Improving patient-centred care

The Ministry of Health recently released its health system planning guide, Setting Priorities for the BC Health System. Priority one in the guide is to shift the health care system from a disease-centred focus to more of a patient-centred focus. The document states this focus “will drive policy, service design, training, service delivery, and service accountability systems over the coming 3 years.”[1]

For the Specialist Services Committee (SSC), creating patient-centred specialist care has been a unifying vision and central activity for Doctors of BC and the Ministry of Health for the past 4 years.

A number of the 21 SSC Quality and Innovation Initiatives led by specialist physicians that have focused on patient-centred care are now coming to fruition. Below are summaries of just three projects that are helping improve the specialist care system for patients in BC.

BC Inherited Arrhythmia Program
The multidisciplinary BC Inherited Arrhythmia Program (BCIAP) was recently established, with help from a $500 000 grant from SSC, to provide expert care, management, and support to the one in 500 British Columbians who may be affected by an inherited heart rhythm condition. People with this condition are at risk for sudden cardiac arrest. When at-risk individuals are identified, effective treatment can be provided and tragedies prevented. 

British Columbians with a history of inherited heart rhythm conditions, unexplained cardiac arrest, or sudden unexplained death in a family member are encouraged to consult their family doctor about a referral to the BCIAP. Operating out of two main sites in Vancouver and Victoria, the program also has outreach and support for patients and specialists across the province.

For more information see Cardiac Services BC at www.phsa.ca.

Prostate Cancer Supportive Care Program
This comprehensive survivorship program for prostate cancer patients and their partners, addressing concerns that arise from the time of initial diagnosis to end-of-life care, received $500 000 in start-up funding from the SSC. The program offers five patient-care modules that address the decision-making and coping challenges along the entire disease trajectory and serves both the physical and psychological needs of men with prostate cancer and their partners. The five modules cover treatment options, sexual function, lifestyle management, androgen deprivation therapy, and pelvic floor physiotherapy.

“We have brought all the services together and put the patient and their partner in the middle of it,” says Dr Larry Goldenberg, professor and head of the Department of Urologic Sciences and director of development and supportive care at the Vancouver Prostate Centre. “It is the patient deciding on what they need; not the doctor. That is patient-centred care.”

Youth with complex conditions transferring to adult care
Each year in BC roughly 1700 youth with chronic health conditions graduate from the pediatric care system into an adult care system. The difficulty in transitioning can lead to increased morbidity and mortality for young patients. This large conceptual and logistical project, which received $750 000 from the SSC, as well as funding from other sources, has a steering committee of 18 people and more than 200 individuals involved. The SSC grant is being focused on four stages of specialist involvement, beginning with two specialty areas—cardiology and neuromuscular conditions.

The first stage is to identify specific pediatric and adult specialists willing to tackle the issue of transition. Then, working together, the teams co-develop long-term care plans and treatment guidelines for specific conditions. The third stage provides educational and skill-building programs, as well as support services for specialists and their office staff to help fill gaps in care. And finally, transition plans will be implemented.

“This is such a complex issue that looking at it through just one lens is not going to solve the problem,” says project lead Dr Sandra Whitehouse, a pediatrician at BC Children’s Hospital.

It is these kind of projects, and many more being funded by the SSC, that are helping shift health care culture from being disease-centred to patient-centred, and translating concepts, strategies, and policies into actionable, attainable, and sustainable practices.

By focusing on the primary objective of improved patient care, the Doctors of BC and Ministry of Health representatives on the SSC have found common ground for the committee’s activities and priorities. For more information on how you can get involved, please see sscbc.ca.
—Sean Virani, MD
Doctors of BC Co-Chair, Specialist Services Committee
—Kelly McQuillen
Ministry of Health, Former Co-Chair, Specialist Services Committee

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This article is the opinion of the SSC and has not been peer reviewed by the BCMJ Editorial Board.

References

1.    Ministry of Health. Setting priorities for the BC health system. Accessed 27 March 2014. www.health.gov.bc.ca/library/publications/year/2014/Setting-priorities-B....