Healthy Living in the North

Shared electronic medical record leads to better outcomes for Northern BC patients

Editor’s note: A condensed version of this story appeared on page 24 of the May 2019 issue of Canadian Healthcare Technology.

Dr Clifford and Alyssa posing together in front of a computer monitor.

Working together to design MOIS enhancements: Dr. Bill Clifford, Chief Medical Information Officer, Northern Health, and Alyssa Halliwell, Director – Support and Services, Applied Informatics for Health Society (AIHS). Photo by Darren Smit, smit,photography

Imagine being in charge of the health and wellness of 300,000 people scattered over a wild and remote area the size of France, where there’s one bear for every two people, ten-hour drives between communities are the norm, and winter brings temperatures of -20 C or below.

This is the challenge faced by Northern Health (NH), the organization responsible for providing health care in Northern British Columbia.

However, thanks to a new shared electronic medical record (EMR), health care providers in parts of Northern BC can now easily access the most up-to-date information about their patients at any time of the day or night, enabling them to provide better care.

The EMR in question is MOIS® (Medical Office Information System), developed in 1990 by Dr. Bill Clifford of Prince George, BC.

More than 11 years ago, Dr. Clifford selflessly donated the software to a not-for-profit, and now MOIS® is owned, collaboratively developed, administered, and licensed by the Applied Informatics for Health Society (AIHS). AIHS has been working with Northern Health ever since.

Recently, AIHS and Northern Health won the Technology in Healthcare Award at the 2019 Healthier You Awards in Prince George. AIHS and NH work together with health care providers to design and build a system capable of streamlining the often complex workflows involved in health care.

“We partner with Northern Health to improve efficiency and outcomes,” says AIHS CEO Bill Gordon.

“We’ve had a great partnership with AIHS for over a decade,” says Darren Ditto, NH Regional Manager, Clinical Applications & Specialty Care Solutions. “Things have changed and grown over the years, but what remains constant is that by working in partnership with our providers and AIHS, we collectively make MOIS® better able to serve our patients. Another huge benefit of AIHS is that they’re not-for-profit, so we can work on a system and not have to worry about the bottom line in deciding what features are included – it truly is for the good of the patient.”

Northern Health currently has several separate instances of the MOIS® EMR.

“We’re working with Northern Health to consolidate the instances and to reduce any barriers between health teams even more in an effort to provide the right information to the right people at the right time,” says Larry Chrobot, Senior Director at AIHS.

MOIS® functionality includes documenting and in many cases, electronically downloading, key elements of the patient medical record, including:

  • Encounter notes and measures
  • Prescriptions, long-term medications and labels
  • Health issues and rankings
  • Allergies and medication administration records
  • Past procedures
  • Diagnostic imaging reports
  • Consultation and referral reports
  • Patient preferences and care plans
  • Team-based communication, including EMR-to-EMR communication
  • Service documentation

Sharing this information between different members of the health care team is key in providing comprehensive, coordinated care.

MOIS® and Northern Health: Six stories of success

Headshot of a smiling Dr. Campbell.

Dr. Suzanne Campbell, a GP who works at the Omineca Medical Clinic in Vanderhoof.

Dr. Suzanne Campbell is a GP who works at the Omineca Medical Clinic in the small Northern BC farming community of Vanderhoof (pop. 4,439).

Northern Health is implementing changes to strengthen basic health care: they’re putting a model in place where an interprofessional team will support each physician’s or nurse practitioner’s office.

Depending on the size of the community, the interprofessional team can include nurses, physiotherapists, occupational therapists, social workers, and more. Dr. Campbell is an important part of the Vanderhoof interprofessional team: “While the patient has the most vested interest in their health outcome, the physician is the quarterback of team health care,” says Chrobot.

When the team began using the same MOIS® EMR, all team members, including Dr. Campbell, could view patient notes whenever needed, helping them provide continuous, coordinated care.

“The Omineca Medical Clinic in Vanderhoof was one of the very first clinics to put their hand up and ask for that integration in MOIS®,” says Chrobot. “They took that leap of faith in the pursuit of better patient outcomes. They were visionary, and one of the first in Northern BC to do that. For a clinic to take that on, that was tremendous.”

Below are six informal case studies highlighting the success of this new way of working, seen through the lens of this rural physician.

