Primary Health Care: Heartland’s Winning Combination

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Did you know that when you walk, ski, curl or swim, go to your doctor, visit your local pharmacist or dial a toll-free health advice line, you are playing a very important role in your own health care ? You are supporting the concept of primary health care (PHC).

PHC is not a new concept – it’s been in existence for years. We believe that it will ensure better health for all of us.   We also think it has the potential to keep waiting lists down and lessen the pressure on emergency rooms.

“It’s all part of making the system sustainable,” says Lyle Leys, Heartland Health Region Board Chair. “We are looking at building a health system that will help us stay as well as possible, rather than just treating us when we get sick.”

Primary health care is about the whole person – our social, physical and mental health – and focuses on health rather than just illness. To make sure that the ‘whole person’ approach happens, the   PHC framework addresses four key pillars: access, information, healthy living and teamwork:

Access means that we receive the right service at the right time in theright place. Because we recognize that you may need help or advice outside of regular office hours , we’ve implemented tools like the HealthLine and the Smoker’s Helpline .  

Information is another key component in PHC. As the most important member of your health care team, you must have the information you need to make good decisions about your health and health care. HealthLine and HealthLine OnLine are great information sources, as is your doctor.

Healthy living is about you keeping yourself well, focus ing on prevention, self-care and good management of chronic conditions. “ People can help to keep themselves healthy by eating the right foods , exercising and dealing with personal stress levels , ” says Ken Wersch CEO for the Heartland Health Region.

Teams mean that health care providers work together to ensure that you have access to the appropriate health professionals and community partners you may need to ensure health and wellbeing. Continuity of care is improved and duplication of services reduced.

In the upcoming weeks, Heartland Health Region will look at primary health care initiatives taking place in the region. We’ll be introducing people who are helping to make primary health care a success. We’ll take a closer look at how each of us can take responsibility in meeting our own health care needs. Together, we’ll gain greater understanding of how the primary health care focus can improve our lives. Together, we’ll become Heartland’s “Winning Combination.”
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Working together communities deliver better care

The practice of relying solely on your family doctor when you’re in need of health care is starting to change. Health organizations around the world, across the country, and in our own community are embracing primary health care and the concept of a team approach. The team approach sees health care professionals from various disciplines working together to improve continuity of care, reduce duplication of services, and ensure you have access to appropriate health professionals when you need them.

One Saskatchewan community leading the way when it comes to the team approach is Hudson Bay . Its team has been in existence for the last six-and-a-half years and is made up of many health care professionals - from physicians and nurse practitioners to a mental health and addictions specialists.

Although not all of the providers are under the same roof, the team works together to ensure patients get the care they need when they need it. “There are no boundaries between the different professionals in terms of respecting each other and in terms of what they are able to do and how they communicate. Ultimately, the patient gets the right mix of provider,” says Linda Barlow, director of Primary Health Care in Hudson Bay .

In addition to medical professionals, the team also enlists the help of other community members such as the police (RCMP) and local schools. Together, the groups combine their expertise to provide health promotion programs that educate the community on issues like bullying, self-esteem, nutrition and smoking.

“We have to remember the determinants of health are things like poverty and good food and shelter and these determinants fall out of the boundaries of medical provision,” says Dr. Don Gelhorn, a family physician who is part of the Hudson Bay primary health care team. “If we work together, we can identify the p rob lems in the community and come up with a multi-pronged approach to tackling them.”

While health professionals and various community members are all key players on the Hudson Bay primary health care team, so are the community’s residents. Each patient who receives care or services is encouraged to take a lead role in the management of their health by learning about their well-being and taking steps to prevent disease and maintain health. “We get the patient to recognize and become well-informed about their illness and chronic disease, says Dr. Gelhorn. “We get them to accept it and become motivated enough to participate in the management of their disease process so they can start to make improvements.”

Since Hudson Bay ’s team began working together almost seven years ago, it’s been considered a huge success. In fact, many health organizations have used it as a model for their own teams, in hopes of providing patients with better care. Heartland is one of the regions looking to build on the team approach being used in Hudson Bay . There are already a handful of teams within our region and the goal is to build upon that.

