 - 1815 Kirschner Road Kelowna, BC V1Y 4N7 Glacier Media Group

Sales & Marketing Kevin Dergez Director of Special Projects kdergez@glaciermedia.ca Ellyn Schriber Newsmedia Features Manager BC eschriber@glaciermedia.ca Keshav Sharma Manager Specialty Publications ksharma@glaciermedia.ca

Advertising Sales The Daily Courier – Kelowna Kamloops This Week

Creative Director / Eric Pinfold eric@phitted.com | www.phitted.com Advertisements in this magazine are coordinated by Glacier Media. Interior Health does not endorse products or services. Any errors, omissions or opinions found in this magazine should not be attributed to the publisher. The authors, the publisher and the collaborating organizations will not assume any responsibility for commercial loss due to business decisions made based on the information contained in this magazine. Speak with your doctor before acting on any health information contained in this magazine. No part of this publication may be reproduced or transmitted without crediting Interior Health and Glacier Media. Printed in Canada. Please recycle.

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Making the MOST of a tough situation When Judy Nicol’s father passed away in Alberta, she experienced first-hand the challenge of not having all members of the healthcare team on the same page.

above: When her father passed away, Interior Health Practice Lead Judy Nicol experienced first-hand what can occur when health-care providers are not all on the same page regarding end-of-life care.

6 Healthier You

summer 2016

“His family physician knew what my Dad wanted but the hospital staff didn’t, so the care he received was not in line with previous decisions made. If there had been a way to communicate family physician orders with the broader health-care team, unwanted or unnecessary treatment could have been avoided,” Judy says. As a professional practice lead for Interior Health, Judy’s experience working in the health-care field meant she was ready and able to advocate for her father’s wishes - but not everyone has that knowledge or comfort level. That’s why it’s important to have discussions about end-of-life care in advance, then have wishes documented and shared with loved ones and the health-care team. Now there’s a new tool in Interior Health to further these conversations and help share the information. An initiative called MOST, or “Medical Orders for Scope of Treatment,” was introduced last year in Interior Health. MOST is a physician order that outlines what medical care best fits an individual based on their wishes and current health status. It provides direction to the health-care team on level of resuscitation, critical care, and/or medical interventions to minimize unnecessary or unwanted medical treatment.

“MOST provides a single form, but most importantly, a standard process for timely and accurate information across all care settings within Interior Health,” says Maureen Detwiller, who co-led implementation of MOST across Interior Health. “After an individual discusses their wishes with their family, it’s important to also share them with their health-care team, so appropriate plans and treatment options can be discussed. The process promotes the alignment of Advance Care Planning with treatment interventions when developing an overall care plan.” The result of these discussions about goals of care will be the physician filling out a MOST designation, which then appears electronically in Meditech, the patient information computer system used in Interior Health facilities. That information follows the individual through the health-care system, no matter where they are receiving care. “This sets Interior Health apart from other health organizations in Canada,” says Judy. As a doctor and member of the steering committee that introduced MOST in Interior Health, psychiatrist Dr. Paul Dagg calls MOST an important physician-to-physician communication tool. “Increasingly we are practicing not just as a lone doctor but as part of a health-care team. But the more individuals who are involved in a patient’s care, the more people need to be aware of that patient’s wishes,” says Dr. Dagg. “We also see patients from across the region or, as is the case with specialized facilities like here at Hillside Centre, we have patients from across the province. So it’s really important that we are effectively sharing patient information. “ “We are also encouraging and seeing more families involved in the care of their loved ones. MOST helps break down complicated clinical information into understandable language so they can be better informed about decision making.” “The discussions can bring up difficult ethical and emotional issues. Ideally these are conversations that are occurring when people are healthy and able to make informed choices.” Enhancements to MOST were made possible thanks to the creation of the Dignity Fund by an anonymous donor to the Kelowna General Hospital Foundation.

More info: Please visit the Making the Tough Decisions page under Palliative Care at www.interiorhealth.ca.

Advance Care Planning: Start the conversation about end-of-life care Advance Care Planning is a process of reflecting on your values and wishes and having these important discussions with loved ones. You may consider expressing your wishes and instructions in writing by appointing your representative who will speak for you if you cannot speak for yourself in a Representation Agreement, and/or by indicating specific instructions to your health-care provider about any health-care treatment you may or may not wish in an Advance Directive.