Checking in on a new mom’s challenges

Dr. Campbell’s patient Ashley[1] gave birth via c-section, returning afterwards to her remote rural home, where she struggles with cognitive challenges, as well as financial and transportation issues.

Dr. Campbell worried how Ashley would cope with a newborn, in addition to recovering from surgery, plus her other challenges. She feared that with Ashley’s transportation difficulties, it would be hard to provide the close monitoring and support she felt Ashely would need.

However, the interprofessional team was able to solve this communication problem using the shared MOIS® EMR: every time a nurse or community support worker visited Ashely at home, Dr. Campbell was immediately aware and could easily read their notes the same day. The team was able to support Ashley at home and minimize her travel. At the same time, Dr. Campbell was kept in the loop and was reassured that Ashley was recovering from her c-section, was coping with her other challenges, and that the baby was thriving.

Helping a senior stay out of hospital

Dorothy, a 90-year-old Vanderhoof resident, was clear about her priority to avoid spending time in hospital. She wanted to remain at home as much as possible, even though her health was declining. When she developed pneumonia and congestive heart failure, the interprofessional team was able to care for her at home thanks to daily nursing visits that were set up quickly with a simple message request through MOIS®.

The nurses who visited her each day recorded her vital signs and responses to treatment in the shared MOIS® chart, which Dr. Campbell could easily view. Dorothy also had a home visit from an occupational therapist, who arranged equipment to support her at home. As she responded to treatment, Dorothy’s nursing visits decreased as appropriate, to weekly, then monthly.

Throughout this time, the whole team, including nursing and occupational therapy, easily stayed up to date on Dorothy’s care because each member, including Dr. Campbell, was documenting their encounters with the patient in the same shared EMR.

Providing support after a fall

Debbie, 65, was recovering from a recent hip replacement when she fell and injured her knee. Dr. Campbell saw her in the emergency department on Friday afternoon and found that although Debbie wanted to be able to stay at home, her mobility and ability to look after herself were severely affected by both the hip surgery and new knee injury. To safely function at home over the next few weeks, she would need support and equipment from the interprofessional team in order.

Usually, in a rural area, someone like Debbie would have to spend the weekend in hospital while their doctor arranged the needed supports and ensured that everything was in place before discharge on Monday or Tuesday. Instead, Dr. Campbell was able to use the shared EMR to coordinate Debbie’s care. With a few messages sent through the EMR, she was able to confirm that the interprofessional team would see Debbie urgently on Monday, allowing her to feel comfortable about discharging this patient over the weekend.

On Monday morning, Dr. Campbell received a message in MOIS® to let her know that the team was looking after Debbie, and that the occupational therapist had already made a home visit that day. Because the team could communicate quickly and easily using the EMR, Debbie could avoid spending time in hospital.

Keeping everyone in the loop on a hospital readmission

Alyssa, a resident of Vanderhoof with multiple diseases and social challenges, had emergency abdominal surgery in nearby Prince George. Two days later, she was assumed to be stable enough to travel back to Vanderhoof and was discharged.

However, she quickly experienced complications and was readmitted to hospital in Vanderhoof for three days. Because of a delay in communication, Dr. Campbell didn’t know about Alyssa’s discharge and readmission.

The second time Alyssa was discharged, though, she was connected with the interprofessional team. The notes from this team in the shared chart now alerted Dr. Campbell that not only was Alyssa no longer in Prince George, but she’d suffered complications after her surgery and needed more support.

When Dr. Campbell discovered Alyssa was home, she also learned that the interprofessional team was already taking care of dressing changes and giving her the supports she needed. Although Dr. Campbell had been left out of the communication loop at first, she could easily see that Alyssa’s current needs were being met, because they’d been captured in the MOIS® EMR.

Heading off complications for an MS patient

Doris has severe multiple sclerosis, resulting in paralysis and many complications. With dedication and support from her husband, plus private home support, she’s able to live at home. However, she’s at a high risk of infection, and if she were admitted to hospital, this risk would significantly increase.

Doris lives in a rural area outside Vanderhoof. Dr. Campbell phones her regularly and makes occasional home visits. Recently, Doris was having some issues and it was important to determine whether she had an infection that needed treatment, or if it was something more complex.

Using the shared EMR in MOIS®, Dr. Campbell was able to connect with the nurse, who then made arrangements to visit Doris the next day. The nurse collected the necessary information and taught Doris’s husband how to provide the new care that his wife needed. This quick response helped to prevent unnecessary antibiotics, more complications, or a possible hospital admission for Doris.

