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MSC Story - Team Support for GP Helping Young People Access the Care They Need

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1540
Published Date
2019
Link to File
/media/divresources/MSCStory_TeamSupportforGPHelpingYoungPeopleAccesstheCareTheyNeed.pdf
Description
"These most significant change (MSC) stories take readers on a journey toward understanding how patient medical homes are removing barriers to care around the province. This story tells the reader about how working onsite with a team helped a GP feel more supported to provide care for youth."
Corporate Author
General Practice Services Committee
Published Date
2019
Topics
Team-Based Care
Patient Medical Home
Evaluation
Most Significant Change
Resource Type
Story
File Type
Pdf
Link to File
/media/divresources/MSCStory_TeamSupportforGPHelpingYoungPeopleAccesstheCareTheyNeed.pdf
Description
These most significant change (MSC) stories take readers on a journey toward understanding how patient medical homes are removing barriers to care around the province. This story tells the reader about how working onsite with a team helped a GP feel more supported to provide care for youth.
Less detail
Published Date
2019
Link to File
/media/divresources/MSCStory_TimeandaTeamApproach.pdf
Description
"These most significant change (MSC) stories take readers on a journey toward understanding how patient medical homes are removing barriers to care around the province. This particular story is about how the PMH innovation allows nurses spend extra time with patients to help support the GP."
Corporate Author
General Practice Services Committee
Published Date
2019
Topics
Patient Medical Home
Team-Based Care
Evaluation
Most Significant Change
Resource Type
Story
File Type
Pdf
Link to File
/media/divresources/MSCStory_TimeandaTeamApproach.pdf
Description
These most significant change (MSC) stories take readers on a journey toward understanding how patient medical homes are removing barriers to care around the province. This particular story is about how the PMH innovation allows nurses spend extra time with patients to help support the GP.
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Navigating the Team-Based Care Journey - Guide to GPSC TBC Resources

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1611
Published Date
2022-03
Link to File
/media/divresources/Guide_to_GPSC_TBC_Resources-2022-03-23.pdf
Description
"Team-based care is being established by diverse groups such as practices and providers, communities, and health leaders planning primary care networks. This Guide to GPSC TBC Resources is for all audiences interested in developing and implementing TBC. The Guide provides tangible steps and support for all stages throughout the implementation and improvement of TBC, from engaging and exploring, preparing, implementing, and strengthening and sustaining TBC. Resources in the Guide include tools that can be used independently or with training or coaching opportunities described in the Guide."
Corporate Author
General Practice Services Committee
Published Date
2022-03
Topics
Team-Based Care
Resource Type
Guide
File Type
Pdf
Link to File
/media/divresources/Guide_to_GPSC_TBC_Resources-2022-03-23.pdf
Description
Team-based care is being established by diverse groups such as practices and providers, communities, and health leaders planning primary care networks. This Guide to GPSC TBC Resources is for all audiences interested in developing and implementing TBC. The Guide provides tangible steps and support for all stages throughout the implementation and improvement of TBC, from engaging and exploring, preparing, implementing, and strengthening and sustaining TBC. Resources in the Guide include tools that can be used independently or with training or coaching opportunities described in the Guide.
Less detail
Published Date
2017-01
Link to File
http://www.gpscbc.ca/sites/default/files/uploads/GPSC%20PMH%20Postcard%20201701F.pdf
Description
"This postcard uses an image to show that we're all working towards an integrated system of care, whether we call it Primary Care Home, Community of Practice, Integrated Community Services, Patient Medical Home, or Team-Based Care."
Corporate Author
General Practice Services Committee
Published Date
2017-01
Topics
Team-Based Care
Patient Medical Home
Resource Type
Postcard
File Type
Pdf
Link to File
http://www.gpscbc.ca/sites/default/files/uploads/GPSC%20PMH%20Postcard%20201701F.pdf
Originating web page
http://www.gpscbc.ca/what-we-do/primary-care-bc/pmh-resources
Description
This postcard uses an image to show that we're all working towards an integrated system of care, whether we call it Primary Care Home, Community of Practice, Integrated Community Services, Patient Medical Home, or Team-Based Care.
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Nurses in Primary Care: Four Experiences Across BC - Pre-Session Reading Material