Advances in health care mean we are in a position to intervene and extend lives. At the same time, we have an increasingly aged population. These factors combined mean that having a plan in place for end-of-life care is more important than ever. Plans may include information about the type of care an individual would or wouldn’t want, as well as other personal information, such as spiritual preferences or specific wishes for family members or friends. Such planning significantly reduces stress, depression and anxiety in family members and caregivers who are aware of a patient’s wishes and can act with confidence on their behalf. “These are important considerations that are best to occur when we are in good health,” says Interior Health Professional Practice lead Judy Nicol. “Advance Care Planning allows us to have our wishes about living and dying respected when we are no longer capable of exercising this control ourselves”. There are three main options within Advance Care Planning that come into effect if you have lost capacity to give or refuse consent at the time care is needed: • Talk to loved ones who may act as your Temporary Substitute Decision Maker(s). • If you’d rather have someone else speak on your behalf, complete a Representation Agreement. • If you wish to convey specific instructions regarding medical care directly to your doctor, complete an Advance Directive. For more information, visit the Advance Care Planning page under Your Care at www.interiorhealth.ca. summer 2016

Healthier You

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#Itstartswithme

Cultural safety and humility in health services Creating a climate for change

By FNHA CEO Joe Gallagher and IH President & CEO Chris Mazurkewich

Exciting work is underway in the Southern and Central Interior that is part of a provincial movement, created right here in B.C. that will result in higher quality, culturally safe services for First Nations and Aboriginal peoples and all British Columbians. In July 2015, all B.C. Health Authority CEOs signed a Declaration of Commitment to advancing cultural humility and cultural safety within their health service organizations. Importantly, this health system-wide commitment to the declaration means all health professionals have the mandate to pay attention to, and advance, cultural humility and safety in their practice. An important principle to delivering on this commitment is the understanding that each and every First Nations person in this province owns their own health and wellness journey and that as a system, we work together to support optimal wellness.

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above: The Senior Executive Team at Interior Health was one of the first groups to participate in a new training session called Cultural Safety: A Peopleâ&#x20AC;&#x2122;s Story.

Joe Gallagher, CEO of the First Nations Health Authority.

What is cultural humility? Cultural humility is a process of self-reflection to understand personal and systemic biases. It is about pausing in the moment to question our assumptions. Questioning our own assumptions enables us to develop and maintain deeper and more respectful relationships based on mutual trust. Cultural humility also involves humbly acknowledging oneself as a learner when it comes to understanding another’s experience.

already underway in the form of Peacemaking Circles to discuss and resolve challenges, based on a restorative justice model for conflict resolution, as well as increasing the number of First Nations and Aboriginal health staff in the health system generally. The journey to creating greater cultural safety in the health system begins with each of us pausing to self-reflect in order to better understand where our assumptions come from and humbly asking for help when we need it. We’ll know that we’ve achieved cultural safety when the people receiving our services tell us we have. Each year National Aboriginal Day is celebrated on June 21, and First Nations communities throughout the southern and central interior celebrate wellness in their communities as part of the First Nations Health Authority Aboriginal Day of Wellness. This year the day also marked the official public launch of the cultural humility and safety concept in B.C. More info: Please visit the FNHA online at www.fnha.ca and sign up for the newsletter.

Cultural humility leads to cultural safety Cultural safety is an outcome based on respectful engagement that recognizes and strives to address power imbalances between providers and clients inherent in the health-care system. It contributes to an environment free of racism and discrimination, where people feel safe when receiving health care. When health-care professionals engage with First Nations peoples from a place of cultural humility, they are helping to create a safer health-care environment where individuals and families feel respected and understood. First Nations peoples are therefore more likely to access care when they need it and access care that is appropriate to their needs. This Declaration of Commitment is an important step towards embedding cultural safety and humility within the provincial system and includes three priority areas: creating a climate for change; engaging and enabling partners; and implementing and sustaining change. B.C. is hugely diverse and home to over 200 First Nations communities and 32 distinct Nations. Health-care providers are not expected to be cultural experts for all B.C. First Nations - exercising humility is about being comfortable stating what we don’t know. Each regional health authority is implementing change in their organization in different ways, in partnership with First Nations whose territory they operate in. The seven Nations here in the interior include the Dãkelh Dené, Ktunaxa, Nlaka’pamux, Secwepemc, St’át’imc, Syilx and Tsilhqot’in (learn more about the seven Interior Nations at www.fnha.ca). In the Southern and Central Interior, this work will take a number of forms including developing an interior vision for cultural safety and humility, localizing cultural competency training throughout the region, and increasing awareness of interior Nation-specific culture, traditions, geography and history among health staff. This work is

