SUDBURY NURSE PRACTITIONER CLINICS ANNUAL REPORT October 01 2013 – September 30 2014

Sudbury District Nurse Practitioner Clinics – A Bold Step in Primary Health Care Delivery

About SDNPC

Sudbury District Nurse Practitioner Clinics (SDNPC) opened its doors to patients during the summer of 2007. The first clinic site is located near the downtown core in the City of and a second site is open in Lively. The clinics are a bold step forward in primary health-care delivery in with a model of care that utilizes Nurse Practitioners in a way that allows them to practice to their full scope. SDNPC recognizes Nurse Practitioners contribution to the health-care system as vital and necessary if Ontario is to solve the current primary health care crisis.

NPs complete patient intakes, physical assessments and refer patients for diagnostic testing. They diagnose and prescribe medication for a variety of illnesses and monitor stable chronic diseases. Many patients will only need to see their Nurse Practitioner. However, all members of the inter-professional team see patients and are available for consultation with the Nurse Practitioners. The clinics have medical secretaries/receptionists, as well as an Administrative Lead, who support the efficient functioning of the clinics ensuring that health care providers can focus on providing patient care.

Orphan patients often fear ending up in the hospital, or even becoming an ALC statistic, by nature of the episodic care they receive at walk-in clinics and overcrowded Emergency Departments. NP-led clinics are part of the solution to increasing access to health care for those orphan patients in our communities.

The opening of SDNPC was possible due to funding from the Ontario Ministry of Health and Long Term Care, and support from Sudbury area Nurse Practitioners, the Registered Nurses’ Association of Ontario, the Nurse Practitioners' Association of Ontario, the City of Greater Sudbury, Chapleau Health Services and The Township of Chapleau.

Sudbury District Nurse Practitioner Clinics is a not for profit corporation and has a mixed community/provider Board of Directors.

SDNPC History

SDNPC was founded through the hard work of Marilyn Butcher and Roberta Heale, nurse practitioners within the community of Sudbury who saw an overwhelming number of “orphan” patients who needed access to primary care. With persistence and dedication, Marilyn and Roberta actively pursued their vision of a Nurse Practitioner led clinic and lobbied all levels of government to gain support for their dream. In 2007, that dream became reality when SDNPC first opened their doors to patients.

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Striving to Transform Primary Healthcare Delivery in the Sudbury District

Strategic Plan Directions

Provide primary health care to the greatest number of unattached patients possible

SDNPC continues the intake of unattached patients, acts to serve a targeted number of patients, maximizes access to timely care and encourages the development of innovative, staff driven strategies to increase access.

Implement a Quality Improvement Plan based on best practices, leading to improved outcomes for patients

SDNPC is committed to continuous data collection and analysis through the use of patient engagement surveys and the implementation of the quality improvement monitoring program using quality indicators (QIP). Not only will this information help to inform practice but it will help maximize inter-professional care within full scopes of practice and ensure utilization of effective risk management practices.

Further develop partnerships to address gaps in the primary health care system

SDNPC continues to expand existing community partnerships and develop new alliances through the promotion of community awareness of the SDNPC model of care and collaboration with other primary care providers and models to improve patient centered care. SDNPC also enhances community engagement through networking opportunities and student placements.

To be recognized as a health care provider of choice within the City of Greater Sudbury

SDNPC fosters an innovative workplace environment that promotes increased access to patient care and promotes a healthy workplace and work life balance. We continue the intake of unattached patients, fostering inter-professional approaches with the sharing of best practices and ensuring effective risk management practices are in place.

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A message from the Clinic Director

Jennifer Clement, RN(EC) Clinic Director

Welcome to Sudbury District Nurse Practitioner Clinic’s Annual General Meeting for 2014. This report covers the period of time between October 1, 2013 to September 30, 2014. Now entering our eighth year of operation, the staff of SDNPC continues to follow our mission of providing comprehensive primary health care through an interdisciplinary approach. We are proud to say that since our opening, approximately 4800 patients have registered at the clinic and we continue to accept new intakes. In this time of change within the health care climate, we continue to offer effective, client centred programs and services.