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1114
Health Authority
Fraser
Interior
Vancouver Coastal
Division
Central Okanagan Division of Family Practice
Powell River Division of Family Practice
Kootenay Boundary Division of Family Practice
White Rock South Surrey Division of Family Practice
Published Date
2018-04-17
Link to File
/media/divresources/Nurses_in_Primary_Care_Pre_session_Handout.pdf
Description
"A pre-reading summary of the Nurses in Primary Care: Four Experiences Across BC session at the GPSC Summit 2018."
Health Authority
Fraser
Interior
Vancouver Coastal
Division
Central Okanagan Division of Family Practice
Powell River Division of Family Practice
Kootenay Boundary Division of Family Practice
White Rock South Surrey Division of Family Practice
Corporate Author
General Practice Services Committee
Published Date
2018-04-17
Topics
Nurse
Patient Medical Home
Team-Based Care
Primary Care
Event
GPSC Summit 2018
Workshop
Nurses in Primary Care: Four Experiences Across BC
Resource Type
Summary
File Type
Pdf
Link to File
/media/divresources/Nurses_in_Primary_Care_Pre_session_Handout.pdf
Description
A pre-reading summary of the Nurses in Primary Care: Four Experiences Across BC session at the GPSC Summit 2018.
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Program
Practice Support Program
Published Date
2018
Link to File
/media/divresources/PSPTBCTool_Patient_Journey_Map.pdf
Description
"This tool will help you identify team actions to support the patient journey, and determine how to collectively achieve them."
Program
Practice Support Program
Corporate Author
General Practice Services Committee
Published Date
2018
Topics
Team-Based Care
Quality Improvement
Team-Based Care: Implementing Stage
Resource Type
Tool
File Type
Pdf
Link to File
/media/divresources/PSPTBCTool_Patient_Journey_Map.pdf
Description
This tool will help you identify team actions to support the patient journey, and determine how to collectively achieve them.
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Patient Medical Home in rural communities: What are the realities? - Audio Recording Part 1

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1024
Published Date
2017-06-20
Link to File
/media/divresources/DoBC_6_20_17_Patient_Medical_Homes_in_Rural_Communities_pt1.mp3
Description
"Part 1 of audio presentations at the Patient Medical Home in rural communities: What are the realities? session at the GPSC Spring Summit 2017."
Corporate Author
General Practice Services Committee
Published Date
2017-06-20
Topics
Rural
Telehealth
Team-Based Care
Maternity Care
Patient-Centred Care
Patient Medical Home
Community Engagement
Event
GPSC Spring Summit 2017
Workshop
Patient Medical Home in rural communities: What are the realities?
Resource Type
Audio Recording
File Type
MP3
Link to File
/media/divresources/DoBC_6_20_17_Patient_Medical_Homes_in_Rural_Communities_pt1.mp3
Recording Length
1hr 29min 26sec
Description
Part 1 of audio presentations at the Patient Medical Home in rural communities: What are the realities? session at the GPSC Spring Summit 2017.
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Patient Medical Home in rural communities: What are the realities? - Audio Recording Part 2

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1025
Published Date
2017-06-20
Link to File
/media/divresources/DoBC_6_20_17_PatientMedicalHomeinRuralCommunities.mp3
Description
"Part 2 of audio presentations at the Patient Medical Home in rural communities: What are the realities? session at the GPSC Spring Summit 2017."
Corporate Author
General Practice Services Committee
Published Date
2017-06-20
Topics
Patient Medical Home
Rural
Telehealth
Team-Based Care
Maternity Care
Patient-Centred Care
Community Engagement
Event
GPSC Spring Summit 2017
Workshop
Patient Medical Home in rural communities: What are the realities?
Resource Type
Audio Recording
File Type
MP3
Link to File
/media/divresources/DoBC_6_20_17_PatientMedicalHomeinRuralCommunities.mp3
Recording Length
1hr 13min 25sec
Description
Part 2 of audio presentations at the Patient Medical Home in rural communities: What are the realities? session at the GPSC Spring Summit 2017.
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The Physician’s Control of the Patient’s Medical Record