Cultural safety within Interior Health While the health status of Aboriginal people has improved over the past few decades, inequities still exist. The health outcomes of Aboriginal people are disproportionately lower compared to those of non-Aboriginal Canadians. The Aboriginal Health and Wellness strategy is a primary guiding document for the Aboriginal Health Team and Interior Health – and the number one strategic priority identified in this plan is to advance cultural competency and cultural safety within Interior Health. A number of initiatives are now underway across Interior Health to help achieve this goal, such as the recruitment of an Aboriginal Cultural Safety Educator, who offers a training session called Cultural Safety: A People’s Story. The session provides Interior Health staff and physicians a better understanding of the Aboriginal landscape in the southern and central interior while speaking of the First Nations and Métis peoples in the region, the power imbalances at play, and how that impacts present day relations in institutional settings. Interior Health’s Senior Executive Team took advantage of the training in May and gained some valuable insights. For example President and CEO Chris Mazurkewich “found the 1910 letter from three Interior B.C. chiefs to the Prime Minister fascinating. The chiefs made reasonable requests in a diplomatic and respectful manner for things they believed had been previously agreed to. Fast forward 100 plus years and the letter is still largely applicable. Is IH, you and me, listening and accommodating today?” he asks. The introduction of Peace Making Circles; an Aboriginal Cultural Care Advisory Committee; guidelines surrounding the welcoming and acknowledgement of First Nations Traditional Territory as well as use of traditional tobacco during smudging ceremonies on site; and an Aboriginal Art Initiative are among the many other activities underway to promote cultural safety and understanding. To learn more visit Aboriginal Health under Your Health at www.interiorhealth.ca. summer 2016

Healthier You

AD VER TO RI A L

EXERCISE: TAKE IT REGULARLY, NOT SERIOUSLY. If I said to you “exercise is good for you”, would you be surprised? Unlikely. There are very few people who are unaware that exercise is good for the body, mind and soul. In my discussions with people who do not yet exercise, the barrier to starting seems to be either a dislike of a mode of exercise tried in the past or being unsure of how to start. Lets look at exercise a bit differently. Lets not see it as a “4-letter word” but as a way to have some fun! I think of exercise as an effective therapy for many chronic conditions (when combined appropriately with pharmaceutical and medical therapies) with a wonderful side effect of increased quality of life. This therapy is most effective if taken regularly as a part of your daily routine. It should not be missed (like brushing your teeth). If done properly, the dose-response relationship can be observed as increased exercise tolerance after just a few short weeks! Stairs will be easier to climb and parking lots will seem smaller. According to the Canadian Society of Exercise Physiology, the optimal dosage varies by age but the recommendation for adults 18 – 64 years is 150 min of moderate intensity

aerobic exercise per week + resistance training of the major muscle groups at least 2 days per week and flexibility training (stretching) on days that other physical activity takes place. How do you get to the “optimal dosage” of exercise? Slowly. Negative side effects such as injury (or worst) can be incurred if we add this stress to the system too quickly. Always speak to your primary health care provider before starting an exercise program if there is any concern about safety. Think of exercise the way you do other medication. You want to start at a low dosage that your body can handle. Slowly increase dosage as your body will tolerate. You may experience slight muscular discomfort every time you increase the dosage and that is acceptable. Soon, that muscle pain will be replaced by increased strength! Find something that you like to do to move your body. Exercise can come in all shapes and sizes. Get creative and have some serious fun! Some ideas for fun might be dancing or a social walking group. Find something that you like to do and then add movement to it. Exercise must be taken regularly but does not need to be taken seriously.

