Team Up! Team-based primary and community care in action

In episode 9 of TeamUP!, the focus is on exploring the integral role nurses play in medication management within primary care teams.

We will hear interview clips from Kacey, a registered nurse, who explains the responsibilities nurses hold, including taking comprehensive medical histories, assessing medication impacts, advocating for patients, and educating them about their medications. The discussion highlights the value nurses add during transitions of care and their ability to address sensitive topics, such as financial challenges, which may affect medication adherence. Nurses build patient trust, provide follow-up education, and work collaboratively within the team to enhance patient care.

Special Thanks

============

Throughout this season you’ll hear from several amazing nurses:

• Angela Wignall is a Registered Nurse who has worked in perinatal health and public health. Since recording this episode Angela has been promoted to the CEO of the Nurses and Nurse Practitioners of BC from her position as Senior Executive Director. Angela is also a board member at the Canadian Nurses Association.
• Diana Boateng is a Registered Nurse and is working on her dual master’s degree in nursing and health informatics. In her Masters, she is a co-op student working with the Innovation Support Unit. Her background is mostly in acute care but she has been interested in exploring what it means to be a nurse in primary care.
• Hannah Roy works as a Registered Nurse in primary care and urgent primary care. She has certified practice in STI management and is completing her Masters degree to be a nurse practitioner.
• Jamie Duteil is a Registered Nurse and the Health System Improvement Director at Health Quality BC. She has managed urgent primary care centres and acute care centres.
• Kacey Wall is a Registered Nurse and a diabetes educator, she has worked in primary care networks and is a team member of the Innovation Support Unit.
• Nikki Kafal is a Registered Nurse and has spent her career working in emergency and critical care settings. She is completing a dual master degree in nursing and health informatics and joins the Innovation Support Unit as a co-op student.

In episode eight of TeamUP!, we learn about the benefits of shared visits with a primary care provider and a nurse.

Morgan and Sarah discuss how these shared visits can enhance team capacity, improve care for complex illnesses, foster team building, and create immediate capacity in the moment. With insights from nurses, the episode highlights the importance of synchronized care plans, trust-building, and efficient multitasking, all while encouraging you to incorporate a shared visit in your practice to fully understand the benefits.

Special Thanks

============

Throughout this season you’ll hear from several amazing nurses:

• Angela Wignall is a Registered Nurse who has worked in perinatal health and public health. Since recording this episode Angela has been promoted to the CEO of the Nurses and Nurse Practitioners of BC from her position as Senior Executive Director. Angela is also a board member at the Canadian Nurses Association.
• Diana Boateng is a Registered Nurse and is working on her dual master’s degree in nursing and health informatics. In her Masters, she is a co-op student working with the Innovation Support Unit. Her background is mostly in acute care but she has been interested in exploring what it means to be a nurse in primary care.
• Hannah Roy works as a Registered Nurse in primary care and urgent primary care. She has certified practice in STI management and is completing her Masters degree to be a nurse practitioner.
• Jamie Duteil is a Registered Nurse and the Health System Improvement Director at Health Quality BC. She has managed urgent primary care centres and acute care centres.
• Kacey Wall is a Registered Nurse and a diabetes educator, she has worked in primary care networks and is a team member of the Innovation Support Unit.
• Nikki Kafal is a Registered Nurse and has spent her career working in emergency and critical care settings. She is completing a dual master degree in nursing and health informatics and joins the Innovation Support Unit as a co-op student.

In this TeamUP! teamBIT Morgan is on his own again. This time he's talking about how to plan and promote a dedicated “nurse clinic” in your primary care practice to boost the presence of new nursing staff in your practice. The discussion includes selecting a focus area for the clinic, organizing appointments, and effectively promoting the clinic through various channels.

Examples given include clinics for blood pressure, immunizations, well-baby checks, diabetic foot checks, and STI screenings. The episode also emphasizes the importance of teamwork and patient engagement, with insights on making nurse clinics an accessible and valuable addition to practice.

Special Thanks

============

Throughout this season you’ll hear from several amazing nurses:

• Angela Wignall is a Registered Nurse who has worked in perinatal health and public health. Since recording this episode Angela has been promoted to the CEO of the Nurses and Nurse Practitioners of BC from her position as Senior Executive Director. Angela is also a board member at the Canadian Nurses Association.
• Diana Boateng is a Registered Nurse and is working on her dual master’s degree in nursing and health informatics. In her Masters, she is a co-op student working with the Innovation Support Unit. Her background is mostly in acute care but she has been interested in exploring what it means to be a nurse in primary care.
• Hannah Roy works as a Registered Nurse in primary care and urgent primary care. She has certified practice in STI management and is completing her Masters degree to be a nurse practitioner.
• Jamie Duteil is a Registered Nurse and the Health System Improvement Director at Health Quality BC. She has managed urgent primary care centres and acute care centres.
• Kacey Wall is a Registered Nurse and a diabetes educator, she has worked in primary care networks and is a team member of the Innovation Support Unit.
• Nikki Kafal is a Registered Nurse and has spent her career working in emergency and critical care settings. She is completing a dual master degree in nursing and health informatics and joins the Innovation Support Unit as a co-op student.