Preparing for a difficult conversation

An oncology patient had an appointment to see a counsellor, but between the referral and the first appointment, her diagnosis sadly changed from hopeful to terminal.

Dr. Campbell was able to attend the daily meeting with the interprofessional team. This meant it was easy for her ask the counsellor to provide an update before the appointment that day. This direct conversation meant the counsellor was fully prepared going into the first support session with the patient.

Supporting a senior’s wish to die at home

Elaine, a 99-year-old Vanderhoof resident, wanted to die at home. She had significant medical problems, but was alert and could direct her own care and express her wishes. Elaine’s situation was complicated by the fact that she lived on a rural property many miles out of town.

Providing end-of-life care at home in a rural area is challenging because there’s limited medical home care available in the evening and on weekends. It’s only possible with a dedicated family and an excellent communication system.

The interprofessional team, including Dr. Campbell, regularly visited Elaine at home to look after her needs and keep her comfortable. All the team members charted their visits in MOIS® so they could stay updated in real time on any changes in Elaine’s needs and condition.

Eventually, Elaine’s life came to a peaceful end at home, according to her wishes.

Summary

To sum up, a shared electronic medical record in MOIS® benefits Northern BC patients in many ways. The fact that all members of the interprofessional care team can access the same information helps ensure coordinated care and leads to better outcomes for Northerners.

“AIHS and MOIS® for us means reliability, efficiency for our practice and organization,” says Dr. Cathy Textor, a family physician in Prince George, and the same is definitely true throughout Northern BC, including Vanderhoof and the Omineca Medical Clinic.

[1] All patient names and identifying details have been changed.

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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“Don’t judge us. None of us want to die.” A success story of a woman struggling with addiction

Selfie of Teri-Lynn.

“If it wasn’t for naloxone or Narcan, I’d be dead,” she says.

Teri-Lynn was put up for adoption by her biological parents, both of whom struggled with substances. She remembers from a young age thinking she’d done something wrong to not be loved or wanted. This message became deep-rooted as she was moved from foster home to foster home due to abusive environments. Fortunately, Teri-Lynn eventually moved into a great, safe foster home, with people who she still has a close relationship with.

Growing up, she still unconsciously, yet desperately, sought acceptance. She found that despite being kicked out of school, providing THC (the mind-altering ingredient found in cannabis) to her friends was worth it to her. At 14 years old, she became hooked on crack cocaine, a habit she supported by engaging in criminal activity. After three years of experiencing repeated episodes of paranoia and drug-induced psychosis, she hitchhiked with a friend to the downtown East side of Vancouver and soon began using heroin and fentanyl.

This cycle of stealing and other criminal activity continued until her 18th birthday, when she became pregnant. She did her best to cut back on her use, to “do right by her baby,” but after a year, this lifestyle was too much and after one hit, she was hooked again.

She became re-entrenched in a life of stealing and other criminal activity to support her substance use habit. During that time, nurses, shelter staff, strangers, and mental health workers revived her 22 times.

“If it wasn’t for naloxone, I’d be dead,” says Teri-Lynn. “I was tired of having seizures, going to jail, being on the psychiatric unit for being suicidal, seeing cops outside my window, hiding in the closet because I was so paranoid, going to detox three times and treatment three times.”

After being on the methadone program for three years, fearing she’d overdose due to ongoing polysubstance use, she made the move back to Fort St. John with only a 4-week prescription.

After connecting with the Fort St. John Northern Health mental health office, she was immediately accepted into the Opiate Substitution Treatment Program (OSTP) and began working with the staff and Dr. Ohiaeri (now the Northern Health Medical Lead for Addiction in the Northeast).

Opiate Substitution Treatment provides clients with methadone or Suboxone to provide stable, long-acting relief from withdrawal and cravings. These medications replace the heroin or fentanyl that’s causing the problem with a regular dose of medication, which allows for a stable life.

During the intake process for the program, she was diagnosed with Hepatitis C and knew that changes needed to be made.

“Dr. Ohiaeri understood how hard it was for me, but still called me out when I told him I wasn’t clean. At first I didn’t like him, but looking back that’s what I needed,” says Teri-Lynn.

She recalls how the Women’s Resource Society and the mental health office helped her navigate the medical system, which had previously looked down on her and judged her. She found the staff to be open-minded and caring.