Jennifer Edgecombe

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Quick and nutritious recipes to make healthy eating a breeze For more information about healthy eating, visit www.healthyfamiliesbc.ca or call HealthLink BC at 8-1-1 (toll-free). Registered dietitians are available Monday to Friday from 9 a.m. to 5 p.m. to answer your nutrition questions.

By Public Health Dietitian Rose Soneff

This recipe was given to me about five years ago and I make it at least once a month. I use it as a salad or as my all-in-one vegetarian meal. I also substitute other vegetables such as cucumbers, jicama, or even apples, if I don’t have the suggested ones on hand. Quinoa is an ancient grain originally grown in Bolivia and Peru. It is ranked as the highest nutrient grain. Quinoa is cooked in a similar method to rice, in about 10-15 minutes. Cook a larger amount and use as a side dish, add to stews, casseroles, or freeze for later use.

Lentil and quinoa salad makes good use of fresh herbs in the summer, and is a great flexible recipe.

Lentil and quinoa salad Ingredients • 1 cup quinoa, cooked • 1 can (19 oz) lentils, drained • 2 cloves of garlic, crushed • 1/2 cup sliced black olives • 1 tsp (or less – to taste) salt • 2 Tbsp fresh mint (or substitute 2 tsp dried) • 2 Tbsp fresh dill (or substitute 2 tsp dried) • 1/4 cup fresh parsley, chopped • 1/3 cup green onion, sliced into thin rounds • 1 green or red pepper, chopped • 1 stalk of celery, diced • 1/2 cup feta cheese, crumbled • 1 tomato, diced • 1/2 cup toasted chopped walnuts, almonds or sunflower seeds. Directions Mix together all ingredients. Combine for use as a dressing: • ¼ cup olive oil • ¼ cup lemon juice

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MENTAL HEALTH AND SUBSTANCE USE

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building a better road to recovery Betty loves her son unconditionally and she’s there for him when he needs her, even in the toughest of times.

But sometimes the circumstances are just too big to handle alone and that’s when a parent expects help will be available from professionals. Unfortunately, the response is not always what a desperate person expects. Betty’s son struggles with drug addiction and he wants to get clean. Imagine the relief a mother feels when the 23-year-old son she has worried about for eight years finally tells her he is ready to get help. And then how her hopes crash when the help she is hoping for isn’t readily available. Betty called Interior Health Mental Health and Substance Use looking for help for her son. The family met with an intake counsellor the very next day. Her son was placed on a waiting list to see a counsellor and referred to an outpatient counselling group that met four times a week. The parents were referred to a two-part education session that met once a month and a support group that met monthly. Betty’s son went to the group sessions but he was discouraged. “I kept telling him to hang in there. We have to work with the system to get you what you really need. But at the same time I was also feeling frustrated.” Both son and family felt they needed something more intensive. “As parents, we needed to know how to care for him at that moment and what we could do to help keep him safe while he waited for treatment. We needed help to navigate the system, understand our options and the timelines so we could prepare but instead we had to wait.” However, when Betty found out her son was using heroin and fentanyl she was afraid for his life after hearing so much about fentanyl being deadly. She felt she couldn’t wait any longer.

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above: Dave Harrhy, Executive Director, Mental Health and Substance Use says Interior Health is working to find real solutions. Treatment beds such as those recently announced will play a big role in this work, as will removing stigma around mental health and addictions.