In this episode of TeamUP!, Morgan and Sarah discuss promoting a new nurse to patients in your practice.

Our hosts discuss the integration of nurses into primary care teams and highlight the importance of effective communication with patients regarding team-based care transitions. The conversation includes examples and scenarios for promoting new nursing staff within clinics, individual patient engagement strategies, and addressing patient concerns about seeing new team members. The episode also emphasizes understanding patient apprehensions and providing tangible benefits and personal introductions as a way to build trust and comfort.

Special Thanks

============

Throughout this season you’ll hear from several amazing nurses:

• Angela Wignall is a Registered Nurse who has worked in perinatal health and public health. Since recording this episode Angela has been promoted to the CEO of the Nurses and Nurse Practitioners of BC from her position as Senior Executive Director. Angela is also a board member at the Canadian Nurses Association.
• Diana Boateng is a Registered Nurse and is working on her dual master’s degree in nursing and health informatics. In her Masters, she is a co-op student working with the Innovation Support Unit. Her background is mostly in acute care but she has been interested in exploring what it means to be a nurse in primary care.
• Hannah Roy works as a Registered Nurse in primary care and urgent primary care. She has certified practice in STI management and is completing her Masters degree to be a nurse practitioner.
• Jamie Duteil is a Registered Nurse and the Health System Improvement Director at Health Quality BC. She has managed urgent primary care centres and acute care centres.
• Kacey Wall is a Registered Nurse and a diabetes educator, she has worked in primary care networks and is a team member of the Innovation Support Unit.
• Nikki Kafal is a Registered Nurse and has spent her career working in emergency and critical care settings. She is completing a dual master degree in nursing and health informatics and joins the Innovation Support Unit as a co-op student.

Links and Resources

====================

The Communication to Patient Checklist aims to equip your clinic with easy to follow, and categorized, ideas of when and how you can bring up team-based care to your patients. https://teambasedcarebc.ca/resources/tbc-communication-to-patient-checklist/#details

In this mini teamBIT of an episode, Morgan is podcasting solo and looks into what a certified practice means in nursing, specifically in the context of British Columbia. There are five distinct areas of certified practice for nurses in BC, and they allow for autonomous diagnosis and treatment within specific scopes.

Morgan goes into detail for each certified practice: reproductive health, STI treatment, opioid use disorder management, RN first call, and remote practice. Emphasis is placed on the benefits of certified practice for primary care teams and the importance of integrating these certifications into practice.

Special Thanks

============

Throughout this season you’ll hear from several amazing nurses:

• Angela Wignall is a Registered Nurse who has worked in perinatal health and public health. Since recording this episode Angela has been promoted to the CEO of the Nurses and Nurse Practitioners of BC from her position as Senior Executive Director. Angela is also a board member at the Canadian Nurses Association.
• Diana Boateng is a Registered Nurse and is working on her dual master’s degree in nursing and health informatics. In her Masters, she is a co-op student working with the Innovation Support Unit. Her background is mostly in acute care but she has been interested in exploring what it means to be a nurse in primary care.
• Hannah Roy works as a Registered Nurse in primary care and urgent primary care. She has certified practice in STI management and is completing her Masters degree to be a nurse practitioner.
• Jamie Duteil is a Registered Nurse and the Health System Improvement Director at Health Quality BC. She has managed urgent primary care centres and acute care centres.
• Kacey Wall is a Registered Nurse and a diabetes educator, she has worked in primary care networks and is a team member of the Innovation Support Unit.
• Nikki Kafal is a Registered Nurse and has spent her career working in emergency and critical care settings. She is completing a dual master degree in nursing and health informatics and joins the Innovation Support Unit as a co-op student.

Links and Resources

=======================

BCCNM Certified Practice website details the five certified practice designations available for nurses in BC along with their scope: https://www.bccnm.ca/RN/learning/certified-practice/Pages/Default.aspx

BCCNM Section 8: Restricted activities for certified practice gives more detail on the 5 certified practice designations: https://www.bccnm.ca/RN/ScopePractice/part4/section8/Pages/Default.aspx

Canadian Nursing Association - Advanced Practice Nursing webpage provides detailed information on both the clinical nurse specialist and nurse practitioner role and how they help meet the complex health needs of Canadians: https://www.cna-aiic.ca/en/nursing/advanced-nursing-practice

In this episode of TeamUP! we learn about the complexities of being an employer of a primary care nurse within smaller private clinics.