She was placed on medical disability due to a seizure disorder and things started to look up. She had stable housing and a regular income and was ready to make some big changes. She joined Narcotics Anonymous, working the 12-step program and going to church. These agencies provided some much needed support and acceptance.

It was at this time she requested to be transitioned into Opiate Agonist Treatment (OAT), with the intention of coming off medication altogether. This program supports clients with opioid use disorder by using a harm reduction approach and providing overdose survival training, take home naloxone kits, and opioid agonist therapy (buprenorphine/naloxone or methadone). Opioid agonist therapy works to prevent withdrawal and reduce cravings for opioid drugs. People who are addicted to opioid drugs can take OAT to help stabilize their lives and reduce the harms related to their drug use.

Teri-Lynn characterizes this decision as “the best thing ever. It helped me stay clean. Everyone should be offered it. I started on 32mg and within three months was down to 2mg. I’ve been off for 30 days and I don’t have any cravings. These past several months have been the first time in my life I’ve been motivated, happy and healthy. I’m even working part-time as a cashier at a local fast food establishment.”

She has reconnected with her 13-year-old daughter, who lives full-time with her father, and has recently been granted custody of her 5-year-old daughter, four days a week. She is slated to go to court in the near future, with the support of the foster mom, to ask for full custody. Teri-Lynn was also referred for Hep C treatment and is now cured.

Her advice: Have naloxone at shelters, Women’s Resource Centre, Mental Health Centres, hospitals, and Narcotics Anonymous meetings. Make access to naloxone easy. Have peer volunteers providing clean needles, naloxone kits, and candy for people on the streets.

“Don’t judge us. None of us want to die,” says Teri-Lynn.

Teri-Lynn has naloxone kits in her car, her house, and her purse.

“If it wasn’t for naloxone or Narcan, I’d be dead,” she says.

She currently holds a General Service Resource position with Narcotics Anonymous, chairs meetings, and advocates opiate substitution treatment to her peer groups.

If you or someone you know needs help, go to the Northern Health Mental Health and Substance Use webpage, the overdose prevention webpage, or call the crisis line at 1-800-784-2433 (1-800-SUICIDE).

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Bringing care to where the people are – nurse on Mobile Support Team brings care to Carrier Nations

Editor’s note: May 6-12 is Nursing Week! This story is one of several we’ll post this week to celebrate and showcase the many different types of nursing roles in Northern Health in honour of Nursing Week!

A sewing machine and handbag.

Jolene organizes community events as a way for people to disconnect from trauma, stress, or anxiety. The handbag making workshop was a big success!

“I know that I need to be flexible in my role. I need to be ready when the people are ready,” says Jolene Pagurut, a nurse on the Mobile Support Team in Quesnel.

Jolene travels to provide mental health and wellness support to three Southern Carrier Nations around Quesnel – Lhoosk’uz, Ndazko, and Lhtako. This Mobile Support Team is a partnership with Northern Health, First Nations Health Authority, and the three nations. The communities have renamed this Mobile Support Team to “Dakelh Wellness.” Dakelh is the Carrier word for Carrier.

“The best part of this position is the people from the communities I serve – being able to help people along their healing journey in a good way,” says Jolene. “The support of Northern Health, the community leaders, elders, and First Nations Health Authority makes it possible to use traditional and creative interventions to meet people where they are at and to help them reach their wellness goals. Really, so much of the success of this program is the partnership with NH and the community leaders.”

Right now, Jolene is the only team member, but works very closely with the team of health care professionals that provide primary and community care in Quesnel. A social worker will be joining Dakelh Wellness on May 15, and they’re looking for a counsellor for the team as well.

Jolene works to help people overcome the discrepancies in the social determinants of health, including things like low-income, housing, access to food, and other challenges with navigating the health care system. She supports individuals who live on and off reserve. Many of them are couch surfing or homeless and she’ll go to help them where they’re at – in their homes, on the riverbank, in a homeless shelter, or on the street.

A selection of baked goods.

Jolene has also gotten people together to make baked goods for the Elders.

This is Jolene’s third year in the role and she’s now better known in the community. She now knows where the people are. Jolene often receives messages from family members who will let her know they’re worried about a family member and tell her where they can find them. Jolene will go to them, wherever they may be at the time, and bring them a coffee or water and sit with them, listen, and help with setting goals with where they’re at. The next time she meets with them, she’ll help them move towards their bigger goals.

