SSC Co-Chair Report

Welcome to the Co-Chair Report, which keeps you informed about the actions and activities of the Specialist Services Committee (SSC). The committee members are made up of representatives from Doctors of BC, Ministry of Health and Health Authorities. 

Mr Ryan Murray                              Dr Ahmer Karimuddin
SSC Co-Chair (Interim)                   SSC Co-Chair
Ministry of Health                            Doctors of BC
& Health Authorities       

See Co-Chair letter on Specialists and PCNs

October 2019 Report

With the new Physician Master Agreement approved earlier this year and the end of our previous strategic plan (2016-19), we are pleased to announce that our revised three-year strategic plan is ready and includes a few new improvements and areas of work for this time period.

Before introducing the improvements however, it is important to thank all the stakeholders who helped us in the process. At the Specialist Symposium earlier this year, over 200 participants, mainly specialists representing both communities and facilities across BC helped us identify and prioritize their needs. During several sessions last year, our health authorities and allied partners also assisted us to explore collaborative solutions in addition to several consultations we held with the committee itself. All of this resulted in us gaining a better knowledge of BC’s specialist care challenges on the ground, and coming up with inclusive and collaborative solutions, some of which, we seek to pursue through our revised strategic plan in the next three years (2020-23).

SSC's New Strategic Framework:

The three components of work identified in the new Strategic Plan are similar to our previous plan, but have been re-worded to best represent our work. The actual work we intend to undertake as part of each of the components however have improved to address the changing needs of our target populations and partners. Our three buckets of work include:

1. Engage Physicians & Health Partners
2. Transform Care Delivery
3. Develop Physician Capability

Engage Physicians & Health Partners:

Outlined below are the ways in which we intend to engage our health authorities and partners:

1. Our flagship Facility Engagement Initiative (FEI) will continue to fund and support the Medical Staff Associations (MSAs) to increase engagement among members and with their health authorities.

NEW
2. Collaborative Councils: will bring together health partners and facilities across BC to bring alignment in specialist work around the province.

NEW
3. Improving Specialist Job Satisfaction: will work to address physician burnout and improve provider experience of care delivery.

NEW
4. Supporting Community Based Specialists: will explore how community specialists can be better integrated in the work of SSC.

Transform Care Delivery:

The contributions we are making to help transform BC’s health care system are as follows:

1. The Quality & Innovation projects that we started supporting in 2015 to support specialist physicians’ ideas for improvement have gained a new momentum with a small percentage of successful projects spreading their work to larger localities, regions and in some cases province wide. We are focused on sustaining the remaining projects and do not intend to accept new applications through this initiative.

2. Building on the successes and learnings from the first round of the Enhancing Access Initiative, we have renewed funding to this initiative in our effort to improve patient access by enabling specialist groups to implement a pooled referral model of service delivery.

3. The Surgical Patient Optimization Collaborative builds on the experience of our previous Enhanced Recovery After Surgery (ERAS) initiative and is working with teams across BC to optimize surgical patients’ health before major surgery for improved surgical outcomes. The work of this collaborative is hoped to be integrated in the health care system after its completion by the end of 2020.

4. SSC Fees will continue to compensate specialists to provide coordinated and timely care to patients and to consult other clinicians on complex cases. The funds continue to be provided by the SSC but will be operationally managed by the Ministry of Health starting mid-2020.

Develop Physician Capability

We will continue to develop physician capability via our three initiatives:

The Physician Quality Improvement Initiative (PQI) will continue to train physicians in quality improvement and support their Learning Action Projects. Extended funding will ensure its spread and regional focus.

The Physician Leadership Scholarship fund will continue to empower specialists to pursue leadership training of their choosing as approved by the SSC and Shared Care committees.

The UBC Sauder Leadership Program will also continue to enable physicians to pursue accredited leadership training by the University of British Columbia.

We hope that with the above descriptions we were able to shine a light on our new strategic framework. Download a one-pager for information on our strategic framework here. If you have questions, or need further information, contact sscbc@doctorsofbc.ca

June 2019 Report

Recent Successes

We think it’s time to acknowledge some recent successes, growth, and enthusiasm we have witnessed in the past few months in regard to the work of the Specialist Services Committee. These include, but are not limited to the following:

• The PQI Summit last November brought together 400 participants from across the province who celebrated their QI successes, connected with their colleagues and were inspired by Dr Don Berwick, one of the top leaders in Quality Improvement. PQI has 220 graduates so far and has supported 216 projects.
• The work of Facility Engagement is growing and not only helping the sites establish their Medical Staff Associations (MSA) and build relationships with their health authorities, but also helping them enrich the quality of their engagement by supporting 72 MSAs through 632 collaborative activities.
• The enthusiasm expressed by over 100 participants at the launch of the new Surgical Patient Optimization Collaborative (SPOC) also made us realize the importance of attending to this area of care. SPOC will help optimize 13 clinical components of surgical patients’ health over the next 18 months in several sites around the province. The work of this collaborative is expected to be integrated into the health care system after completion.
• The Specialist Symposium held in January, brought together over 200 physicians from across the province to help us capture their voices and prioritize matters based on their feedback in our next three-year strategic plan (2020-23). This event was co-hosted with the Specialists of BC. In addition to the symposium, we’ve also gathered feedback from our health authority partners, and a variety of other tables with whom our work intersects. Our new strategic plan will be made available by the Fall of this year.