Our hosts, Morgan and Sarah, discuss the complexity of being both a clinical team member and an employer, emphasizing the need for clear clinical policies and role definitions. Major topics include the challenges of holding multiple roles, the impact of power dynamics in teams, and the importance of transparent organizational policies. They also provide practical advice on creating clinical workflows, drafting policies, and leveraging nurses' skills for better team integration and patient care.

Special Thanks

============

Throughout this season you’ll hear from several amazing nurses:

• Angela Wignall is a Registered Nurse who has worked in perinatal health and public health. Since recording this episode Angela has been promoted to the CEO of the Nurses and Nurse Practitioners of BC from her position as Senior Executive Director. Angela is also a board member at the Canadian Nurses Association.
• Diana Boateng is a Registered Nurse and is working on her dual master’s degree in nursing and health informatics. In her Masters, she is a co-op student working with the Innovation Support Unit. Her background is mostly in acute care but she has been interested in exploring what it means to be a nurse in primary care.
• Hannah Roy works as a Registered Nurse in primary care and urgent primary care. She has certified practice in STI management and is completing her Masters degree to be a nurse practitioner.
• Jamie Duteil is a Registered Nurse and the Health System Improvement Director at Health Quality BC. She has managed urgent primary care centres and acute care centres.
• Kacey Wall is a Registered Nurse and a diabetes educator, she has worked in primary care networks and is a team member of the Innovation Support Unit.
• Nikki Kafal is a Registered Nurse and has spent her career working in emergency and critical care settings. She is completing a dual master degree in nursing and health informatics and joins the Innovation Support Unit as a co-op student.

Links and Resources

========================

BCCNM Controls on Nursing Practice:

This is an infographic that highlights the four levels of controls on a registered nurses’ practice. https://www.bccnm.ca/RN/ScopePractice/part1/Pages/controls.aspx

RN Suturing Decision Support Tool for BC:

This document is a detailed decision support tool to assist registered nurses working in British Columbia.https://www.clwk.ca/get-resource/treating-minor-uncomplicated-lacerations-adults-guideline/

BC Guideline (just updates July 2024) on COPD:

A scope-guide document that provides recommendations for how to interact with a person with chronic obstructive pulmonary disease.

https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/copd

In this episode, we dive into the differences between Licensed Practical Nurses (LPNs) and Registered Nurses (RNs) within primary care settings.

Morgan and Sarah look at how each role fits into a primary care team, considering their distinct scopes of practice, training, and the types of patients they typically manage. Importantly the hosts give key clinical examples to highlight where one type of nurse may be better suited for a practice. The hosts emphasize how hiring a nurse that will be utilizing their full skillset in clinic is often better than hiring an overqualified nurse to work below their scope and recommend resources that are available to support integrating nurses into clinical teams.

Special Thanks

============

Throughout this season you’ll hear from several amazing nurses:

• Angela Wignall is a Registered Nurse who has worked in perinatal health and public health. Since recording this episode Angela has been promoted to the CEO of the Nurses and Nurse Practitioners of BC from her position as Senior Executive Director. Angela is also a board member at the Canadian Nurses Association.
• Diana Boateng is a Registered Nurse and is working on her dual master’s degree in nursing and health informatics. In her Masters, she is a co-op student working with the Innovation Support Unit. Her background is mostly in acute care but she has been interested in exploring what it means to be a nurse in primary care.
• Hannah Roy works as a Registered Nurse in primary care and urgent primary care. She has certified practice in STI management and is completing her Masters degree to be a nurse practitioner.
• Jamie Duteil is a Registered Nurse and the Health System Improvement Director at Health Quality BC. She has managed urgent primary care centres and acute care centres.
• Kacey Wall is a Registered Nurse and a diabetes educator, she has worked in primary care networks and is a team member of the Innovation Support Unit.
• Nikki Kafal is a Registered Nurse and has spent her career working in emergency and critical care settings. She is completing a dual master degree in nursing and health informatics and joins the Innovation Support Unit as a co-op student.

Links and Resources

=====================

Nurse Compass:

An interactive learning tool created to help primary care providers, leaders, and teams get to know and improve their knowledge of the scopes of practice for nurses in British Columbia. https://teambasedcarebc.ca/nurse-compass/

FPSC has a virtual guide to support the Ministry of Health’s Nurse in Practice Program https://fpscbc.ca/integrating-nurse-practice

In this episode Morgan and Sarah talked about blood pressure as an example when they were talking about diagnosis and management and nursing roles . See Hypertension - Diagnosis and Management for more information:

This document outlines recommendations on how to diagnose and manage hypertension in adults. https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/hypertension

In this episode, Morgan and Sarah dive into the distinctions between doctors and nurses.

