CPHC Brockville

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CPHC Brockville Gananoque
Community FHT

• History
• CPHC FHT provides health care services to the
  population within Brockville, Gananoque and the
  Leeds and Greenville counties.
• Leeds Greenville County encompasses 3350 square
  km and is on the north shore of the St. Lawrence
  River. It is situated with Kingston to the west,
  Cornwall to the east and Ottawa to the north and
  has a population of 99,206 in 2006.
• 2003 The Ministry of Health Long Term Care
  sponsored two Nurse Practitioner Clinics in
  Brockville.
• It developed into the Community FHT in 2006.
• Presently there are four clinics ( 3 Brockville
  1 Gananoque), one nursing home and one mobile
  unit

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Leeds and Greenville Counties

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Family Health Team

• Primary Health Care Team Consists of
• - 1 executive director
• 1 manager
• 7 physicians
• 1 PT psychiatrist
• 4 nurse practitioners
• 4 RNs
• 1 RPN
• 1 PT dietitian
• 1 PT social worker
• 5 program assistants
• 1 driver

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Programs Diabetes Education Centre

• Diabetes Education Centre
• Established in 1981
• No charge to participants
• Services Provided
• Group Education Classes
• Individual counseling with Nurse Educator
• and Dietitian
• Insulin therapy initiation and adjustments
• Pre diabetes strategies
• Link to community support services.

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Family Health Team Mobile Unit

• Mobile Primary Care Unit
• Established in 2006
• Mobile Unit is a a 30 x 10 RV which has been
  retrofitted with a fully equipped examination and
  treatment room.
• Staffed by a Nurse Practitioner (NP), a program
  assistant and driver.
• The NP prescribes within her scope of practice
  and works with a collaborating MD.
• The NP provides diagnosis, treatment for common
  health concerns, screening for chronic diseases,
  ordering diagnostic tests, prescriptions, health
  teaching and counseling.
• Communities the mobile unit visits Carleton
  Place, Perth, Smith Falls, Delta, Lyndhurst,
  Athens, Bolingbrook, Brockville, Rockport,
  Gananoque, Prescott, Cardinal and Kemptville.

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CPHC FHT Programs and Services

• Foot Care Clinics
• A certified foot care registered nurse provides
  foot care services at twoclinic sites to the FHT
  patients
• Smart Seniors Exercise
• Exercise classes designed to assist older adults
  with physical challenges in maintaining their
  independence. Geared to personal functional
  ability.
• Carveth Nursing Home
• Medical care is provided to sixty-five residence
  in a nursing home by a physician and nurse
  practitioner.

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CPHC Community Support Services

• Adult Day Services
• Caregiver Information, Education Training
• Caregiver support and Counseling
• Respite services
• Diners Clubs
• Friendly Visiting
• Home Help/Homemaking
• Home Maintenance Repair
• Meals on Wheels
• Transportation
• Telephone Reassurance
• Previously the VON Services

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Challenges on the Journey

• Communication
• - Multiple team meetings at different
  sites
• Difficult to gather all of team together
• Setting up communication systems voicemail,
  email, EMR
• Clinic Development
• Renovation and update of clinics
• Equipment
• Space obtaining, limited
• Staffing physician and NP recruitment
• After hours clinics
• Standardization of Paperwork
• Development of CPHC Management and Clinical
  Policies and Procedures
• Establishing a Electronic Medical Record
• Building Community Partnerships

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Nurse Practitioner Role and Challenges

• Role of the NP
• Provide autonomous comprehensive patient care
  within the clinics, mobile unit and nursing home
• Independent patient assignments
• Collaboration with physicians and
  interdisciplinary team
• Work within scope of practice
• Development
• Organize team continuing education activities and
  patient preventative care programs.
• Developed NP practice guidelines for CPHC
• Completion of Medical Directives
• Challenges
• Limitations of Scope of practice and prescriptive
  authority
• Limited RN/RPN clinic support
• Limited administrative support
• Educating the public about NP role