Oxford Situation Table mitigates acutely-elevated risk to county residents

By Heather Rivers for the Woodstock Sentinel-Review

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The Oxford Situation Table is a group of local agencies working together to make a difference.

104.7 Heart FM

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Ontario Providing Faster Access to Medical Specialist Services

Ministry of Health and Long-Term Care

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Thunder Bay nurse practitioners lobby for pay raise

By CBC News

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Health and wellness show tests positive

By John Tapley for the Ingersoll Times

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Creating a Culture of Collaboration

By John Tapley for the Ingersoll Times

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Nurse practitioner-led clinic considered a success

By Tara Bowie for the Ingersoll Times

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New lead at nurse practitioner-led clinic

By John Tapley for the Ingersoll Times

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Nurse practitioner-led clinic opens doors

By Jennifer Vandermeer for the Sentinel-Review

INGERSOLL – It was just its first day open to the public, but staff at Ingersoll’s nurse practitioner-led clinic had already dealt with a medical emergency.

Oxford EMS was called to the new King Street East location to transport the patient to hospital.

Otherwise, the day was spent registering new patients. About 350 people, not having a family physician of their own, have been registered so far.

A tour of the two-storey facility included a look at the clinic’s own lab, two pediatric-specific exam rooms, eight regular patient exam rooms, a treatment room, administration space, a gym, addictions counselling space and the Dr. Kelly Shaughnessy community room, which is shared with Pharmasave.

Community partnerships with various organizations and businesses will help the clinic provide a broad spectrum of service to its patients and the community.

One special service for clinic clients is the Counterweight program. The Ingersoll nurse practitioner-led clinic (NPLC) is the first practice to offer this weight-loss program in North America.

Nurse practitioner and clinic administrator Shelly Redman said the clinic is not a walk-in for the general public but is set up so that the clinic’s patients may get same-day appointments.

Redman explained the clinic is designed as an advanced access model, “which means we prioritize our day and don’t fill every spot.” About 30% of the day is pre-booked and the rest is available for patients who call.

Funded by the Ministry of Health and Long-Term Care, the clinic will be staffed by four nurse practitioners, who will be able to take on up to 3,200 patients who don’t have a primary health-care provider.

The Ingersoll clinic is the first of its kind in Oxford County and was one of 14 approved in a third wave of funding. A total of 26 nurse practitioner-led clinics are expected to be open across Ontario by the end of 2012.

In filing its application, Ingersoll, which has an estimated 6,000 people living in the area who don’t have a primary health-care provider, outlined the need for a clinic here. The application included information on demographics, doctor shortages and hospital emergency department visits.

“There was a multitude of different factors that went into that document,” Redman said.

Nurse practitioners have a minimum two years of full-time nursing experience and advanced degrees to provide primary care services, including many performed by a doctor, such as writing prescriptions.

“It’s the same care as anywhere else. It’s just a team that’s all on site providing comprehensive healthcare,” said Lisa Longworth, a member of the clinic’s administration team.

The clinic is expected to take some of the pressure off of the emergency department at Alexandra Hospital because, until now, that was the only health-care option available to people without a family doctor.

With extended hours of 8:30 a.m. to 8:30 p.m. Monday through Thursday, and 8:30 a.m. to 4:30 p.m. on Friday, registered patients will have ready access to care.

While only people who don’t have a primary health-care provider will be accepted, nothing is needed to register as a patient with the clinic.

A volunteer board of directors made up of dedicated local residents governs the operation, she said.

For more information about the clinic or to register as a patient, go to the clinic web site at: www.ingersollnplc.ca


Prescription drugs: Ending the cycle

Despite obstacles – and some lengthy wait times – there is hope for local addicts.

By Heather Rivers Sentinel-Review

WOODSTOCK – Residents seeking addiction treatment in Oxford County can wait up to 100 days for access to services – the longest wait in the South West region.

According to the November 2011 report The Time is Now: A Plan for Enhancing Community-based Mental Health and Addiction Services in the Southwest LHIN, Oxford County has the highest wait time in the region – far out of proportion to other communities.

For example, Middlesex has a wait of 25 days, Grey County has a wait of 18 days and Perth has a one-day wait time.

Bruce County virtually has none.

“There is no question that Oxford County has the highest wait time for addictions. Hence, the requirement for additional resources,” said Mike Barrett, director of the South West Local Health Integration Network. “We see throughout the report pressures in different areas. As we move forward, we need to make sure we address identifiable deficiencies. Finding resources is going to be a challenge.”