This past year has again been a very busy and exciting year for all those at SDNPC. We were able to monitor the progress of our first Quality Improvement Plan submission (see the outcomes in the pages ahead) and target the areas in which adjustments could be made to our plans of care. Continuing education is ongoing with many of our staff members and in the past year, we have had a staff member become a Certified Gerontology Nurse through the Canadian Nurses Association and another become a Master Reflexologist.

SDNPC is proud to have partnered with the North East Specialized Geriatric Services to provide enhanced services to both organizations. We have also joined forces with the City of Lakes Family Health Team to provide fall prevention safety to our at risk seniors.

This past spring brought with it the retirement of one of our collaborative physicians, Dr. Duncan McMillan. It was a great pleasure to work with Duncan and the knowledge he brought with him to the clinic was invaluable both for staff and patients alike. We have welcomed two new physicians to our team, Dr. Jennifer Lam and Dr. Jennifer Zymantas, and we are very much looking forward to working with them.

As we move forward, we will continue to strive to meet not only our strategic plan objectives but also our Quality Improvement Plan directives, ensuring patient driven care is at the forefront of everything we do.

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A message from the Board Chair

As our history making organization enters its seventh year, the Board wishes to recognize the monumental daily efforts of our staff, whose bios follow later in this report. Sudbury District Nurse Practitioner Clinics has provided exemplary primary health care for close to 5 000 patients and has been a leader in collaborative health care delivery. We want to commend the staff for their efforts this year, particularly in the innovative manner they have managed a reduction in funding from the Ministry of Health and Long Term Care. We also are proud of the organization’s achievement towards the QIP goals and the efforts the Clinic Director has made towards identifying operational metrics that will assist in quantifying the tremendous work done by the organization.

Our Strategic Plan shapes both our governance planning and our operations functions. All our board meetings focus on the goals of Access, Quality, Partnerships and Culture to ensure that the organization is continuing its forward momentum to achieve our 2013 – 2016 Strategic Plans.

During the past year, we took time to review our Board Policies and learn more about board governance functions. To this, a special thank you goes to Board Member Gisele Guenard, whose visionary leadership has been invaluable.

We have had significant changes to our Board of Directors this year. We said goodbye to long time Board Chair and Director Roger Pilon and Board Members Monique Proulx and Sandra Bertoli. At the same time, we feel honoured to bring on three new Board Members – Laura Hill NP, Angie Wiwczor NP and Valerie Scarfone. At this Annual General Meeting, long time Board Member Bev Lafoley will be resigning after providing the organization with over 6 years of expert governance advice and volunteer activities. We thank all past and current Board Members for their hours of voluntary contributions.

Marilyn Butcher, RN(EC) Board Chair

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The Past Year in Review – Some Highlights

10,723 Number of patient visits SDNPC is open daily from 8:30 – 4:30 and 12:00 – 8:00 the last Tuesday of every month. There are dedicated same day appointment slots in each nurse practitioner’s schedule to avoid visits to WIC’s and the Emergency room. Starting this fall, the registered nurse will start to see same day acute episodic visits.

118 Number of attendees in the Stress & Stress Management Program Last year Stress & Stress Management was our most popular program. Maintaining mental health is a lot like eating well and exercising: it requires a little effort every day. Devoting a bit of each day to improving mental health may have great rewards, such as feeling better and less chance of illness (such as heart disease or depression). The Stress Management program runs weekly for six weeks and offers attendees a chance to learn the science behind stress and its effects on the body and concrete ways to apply in our everyday life.

31 Number of participants in the Stand Up Program Once again, Stand Up ran from September to December 2013 and provided exercise training and education to support fall prevention. This year 21individuals enrolled in Stand Up and 5-10 individuals joined us year round for maintenance sessions. In 2014, the Stand UP program is receiving renewed support through the NELHIN and Sudbury- Manitoulin continues to be a leader in the province, in terms of aggressively improving access of older adults to exercise.