You can access more information about SSC’s work in our Annual Report (April 2018 to March 2019).

Physician Master Agreement (PMA) 2019-2022

The New PMA was ratified with 96.8 percent of votes in favour of the new agreement. SSC’s mandate continues under the new PMA and we have an additional $5 million to utilize over the three-year term of the new agreement. Under the new PMA, the SSC and Labour Market Adjustment (LMA) Fees will be moved out of SSC’s budget into the Ministry of Health’s Medical Services Plan (MSP), effective April 1, 2020. We encourage specialists to continue using these fees prudently as SSC will still be responsible for funding utilization growth above 2.4 per cent annually during the term.

Committee Changes

Over the past few months we’ve welcomed a few new faces to the committee that include:

• Dr Paula Lott, Obstetrician & Gynecologist as Doctors of BC representative (Alternate)
• Dr Christine Hall (Island Health representative),
• Tommy Gerschman, President, Specialists of BC (guest),
• Dr Faisal Khosa, Radiologist as Doctors of BC Representative (Alternate)

And have appreciated and said farewell to:

• Dr. John Falconer (guest from Specialists of BC)
• Dr Malcolm Ogborn, (Island Health representative)

September 2018 Report

Note: Dr Ron Carere has stepped down as the SSC Co-chair for the Ministry of Health. For the interim, Mr. Brendan Abbott, a long-standing member of the SSC has kindly agreed to step in. We wish to thank Ron for his support and insights.

Patient Voice

We exist as a Committee to help make improvements to health care – specifically as it relates to our BC specialist-physicians. Since health care is about taking care of people, we thought as a committee it was important to hear from the very people who use our system – patients.

Although, we often hear from patients and families at different points and levels of health care, fully incorporating the patient voice into our committee will help influence our work and quantify our direction. At the September meeting, we welcomed three new patient representatives, who come from the Patient Voices Network. We are pleased that they have agreed to regularly attend our committee meetings and we look forward to their valuable contributions.

Planning for the Future

As the SSC enters into its final year of the current three-year strategic plan, a process is now underway to develop the next three-year plan that includes robust stakeholder engagement and consultation.

As part of the overall engagement strategy, conversations between SSC and Specialists of BC have resulted in the hosting a Specialist Symposium January 18, 2019. A working group representing SSC, The Ministry of Health, Doctors of BC and Specialist of BC are currently planning the event, whose broad purpose is to engage and gather the feedback of front-line and specialist champions in BC to inform the future directions of SSC and Specialists of BC. SSC sees this event as a core element of our broader SSC engagement strategy process.

A Few Words from Ron…

As mentioned, I have stepped down from the SSC Co-chair position. I did so after much reflection. I enjoyed my time with the SSC and learned a great deal. I truly appreciate all the support I received from my fellow Co-chair Matt Chow and getting to know my fellow committee members a little better. Special thanks to Director Adrian Leung and all of the SSC staff whose great work keeps our committee going.

I was welcomed as the SSC Co-chair several years ago by my colleague Sean Virani who was the Doctors of BC Co-chair at the time. As a newcomer, I was impressed that it was not obvious who represented who because everyone was working towards the same goal of doing what was best for patients, specialists and our system of care. It was also notable to me and admirable how important it is to the committee to seek robust metrics to evaluate the work it does.

At this time I find increasing demands in my role at Providence Health Care and I am not able to give the committee the time it deserves. The SSC is an important committee that has excellent participation from high quality individuals and I am honored to have played a small role. For the moment, I understand the Co-chair role is in the very capable hands of Brendan Abbott. Thank you all, best wishes and personal support in continuing to make meaningful change.

June 2018 Report

We are half-way through 2018 and we continue to focus on our goal of being more transparent and inclusive. We are one of the smaller joint collaborative committees, and as a result we need to be more inventive in how we provide our support to specialists.

Enablers

We really view SSC work as being enablers – we enable specialists to be involved in system and quality improvement, in developing leadership skills, in building networks of support - to bring excellence to BC’s health care system. Our biggest goal is for specialists to feel that the SSC is the committee that will effectively bring their knowledge, ideas and skills as a positive influence in a collaborative working relationship with our Ministry of Health and health authority partners.

Past Year

We have seen a lot happen with a number of our initiatives in the past year. With Facility Engagement, the needle moved substantially from growing to maturing – with so many sites now established and working on their unique priorities. In addition, activities such as Physician Quality Improvement and the Physician Leadership Scholarship Fund are building networks of specialists who are becoming leaders today and will carry those skills far into the future.