“My hope is that when I find them somewhere, I’ll leave them in a better place than when I found them. This often involves using harm reduction strategies and lowering barriers to receiving health care. For example, providing naloxone training and kits, or talking to someone who’s using IV heroin about smoking instead, or giving them new needles,” says Jolene. “The next time I meet them, they might be interested in hearing about the Suboxone program.”

The people that Jolene works with are overcoming so many challenges; many are homeless or live over two hours away from Quesnel. Some individuals have challenges with reading and writing, and Jolene is able to help them with filling out forms or better understanding medications. Jolene will also help by taking them to the pharmacy, or connecting with the pharmacist and making a plan to get the medication out to them in the community. They work to help their patients overcome the barriers in creative and meaningful ways.

“Filling a prescription when the person lives two hours away can be like a relay race – we get the prescription at the pharmacy in Quesnel and can get it on a medical van to one community and another community member can bring it to the final destination. We work hard and make it happen,” says Jolene.

Jolene also organizes community events as a way for people to disconnect from trauma, stress, or anxiety. She held a handbag making workshop last week. The intent was to train the elders to make the handbags and then they would teach the youth.

It turned out that some of the Elders were experts at sewing and were farther ahead than expected; they had to provide additional projects for them to work on. The youth also caught on very quickly and were soon helping the Elders. The event was a huge success, with people showing up at 8 am and staying until midnight. In the past, Jolene has also organized a food-dehydrating workshop and a canning workshop.

“It’s all about listening to what they want to do,” says Jolene.

Some of the other work Jolene does includes managing people with severe and persistent mental illness, working with the methadone doctor and doing Suboxone inductions, and referring individuals or families to treatment. She works with the team of health care professionals in the community and connects patients to the team for other services when needed, and will also attend doctor’s appointments with the patient. She strongly advocates for the patient. If she’s already in the community for a visit and something else comes up, like a dressing change on a wound or a baby check, she’ll use Skype or Telehealth and connect the family to a doctor right away.

“I’m working to help people increase their safety and support. I’m a safe person to talk to who can connect them to more people for physical, emotional, mental, spiritual support. I’m building on what’s already there with such resilient people,” says Jolene.

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Public health resource nurse providing support to primary care nurses in Prince Rupert

Editor’s note: May 6-12 is Nursing Week! This story is one of several we’ll post this week to celebrate and showcase the many different types of nursing roles in Northern Health in honour of Nursing Week!

Headshot of Kim Hughes.

Kim Hughes, public health resource nurse in Prince Rupert.

Kim Hughes is a public health resource nurse in Prince Rupert, supporting primary care nurses, by providing them with practice support and mentorship in the area of public health.

“I really love mentoring and teaching. That’s always been an area of passion for me. When I’m able to do that and help people develop – that’s exciting for me,” says Kim.

Public health includes areas such as: provincial immunization programs (all ages); early childhood support for child health clinics and child health assessment; care during and after pregnancy; harm reduction; communicable disease (e.g., measles); school programs; and sexual and reproductive health. All of these areas support a complete state of physical and mental health that enables a person to lead a socially and economically productive life.

One of many public health resource nurses across the Northern Health region, Kim provides support to nurses, both experienced and new, to the practice area of public health. She works closely with them to develop orientation plans and supports them with their practice. She’s there to answer any questions and works alongside registered nurses (RNs), licensed practical nurses (LPNs), and registered psychiatric nurses (RPNs) in clinics when they’re new and learning. She provides information to nurses to keep them up to date on best practices, new practice changes, and regional or provincial programs in the various areas of public health.

Kim started in her role as a public health resource nurse when the role was first created at Northern Health in 2016. Preventive public health leadership provides guidance and then Kim is able to develop the role at a community level.

“Because I’m one of the original public health resource nurses, I’ve been able to be really involved in the development of the role and how it looks,” says Kim.

Kim walks alongside the nurses in their own practice and helps them develop their role. She gets to watch them become well-rounded primary care nurses – able to provide all services to their community. Kim can also sit in with a primary care nurse when they see a patient and provide in-the-moment support in more difficult situations.

Kim hopes that this story will show nursing students that there are so many nursing positions out there that go beyond providing direct care to patients. She encourages all nurses to learn about a variety of nursing roles and to see how nurses can support other nurses to provide the best care they can!