continued on page 16 

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continued from page 14 that we work to remove the stigma around mental In the end, Betty took her son to a private facility where he was admitted for detox and treatment. health and substance use. All families and individuals This treatment comes at a cost and is not something should be treated with compassion and caring when Betty can easily afford. But she can’t contemplate the they reach out for help. By removing stigma we make it alternative, which she fears would be burying her son. easier for people to ask for help. And when that request for help comes in, we owe it to them to demonstrate Her disappointment with the system is understanding and provide access to programs and understandable. support. Dave Harrhy, Executive Director, Mental Health and There are programs in place both through Substance Use for Interior Health, met with Betty to community agencies and Interior Health that will discuss her experience. support people as an interim measure until longer “There are huge demands on the mental health and term treatment options are available. These supports substance use system across the country. Our teams are will strengthen going forward as resources are directed responding as best they can, and I can appreciate that, toward this area of care. (Seventy-three new substance when someone is in crisis and/or in pain, our response use treatment beds were may not be enough when it announced this spring for comes to what families hope communities throughout for and expect,” says Dave. “We need to be there for Interior Health – see sidebar “The needs of the clients can families and individuals when for more details). be very complex, especially they are ready to get help.” Betty says she is more for those with serious hopeful about the system substance use issues that – Dave Harrhy today with mental health may also be dealing with a and substance use as an co-occurring mental illness. identified priority for We know there are barriers Interior Health. to accessing care and we are making it a priority to reduce those barriers.” “I hope this can help improve the system. I hope that as the strategy moves forward there are opportunities These are the difficult issues Interior Health is for stakeholders to have input – talk to families, talk to working on with the intent of finding real solutions. It’s why Interior Health is focusing additional resources clients, talk to the community about their experiences – that is how to find the real problems and the first step to towards improving services for mental health and finding solutions.“ substance use clients through its five key strategies for 2016-2018. Dave takes Betty’s solution to heart and has invited her to join the Mental Wellness Advisory Committee, a “We need to be there for families and individuals group of people with lived experience whose input will when they are ready to get help. We all know that influence the redesign of the system of care. timely intervention is crucial when people are severely addicted to life-threatening substances and are asking As for Betty’s son – he continues to work on his for help.” recovery. He recently celebrated 90 days clean and sober In addition to timely access Dave says it’s crucial and Betty couldn’t be more proud of him.

New treatment beds coming to Southern and Central Interior An additional 73 substance use treatment beds were announced on April 6, 2016 for communities throughout Interior Health. The new beds will support and enhance existing substance use treatment services and allow Interior Health to better provide integrated specialized care planning and services in collaboration with clients who have complex substance use issues and their families.

16 Healthier You

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•O f the 73 beds, 57 will be support recovery beds providing clients a safe, substance-free setting while they await residential treatment, return from residential treatment or transition to a more stable lifestyle. Some will be provided by an Aboriginal organization and dedicated to Aboriginal clients. •T he remaining 16 beds will be withdrawal management beds (detox) supporting adults (12 beds) and youth (four beds) through the early stages of withdrawal from alcohol and/or other substances. •P lanning for the beds, which will be located in several communities throughout Interior Health, is now underway. • The exact locations will be determined through the competitive procurement process. All beds are anticipated to be operational by spring 2017.

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Access to primary care is one of Interior Health’s five key strategies for 2016 – 2018. Primary care is often considered a person’s first point of contact into the health system. For most people, this would be their family doctor, or a nurse practitioner. Primary care is meant to be centered around a person’s basic individual needs over their whole life span. It also integrates care provided by other health-care providers, to ensure all care is coordinated. In the Kootenay-Boundary, the first essential steps toward developing primary care homes are under way. That initial work begins with community engagement. Those two words also encompass a wide range of voices, all of which must be heard and included if the primary care home model is to succeed. It may not sound extraordinary, but it’s crucial to ensuring this new way of providing holistic, full-service primary care to large groups of patients is done right. 18 Healthier You

summer 2016

above (left to right): Dr. Lee McKay, Physician Lead for the KootenayBoundary Division of Family Practice, Cheryl Whittleton, Interior Health KB Health Services Administrator, and Andrew Earnshaw, Executive Director of the KB Division of Family Practice, are working together to engage stakeholders in the development of a primary care home model for KB communities.