122 Number of procedures done within the clinic SDNPC offers a monthly “Lump and Bump” day at each of its sites for the removal of moles, suspicious lesions and soft tissue masses saving patients from having to wait up to a year to see a dermatologist. SDNPC is also fortunate to have a collaborative physician who performs IUD insertions and endometrial biopsies right within the clinic.

36 Number of OTN referrals made SDNPC launched the use of PCVC OTN in September 2013 (PC based OTN services). Thanks to the Store Forward Dermatology program through OTN, providers are able to send referrals (including pictures of the condition they are discussing) directly to a dermatologist and have a response within up to seven days – most times however, a response is received within the same day. OTN services have also allowed patients to access psychiatry services in a more timely manner.

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2054 Number of phone visits made Phone visits are being utilized to review results, follow up on the status of medication changes, answer patient questions and a large number of other reasons. Time is dedicated each day for returning patient calls and phone visits are also scheduled into a provider’s schedule.

125 Number of home visits Home visits allow the provider a chance to see the patient in their own environment and get a sense of items like fall risks within the home, how patients are able to manage their activities of daily living. Home visits are also important to patients who are unable to access the clinic for any number of reasons.

18 Number of student placements SDNPC offers placements for both nurse practitioner students but also students from the School of Medicine and pharmacy students. Students are exposed to not only complex primary care issues, but also learn the importance of inter-professional teams working together for the health of the patient.

1490 Number of physician – NP collaborations Collaboration between the physician and NP is an integral aspect of care for the patients of SDNPC. Collaboration can take place face to face, by phone or through the messenger aspect of the electronic medical record. Collaboration with the physician takes place when the NP wants to order a test that is beyond their scope, would like to refer a patient to a specialist or wants to review a case for advice with the management. SDNPC is very fortunate to have four dynamic collaborative physicians working with us.

2 Days a month dietician will be working with the NESGS group Optimal nutrition is important at every age, but it is especially important for older adults. Aging is associated with several physiological, psychosocial, and environmental changes that can negatively impact food intake. Poor nutritional status can contribute to frailty, impact functional ability, decrease immunity, and result in poor wound healing. Malnutrition is also associated with a higher risk of morbidity and mortality and compromises the outcomes of underlying conditions. Early identification and prompt treatment of malnutrition can help to reduce mortality and optimize the health status of older adults.

These numbers reflect the period of time from October 1/13 – September 30/14

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Results of the 2013-2014 Quality Improvement Plan

Quality Objective Target Actual Performance Dimension Access To Improve timely access for patient appointments. 70% of 70.5% patients will have apt within 1 week Integrated To become fully integrated with the POI (Physician Office Full Fully integrated Integration) system to electronically receive all hospital integration reports. Integrated To ensure all patients discharged from the hospital are 75% SDNPC was unable to seen in follow up within one week of hospital discharge. accurately capture this data this year due to technical issues however those issues have been resolved and we are now tracking this data. Integrated To become fully integrated with the CCAC's telehome Full Fully integrated (two care program for patients with Congestive Heart Failure integration patients received this (CHF). service) Patient How satisfied are you with the services you receive from 92% Survey results showed Centred your Nurse Practitioner? that 12.5% of patients polled were satisfied and 70% of patients were very satisfied with their care from their NP. Patient When you see your doctor or nurse practitioner, how Collect 95.8% of the patients Centred often do they or someone else in the office encourage baseline surveyed responded that you to ask questions? data they are encouraged to ask questions. Patient How have the services at the SDNP clinic impacted your Collect Of the patients surveyed, Centred health? Are you happy with these impacts? baseline 65.8% of the patients data believe that their health conditions are under better control, 2.5% don't believe that their health conditions have improved and 31.7% of patients felt that this was not applicable to them. Patient When you see your doctor or nurse practitioner, how Collect 81.7% of patients Centred often do they or someone else in the office spend baseline surveyed felt that the NP enough time with you? data always spent enough time with them during their appointments.