Julia Nunes, who has in the past been the only full-time addiction worker through Thames Valley Addiction Services in Oxford County, said it has been tough providing timely services for those with addiction issues.

“It doesn’t feel good to talk to someone and tell them they have to wait four months before I can see them,” she said. “It’s hard to understand how it gets decided. There are definitely some areas that have more counsellors for less of a population.”

By the time she can offer services to those on the wait list, the client may have made changes on their own, gone outside the county or even given up.

“It has happened,” she said.

Nunes said her wait list currently isn’t as long as times in the past, with about a four-week wait.

“It ebbs and flows as far as a wait list. It’s about two to four weeks now, but it has been as high as four months,” she said. “Hopefully people will know it isn’t as long a wait time and may be encouraged to contact us.”

Nunes provides her clients with access to community treatment and counselling, referrals to residential treatment if needed, and referrals to other supports in the community.

Nunes said interventions, like those shown on television shows like Intervention Canada, are not ideal.

“They can have a pretty bad outcome for clients. People can end up feeling under attack,” she said. “If someone forces someone into change, it’s usually not going to last.”

Following best practices, Nunes said the less intrusive treatment is usually the most effective.

“If they are able to make changes within a community treatment setting then that’s the best,” she said. “If not, we look at more intrusive forms.”

Twenty-one-day residential programs are offered in communities such as Simcoe but not in Oxford County.

Starting Wednesday, Feb. 1, those seeking addictions counselling in Oxford will have more access in the form of a new nurse practitioner-led clinic in Ingersoll. The clinic has been described as the new delivery model for primary care and will offer clinical services to up to 3,200 people who currently don’t have a family physician.

“It’s the first of its kind, the only one in Oxford County,” said Shelly Redman, clinical administrator and nurse practitioner lead. “It’s very exciting and a long time coming.”

Redman, who is also chair of the Oxford County Drug Task Force, said her eyes were first opened to the drug culture when she worked at the Woodstock and Area Community Health Centre (WACHC).

“There was definitely some drug-seeking behaviours,” she said. “It led me to the development of these programs and led me to take on the chair of the Oxford County Drug Task Force.”

Developed in 2006, the Oxford County Drug Task Force is comprised of over 70 health-care, education, law enforcement, mental health and other community services workers.

Their work is focused on a vision of “a community free of problems associated with the harmful effects of substance abuse.”

Through a collaboration bringing together the WACHC, the new nurse practitioner clinic and Addiction Services of Thames Valley, an Oxford Addiction Treatment Strategy has been developed, designed to provide a standardized approach for substance abuse assessment and addiction community treatment in Oxford County.

Through the strategy, they are able to add an addictions counsellor to the Ingersoll clinic, with plans to eventually add one in Tillsonburg.

The Ingersoll clinic will also see the addition of a half-time youth addiction counsellor.

“The projection is, by the summer of 2012, we’ll have pretty much eliminated the wait list and be able to provide intake services within 24 hours from the client’s call,” Redman said.

Redman said reducing wait time is critically important due to a higher-than-average suicide rate in Oxford County.

“If we’re able to eliminate the wait, we hope we can make an impact on suicide rates in Oxford County,” she said.

According to a report released this week by Oxford County public health and emergency services, the average number of suicide per 100,000 in Oxford County from 2003 to 2007 was 12.11, while in Ontario, the average was 8.45 per 100,000.

The addition of a youth addictions counsellor is also designed to help target a growing trend in youth.

A 2008 report from the Oxford Drug Task Force showed that prescription drug use in youth continues to rise. Redman said the clinic will offer a holistic approach to health care and addiction issues.

“We look at the person as a whole and the community as a whole,” she said. “It’s a holistic model of care.”

She also said the clinic is “trying to take a stand of potential drugs of abuse.”

“We develop a holistic approach to pain management that doesn’t only include narcotics,” she said.

Using an evidence-based approach, Redman said the clinic will develop care maps for patients, with treatments that might include chiropractic and massage.

They also want to develop a methadone support group for those receiving methadone treatment.

“We recognize in Oxford County there isn’t the support to go along with medication management,” she said. hrivers@bowesnet.com


“RNAO looks forward to the day when Nurse Practitioner-led clinics are located in every pocket of the province so all Ontarians have access to quality and timely primary health care.”