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1139
Program
Divisions of Family Practice
Link to File
https://www.divisionsbc.ca/provincial/resources/medical-records-issues-guidelines/ii-physicians-control-patients-medical
Description
"This guideline regarding physician's control of the patient's medical record can be used to better understand responsibilities related to information sharing within a team."
Program
Divisions of Family Practice
Corporate Author
General Practice Services Committee
Topics
PMH Attributes: TBC Toolkit - TBC Communication
Team-Based Care
Privacy
Patient Medical Home
Resource Type
Policy
File Type
Web page
Link to File
https://www.divisionsbc.ca/provincial/resources/medical-records-issues-guidelines/ii-physicians-control-patients-medical
Originating web page
https://www.divisionsbc.ca/provincial/resources/medical-records-issues-guidelines/ii-physicians-control-patients-medical
Description
This guideline regarding physician's control of the patient's medical record can be used to better understand responsibilities related to information sharing within a team.
Less detail
Published Date
2019
Link to File
/media/divresources/PMH_QI_Extension_TBC.docx
Description
"This is a GPSC developed tool which helps to surface potential practice opportunities in the context of the Patient Medical Home model of care."
Corporate Author
General Practice Services Committee
Published Date
2019
Topics
Team-Based Care
Quality Improvement
Team-Based Care: Exploring & Engaging Stage
Resource Type
Tool
File Type
Word
Link to File
/media/divresources/PMH_QI_Extension_TBC.docx
Description
This is a GPSC developed tool which helps to surface potential practice opportunities in the context of the Patient Medical Home model of care.
Less detail
Program
Divisions of Family Practice
Description
"The Practice Toolkit provides a variety of policies and procedures for clinics."
Program
Divisions of Family Practice
Corporate Author
General Practice Services Committee
Topics
Practice Efficiencies and Support
PMH Attributes: TBC Toolkit - Additional Resources
Team-Based Care
Patient Medical Home
Resource Type
Website
File Type
Web page
Originating web page
https://www.divisionsbc.ca/provincial/resources/practice-toolkit
Description
The Practice Toolkit provides a variety of policies and procedures for clinics.
Less detail

Principles and Approaches to Best Practice Team Based Care and Organizational Excellence – Reflections from the Nuka Symposium, August 2019 - Presentation

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1538
Published Date
2020-01-22
Link to File
/media/divresources/PresentationReflectionsfromtheNukaSymposiumWebinar.pdf
Description
" Southcentral Foundation has had tremendous success in improving primary care from a quadruple aim perspective. In August 2019 a cohort of 19 attended a symposium created for BC participants to learn about their Nuka Model of Care.The webinar, hosted by Dr Dan Horvat along with a panel of Physicians who also attended, presented on the key learnings and how they can be applied in BC. This is the slide deck used during the Principles and Approaches to Best Practice Team Based Care and Organizational Excellence – Reflections from the Nuka Symposium, August 2019 webinar held on January 22, 2020."
Corporate Author
General Practice Services Committee
Personal Author
Dr Bonnie Bagdan Dr Dan Horvat Dr Alan Ruddiman Dr Tim Troughton
Published Date
2020-01-22
Topics
Primary Care
Patient Medical Home
Primary Care Network
Engagement
First Nations
Governance
Team-Based Care
Event
Divisions Webinar Learning Series
Resource Type
Presentation
File Type
Pdf
Link to File
/media/divresources/PresentationReflectionsfromtheNukaSymposiumWebinar.pdf
Description
Southcentral Foundation has had tremendous success in improving primary care from a quadruple aim perspective. In August 2019 a cohort of 19 attended a symposium created for BC participants to learn about their Nuka Model of Care.The webinar, hosted by Dr Dan Horvat along with a panel of Physicians who also attended, presented on the key learnings and how they can be applied in BC. This is the slide deck used during the Principles and Approaches to Best Practice Team Based Care and Organizational Excellence – Reflections from the Nuka Symposium, August 2019 webinar held on January 22, 2020.
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Principles and Approaches to Best Practice Team Based Care and Organizational Excellence – Reflections from the Nuka Symposium, August 2019 - Recording