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The Year Ahead for Sudbury District Nurse Practitioner Clinics

Ottawa Model for Smoking Cessation – Implementation Fall 2014

The Model for Smoking Cessation (OMSC) is a simple, systematic approach for addressing tobacco use with smokers and for supporting successful quitting using the best available evidenced- based treatments. It emphasizes interdisciplinary collaboration to permit fast paced clinics to adopt the program without noticeable impact on daily patient flow. It is based on a 3 A’s approach: ASK, ADVISE and ACT. Using a facilitation based implementation model, the providers in the clinic will be taught to successfully integrate the program into their daily flow, trained to provide effective counseling and strategic advice and will lead program evaluation and quality improvement cycles.

Same Day Acute Episodic Visits with the RN – Implementation Fall 2014

With the use of medical directives, the RN will start seeing and treating patients for acute episodic visits (ear infections, sore throats, bladder infections). This will help alleviate visits to the local emergency departments and walk in clinics.

Student Placements

SDNPC will continue to be a host for student learners as we believe that there is much to learn in our environment for students of all disciplines.

Research Studies

SDNPC will be part of three research studies being conducted by PhD students and a local university. We are proud to take part in these studies as we believe that these studies will highlight the exceptional care NP led clinics provide to their patients.

Programming

SDNPC will continue to offer our Stand Up and Stress Management programs in the upcoming year but we are pleased to introduce a new program for patients suffering from chronic pain. SDNPC will be partnering with Janine Saunders, a physiotherapist who operates Pilates Pro in Sudbury. This program will be a four to six week workshop where patients will learn about the MELT method and how to engage the deep core muscles at the spine, shoulder and pelvic girdle while balancing the nervous system and releasing tension in the muscles that leads to dysfunctional movement patterns. The MELT Method is excellent for the rehabilitation of injuries, improving postural problems & relieving chronic pain all over the body, as well as targeting any imbalances in the body before they cause injury or dysfunction.

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Biographies: Sudbury District Nurse Practitioner Clinics Staff

Julie Allen, Medical Secretary A lifetime resident of the north, Julie obtained her Medical Office Administration diploma from Everest College and has been working with the SDNPC team since 2009. An adventurer at heart, she is often on the go trying daring new activities. Julie is currently working towards her human resources diploma.

Arro Barry, Registered Nurse Arro is a graduate of Laurentian University’s Bachelor of Science in Nursing program. In her role as a primary care registered nurse, Arro has the opportunity to wear many hats. At SDNPC she works with patients to support their health throughout the lifespan: in the clinic setting, in their homes, individually and in groups. Before coming to Sudbury and making it her home, she worked in Northern rural settings in Moosonee and the Yukon as well as spending time providing chronic care in Thunder Bay. She is pleased to be part of such a professional and focused team at SDNPC. A nature enthusiast and avid gardener, she is currently pursuing her Master’s degree.

Jana Carter, Nurse Practitioner A graduate of McMaster University’s Bachelor of Science in Nursing program, Jana obtained her Nurse Practitioner Certificate from Laurentian University in 2009. Prior to expanding her horizons to take on the NP-PHC role, her professional career was based in Public Health, having served the communities under the Porcupine and Sudbury & District Health Units. Jana is also SDNPC’s certified Lactation Consultant. She is a devoted hockey mom and serves on the executive of the Walden Minor Hockey Association. She also holds a seat on the board of the Capreol Nurse Practitioner Led Clinic.

Bev Castonguay, Social Worker Born and raised in Sudbury, Bev has had the opportunity to work in many types of settings before coming to the SDNPC. She enjoys primary care as it affords her the flexibility in working with different groups of people deal with mental health issues, chronic disease management or health prevention strategies. Having worked in both acute care and community settings, she is enjoying the opportunity to work as part of a multi-disciplinary team. Currently, Bev serves as the Board Chair for the Children’s Treatment Centre of Sudbury.

