• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Mary Geroux
 

Mary Geroux

on

  • 1,103 views

 

Statistics

Views

Total Views
1,103
Views on SlideShare
1,101
Embed Views
2

Actions

Likes
0
Downloads
1
Comments
0

1 Embed 2

http://www.slideshare.net 2

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment
  • Clinic Logo: Colour waves represent NPs, other health care providers, and administration The white waves represent individual, family & community The black outline represents the goal of optimal health Waves circling around each other and meeting in the centre indicates that each has autonomous decision-making but works collaboratively with the other Dark Blue = water; Light Blue = sky; Green = forests; and this represents the Sudbury District!
  • What sets a NP led clinic apart from the rest is in the governance.
  • Northern Ontario Sudbury (300km E of SSM; 390 km N of Toronto), Lively (20 km W of Sudbury),Chapleau (410 km N of Sudbury)
  • When patients are registered to the clinic instead of rostered to a physician, if and when a physician leaves, that patient remains under care of their NP. Patients do not have access to book with physician directly
  • David MacNeil – VP Clinical Services SRH Bill 179:Regulated Health Professions Statute Law Amendment Act, 2009 (“Bill 179”), which received Royal Assent on December 15 th , 2009. Bill 179 decreases barriers, increases access to primary care by expanding scopes of practice of certain regulated health professions. New NP clinics will continue to increase access to primary care
  • 6 month clinic evaluation: Satisfaction survey, overall high to very high satisfaction with service provided

Mary Geroux Mary Geroux Presentation Transcript

  • Sudbury District Nurse Practitioner Clinics
    • An Innovative Community Solution
    • Mary Geroux, NP-PHC
  • SDNPC
    • Who? What? Where? When? Why? How?
    • Challenges/Successes
    • Managing Patients Within the Team
    • Impact/Outcomes
    Sudbury District Nurse Practitioner Clinics
  • Who are we?
    • Canada’s first NP led clinic
    • 3 sites: Sudbury (2800), Lively (1600), Chapleau (6 outreach Well Women clinics/year)
    • Bilingual Services
    • Multidisciplinary Team: NPs, MDs, RN, Pharmacists, Social Worker, Dietician
    Sudbury District Nurse Practitioner Clinics
  • Who are we?
    • 5.5 NPs
    • 2 physicians (22 hours per week)
    • Consulting pediatrician (5 hours per week)
    • Pharmacist (15 hrs per week)
    • RN (40 hours per week)
    • Support staff (Office manager, medical secretary)
    Sudbury District Nurse Practitioner Clinics
  • What is a NP clinic?
    • Group of NPs coming together to form not for profit corporation
    • Board of Directors includes 51% NP representation.
    • Develop board bylaws that are respectful of collaborative practice and patient centered
    • NP at Director level
    Sudbury District Nurse Practitioner Clinics
  • What do we do?
    • Full scope comprehensive primary health care that reduces numbers of “orphan patients”
    • Target underserviced populations
    • Interdisciplinary Practice
    • Programs (Why Weight?!, Diabetes Education, Spirometry)
    • Partners with the community (Lively Highschool)
    Sudbury District Nurse Practitioner Clinics
  • Sudbury District Nurse Practitioner Clinics Chapleau Lively
  • When & Why?
    • Tens of thousands of Sudburians without access to care
    • 8 unemployed NPs
    • Formal submission to government Feb 2006
    • MOHLTC announced clinic in Nov 06, clinic doors opened in August 2007
    Sudbury District Nurse Practitioner Clinics
  • How?
    • Marilyn Butcher & Roberta Heale
    • Vision created over time during practice experiences ( Working, lobbying, writing proposals, introducing role to communities & agencies)
    • Solicited support from municipal leaders, nursing organizations and media
    • Public responded positively
    Sudbury District Nurse Practitioner Clinics
  • Sudbury District Nurse Practitioner Clinics
  • Process
    • Intake form is completed, reviewed by the director with input from NPs & MDs
    • Large majority of patients are accepted
    • Patients registered to clinic as an entity (not rostered to a physician or the clinic)
    • Intake appointment scheduled with an NP
    • After intake, patients are scheduled for a physical exam and may be sent for investigations/tests
    • We cannot take everybody
    Sudbury District Nurse Practitioner Clinics
  • Managing patients within the Team
    • Patients generally see “their NP”
    • NP is patient navigator/case manager
    • Physician functions as primary health care specialist, seeing patients referred to them by the NP; follow-up may continue until problem is resolved or patient is stable
    • Many complex patients are co-managed
    • Pharmacist and RN
    Sudbury District Nurse Practitioner Clinics
  • Referrals
    • Patients are mainly referred to other team members
    • Specialist referrals need to be co-signed by physician due to a payment discrepancy – this can cause unnecessary delays
    • Many community programs - where the specialist is under a different payment model - do not require a co-signature
    Sudbury District Nurse Practitioner Clinics
  • Challenges
    • Complex/high needs patients who have not been accepted by family practices and have attended walk in clinics for years
    • Chronic diseases with many co-morbidities, complications, mental illness, developmentally delayed, elderly, low socioeconomic status
    Sudbury District Nurse Practitioner Clinics
  • More Challenges
    • Physician compensation
    • Current method of payment not supportive; not lucrative
    • OMA/colleague pressure
    • MD support is key
    Sudbury District Nurse Practitioner Clinics
  • Successes
    • Full support of government
    • Announcement of next 12/25 NP led clinics based on our model
    • Not reorganization of existing practices, addressing orphan patients
    Sudbury District Nurse Practitioner Clinics
  • Sudbury District Nurse Practitioner Clinics
  • Impact/Outcomes
    • Addressing the orphan patient population
    • 7% ↓ in volume of ER visits, directly attributed to ↑ access to primary care
    • High profile NP clinics important for Bill 179
    Sudbury District Nurse Practitioner Clinics
  • Impact/Outcomes
    • Detection of previously undiagnosed chronic diseases (ie. DM, HTN, Chol, cancers)
    • Clinic evaluation done after 6 months
    • MOH evaluation last year, results pending
    • Outcome evaluation later this year
    • Historic system change, grassroots, nursing initiative
    Sudbury District Nurse Practitioner Clinics
  • What does the future hold?
    • Much promise!!
    • Increasing support for this model of care
    • Additional NP clinics
    • Bill 179
    Sudbury District Nurse Practitioner Clinics
  • YWCA Women of Distinction Award 2009 Sudbury District Nurse Practitioner Clinics