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1537
Published Date
2020-01-22
Link to File
/media/divresources/PrinciplesApproachestoBestPracticeTBC_ReflectionsfromtheNukaSymposium_recording.mp4
Description
"This is the recording of the Principles and Approaches to Best Practice Team Based Care and Organizational Excellence – Reflections from the Nuka Symposium, August 2019 webinar held January 22, 2020."
Corporate Author
General Practice Services Committee
Personal Author
Dr Bonnie Bagdan Dr Dan Horvat Dr Alan Ruddiman Dr Tim Troughton
Published Date
2020-01-22
Topics
Team-Based Care
Primary Care
Patient Medical Home
Primary Care Network
First Nations
Engagement
Governance
Event
Divisions Webinar Learning Series
Resource Type
Audio Recording
Video Recording
File Type
MP4
Link to File
/media/divresources/PrinciplesApproachestoBestPracticeTBC_ReflectionsfromtheNukaSymposium_recording.mp4
Recording Length
59mins 13secs
Description
This is the recording of the Principles and Approaches to Best Practice Team Based Care and Organizational Excellence – Reflections from the Nuka Symposium, August 2019 webinar held January 22, 2020.
Less detail
Program
Practice Support Program
Published Date
2018
Link to File
/media/divresources/PSPTBC_Flexible_Learning_Opportunities.pdf
Description
"Overview of PSP's TBC flexible learning opportunities, which help primary care providers and practice teams develop competencies key to successful team based care in practice, as outlined in the National Interprofessional Competency Framework."
Program
Practice Support Program
Corporate Author
General Practice Services Committee
Published Date
2018
Topics
Team-Based Care
Quality Improvement
Team-Based Care: Strengthing & Sustaining Stage
Resource Type
Summary
File Type
Pdf
Link to File
/media/divresources/PSPTBC_Flexible_Learning_Opportunities.pdf
Description
Overview of PSP's TBC flexible learning opportunities, which help primary care providers and practice teams develop competencies key to successful team based care in practice, as outlined in the National Interprofessional Competency Framework.
Less detail

Report – Moving Forward Together: Supporting Team-based Care and Networks in Community

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1042
Program
Divisions of Family Practice
Published Date
11-03-2017
Link to File
/media/divresources/ReporttoDivisions_ Nov3and6_Events.pdf
Description
"Report from the Moving Forward Together: Supporting Team-based Care and Networks Community event on Nov 3 & 6, 2017. The GPSC’s Incentives Working Group (IWG) and the Team-based Care Task Group (TBC TG) met with Divisions and health authority partners to discuss emerging ideas for supporting Patient Medical Homes (PMH) and Primary Care Networks (PCN)."
Program
Divisions of Family Practice
Corporate Author
General Practice Services Committee
Published Date
11-03-2017
Topics
Team-Based Care
Incentive Fee Codes
Event
Moving Forward Together: Supporting Team-based Care and Networks in Community
Resource Type
Report
File Type
Pdf
Link to File
/media/divresources/ReporttoDivisions_ Nov3and6_Events.pdf
Description
Report from the Moving Forward Together: Supporting Team-based Care and Networks Community event on Nov 3 & 6, 2017. The GPSC’s Incentives Working Group (IWG) and the Team-based Care Task Group (TBC TG) met with Divisions and health authority partners to discuss emerging ideas for supporting Patient Medical Homes (PMH) and Primary Care Networks (PCN).
Less detail
Division
Sunshine Coast Division of Family Practice
Published Date
2021-05-04
Link to File
/media/divresources/SocialWorkerRole_FINAL_V2.pdf
Description
"This infographic was created by the Sunshine Coast Division of Family Practice and Vancouver Coastal Health to show the various roles occupied by a Primary Care Social Worker. This resource can be used by other PCNs, it can be provided to patients, or it could be placed in a clinic. It can also be used as a guiding template to be adapted or changed based on the role."
Division
Sunshine Coast Division of Family Practice
Corporate Author
Sunshine Coast Division of Family Practice
Vancouver Coastal Health
Published Date
2021-05-04
Topics
Primary Care Network
Team-Based Care
Human Resources
Resource Type
Info Graphic
File Type
Pdf
Link to File
/media/divresources/SocialWorkerRole_FINAL_V2.pdf
Description
This infographic was created by the Sunshine Coast Division of Family Practice and Vancouver Coastal Health to show the various roles occupied by a Primary Care Social Worker. This resource can be used by other PCNs, it can be provided to patients, or it could be placed in a clinic. It can also be used as a guiding template to be adapted or changed based on the role.
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Sample Medical Office Assistant Job Description