Jennifer Clement, Clinic Director/Nurse Practitioner A lifelong resident of the north, Jennifer earned her Bachelor of Science in Nursing from Laurentian University in 1997. After working as an RN in Texas, Mississauga and Sudbury in hospital acute care settings, she returned to school to earn her certificate as a Primary Health Care Nurse Practitioner in 2008. She has been with the clinic since 2008 and has been the director of the clinic since September 2012. She is back in school once again working towards her diploma in Health Care Management. Jennifer also serves on the board of the Children’s Treatment Centre.

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Jennifer Dawson, Nurse Practitioner Jennifer is a 2002 nursing graduate from Memorial University of Newfoundland. She has spent the majority of her career working in Cardiology, Emergency Medicine and Intensive Care. Overlapping with this, she has also taught BScN students for a period of 6 years and worked in primary care. With a significant acute care background she decided it was time to change the pace and embark upon becoming a Primary Health Care Nurse Practitioner. She started at SDNPC immediately after graduation in 2012 and since this time she also pursued and completed her Masters in Nursing.

Kim Demers, Nurse Practitioner Kim grew up in the true north of Ontario working in Red Lake after graduating from Confederation College where she obtained her diploma in Nursing. She moved to New Liskeard and obtained her Bachelor of Science in Nursing through Lakehead University. She and her family moved to the Sudbury region and after working many years in the emergency department, Kim obtained her certificate as a Primary Care Nurse Practitioner in 2007 and has been with SDNPC since 2008.

Christina Dippong, Registered Practical Nurse A graduate of Cambrian College’s RPN program in 2000, Christina has worked in all aspects of health care from nursing homes, to community agencies and the local hospital. Christina is the clinic’s phlebotomist, foot care specialist, reflexologist and OTN coordinator to name a few job titles. Christina is also the founder of the Lively Little League baseball league.

Stephanie Doni, Dietician Stephanie graduated from The University of Western Ontario with a Bachelor of Science (Foods and Nutrition) degree and completed her dietetic internship with the Northern Ontario Dietetic Internship Program. Stephanie has also obtained certification as a Certified Diabetes Educator. She joined SDNPC in 2011 and has experience counseling patients on a variety of nutrition related topics. Stephanie writes a monthly column for the Walden Today newspaper and is on the Board of Directors for Meals on Wheels.

Tiffany Furlong, Nurse Practitioner Tiffany graduated cum laude from the Laurentian University School of Nursing in 2009. She worked in geriatrics for the next two years with a special interest in palliative care, wound care, and management of dementia. She obtained her Primary Care Nurse Practitioner certificate from Laurentian in 2012 and has been working as a nurse practitioner with the Sudbury District Nurse Practitioner Clinic since October 2012. She has since completed a specialty certification in gerontology via the Canadian Nurses Association and is a certified geriatric nurse. Tiffany remains current with evidence-based guidelines through regular completion of educational modules via McMaster University.

Mary Geroux, Nurse Practitioner Mary obtained her Registered Nursing diploma from Sault College in 1998 and completed the Critical Care Nursing Certificate from Cambrian College in 2002. She has worked as a Registered Nurse in Sault Ste. Marie, Sudbury, California and Washington D.C. She completed the Bachelor of Science in Nursing and Primary Health Care Nurse Practitioner Certificate at Laurentian University in 2006. Following completion of her degree, she worked as a locum NP in Chapleau before being hired to work at the Sudbury District Nurse Practitioner Clinics in 2007. She left in 2012 to specialize in Bariatrics at Health Sciences North, and returned to her previous primary care practice at SDNPC one year later.