Primary Care Homes will incorporate an interprofessional team of health-care providers who will meet the primary care needs of the community population by providing continuity of care, access to a full menu of quality (effectiveness, access, acceptability, appropriateness, and safety) primary care services and, as required, timely access to specialized health-care services. They are relatively new to B.C., but are the face of the primary care system in Alberta and across the ocean in the United Kingdom. Northern Health is the first health authority in B.C. to begin implementing a primary care home that has the essential components. Within Interior Health, progressive work toward developing a primary care home is taking place in the Kootenay Boundary between the area’s Division of Family Practice and Interior Health leaders. Health authorities and family physicians have traditionally operated at a distance from each other. In recent years, though, partnerships have developed between the Ministry of Health and the Doctors of B.C. through the General Practice Services Committee, which has representation from both. That same co-operative approach is what has solidified ongoing progress in the Kootenay Boundary. “Somewhere along the line we recognized we had the same goals,” says Kootenay-Boundary Health Services Administrator Cheryl Whittleton. “We agreed we are all in this boat together.” With that realization, the area’s Collaborative Services Committee, which is co-chaired by Division Physician Lead Dr. Lee McKay and Cheryl, began working on ways of jointly caring for patients with complex, chronic health conditions. Now, the Collaborative Services Committee is looking to expand those partnerships through the Primary Care Home model, which has a patient medical home at its core. Inside that medical home are the physician, patient and family with links to specialized clinics, specialists, community programming, and residential support and in-home treatment services. Andrew Earnshaw, Executive Director of the Kootenay Boundary Division of Family Practice, explains that the attributes and services incorporated in each Primary Care Home are the ingredients, but the actual creation will be the result of collaborative work by a number of partners. “People who live in the local communities have to have a sense of ownership in the primary care home. We won’t be able to deliver a successful primary care home through government involvement alone. Each one has to be designed on the ground from the forces within.” continued on page 20 

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Local doctors and Interior Health staff are coming together to discuss the first step in creating enhanced primary care service – engagement.

Community meetings have begun across the KootenayBoundary with physicians, community leaders and Interior Health front line and managerial Nursing and Allied staff, being asked to identify how they want the process of engagement to occur. The Collaborative Services Committee’s first round of engagement with physicians in the communities of

Castlegar, Boundary and Trail saw strong attendance and cautious optimism from the doctors in attendance. “All appreciate the opportunity that functional teambased primary care offers for improved population health and health system sustainability in the face of the pressures associated with an aging population,” says Andrew. Twelve to 15 sessions in five different areas will allow discussions to occur about what is happening in the health-care landscape; what opportunities are available to strengthen primary care, and also detect whether essential players are motivated to take part in a system change, Cheryl adds. Dr. McKay says it’s important that physicians want to take a leadership role in the development of primary care homes, and that is more likely to occur if they believe that the outcome will make primary health care more effective for their patients, and result in fewer visits to the hospital. Partnership work between the Kootenay Boundary Division of Family Practice and Interior Health employees over the past several years has set the stage for ongoing collaboration for establishing the first primary care homes in Interior Health.

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The sights, sounds, smells and flavours of

summer By Public Health Dietitian Cindy Bossio

Are you heading to the beach for the day, camping for the weekend or having the neighbours over for a barbeque? Grab some local seasonal produce to enjoy along with your summertime fun!

22 Healthier You

summer 2016

There are so many great reasons to eat locally grown foods, but my favourite, by far, is the flavour. Produce fresh from your garden, a farm stand, or a farmersâ&#x20AC;&#x2122; market is picked at the peak of ripeness and is brimming with flavours that make summertime so special.

It’s a bonus that local foods are better for the environment, keep our hard earned money in the community, and are more nutritious than foods that come from afar. For me, summer is a time for: • Fresh strawberries, blueberries, raspberries and a mint leaf bobbing in a tall glass of sparkling water, sipped by the lake. • A colorful parfait layered with yogurt, whole grain cereal, and freshly picked huckleberries enjoyed while sitting on the patio. • A big leafy green salad loaded with spinach, kale, tomatoes, broccoli, cucumbers, and shredded beets, carried next door and paired with the entrée on your neighbour’s grill. • Crunchy ears of corn with fresh dill from a food truck. • Bright red juicy cherries from the Farmers’ Market.

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• Tomatoes and herbs from a Community Garden tossed on a whole-wheat pizza and cooked in an outdoor oven. • A homemade fresh fruit popsicle enjoyed by a child after an afternoon of playing outdoors. • Watermelon sliced and slurped while sitting at a picnic table surrounded by trees. • Celery stalks dipped into fresh salsa made with tomatoes, cilantro, garlic, chili peppers, onions, and passed around the campfire. • Colorful sweet peppers, zucchini, cauliflower, and eggplant, slowly roasted on the barbeque. • The smell of muffins baked in the oven on a cool late summer evening, made from zucchini picked from the garden. Check out what’s in season now at www.bcfarmersmarket.org. Let the sights, sounds, smells, and flavours of summer tempt your senses!