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Providing care from “cradle to grave” for people in McBride

Editor’s note: May 6-12 is Nursing Week! This story is one of several we’ll post this week to celebrate and showcase the many different types of nursing roles in Northern Health in honour of Nursing Week!

Headshot of Susan Umstot.

Susan Umstot, Primary Care Nurse (PCN) in McBride, BC.

Susan Umstot is a primary care nurse (PCN) in McBride, providing health services from “cradle to grave.” Susan started as a PCN in January 2018 and she loves the variety in her work, which includes education during and after pregnancy, newborn baby visits and checks, immunizations, school health, health fairs in the community, home health visits, palliative care, STI testing, well-women checks, and a caregivers support group.

“I really like the variety in it. I can see a newborn baby and then a palliative patient and then teach something about health at a school – all in one day!” says Susan. “I think my favourite part of the role is the school health part. And I like the newborn baby visit part and the women’s health care.”

Susan likes the health promotion part of the role and that it’s about keeping people healthy and making healthier choices. She sees patients from Dome Creek to Dunster, and likes working with so many different people in varying states of their health. She credits her team lead, Karen Desormeau, who is also a nurse, for providing her with such great support in all areas of her role.

“I like to think that parents and kids and people of all ages see me as someone who is approachable – who they can ask things about their health to,” says Susan.

In her role, Susan works to make sure health care is accessible to all. Depending on what the patient’s situation is, she will either visit them in their home, or they’ll come to the McBride community health services building. If a patient is receiving home care services, or it’s a newborn baby check or a palliative patient, Susan will go where they are to provide care.

“Being in your home is the best place to be,” says Susan.

The community health services building is a private space to go see Susan for an appointment. It isn’t attached to the hospital or the doctor’s office (it’s across the parking lot) so there are not as many people in the waiting room. In a small community like McBride, people may wonder about the purpose of your visit; the community health services building isn’t as front and centre as the waiting areas at the hospital or doctor’s office.

The role of the PCN is very patient-centered. It’s about working and thinking to see what works best for the patient and their family.

“A lot of what I do is support the complete person. When I speak with people, I always go back to all parts of their health,” says Susan. “For example, when I teach about sexual health in schools, I start by talking about their brains. Your brain needs to be healthy to make good decisions about your life.”

Overall, Susan wants to help the people of McBride live a happy and healthy life, and provide them with the health information and options to do so.

“I love to help people make a healthier choice – in whatever aspect of their life that may be,” says Susan. “It really is about the whole life spectrum, and helping people making a health choice by giving them the information they need.”

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Nurse working to make life better for seniors at Parkside Care

Editor’s note: May 6-12 is Nursing Week! This story is one of several we’ll post this week to celebrate and showcase the many different types of nursing roles in Northern Health in honour of Nursing Week!

Selfie of Kim Magnant and Amanda Wright.

L-R: Kim Magnant, LPN and Amanda Wright, LPN

“Being a nurse is a great, well-rounded and good feeling job. Anyone would feel that way if you’re doing what you’re supposed to be doing in life,” says Kim Magnant, a Licensed Practical Nurse (LPN) working at Parkside Care in Prince George.

Kim has been an LPN for 11 years, and is a graduate of the College of New Caledonia in Prince George. She’s always enjoyed working with seniors, and worked as a care aid prior to becoming a nurse.

Some of the tasks that Kim does on a regular basis include dressing changes, observing resident overall health (mental, physical, and emotional), assessments, taking and monitoring vitals, and medication administration. She works as a member of a health care team, which includes doctors, dietitians, social workers, care aids, nurses and occupational therapists, who all work together to provide care to the whole person.

“I work every day with the other nurses and care staff to provide the best possible care we can,” says Kim. Nurses also provide emotional and social support, sometimes just as much for the families as for the patient.

Kim strives to be inclusive of each resident, involving them in activities as she can. There is a project going on right now at Parkside Care that tries to bring back a sense of purpose to those residents who are interested, giving them the opportunity to be involved in small tasks like folding laundry or helping out at mealtime. Most of the residents were used to being busy their whole life and welcome the chance to keep busy and active.

