SUDBURY DISTRICT 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 Greater Sudbury and a second site is open in Lively. The clinics are a bold step forward in primary health-care delivery in Ontario 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. 1 | Page 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. 2 | Page 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. 3 | Page 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 4 | Page 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.