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1129
Program
Divisions of Family Practice
Link to File
https://divisionsbc.ca/sites/default/files/Divisions/Provincial/MOA%20Job%20Description.pdf
Description
"This job description for a Medical Office Assistant can be used as a template."
Program
Divisions of Family Practice
Corporate Author
General Practice Services Committee
Topics
PMH Attributes: TBC Toolkit - Understanding TBC
Team-Based Care
Human Resources
MOAs
Patient Medical Home
Resource Type
Job Description
File Type
Web page
Link to File
https://divisionsbc.ca/sites/default/files/Divisions/Provincial/MOA%20Job%20Description.pdf
Originating web page
https://www.divisionsbc.ca/provincial/resources/practice-toolkit/appendices
Description
This job description for a Medical Office Assistant can be used as a template.
Less detail
Program
Divisions of Family Practice
Link to File
https://www.divisionsbc.ca/provincial/resources/practice-toolkit/appendices
Description
"This job description for a Practice Manager can be used as a template."
Program
Divisions of Family Practice
Corporate Author
General Practice Services Committee
Topics
PMH Attributes: TBC Toolkit - Understanding TBC
Team-Based Care
Human Resources
Patient Medical Home
Resource Type
Job Description
File Type
Web page
Link to File
https://www.divisionsbc.ca/provincial/resources/practice-toolkit/appendices
Originating web page
https://www.divisionsbc.ca/provincial/resources/practice-toolkit/appendices
Description
This job description for a Practice Manager can be used as a template.
Less detail
Published Date
2021
Link to File
/media/divresources/Team_Based_Care_Readiness _Tool_Test_VersionMarch24.pdf
Description
"The Team-Based Care Readiness tool determines if support is needed prior to team-based care implementation to support a team’s success in moving forward with implementation. The readiness tool is meant to guide a conversation with a clinic and is intended to be used with a coach to support the discussion and identify areas for potential support."
Corporate Author
General Practice Services Committee
Published Date
2021
Topics
Team-Based Care
Quality Improvement
Team-Based Care: Exploring & Engaging Stage
Resource Type
Tool
File Type
Pdf
Link to File
/media/divresources/Team_Based_Care_Readiness _Tool_Test_VersionMarch24.pdf
Description
The Team-Based Care Readiness tool determines if support is needed prior to team-based care implementation to support a team’s success in moving forward with implementation. The readiness tool is meant to guide a conversation with a clinic and is intended to be used with a coach to support the discussion and identify areas for potential support.
Less detail
Program
Practice Support Program
Published Date
2018
Link to File
/media/divresources/PSPTBCTool _TBC_Preparation_Checklist.pdf
Description
"This tool helps practices new to TBC to think through who you might want on your team and how you want the team to function."
Program
Practice Support Program
Corporate Author
General Practice Services Committee
Published Date
2018
Topics
Team-Based Care
Quality Improvement
Team-Based Care: Exploring & Engaging Stage
Resource Type
Tool
File Type
Pdf
Link to File
/media/divresources/PSPTBCTool _TBC_Preparation_Checklist.pdf
Description
This tool helps practices new to TBC to think through who you might want on your team and how you want the team to function.
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50 public records – page 2 of 3.