Go outside and

play!

The nice weather is here and it’s time to go outside and play! Community playgrounds are a great place for your toddler to run, climb and swing. They also get a chance to meet and learn to play with other children. Healthy Families BC offers up some great advice to keep the experience safe:

The equipment: • Make sure the playground equipment is in good condition, well anchored, and the right size and height for your toddler. If your toddler can’t reach the equipment without help, it’s too big. Children younger than five should use playgrounds designed for preschoolers. The equipment should be no more than 1.5 metres (five feet) high. • Make sure the equipment doesn’t have sharp points, corners, hooks, or joints that could catch clothing. • Look for guardrails, barriers and soft seats. These all help prevent injuries.

The grounds: • Look for playgrounds with lots of space around the equipment. • Playgrounds with sand, wood chips or synthetic materials on the ground are safest. • Teach playground safety: • Always accompany your toddler to the playground and provide proper supervision. Playground falls are a major cause of serious injuries. •T each your toddler not to cross the path of a moving swing. •C heck the temperature of a metal slide with your hand. A metal slide standing in the sun can get hot enough to burn the skin. More info: Playing is fun and we all need to play more. Check out Participaction’s Bring Back Play website for more play information and inspiration at www.participaction.com. 24 Healthier You

summer 2016

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New regional OR helps long-waiting patients get surgery sooner

Lody Olivier didn’t hesitate. For nearly two years, the Vernon man had been waiting for knee replacement surgery on his right knee. He knew from the outset that the wait may be long, and was resigned to the fact. Nonetheless, it was still discouraging when Lody was advised one day, a year and a half into his wait, that it might be another year before he would get called. Then, a month later, Lody received another call and was asked if he’d be willing to travel to Kelowna General Hospital for his procedure. “Absolutely!” recalls the 67-year-old. “Kelowna is just 35 minutes up the road. To have the operation over and done with in Kelowna – not a problem. Let’s do it.” Lody was one of the first patients to take advantage of Interior Health’s regional operating room, located in the Interior Heart and Surgical Centre (IHSC) at Kelowna General Hospital. The regional OR is one component of Interior Health’s surgical strategy – to improve timely access to appropriately scheduled elective surgery. It’s one of Interior Health’s five key strategies for 2016-2018.

above: A

regional OR is located within the Interior Heart and Surgical Centre, which opened in Kelowna in September 2015. 26 Healthier You

summer 2016

left: Lody and Monica Olivier enjoy their horses on their rural property in Vernon.

Innovative solutions were needed to meet Interior Health’s goal of seeing 95 per cent of scheduled surgeries completed within 40 weeks by 2017, says Ben Rhebergen, who is leading the surgical strategy work. “Opening an OR at KGH with access to surgery for both local patients and for patients from outside of Kelowna allowed our surgeons to perform extra surgeries and reduce wait times for our longest-waiting patients,” Ben explains. “This option was chosen as it allowed us to efficiently use the resources that were available to us, to best serve our patients and match system capacity to demand.” Since June 2015, surgeons from Vernon, Penticton, and, for a time, Kamloops have travelled to KGH to take advantage of the regional OR. Initially, an OR that would have been closed over summer to accommodate vacations was kept open to provide the choice for long-waiting patients to have their procedures. It was so successful that a decision was made to continue beyond summer by equipping an additional OR in the IHSC. Procedures have included total hip, knee and shoulder replacements; hernia repairs; back surgery; shoulder repairs; sinus surgery; and ear, nose and throat surgery. “Additional instruments were purchased to accommodate the visiting surgeons,” says Nancy Thomas, the regional OR coordinator, who has some 30 years of perioperative nursing experience. “Processes were developed for the flow of patients to minimize their travel to Kelowna. Work began to standardize the supplies, instruments, and equipment between the different surgeons to improve efficiencies.” Nancy says the biggest challenge for her and team leader Jonas Shoemaker, is coordinating the resources and clinical team for the surgeons and patients, recognizing their need for travel and their preferences in the operating room. But the shared learnings that have come from bringing together so many varied talents has far outweighed any