The residents also enjoy doing creative activities and there are lots of programs at Parkside Care that they can participate in. There’s a Get Fit program, a seated chair exercise class with range of motion movements and light weight exercises, and since Parkside Care is located right next to Rainbow Park, the residents also love going for walks in the park or sitting outside in the courtyards. Lots of the residents work together to help each other get outside.

“I just love nursing,” says Kim. “It’s fulfilling and I love the connections I make with families and residents and coworkers.”

Kim enjoys working with seniors and knowing that they’re stable in their situation.

“I’m just a small piece in the last part of their journey and I like making it feel as happy and special as it can be,” says Kim. “I’m happy to go to work and put smiles on people’s faces.”

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Community paramedics partner with Northern Health communities to increase access to care

Community paramedics are changing patient care in some communities in Northern Health. They’re helping increase access to basic health care services in non-urgent settings, in patients’ homes, or in the community. Throughout Northern Health, 26 communities have community paramedics helping patients.

Patients can see a community paramedic if they’re referred to them by their doctor or health care team, or when they’re discharged from the hospital.

Community paramedics are employed by BC Emergency Health Services, but they work very closely with the teams of health care professionals in the community.

In Fort St. James, the “biggest positive is she [the community paramedic] works really well and has a positive relationship with the First Nations bands. She’s a great liaison for information and understanding their culture,” says Cathy York, team lead for Fort St. James.

The health care team and the community paramedic in Fort St. James are encouraged to share information and they all have a great working relationship. The community paramedic does a lot with the First Nations bands on naloxone training for overdose prevention, and also educates people on diabetes, chronic obstructive pulmonary disease (COPD), and heart disease. She’s also starting to work with local schools to do naloxone training.

Fraser Lake saw benefits when the first community paramedic started. At the time, they were short on nurses, so it was difficult for them to have eyes on some of the people they were concerned about in the community.

“We’re so thrilled to have the program start here, and the paramedics are such an asset to the team,” says Lora Lee Pacheco, team lead for Fraser Lake.

The community paramedic attends team meetings (called “huddles”) in Fraser Lake, which has helped close loops and encourage open communication. If there’s a concern with a patient, the community paramedic will bring it up to the team and sometimes suggest that the physician pay a home visit. They’re proactive in their care and address people’s health concerns early on.

“For example, a man used to come in every second week to the doctor’s office and was going to the hospital once a month. Now, because of the home visits of the community paramedic, he hasn’t been in the hospital since July,” says Lora Lee. “It just goes to show how important it is to check in on people and how far this program goes to prevent hospital admissions.”

Fraser Lake’s community paramedic has also taken over naloxone and CPR training in the community itself, as well as in surrounding First Nations communities. To save time, she’s also spending 1-2 hours a week at the Autumn Services Centre to follow up with people she would normally do a home visit with.

In Burns Lake, the community paramedic started only a few months ago. Since then, the team has found that he’s able to catch concerns with patients earlier on than if they waited to see their doctor. To help prevent crises, he’ll bring patients with any concerns directly to the health care team – another great example of how community paramedics are partnering with Northern Health and the local community health care teams to provide better patient care.

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Our People: Spotlight on Barb Haagenson

Barb Haagenson outside against a wintery background.Barb Haagenson is a social worker on the primary care interprofessional team in Tumbler Ridge. She joined the team in September 2018, moving from Powell River, BC.

Can you tell me about your role as a social worker?

Currently, I’m working as a social worker and focusing on people struggling with mental health and substance use issues. I work with adults, and I also do traditional social worker jobs, such as helping with applications for disability and assisting with finding housing for people. I’m working on expanding my knowledge and helping people that are receiving home and community care or palliative services.

When I was doing my undergraduate degree at the University of Victoria, we learned about the perspective of generalism, described at school as a basic grounding of integration of practice, policy, and research at each system level of practice. It’s about a broader view of work among and across systems. I’ve done a lot of work with people and this perspective just fits. Whatever comes up in a person’s life, that’s what we work on with them.

I bring a generalist lens to every patient that comes to see me. For example, if they’re coming to talk to me because they struggle with depression, I also look to see if there are housing or economic struggles. I feel fortunate because I’m biased towards having a generalist perspective. There is such a huge benefit of working this way for the patient – they come to me to discuss what’s important to them and I work with them where they’re at.

I did my graduate degree at the University of BC – Okanagan. It was more specialized with a clinical focus. I learned with nurses and other health care professionals and worked in an interprofessional way – it felt like a good fit.