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Katherine Judd, Medical Secretary Katherine has been employed as a medical secretary with the SDNPC since the summer of 2007 when the first opened. She has worked in the medical field for over 35 years and brings a wealth of knowledge to the team. In her spare time, Katherine enjoys spending time with her grandchildren, training her dogs, gardening, archery and swimming.

Chantalle St. Michael, Medical Secretary A resident of the north, Chantalle spent many years in before returning to her local roots. She obtained her Medical Office Administration diploma from Everest College and worked for the Espanola Family Health Team before joining SDNPC in 2010. She is currently working towards her human resources diploma.

Claudette Thibeault, Medical Secretary Claudette has been with SDNPC since it’s opening in 2007. A graduate of Cambrian College’s Microcomputer Business Application Program, she has also obtained her Ward Clerk certificate. She is currently back in school working towards an Office Administration, Medical Transcription diploma.

Nancy Tripodi, Registered Pharmacist Nancy is a pharmacist licensed with the Ontario College of Pharmacists. She is a graduate of the University of Faculty of Pharmacy and completed a residency program at The Hospital for Sick Children in Toronto. Following that, she returned to her hometown of Sudbury to begin her career with Med-I-Well Services Ltd. which is contracted to provide pharmacy consultant services to the SDNPC.

Sharon Vukoja, Administrative Lead Sharon has been the Administrative Lead for the clinic since its inception in 2007. She holds a Bachelor of Arts from McMaster University and obtained her certification in procurement. She has an extensive background in Construction Management which was an added bonus during SDNPC’s several capital construction projects. She is responsible for ensuring the clinic runs smoothly by ensuring Policies and Procedures are current and in line with Ministry of Labour requirements and prepares funding reporting for the Board and the Ministry on a monthly and quarterly basis. Sharon is also responsible for the accounting, information technology, and facility management issues as they arise. She has lived in Sudbury most of her life and loves all that the city offers including but certainly not limited to the magnificent natural environment and local theatre.

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Sudbury District Nurse Practitioner Clinics Collaborative Physicians

Catherine Cervin, Collaborating Physician Dr. Cervin, originally from Ontario, began her career practicing family medicine in the Northern Ontario communities of and Sault Ste. Marie for seven years before embarking on an academic career. From 1997 to 2007, Dr. Cervin facilitated the growth of the residency program from two community sites to five, as residency program director in the Department of Family Medicine at Dalhousie University in Nova Scotia. She also served as interim department head of Dalhousie Family Medicine from 2009 to 2010. In addition to her work with SDNPC, she is the Associate Dean of Northern Ontario’s School of Medicine Postgraduate Education.

Jennifer Lam, Collaborating Physician

Shelley Ann Routhier, Collaborating Physician Originally from Valley East, Dr. Routhier graduated from Laurentian University with a Bachelor’s in Biochemistry before attending Queen’s University for Medical School. She completed her residency in Family Medicine in Sudbury. She has been working at the Centre de Santé Communataire since 1997 and joined the SDNPC team as collaborative physician in 2010.

Jennifer Zymantas, Collaborating Physician Dr. Zymantas obtained her MD at Northern Ontario School of Medicine (NOSM) at the Thunder Bay Campus in 2011, followed by completion of a Family Medicine Residency at Northern Ontario School of Medicine (NOSM) at the Sudbury Campus in 2013. She is currently working as a hospitalist at Health Sciences North (HSN), several of the walk-in clinics and at the Sudbury District Nurse Practitioner Clinics.

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Governing Board of Directors 2013 – 2014

Marilyn Butcher, Board Chair Marilyn co-authored the proposal for the first NP led clinic in and retired from her position as inaugural Clinic Director for the Sudbury District Nurse Practitioner Clinics (SDNPC) in 2010. She remains on the Board of Directors of SDNPC. Marilyn has launched her own consulting firm and is working with health care organizations and groups of NPs who are launching their own NP – Led clinics. She assists with business and operational planning, budget and site development and creates best policies and procedures. She maintains her clinical focus by practicing as a nurse practitioner in rural northern Ontario.

