8 new Vitalité primary-care teams accept 11,500 orphan patients, reduce waits

Eight new primary health-care teams made up of a few dozen doctors and a number of nurse practitioner across the Vitalité Health Network have accepted 11,500 orphan patients in the past six months and reduced the average wait to access care from more than 12½ days to seven, the board of directors heard Tuesday.

Two of these family health teams have been created within the past couple of weeks, since the quarterly report, showing six teams was prepared, said Patrick Parent, assistant CEO, strategic execution, and senior vice-president of client programs and professional services.

"It changes every week," he said in French during the public meeting, held in Campbellton.

About 20 more teams are in the works, with plans to add other professionals, such as social workers, according to the report, entitled Rising Above Challenges.

"We believe that within a year, we can actually reach out to all the orphan patients within all the Vitalité communities," Parent said.

He believes the model will also help with recruitment. "This is what we hear from doctors in school, they want to work this way and they've shown interest because this exists," he said.

Dr. France Desrosiers, president and CEO, described the initial results of the pilot project, designed to improve access to care, as "promising for the future of primary health care."

It was among several initiatives covered in the Jan. 1-March 31 report and highlighted during the meeting. Some of the others included efforts to improve hospital patient flow to ensure a bed is available as soon as a patient requires acute care, and nursing recruitment, which has exceeded departures for the second year in a row.

"While Vitalité Health Network has been very much in the news since the start of 2024, behind the scenes, efforts have continued so that we can rise above the challenges and stay on course for continuous improvement," Desrosiers said in a statement.

"In a way, these are pathways taken to support the necessary transformation of the health care system, brought about by an aging population, an increase in chronic diseases and the labour shortage," she said.

Goal of team model is access within 5 days

Access to primary health care is one of Vitalité's major strategic priorities, according to the report.

About 74,000 New Brunswickers do not have a primary-care provider, deputy minister Eric Beaulieu told the legislature's standing committee on public accounts in February, although the actual number is likely higher since some people may not have registered.

Of those, roughly 54,000 people now have access to a team of primary-care providers through NB Health Link, launched in 2022, while they wait for a permanent provider, he said.

Vitalité believes its team-based approach — already active in Dieppe, Moncton, Edmundston-Upper Madawaska, and Cocagne-Cap-Pelé  — is the solution.

Each patient is cared for by a team of health-care professionals, rather than a single physician, and each team is connected to its own referral group, which is responsible for quickly guiding patients to the right service provider.

"The aim is to provide access in five days, while also providing better follow-up thanks to the creation of a connected system," the report says.

Under the team-based model, some care typically provided by doctors, such as pap tests and newborn checkups, can be delegated to other health professionals.

Administrative support is also provided, freeing up the professionals to focus on providing care.

New teams will likely be located in Shediac, Grand Falls, Bathurst and Campbellton next, Parent has said.

Nearly 70% of doctors to be part of teams

About 150 doctors have agreed to be part of the team-based model, the board heard. That's nearly 70 per cent of doctors within the Vitalité network.

"Traditional family medicine is suffering, and this new model helps us," Dr. Renelle Gautreau, one of the participating family physicians in Dieppe, N.B., said in a recent  Vitalité-issued news release.

"I'm accessible much more quickly and able to do better follow-ups," she said. "I've been able to take on new patients, something I haven't been able to do for 10 years."

Parent told the board he believes universities could start training doctors using Vitalité's family health team model.

Fifteen nurse practitioners and 32 other health professionals are also involved in building these team-based models, the report says.

In addition, Vitalité has a medical director dedicated to this project and has created new manager positions.

Once the primary-care provider groups have been created, other professional services will be added, such as psychologists, physiotherapists, and speech language pathologists. This step has already begun in Edmundston and Dieppe, with social workers.

18-month goal for patient flow, hospital performance

Improving patient flow and hospital performance is Vitalité's other major strategic priority. It has set a goal of 18 months.

"This major transformation will involve not only the creation of a new organizational culture, but also the deployment of a range of strategies and new processes," the report says.

These include creating discharge planning teams and establishing assessment criteria to make it easier to identify alternatives to hospital admission, anticipate the risks of delays, and determine the measures needed for the return home.

The plan also calls for new communication tools designed to keep families better informed about care and the anticipated discharge date.

22 kinesiologists hired

A patient mobilization program, which aims to accelerate recovery, should help with patient flow, Vitalité says.

A team of kinesiologists helps inpatients with exercises to maintain muscle mass, improve mobility, and reduce the risk of complications, while also easing the burden on nurses.

Of 26 kinesiologist positions created, 22 have been filled. They are working throughout Vitalité's four health zones, and also provide follow-up after discharge to help patients maintain independence and prevent readmission, the report says.

The average length of stay has decreased by one day, it says.

"We have also noted an improvement in mobility and autonomy in the activities of daily living."

365 patients receive robotic surgery

The robotic surgery program, launched last year at the Dr. Georges-L.-Dumont University Hospital Centre in Moncton, N.B., also impacts patient flow because it frees up beds more quickly, according to the report.

The robot enables less invasive surgery, which reduces the risk of complications, promotes faster recovery and therefore shortens hospital stays, it says.

Since Feb. 1, 2023, 365 patients were operated on using the surgical robot, purchased with $6.5 million raised through the CHU Dumont Foundation.

Compared with open or laparoscopic surgery, the average length of stay decreased by more than two days for kidney removals, about 1½ days for bladder removals, and half a day for hysterectomies and prostatectomies.

The robot has also made surgery possible for morbidly obese patients, whose only option before would have been chemotherapy or radiation, Dr. Jocelyne Hébert, director of surgical services.

Six surgeons are currently trained to use the robot for urology and gynecologic oncology surgeries, but Vitalité plans to start using it for other surgeries, such as thoracic and general surgeries, soon, once more surgeons are trained, said Hébert.

She believes Vitalité will need another robot within less than a year if it wants to be able to continue to offer the same services.

"We've used it to maximum capacity and the requests are still coming in."

Recruitment trips to Morocco, Ivory Coast planned

Vitalité has international recruitment missions planned this spring to Morocco and the Ivory Coast in West Africa.

Last fall, Vitalité took part in job fairs in Morocco, France and Belgium, as well as in virtual fairs with international candidates. Nearly 200 potential hires were identified and the recruitment team is working to confirm these hires.

In 2023, more than 100 new international employees started at Vitalité, the report says.

Vitalité hired a total of 198 new registered nurses, licensed practical nurses and patient care attendants between April and December, compared to 117 departures during the same period.

The health network has a "talent acquisition team," which meets daily.

Some recruitment initiatives include support with immigration and community settlement, financial incentives, and improving the experience of student employees.