To find out more about the role you play as a member of your primary health care team, call the Heartland Health Region at 306. 882.4111. Together, Heartland believes that you and your primary health care team are a “Winning Combination!”
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Teaming up for top-notch care

Donna Lawson has had her fair share of health p rob lems over the last few years. Not only is she an asthmatic, she also deals with other serious chronic conditions and requires special medical attention on a regular basis. Despite not having a full-time physician based in her home community of Beechy, Lawson doesn’t have to wait long to receive care. Thanks to a primary health care team set up for residents of the Heartland Health Region, Donna has access to several different health care professionals, “Anybody that has a medical need that requires being seen once a week or once every two weeks, it’s (PHC) a benefit when they can’t see their doctor.”

In addition to two physicians, the team Lawson and others with chronic conditions benefit from includes a diabetic nurse educator, a home care nurse, a lab technician as well as Registered Nurse-Nurse Practitioners. Although some of the health care providers are spread throughout a handful of communities, many of the team members travel to neighbouring communities to see patients. They also network by email, on the phone and face-to-face to share resources. “It’s very important to have a team approach. I think it’s very good for the patient,” says Sadie Gross, Registered Nurse (Nurse Practitioner) in Lucky Lake . “They get better overall care when they can see and hear from all different levels of care how to manage their condition.”

The team approach to primary health care as a model to provide quality health and wellness care has been in existence for a number of years. Now however, it is becoming a priority across the country and here in Heartland, as staff shortages continue to be a p rob lem. Because care is spread out among various health care professionals, teams provide more tailored care for the patient as well as reduce wait lists. Having a steadier workload also allows physicians to focus on the more serious cases and gives the entire team more time to help their patients. “You get to see the person and their whole picture, not just their disease,” says Cathy Ringrose, Registered Nurse (Nurse Practitioner) in Beechy. “Also, if a patient has a question, they have someone to call.”

Together, the various health care professionals who are part of the chronic disease management team can make a huge difference, but so can the patient. As the centre of their health care team, they have the ability to take an active role. “With chronic disease, they have to get into a self-management role. Without that, my goals for them may not be livable or obtainable,” says Gross. “They have to be willing and able to understand how to do certain things.”

Donna Lawson of Beechy has learned to take better care of herself since becoming part of her primary health care team. She says that despite some setbacks, she feels good and credits the team of professionals in her community for her improved health. “I’m completely satisfied. I’ve thought many times we are very fortunate to have what we have here.”
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Primary Health Care - Accessing the right service, at the right time and in the right place

 Did you know that you can:

• have your blood pressure checked at a wellness clinic in your community?
• keep your diabetes in check with the help of a diabetes nurse educator or diabetes dietitian team?
• receive travel-related health advice and medication from your local travel clinic?

These health and wellness services are all available thanks to the Heartland Health Region’s ongoing efforts to ensure everyone has equal access to primary health care.

Access ensures you receive the right service, at the right time and in the right place. “Going to clinics that provide specialized care gives you direct access to the most up-to-date and best practices because that’s each professional’s business,” says Carolyn Glessing, vice-president of Community Services.

Having the most up-to-date services easily accessible can not only provide you with the kind of care you need, it can also help you learn how to self-manage and take ownership of your health and wellness. “Without these services, the average person may, because of inconvenience, neglect their health,or not get the care they need in a timely fashion,” says Glessing.

The primary health care framework also recognizes that you may require information and care outside regular office hours.That’s where Saskatchewan Health’s Healthline and Healthline Online come into the picture. Besides providing health information to callers, they can provide information about the various health and wellness services available in the region. Heartland is working hard to make sure that information is kept up-to-date, so you can access the right ones when you need them. With your active participation, we can make primary health care Heartland’s “Winning Combination”.
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Getting care when and where you need it – in your own home

Holly Darmokid knows first hand the importance of home care. Her mother, Betty St. John, received home care services through the Heartland Health Region for the 10 years before she passed away in December, In the beginning, St. John needed help with basic household duties like laundry and meal preparation. Later on, she required around-the-clock care. “It was extremely high on my list to have my mom at home because she was extremely happy to be in her own home,” says Darmokid. “She told my siblings several times a month, ‘you don’t have to worry about your mother. I just love it here.”

