2023 Northern BC Research and Quality Conference - Concurrent Session Information

Conference Poster

Concurrent Session B 

Date: November 8

Time: 11:00am - 12:00pm 

Location: University of Northern BC, 6-205 

Theme: Accessibility to Health Care 

Heather Gummow 

Title: Penicillin Allergy De-Labeling Clinic at UHNBC 

Aim Statement: By January 2023, develop a clinic at UHNBC to assess and de-label Northern patients with a penicillin allergy label. 

Methods: Building processes to support delivery. Testing implementation strategies to determine readiness. Process mapping roles and responsibilities to ensure clinic flow and emergency processes are clear and documented. Review of data collection sheet used in original project and local selection of specific metrics and events to track, collect, organize, and analyze the resulting preliminary data. 

Person/Family/Community Partner Engagement: Patient partners engaged in the original project from PHSA and involved in the testing of clinic access and flow prior to implementation. 

Results: Clinic opened and has successfully assessed and de-labelled 23 patients to date.  

  • High functioning team supporting the execution of each clinic and administrative facilitation behind the scenes. 
  • Collaboration and engagement with other rural sites in the North to share in strategies and support patients assessed requiring medium risk testing.  
  • The population of the North has access to equitable care with significant cost savings to patients.  

Shawna Glassel 

Title: Northern Outreach Allergy Clinic

Methods: NP Shawna Glassel and Allergist Dr. Amin Kanani worked together to design and test the NOAC program. In the absence of a travelling allergy specialist, Northern BC patients were required to travel to Vancouver or Kelowna and wait up to 33 months for specialist allergy care. Shawna and Dr. Kanani created a unique team-based, technology enabled shared care model that allows patients to receive exceptional and timely care without travelling. Shawna receives and manages referrals to the program and provides allergy skin testing. Virtual shared care three-way appointments between Shawna, Dr. Kanani, and the patient provide excellent quality and efficiency of care and immunology treatment is transferred to family practitioners with annual followup testing provided by Shawna.

Outcomes: In the first year, the NOAC has seen 129 patients and decreased wait times by an average of 77%. Wait times for pediatric patients have decreased by up to 96%. Interim patient satisfaction surveys show 95.5% satisfaction with the outreach clinic services with 91% of patients expressing that they prefer to receive care closer to home. 20% of patients surveyed would not have been able to access care if it had only been available in Kelowna or Vancouver. Cost savings to patients from travel alone over the course of their treatment is estimated at $588,240 for the patients seen during the pilot. This number does not include expenses and hardship related to missed work or school and childcare which would have been required by 82% and 18% of patients surveyed respectively.

The NOAC clinic is designed to be culturally safe and accessible and has seen patients from 21 different communities in the first year through word of mouth alone. The program is unique in Canada and allows nurse practitioners to work to the top of their scope in collaborative relationship with a specialist physician. This model could save an estimated $149,211.45 annually over the NITAOP visiting specialist program. The project team looks to expand the NOAC to include venom immunotherapy and expand the number of appointments available as well as spread to include the practices of the 10 additional allergists in Vancouver currently caring for and accepting referrals for Northern patients

Alison James

TitleEmergency medical transport in British Columbia: Narrative stories from providers, decision-makers and patients in rural, remote and Indigenous communities

Abstract:  Emergency medical transportation continues to be an issue in rural and remote British Columbia (BC). High quality response to critical life or limb threatening calls and transportation to definitive care is a fundamental right of all British Columbians. Transportation is a complex phenomenon that is impacted by various different factors: the patient’s condition, services available in the rural/remote community, weather conditions, and availability of air and ground transportation and staff. Overall, there is little data available on emergency transportation in rural communities. The purpose of this research is to document the experiences of physicians, nurses, health authority/other managers, and patients/family members with emergency medical transport in BC rural, remote and Indigenous communities. A partnership approach is used in this study including patients, providers, decision-makers, and researchers. A total of 32 interviews were conducted with providers, patients and decision makers across BC. Using qualitative descriptive methodology, we investigated facilitators and challenges in emergency transports and identified factors that support “successful” transport. Using an appreciative inquiry approach, key themes including:

  1. right care, right time, right place;
  2. availability;
  3. timeliness and transparency;
  4. communication; and
  5. collaboration.

We will also present recommendations to address barriers and challenges. These results will be most valuable in program development, advocacy for transport policy and services delivery, and future research. 

Learning Objective: 

  1. Identify key themes in the experiences of providers, decision-makers, and patients/family members in rural emergency medical transport in BC 
  2. Describe the facilitators and challenges in rural emergency transport
  3. Apply recommendations to address barriers and challenges related to rural emergency medical transport in BC