coordination headaches. “They all want what’s best for the patients,” Nancy says. A total of 641 procedures have been done in the regional OR. “Those are patients that might not have had surgery as quickly.” Dr. Paul Dooley is one of the surgeons from Vernon who has travelled to Kelowna to treat patients in the regional OR, including Lody. While Dr. Dooley is pleased to see that resources have been targeted to help reduce wait times for patients, he’s equally clear that his preference would be to have the necessary resources in his own community, so that patients don’t need to travel – particularly those who are elderly or whose family members or spouses are not easily able to accompany them to Kelowna without added cost. Ultimately, having care closer to home is what’s best for patients. “That being said, the additional resources have allowed more surgeries to be completed. We have been able to address wait lists,” he says. “From a patient’s perspective, it’s good news. From a wait list perspective, it’s helpful. Is it an ideal solution? No. But the quality of care in the regional OR has been exceptional. The actual surgical experience at Kelowna has been great.” That’s a sentiment echoed wholeheartedly by Lody. He went home a day and a half after his procedure last June, after a “fabulous experience” from the care team at KGH. Now, he’s back to his full-time job as a supervisor at Home Depot, and tending to his horses with wife Monica on his five-acre spread near Vernon. And, perhaps most importantly, he’s playing soccer with his four grandchildren again. “Before the surgery, I asked my surgeon, ‘Am I going to be able to kick a soccer ball after all this?’ He said, ‘You won’t be able to play in FIFA, but you will be able to kick a soccer ball.’ And I do,” Lody says. “I would have gone further for my surgery, if need be. This was incredible.” summer 2016

Healthier You

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Important numbers

every senior needs to know

health information

Doctor/Clinic phone number

emergency services

9-1-1

pport at t your health? Need su Have a question abou numbers ep this list of handy Ke s? isi cr a g cin Fa home? ed. reference when in ne at your side for a quick

24 hours, seven days a week, call 9-1-1 in any serious emergency.

Office of the Seniors Advocate

HealthLink BC

8-1-1

â&#x20AC;&#x201C; www.healthlinkbc.ca (Deaf and Hearing impaired services are also available at 7-1-1) HealthLink BC offers 24/7 health information you can trust. Call 8-1-1 from anywhere in British Columbia to speak with a nurse any time of the day or night. On weekdays, you can speak to a dietitian about nutrition and healthy eating. At night, there are pharmacists available to answer your medication questions.

28 Healthier You

summer 2016

1-877-952-3181

For guidance on how to access health-care and social services anywhere in B.C., seniors can call the Office of the Seniors Advocate. This toll-free phone line is available Monday-Friday from 8:30 a.m. to 4:30 p.m.

Patient Care Quality Office

Important numbers

every senior needs to know

Unresolved concerns, compliments or complaints Toll Free Number: 1-877-IHA-2001 (1-877-442-2001) All patients and clients are encouraged to try and resolve any issues at the time and place care is received. However, if that is not possible or your concern is not resolved, contact Interior Health’s Patient Care Quality Office (PCQO). The PCQO provides a clear, consistent, timely and transparent process for patients to register complaints about the care they receive from Interior Health.

Interior Health Elder Abuse Hotline Interior Crisis Line Network

1-844-870-4754

1-888-353-CARE (2273)

For concerns regarding elder abuse, Interior Health will help connect you to the appropriate designated responder for follow-up.

Serves the entire Interior Health area. Provides confidential emotional support, crisis and suicide assessment/intervention and resource information to people at the community level.

First Link® Dementia Helpline (Alzheimer Society)

1-800-936-6033 For those living with dementia or those who have questions about the disease, the First Link® Dementia Helpline is a confidential service with trained, caring staff and volunteers to answer calls and provide information and support. Hours: Monday to Friday, 9 a.m. to 4 p.m.

BC Drug and Poison Information Centre

1-800-567-8911

A 24-hour telephone information service that provides immediate information about the effects of drugs and poisons and treatment to health-care providers and the general public.

Home and Community Care local contact information is listed by community under “Your Care” at www.interiorhealth.ca, or under “Health Authorities” in your phonebook’s blue pages.

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