St. John was not alone. Heartland residents needing extra help following a hospital stay or a diagnosis, as well as the elderly, have access to a wide range of services through Heartland’s Home Care program. Help with medication or rehabilitation exercises, cleaning, laundry and meal preparation services can be provided. Home care clients can also utilize respite or palliative care, depending on their needs. “Home care within Heartland is preventative, curative, rehabilitative and it’s supportive. Our clients get very good care,” says Adele Ritchie, Director of Home Care with the Heartland Health Region.

Having these services available under the home care umbrella is a very important part of primary health care. Home care ensures residents have access to the right service at the right time in the right place. It allows people to seek specialized care from the most appropriate professional. Home care also provides consistent and seamless care, supporting clients to take ownership of their health and wellness, and ultimately eases some of the pressures on the health care system. “It keeps our residents at home, independent and out of the hospital longer,” says Ritchie.

Although Heartland’s population is largely rural, all residents in the health region have access to home care services. Because home care staff work flexible hours and are able to travel, home care clients are never left without care. “Our services are about equality and being accessible for anybody. We do the best we can with what we’ve got.”

For Holly Darmokid, home care not only provided her mother the care she needed, it provided peace of mind. At the time, she lived in Saskatoon while her mother was 174 kilometers down the road in Brock. Despite the distance between the two, Darmokid says she didn’t worry as much about her mother. She knew she was in good hands and at home, where she wanted to be. “It was only through home care she was able to stay in her own home. That gives me good satisfaction.”
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Be proactive! What you can do to be in better health

Just as your vehicle needs gas, oil and routine maintenance to run smoothly, your body needs to be taken care of through taking a proactive approach to getting proper nutrition and exercise. When you look after your body, you are participating in the ‘Healthy Living’ pillar of the Primary Health Care framework, and playing a key role on your primary health care team.

Healthy living is about staying healthy and well, rather than just treating people when they’ve become sick. The approach encompasses preventative measures, managing chronic disease and encouraging us to follow self-care recommendations.

One of the ways Heartland is helping residents do just this is through Wellness Clinics held regularly in several local communities. During each Clinic, any Heartland resident can access help with managing medications or monitoring weight. You can get your blood sugar levels and blood pressure checked. You even have access to counseling on various lifestyle issues, like sun safety, prevention of dehydration, proper nutrition and exercise. “It’s preventative and helps people maintain their health status and independence. It enables [people] to take responsibility, and improves their lifestyle and quality of life,” says Ann-Marie Dies, Home Care Manager (West) for the Heartland Health Region.

For the most part, staff at the Wellness Clinics have the ability and expertise to provide the support and care residents need. When issues that require further assistance arise, staff refers them to the person’s family physician. Dies says this approach works to alleviate some of the pressure on the health care system. “There are some areas in the region where access to a physician is pretty limited. It also reduces the impact on the acute care aspect too.”

Although seniors make up a large portion of those attending the Wellness Clinics, Heartland is starting to see an increase in the number of younger people taking advantage of these services. For Dies, it means that not only are the clinics a success, but that more people in the community have the potential to be in better health.

To find out more about how you can play an active role in your health by attending a Wellness Clinic in your area, talk to your physician or call your local Home Care office at the number listed below for more information.

Together we can make primary health care Heartland’s “Winning Combination!”
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Stamping out substance abuse- How Heartland project gives higher profile to healthy living

Organized camping trips, once a week gym nights and outings to events like a Saskatchewan Roughrider’s football game. These are just a few of the many activities staff within the Heartland Health Region have organized over the last few months in hopes of steering youth away from substance abuse. “The goal is to provide alternate activities for youth so they don’t get involved in substance abuse or if they are involved to provide them with alternative activities,” says Marlene Weston, Director of Intersectoral and Counselling Services with the Heartland Health Region.