What brought you to Tumbler Ridge?

I really enjoy living and working in remote and rural places. When I was exploring options for work, the North was one of my first choices. I feel really grateful to be working and living where I am. The interprofessional team approach fits with how I want to work and so the team in Tumbler Ridge, combined with the community, was a great fit for my life.

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Four-person show in Hudson’s Hope

The four staff members in Hudson's Hope looking at a document.
L-R: Cara Hudson, lab/x-ray technologist; Susan Soderstrom, primary care nurse; physician; Faye Fladmark, primary care assistant.

Think it can’t be done? Think again. One doctor, one nurse, one combination lab/X-ray technician and one assistant are managing 1,200 patients in the community of Hudson’s Hope.

They do it all. This team works together to manage any emergencies in the community before they are transferred to Chetwynd or Fort St. John, as well as provide regular family doctor visits and checkups to their patients. The team is small so they communicate well with one another.

Because the community is only about 1,200 people, the staff know their panel well and have good relationships with their patients.

On a typical day, Susan Soderstrom, the primary care nurse, could be out in the community assisting a patient and then come back to the clinic and need to help the doctor with a major emergency.

Cara Hudson, the lab/x-ray technologist, took combined training aimed towards working in rural communities so that she can provide both services. Normally, two different people would provide these services.

There is one solo doctor in the community, and he treats a wide variety of issues – everything from prescriptions to chainsaw injuries.

Faye Fladmark, the primary care assistant, deals with everything else that comes through the doors. Managing patient records, ordering supplies, etc.

Through collaboration, innovation, and great communication, this incredible team confidently handles anything that comes their way!

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Thermometers help keep kids out of Dease Lake emergency room

Two staff holding thermometers.
L-R: Amy Bolton, Dease Lake Pregnancy Outreach Coordinator and Anna Fritch, Northern Health Nurse.

When someone goes to the emergency room with a cold or a mild fever, they often end up using some of the time and care needed for people with more urgent health concerns.

Anna Fritch, a nurse in Dease Lake, noticed this trend and decided to do something about it. Her goal was to cut down on the number of unnecessary emergency room visits.

She realized that many people who come to the emergency room don’t have basic health information on how to treat minor illnesses at home.

“I thought, ‘What do I know about taking care of a cold?’ I learned what to do from my mother as a child and how she self-treated us at home,” Anna says.

She realized one problem is that people don’t know where to get health information. Another problem is that people call emergency saying that their child has a fever, but when asked what their temperature is, parents respond that they don’t own a thermometer.

Anna works closely with the pregnancy outreach coordinator in Dease Lake, Amy Bolton. They meet a few times a month to collaborate and share information. When Anna mentioned the issues to Amy, Amy was immediately on board, offering to use some of her budget to buy thermometers.

Anna and Amy now wanted to work out how to give out the thermometers, but also educate people at the same time. They tried to do monthly pre-natal education sessions, but even though Dease Lake is a small town, the turnout wasn’t great.

The next step was to share the information with Dease Lake residents. At a community health fair, Anna provided thermometers, HealthLink BC info on how to take temperatures (children and adults), Northern Health info on treating a child’s fever at home, and a pamphlet from BC Children’s Hospital.

Now, Anna has the same information in her office, along with the thermometers. When a family or an elder comes to the emergency room, she takes the opportunity to educate them about fevers and gives them a thermometer. She teaches them what a fever represents, when to be worried about it, and what to do.

This education “makes a fever less frightening and puts a bit more agency into the hands of families,” says Anna. “People tend to think the moment they’re unwell, there’s nothing they can do.”

“It’s a willingness to partner and support people, but it’s also ‘here’s the tool you need and how to use it.’ These are the situations in which you can help yourself,” says Anna.

Anna says that now, when people call the emergency room to say they’re coming in with a feverish child, they can attach a number to their concern because they’re using a thermometer.

“There’s a difference between hot to the touch and clinically having a fever,” Anna says. “When I did the teachings, I tried to emphasize that ‘I’m giving you the thermometer because when you call me, I want us to be talking about the same thing.’”

Anna and her nursing colleagues are still working on increasing people’s confidence to care for family members themselves. But now, they can objectively measure temperature, which gives Anna and the other nursing staff a talking point to use when they call or come into emergency.

This is a great example of how a simple tool and a little education can help reduce emergency room visits.

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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