She co-authored “Canada's First Nurse Practitioner–Led Clinic: A Case Study in Healthcare Innovation”, in the Nursing Leadership Journal; “Nurse Practitioners : Part of the Solution to the Primary Health Care Crisis”, a presentation to the Romanow Commission on the Future of Health Care in Canada and Merging Traditional Aboriginal and Western Health Practices in a Canadian Urban Aboriginal Community. Marilyn has been an active member of RNAO and NPAO, sitting as NPAO Chair of Political Action and NPAO Chair of Communications in past years. She was given a Honourary Lifetime Award from NPAO and a Lawrence S Bloomberg Faculty of Nursing Award of Distinction from the University of Toronto. Under her leadership, SDNPC was awarded the group Women of Distinction Award.

Marilyn and her husband Stephen have launched Walden Today, a positive community based monthly newspaper in Walden Ontario with a monthly circulation of 5 000 readers.

Gisèle Guénard, Vice-Chair A native of Northern Ontario, Gisèle has served in health care for over 30 years. She has held a variety of positions from patient care to CEO of Espanola General Hospital where she led the launch of one of Ontario's first Family Health Teams and a new long-term care facility. She has served in Public Health, as Administrator in Long Term Care and taught nursing in the college sector.

Her governance roles include director on the board of the North East LHIN. She is currently a director on the board of the Sudbury District Nurse Practitioner Clinics, and a Peer Facilitator for the Canadian Patient Safety Institute - Governance initiatives. She has been a member of, and chaired board committees including quality, governance and audit. She is a past member of the Ontario Hospital Association’s Small Rural & Northern Leadership Council, and presented at OHA and OACCAC conferences.

Gisèle provides support to governance and executive leadership teams through VisionarEase Inc., specializing in Positive Change Leadership and Consulting. Clients include a cross section of the health care and community sector, where she has facilitated and presented for groups from the smallest community agencies to provincial Regional Health Authorities.

Fluent in French and in English, Gisèle is the recipient of the YWCA Women of Distinction Award. Educated in Ontario, she holds a Bachelor of Science (Nursing) degree from Laurentian University, as well as a Master in Education (Sociology) degree from the University of Toronto.

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Gloria Richer, Treasurer Gloria, a native of Sudbury, has been a part of the health care system for over 45 years and has held a variety of positions. In addition to the provision of direct patient care, she has been involved in education, management, research, project management, emergency planning and occupational health and safety.

A strong supporter of professional growth and development for employees at all levels or positions, she participated in the development of mentorship and leadership programs in the long-term care and hospital sectors. She taught nursing in the college sector, was a Nurse Clinician in Critical Care, for Sudbury Regional Hospital, an ACLS Instructor and the Clinical Coordinator for the Paramedic/ Base Hospital Program.

She was the Clinical Manager for CVT ICU and SDU at Sudbury Regional Hospital, Memorial Site for many years and is currently Site Administrator for Villa St. Gabriel Villa.

Her governance roles include director on the board of the IOOF Senior’s Homes Inc. in , for a five year term. She has been a member of, and chaired board committees including Resident Care, Finance, Quality/Risk management, and the Property and Planning committee.

Laura Hill, Director Laura, a native of Sudbury, graduated from McMaster University’s Bachelor of Science in Nursing program in 2006 then went on to obtain her Masters in Nursing from York University in 2010. She recently (2013) graduated from Toronto University’s NP-Adult Program. She has worked in both Sudbury and Moose Factory as a nurse in various units such as medicine, surgery, obstetrics, emergency and geriatrics and is currently working as an NP in Health Science North’s emergency department. She is also a volunteer for Camp Manitou working as the Camp Nurse for Junior Girls week. She and her husband love going camping, kayaking and outdoor fun and she is excited to be on the board of directors for such an amazing clinic, something that is homegrown and puts Sudbury on the map as a leader in nursing.

