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Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
Mary Geroux
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Mary Geroux

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  • 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
  • Transcript

    • 1. Sudbury District Nurse Practitioner Clinics
      • An Innovative Community Solution
      • Mary Geroux, NP-PHC
    • 2. SDNPC
      • Who? What? Where? When? Why? How?
      • Challenges/Successes
      • Managing Patients Within the Team
      • Impact/Outcomes
      Sudbury District Nurse Practitioner Clinics
    • 3. 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
    • 4. 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
    • 5. 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
    • 6. 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
    • 7. Sudbury District Nurse Practitioner Clinics Chapleau Lively
    • 8. 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
    • 9. 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
    • 10. Sudbury District Nurse Practitioner Clinics
    • 11. 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
    • 12. 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
    • 13. 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
    • 14. 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
    • 15. More Challenges
      • Physician compensation
      • Current method of payment not supportive; not lucrative
      • OMA/colleague pressure
      • MD support is key
      Sudbury District Nurse Practitioner Clinics
    • 16. 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
    • 17. Sudbury District Nurse Practitioner Clinics
    • 18. 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
    • 19. 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
    • 20. What does the future hold?
      • Much promise!!
      • Increasing support for this model of care
      • Additional NP clinics
      • Bill 179
      Sudbury District Nurse Practitioner Clinics
    • 21. YWCA Women of Distinction Award 2009 Sudbury District Nurse Practitioner Clinics

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