Team-based approach to care benefits patients and providers

Across the province, family doctors and their health care partners are working to improve patient access to primary care.  At the Fairmont Family Practice in Vancouver, an interdisciplinary group of health care providers is demonstrating how a team-based approach, where providers share responsibility for their patients’ needs, can support this goal. The clinic has eight family doctors, two nurse practitioners, two visiting psychiatrists, and a nutritionist who work together to provide longitudinal, patient-centred care within one clinic. 

Doctors see each other’s patients as needed and share detailed notes with each other via their EMR system to ensure all are aware of a patient’s health history and needs. This means better care for patients. “They don’t need to seek care in other settings like a walk-in or ER, where providers are unfamiliar with their history,” says Dr Kuljit Sajjan.
 
Shared responsibilities also include urgent care and extended hours coverage. Providers have flexible schedules to enable responsive care in the clinic, with many doctors taking turns being “doctor of the day,” having no scheduled appointments and being available to patients with immediate care needs. The doctors also reserve some same-day appointments, take turns opening the clinic on Saturdays, and rotate on-call duties at the hospital. 

Additionally, patients requiring care outside of clinic hours can connect with the practice’s on-call doctor via call services at BC Women’s and Children’s Hospitals. The doctor will then determine the best way to manage the patient’s care, which may involve providing advice over the phone, opening the clinic outside of scheduled hours, or making a home visit.  

Effective communication has been essential to both patients and providers. “Our patients know that their care is coordinated – because their providers are connected,” says Dr Brenda Hardie. “It really matters that our practice has a strong sense of community – extending to our patients and each other.”