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Specialist Team Care improves patient access at Nanaimo Pediatrician Clinic

Posted on Oct 3, 2023

The SSC’s Specialist Team Care Collaborative (STCC) is changing how specialists deliver care in BC, and in turn, changing the lives of patients, families, and physicians for the better.

Dr Jennifer Kouwenberg, a Pediatrician in Nanaimo, doubled her clinic capacity after getting involved in the STCC pilot - making her more available for current patients, and importantly, accessible to new patients who have been on long wait lists.

“I have experienced enormous benefits in the quality of care and patient results within the health authority through building and working in a team approach,” she says.

“I have known for years that a team approach in my community practice is essential, but wrestled with the logistics of how to achieve this approach in my office to enhance patient care and provider sustainability. When I saw a call from SSC to participate in the STCC, I knew this would allow me to move my community practice vision forward.”


More time for physician diagnoses, treatment and problem solving

Team care involves appropriate nurses and allied health professionals (AHPs) assigned responsibilities for the things that a doctor does not need to do, giving the doctor more time to see patients who otherwise would be on waitlists.

In this model, doctors are primarily responsible for three things: diagnosing, treating, and problem-solving the treatment. It is through the nurses and AHPs clearly defined roles on how the data is gathered that the doctor can focus on these three primary tasks.


Supports for multi-disciplinary team member

STCC provided support for Dr. Kouwenberg’s team. Dr. Kouwenberg has selected, trained, and integrated a nurse, a dietician, and a social worker into her practice based on the specific needs and gaps she had identified through years of clinical practice. She will soon add a counsellor as a part of her team.

“The emotional burden and moral distress I previously felt directly related to a lack of access to resources to adequately support my patients’ needs was overwhelming,” she notes. “With a growing team, I can connect families more quickly to needed resources, working toward a more ‘wrap around’ approach for the child and family’s care.”

Dr Kouwenberg’s team members have their own thoughts about working as a team:

  • Social Worker Francine Gosselin: “This approach lets us look at the whole person; not just their symptoms, blood work and diagnosis. To have a team of trained professionals offer their own unique perspective delivers a multitude of benefits for the patients and their families.”
  • Dietician Danica Molson: “I consistently have a supportive team around me to run ideas by and provide different perspectives. We are better able to solve complex problems with a collaborative approach, using immediate and effective communication.”
  • Registered Nurse, Jennifer Campbell: “Working in a team care model with the added support of multidisciplinary members helps reduce the burden of caring for patients alone, which can reduce burnout, as well as increase job satisfaction and retention of our health care providers.”


SSC supports for team care implementation

STCC not only provides financial support, but has resources in place to help develop the specialists’ abilities to truly provide team care, posted on its website.

The website holds a wealth of information on everything from HR processes, developing leadership roles, effective communication, change management, right down to practical items such as budgeting, measuring, process mapping, documentation tips, and so on. Since each speciality is different, the concept is adaptable and flexible.

Dr Kouwenberg notes, “the most unique and critical component of the STCC is a focus on personalized mentorship – from project supervisors and from the community of cross-speciality peer physicians who are part of this project cohort. We have so many touchpoints for mentorship and knowledge-sharing within this project.”

Dr Michelle Teo, co-chair of STCC and her team join in site visits, observe patient flow, and give relevant feedback. There are virtual monthly check-ins with Dr. Teo and her team and province-wide virtual meetings. There are also in-person meetings that include breakout-rooms for each group of teams.

“These opportunities give everyone on the team a safe space to openly share and learn from other teams,” says Dr Kouwenberg.

Reducing moral distress, patient access and care

 What gives Dr Kouwenberg satisfaction about her team approach?

“Over years of medical encounters, I have learned to manage many complex clinical or social dynamic concerns independently, at the great cost of inefficiency. With this new model of care, I now have access to the specialized knowledge and the skills of a social worker, dietician, and upcoming therapeutic counsellor for support,” she notes.

"This allows patient access to necessary supports in a time sensitive manner. Direct team communication about patient issues of concern makes for a truly wholistic approach. Patients are so grateful for the timely access to necessary support.”

“I now work within a team that allows my days with patients to feel uplifting and enlightened, with reduced moral distress, as patients’ needs can be addressed more comprehensively."

“Working collaboratively with a team allows me to have the capacity to increase my clinical days amidst the heaviness that we know can be present with patient care. With this approach, patient care and access is improved, and provider sustainability is achievable. It just makes sense.”

For more information and resources, please visit the STCC website.

Team members L to R:  Francine Gosselin, Social Worker; Dr Jennifer Kouwenberg, MD; Jennifer Campbell, Registered Nurse; Debbie Harilstad, Medical Office Assistant; Danica Molson, Registered Dietitian

 

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