There’s a palpable difference felt even in our committee meetings. We have seen so much more collaboration, willingness to see all sides and a focus on finding solutions, not simply identifying problems. It is energizing and makes us look with great optimism towards the future.  

View to the Future

Spread and sustainability is the language all the joint collaborative committees are using. How do we leverage the good work that is being accomplished and spread the work provincially? As you can imagine, this will take time and the efforts of many.

We are putting supports in place to help – some are small changes, such as cross-pollinating the GPSC and SSC incentive fee working groups with representatives from both committees – to better coordinate our efforts. Some are large, such as the Pooled Referrals Initiative – this and more will bulk up our touchpoints and will allow for a more coordinated, less siloed approach to our work and our impact. This is particularly important as we continue to work with health authorities, for example on Clinical System Transformation and with the government on Patient Medical Homes/Primary Care Networks.  

Shifting Compensation

One other item of note is the shifting landscape when it comes to physician compensation. It used to be fee-for-service was the only payment model physicians wanted. It’s a new world now, as we move towards 2019 and negotiating a new Physician Master Agreement – physicians are expressing their desire for other payment models to be in the mix. We will be watching this closely and advocating for our specialists and their unique skills.  

 

January 2018 Report

Engaging with Physicians and Stakeholders.

A key goal for the SSC is to engage our physicians and stakeholders. We have been working on how to make this goal more structured and what we can do to achieve long-term success. Some of the structures we currently have in place for better engagement include the Facility Engagement and Physician Quality Improvement Initiatives.
We want to reach out more, so over the coming months SSC members will be working on better engaging with you, particularly through Medical Staff Associations, with Specialist Section leaders, and with health authority leadership. We want to hear about the issues and ideas important to you.  If you have ideas or suggestions for how you would like us to engage with you in the future or what you want to see more of from the SSC, please email us at sscbc@doctorsofbc.ca

Facility Engagement

Through the SSC’s Facility Engagement initiative, the committee has heard from Medical Staff Association (MSA) physician leaders from across the province, who have shared many of the opportunities, priorities and challenges that are being identified and being worked on at the site level with the support of funding and resources from SSC.  We now have 67 sites running, with approximately 1500 physicians involved, and 458 projects being undertaken. 

To support relationships between medical staff and health authority partners, MSAs have been connecting across organizations through well-received regional forums that have been held in the Lower Mainland, Island Health, Fraser Health and Interior Health, which have been attended by physicians and health authority leaders.
A number of physicians have reported that the initiative has reinvigorated some MSAs, and brought back physician involvement and enthusiasm in various communities. Learn more through recent stories about the physicians involved in Facility Engagement. 

Physician Quality Improvement (PQI)

The Physician Quality Improvement initiative aims to partner with each of the health authorities to deliver quality improvement training to physicians and provide technical staff resources to help support physician lead QI projects to improve patient care.  All health authorities now have PQI programs up and running.  While health authorities are at various stages of implementation, across BC 423 physicians have received QI training, 46 technical staff have been hired to support physicians, and 143 physician-led projects have been completed or are underway.

Physicians have mentioned how the training and support have really helped empower them to take action to improve patient care by providing them with capability, capacity and confidence to be a QI champion. Read stories about PQI in action.

Clinical Services Transformation (CST)

Our committee is always looking for opportunities to effectively partner with health authorities and organizations to support patient-focused care, health system priorities and the priorities of physicians.  

Currently, the SSC is exploring how it can support meaningful physician involvement and participation with Vancouver Coastal Health (VCH), Provincial Health Services Authority (PHSA) and Providence Health Care (PHC) in the implementation of the Clinical Services Transformation (CST) project. This project intends to establishing common clinical and process standards, including workflows, order sets, clinical guidelines, integrated plans of care and a common electronic health record.

Physicians have identified that there could be improvements to the way information is shared, and that physicians need to be better consulted and involved by CST in the impending implementation, including concerns that impact on patient care, physician workflow, and productivity.  We will provide further updates about this issue as they progress.  

Committee Changes

Two new members join us in January: 
•    Doctors of BC Rep.: Dr Peter Gajecki, Anesthesiologist, Surrey Memorial Hospital
•    Northern Health Rep.: Dr Dietrick Furstenburg, GP and NH Medical Director, Northern-Interior.

Dr. Matt Chow will be taking over the role as Doctors of BC’s Co-chair from Dr. Sean Virani who is stepping down in January 2018.  On behalf of the SSC, we would like to personally and publicly thank Sean for his dedication and leadership on the SSC over the past several years.

Sean has been a member of SSC since 2011 and has been Doctors of BC’s Co-chair since 2013. During this time he has helped foster a collaborative relationship between physicians, Doctors of BC, health authorities and Ministry of Health. We’d like to thank Sean for his service, professionalism, and will miss his colourful bowties.  We wish Sean all the best with his new responsibilities.