Ontario nurse practitioners get expanded powers

The Canadian Press

Date: Saturday Apr. 9, 2011 12:46 PM ET

TORONTO — Expanding powers for nurses inside Ontario hospitals will save taxpayers money and get patients home sooner, Premier Dalton McGuinty said Friday.McGuinty, who has been trailing in public opinion polls, received no less than eight standing ovations during a speech to the Registered Nurses’ Association of Ontario when he promised additional powers for nurse practitioners.They will be allowed to start discharging patients this July, and will be able to admit patients to hospitals starting in July 2012.”You know it’s amazing how much our nurses can do for us if we only let them do it,” said McGuinty. “I’m proud of the fact we are putting ourselves at the forefront really in North America in terms of expanding the lawful authority of nurses.”Nurse practitioners can already admit, treat and discharge patients in emergency rooms and those who are in primary care, but only doctors can discharge patients who are in hospital.The nurses’ lobby had urged the government to give nurse practitioners the power to admit and discharge patients to help ease congestion, and prevent patients from being stuck in hospital on a weekend if they don’t see a doctor on Friday.Ontario will become the first province to give nurse practitioners the additional authority.”When our government allows nurses to do those kinds of things, we free up doctors to do things that only doctors can do,” said McGuinty. “It’s just introducing more efficiency into the system. It comes at a lower cost ultimately to taxpayers, and patients love it.”McGuinty first promised to consider giving nurse practitioners the power to admit and discharge patients when he spoke to the same nurses’ group last year.Doris Grinspun, executive director of the nurses’ association, praised McGuinty for addressing so many of their concerns over the years that her list of demands has been nearly exhausted.”You’re putting nursing where it belongs, and you’re putting nursing in a way that will allow us to change medicare from inside, and that will make medicare more effective and yes, more efficient,” said Grinspun. “So with that I have a new list, so this needs to continue, and the next (goal) will be RN prescribing.”The nurses leapt to their feet when McGuinty spoke about his government’s moves to put the chief nursing officer on hospital boards and to appoint a chief nursing officer in each public health unit.”I take that as a celebration of the progress that we’ve been able to make together,” said McGuinty. “It’s real, and it’s measurable, and it’s felt by those people who work on the front lines, and I’m proud of that progress.”However, the Progressive Conservatives said too many health dollars are taken away from front-line care to pay for bureaucrats and big salaries.”If Dalton McGuinty really cared about nurses and front-line health care, he wouldn’t have wasted $250 million on (local health) bureaucracies,” said Opposition critic Jim Wilson. “Patients and the front-line health care professionals should be the priority and the focus, not paperwork and not bureaucrats.”The province passed legislation in 2009 that would broaden the scope of practice for nurse practitioners, dentists, pharmacists and physiotherapists to reduce congestion in emergency rooms.


Two New Nurse Practitioner-Led Clinics Opening

The South West LHIN will be getting not one, but two new Nurse Practitioner-Led Clinics (NPLCs) to help unattached patients find the health care services they need, Minister of Health and Long-Term Care Deb Matthews announced August 23.

“Nurse practitioner-led clinics are an integral part of health care in Ontario,” said Matthews, who made the funding announcement with London-Fanshawe MPP Khalil Ramal at the Merrymount Children’s Centre on Colborne Street in London, ON. “This investment means more access to quality health care closer to home for Ontarians.”

Matthews said London’s Health Zone NPLC and the Ingersoll NPLC are just two of 14 organizations province-wide to benefit from the current wave of funding. NPLCs are locally-driven family health care delivery organizations that include an inter-professional team of nurse practitioners, family physicians, nurses and a range of other professionals committed to providing comprehensive, coordinated services tailored to the needs of the local community.

“This is a very exciting day for all of the people who have supported our goal of having a Nurse Practitioner-Led Clinic in London,” said Myrna FIrsk, Nurse Practitioner with Health Zone NPLC. This will give clients the opportunity of receiving holistic, full-spectrum care, including prevention, education and mental health support in a community setting. It’s the essence of primary health care – something NPs are well able to deliver!”

Queen’s Park has committed to creating 25 NPLCs before 2012, building on and leveraging the success of Family Health Teams, Community Health centres and other family health care models.NPLCs also support the provincial government’s Emergency/Wait Times strategy through expanded access to in-office family health care – a made-in-Ontario solution that is currently being studied by Alberta and Australia.

Ontarians can be connected to NPLCs through Health Care Connect and Your Health Care Options. To see the Ministry’s Wave 3 funding announcement, click here; for more information on NPLCs click here.