Bev Lafoley, Director Bev is the Director of Therapy at St. Joseph’s Health Centre and is responsible for the restorative care and activity programming at St. Joseph’s Villa and Villa St. Gabriel Villa and the rehabilitation services at the St. Joseph’s Continuing Care Centre. Bev graduated from McGill University with a Bachelor’s degree in Physical Therapy and has worked in clinical practice, education and research.

A strong supporter of her profession, Bev is the Past President of both the Canadian and the Ontario Physiotherapy Associations and Past President of the Physiotherapy Foundation of Canada, a research funding body for physiotherapy research. Through this activity she has developed a strong interest in the governance process including the development of organizational by-laws.

Bev has presented on inter-professional education and care both nationally and internationally and continues to be a strong promoter of team work in health care.

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Valerie Scarfone, Director Since 2013 Valerie Scarfone has been the Executive Director of North East Specialized Geriatric Services a program sponsored by the North Bay Regional Health Centre. Valerie has also worked as a Senior Consultant with the North East Local Health Integration Network. Prior to this, she was the Chief Executive Officer of ICAN (Independence Centre and Network). Valerie has a Bachelor of Arts degree in Sociology from Laurentian University and a Human Resources Certificate from Queen’s University.

Throughout the past twenty-five years, Valerie has served on many boards of directors and has gained vast knowledge on board governance. She has served on the United Way/Centraide Sudbury Board of Directors. In the past, she served on founding boards of local and provincial organizations and was that provincial appointee to the Algoma Health Unit Board.

Currently Valerie is serving on the Board of Directors of the Children’s Aid Society, Community Living Greater Sudbury and has recently joined this board.

Claire Warren, Director Claire has been nursing for over 23 years. Since graduating from the University of Ottawa with her BScN, Claire has worked in Sudbury and area in various roles. She started her career working in the neuro- trauma ICU in Sudbury as well as at the Espanola General Hospital (floor, emergency and OR). She then went to public health where she worked in a number of different programs and departments and in various capacities (public health nurse, manager, director, and evaluator/researcher) for 18 yrs. Claire has occasionally taught courses in the nursing program at Laurentian University and was a member of the University’s Research Ethics Committee for 6 years. She completed her Master of Nursing from Athabasca University in 2005 and the Primary Health Care Nurse Practitioner program in 2012. She is currently working at the NE-CCAC as a primary health care NP specializing in palliative care.

Angie Wiwczor, Director Angie has been nursing for over 13 years. Since graduating from the diploma program at Cambrian College she went onto purse further education and graduated from Laurentian University obtaining her BScN. Angie has extensive pediatric nursing experience in both the hospital and community setting. With children’s health being an area of special interest and passion Angie went on to further her education becoming a Primary Health Care Nurse Practitioner in 2009. Angie officially became a Certified Asthma Educator in 2011. She continues to work with the pediatric population in a variety of outpatient clinics that include; the BALANCE Program (focus on pediatric obesity), Pediatric Asthma Education Clinic, ADHD clinic at the Health Centre for Kids (NEO Kids) at Health Sciences North.

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Acknowledgements

If it were not for all of our partners, SDNPC would not be the success it is today. We would like to thank our hardworking, dedicated staff who go above and beyond to provide care and services to our patients. We would like to thank our families, patients and the residents of the Sudbury district for their continued support of our clinics.

We would like to acknowledge the Ministry of Health and Long Term Care and the Primary Care Branch of the Ministry for their continued support financial support that enables quality, comprehensive primary health care for our patients.

Thank you to the North East Local Health Integration Network and the Sudbury and District Health Unit for their continued support of our Stand Up program providing us with the equipment necessary to run this program. Many seniors are benefitting from this program.

Thank you to Ryan Humeniuk, Recruitment Coordinator, with the City of Sudbury for assistance in the recruitment of our newest physicians. We also want to thank the City of Sudbury itself for the ongoing support of our Lively clinic building.

Thank you to all!

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