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VP Guest Blog - Dr. Victoria Lee: Making the shift to caring for the health of whole communities

09/11/2016 8:00:00 AM | 1 comments |

Across the country – and in fact all over the world –conversations amongst health care leaders are tuned towards this concept of “shift” we talk about so much in Fraser Health. When we talk about the shift, we are talking about moving away from a system that relies heavily on hospitals and towards a system that promotes health and wellness, prevention and management. Refining our use of hospitals and expanding community services are two ways to create a more sustainable system that better supports the health needs of our communities and citizens. Fraser Health is well positioned to make this shift a reality. Our vision Better health. Best in health care. has long stood for our organizational commitment to help people be well, stay well, get well, or manage better and when they are sick or injured, to deliver the very best care we can.  

Our executive team members are committed to making decisions and organizing their portfolios to best support our efforts. I’d like to introduce them and let them tell you how they are supporting Fraser Health’s vision of Better health. Best in health care. 

It’s important to me that when we look improving health and health care services that we consider the community around people as central to their health and wellness. That’s the approach taken by Population and Public Health teams. They recognize that a large part of what makes a person healthy is the health of their community. Under the direction of Dr. Victoria Lee, our teams have partnered with municipalities, non-profits and neighbourhood services to promote wellness from the ground up, and they are in the process of renewing their public health service delivery models to maximize the health of the populations we serve.
 
I’d like to introduce Dr. Victoria Lee, Fraser Health’s Chief Medical Health Officer and Vice President, Population and Public Health.

~Michael Marchbank, CEO and President, Fraser Health


It’s clear to many of us who work in health care that our current system is unsustainable.  Our population is aging and the proportion of frail or complex patients who require a higher level of care is growing rapidly. As medical technologies and pharmaceuticals advance, they also become more expensive, and visits to our emergency departments are outpacing our population growth rate. In light of these trends, we need to provide more comprehensive, sustainable, whole person care instead of providing one-off care that sees patients as parts: you’re a kidney, you’re a heart, you’re a knee. We also need to bring more partners to our care model and at the same time break down traditional silos of care.

So for me, the shift means providing whole care, not only in the health system, but in the broader community, through a network of partnerships with municipalities, community organizations, businesses and neighbourhood services. We need to understand that what makes a person healthy is in large part their community: their access to nutritious food and active recreation, their social connections, and how their neighbourhoods are designed to keep them healthy and safe. We are not only diagnosing individual patients in public health, we are also diagnosing the overall health of communities.

We are doing a lot of work on the ground to achieve this vision. Right now, we are renewing our Population and Public Health service delivery model to adopt an upstream health promotion approach. We are shifting emphasis from ‘one-to-one’ client services to ‘one-to-many’ population-based programs to maximize the health of the populations we serve. As an organization, Fraser Health is paying special attention to communities like Hope, where residents have poorer health outcomes and lower life expectancies.  In order to address these inequities, we announced a $500,000 community health grant earlier this year.

The Mental Health and Substance Use program is also doing a lot of work to increase our community supports in service of this vulnerable population. We added two additional ACT (Assertive Community Treatment) teams in Surrey/Delta and Abbotsford/Mission last year, joining the other two teams in Surrey and Tri-Cities/New Westminster in providing street-level mental health and addictions support to hard-to-reach clients. This spring we partnered to open Beckman Apartments in Maple Ridge, adding more assisted-living housing to help mental health clients recover in the community.  This summer we opened a new facility in Abbotsford on Marshall Road which offers 30 licensed care beds and 20 assisted living beds. We have also opened 40 substance use treatment beds in the last year and a half, and we’re on track to open nearly 100 more by 2017. We recognize that sometimes patients and even professionals can find the range of mental health and substance use services confusing, so we are also  simplifying and streamlining access by developing a single point of referral across our communities.

Fraser Health is home to approximately 90 per cent of government assisted refugees and 40 per cent of immigrants in the province.  We have developed some really exciting new programs geared to our diverse populations. The South Asian Health Institute has employee and volunteer Sehat Wellness Ambassadors delivering health services and health promotion education in temples and gurdwaras in Surrey and Abbotsford.  Given the higher rates of chronic diseases in these populations, it is important that we deliver these services in a culturally sensitive fashion to prevent and manage chronic diseases and promote healthy behaviours. We hope to expand the program to New Westminster and Delta over the upcoming year.  In Aboriginal Health, we are working with the First Nations Health Authority (FNHA) to design a more integrated system of primary care that is coordinated with 32 First Nations communities to provide wrap-around services in the areas of primary health care, public health and mental health and substance use.  Together with First Nations Health Authority, we are investing $2 million to accelerate our progress towards meeting Fraser Salish Wellness goals for all Aboriginal people in the region.

I believe the biggest challenge in moving toward this whole person, community model of health care, is that we all have to change. That means as health care providers and administrators, we have to let our system evolve, like parents letting their children grow up.  We can’t afford to say, ‘this is what has always worked and this is how we have always done it.’ We have to see change as an opportunity. And we can’t just work within the system, because we don’t control the demand for health care. To truly transform health care, we need our patients to change and ‘grow up’ with us.


Comments
Shelley
Patients arrive at ER daily having been to one, tow five or six WIC's - whose office hours report being open - yet they are closed. Patients arrive angry, and frustrated. and say "Next time I'm just going to ER." This extends to their care, and their family's care. NP's are potentially a great resource not yet fully utilized.NP's can - and should- facilitate holistic care, dependeability community-access-hours and promote health-care sustainablility.
19/12/2016 9:41:58 PM

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