The work that Weston and her colleagues are doing is funded through Project Hope, a provincial initiative aimed at promoting healthy lifestyle choices among young people and preventing drug use. In addition to youth activities and education that take a preventative approach to drug use, Heartland is also working to help those already struggling with substance abuse go through detoxification and receive the follow-up care they need. “If communities do not have the infrastructure set up, if these options are not there, it’s going to get a lot more difficult to make the decisions to make healthy choices,” says Crystal Storey, Population Health Promotion Coordinator for the Heartland Health Region.

In addition to young people benefiting from the positive reinforcement and the help they need to stay away from drugs, the entire community gains from having such programs in place. “There are a lot of [negative] spin-offs from substance abuse. There’s crime and suicide, and there’s bullying,” says Weston. “So, to work with these youth to try and channel them into being more productive instead of destructive citizens is important.”

Although health care professionals are playing a key role in keeping our young people drug free, you too can do your part. Because Heartland is working with communities to develop programs that meet local needs, you can have a lot of influence over what happens. All it takes is a little effort. “Maybe spearheading a conversation in the community, or around the coffee table. Asking what can we be doing to help,” says Storey. “You may not have children or any in school but you may be interesting in helping your community as a whole.”

By taking action to build a better community together, we can make Primary Health Care Heartland’s “Winning combination!
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Primary Health Care in Heartland: Moving forward

Primary health care (PHC) plays an important role in keeping you healthy. Whether you’re out for a bike ride or renewing a prescription with your local pharmacist - you are taking responsibility for your personal health care needs and supporting the concept of PHC.

Over the last 10 weeks, we’ve all had the opportunity to learn more about the PHC framework, and about some of the initiatives underway in the region. We focused on primary health care providers right here in Heartland, and highlighted some of the PHC services available in your community. We’ve heard from Heartland residents who have received benefits from the PHC approach.

While this week is the last week of the PHC information campaign, it is only the beginning of Heartland’s push toward increased application of its principles and pillars. That process begins with you! Now that you’ve learned a little about PHC and the opportunities it can provide you, your family and your community, you know how important it is to become the most active player on your primary health care team.

“Once residents of Heartland see primary health care being implemented, they will realize that it’s the way to go,” says Betty Shapka, Vice-Chair of the Heartland Board. “It’s [PHC] going to give people quality services at the time they need it, where they need it.”

Care at the right time in the right place is just one of the key concepts of PHC. This refers to Access, one of the four main pillars of PHC. Coordinating and sharing Information with you and among health care providers; teams working together to provide improved care; and healthy living, focusing on keep you well, rather than just treating you when you are sick are the additional pillars that constitute the PHC framework. Using these key concepts, PHC focuses on the ‘whole’ person, recognizing the importance of social, physical and mental health.

To address all areas of health takes the work of many. “It’s all about teamwork. It’s teams within teams,” explains Lefa Sproxton, Acting CEO for Heartland Health Region. “In regions, in facilities and communities, we all need to work together.”

Moving Heartland forward in applying the PHC framework means that we all play a part in determining what the future will hold. “We want to invite people to participate,” says Sproxton. “Whether that means approaching their caregiver, chatting with a manager about ‘what this [PHC] is all about’ or just talking about PHC and thoughts about how things might be. These are the steps we are hoping to take next.”

Community groups, education groups, special interest groups and the municipal government are encouraged to get involved. “We’d be happy to talk to you and explore new ways of working collaboratively to provide efficient and effective primary health care services in Heartland,” says Sproxton.

The end of this campaign marks only the first step toward building healthier, happier communities in Heartland. Join us as we take our next steps in moving toward the PHC health service model. Call Faye Hofer, Director of Primary Health Care at 306.882.4111 to find out what resources are available to help you rethink the framework in which health care is delivered in your community. Working together, we truly are Heartland’s “Winning Combination”.
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