They explore the value nurses bring to primary care and discuss how autonomy shapes the role of a nurse. Morgan introduces the four domains of nursing: clinical practice, education, research, and leadership. There is an emphasis on the importance of interdisciplinary teamwork, the different approaches to patient care, and the cultural and social aspects that shape the nursing profession, along with examples of what a nursing diagnosis is compared to a medical diagnosis.

Special Thanks

============

Throughout this season you’ll hear from several amazing nurses:

• Angela Wignall is a Registered Nurse who has worked in perinatal health and public health. Since recording this episode Angela has been promoted to the CEO of the Nurses and Nurse Practitioners of BC from her position as Senior Executive Director. Angela is also a board member at the Canadian Nurses Association.
• Diana Boateng is a Registered Nurse and is working on her dual master’s degree in nursing and health informatics. In her Masters, she is a co-op student working with the Innovation Support Unit. Her background is mostly in acute care but she has been interested in exploring what it means to be a nurse in primary care.
• Hannah Roy works as a Registered Nurse in primary care and urgent primary care. She has certified practice in STI management and is completing her Masters degree to be a nurse practitioner.
• Jamie Duteil is a Registered Nurse and the Health System Improvement Director at Health Quality BC. She has managed urgent primary care centres and acute care centres.
• Kacey Wall is a Registered Nurse and a diabetes educator, she has worked in primary care networks and is a team member of the Innovation Support Unit.
• Nikki Kafal is a Registered Nurse and has spent her career working in emergency and critical care settings. She is completing a dual master degree in nursing and health informatics and joins the Innovation Support Unit as a co-op student.

Links and Resources

================

Nurse Compass:

An interactive learning tool created to help primary care providers, leaders, and teams get to know and improve their knowledge of the scopes of practice for nurses in British Columbia. https://teambasedcarebc.ca/nurse-compass/

BC Health Professions Act: Nurses and Nurse Practitioners Regulation:

The detailed act. An online reference with a comprehensive list of definitions, scope of practice information, and other regulations for nurses and nurse practitioners in British Columbia. https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/284_2008

CanMEDS-FM:

Canadian family physician competency framework. In the 2017 document you can find the seven domains that a family physician is expected to be proficient in.

https://www.cfpc.ca/en/education-professional-development/educational-frameworks-and-reference-guides/canmeds-family-medicine

In the first episode of Season 7 of TeamUP!, hosts Morgan and Sarah introduce the season's focus on the role of nurses in primary care. This season will feature interview insights from a range of nurses.

In this episode, Morgan and Sarah discuss the new Nurse in Practice program in BC and explore how nurses can enhance team-based care in primary care clinics. This first episode gives a brief overview of all the topics they aim to cover throughout the season, including: how to support a nurse in your practice, being an employer, and the differences among the nursing designations, along with focused episodes on common conditions like diabetes and anxiety. This episode also highlights a new tool called the Nurse Compass, designed as a learning tool to help primary care clinics understand the scope of nursing roles so that roles can be aligned with practice needs.

Special Thanks

Throughout this season you’ll hear from several amazing nurses:

• Angela Wignall is a Registered Nurse who has worked in perinatal health and public health. Since recording this episode Angela has been promoted to the CEO of the Nurses and Nurse Practitioners of BC from her position as Senior Executive Director. Angela is also a board member at the Canadian Nurses Association.
• Diana Boateng is a Registered Nurse and is working on her dual master’s degree in nursing and health informatics. In her Masters, she is a co-op student working with the Innovation Support Unit. Her background is mostly in acute care but she has been interested in exploring what it means to be a nurse in primary care.
• Hannah Roy works as a Registered Nurse in primary care and urgent primary care. She has certified practice in STI management and is completing her Masters degree to be a nurse practitioner.
• Jamie Duteil is a Registered Nurse and the Health System Improvement Director at Health Quality BC. She has managed urgent primary care centres and acute care centres.
• Kacey Wall is a Registered Nurse and a diabetes educator, she has worked in primary care networks and is a team member of the Innovation Support Unit.
• Nikki Kafal is a Registered Nurse and has spent her career working in emergency and critical care settings. She is completing a dual master degree in nursing and health informatics and joins the Innovation Support Unit as a co-op student.

Links and Resources

• Nurse Compass is an interactive learning tool created to help primary care providers, leaders, and teams get to know and improve their knowledge of the scopes of practice for nurses in British Columbia. https://teambasedcarebc.ca/nurse-compass/
• NNPBC Program Stay tuned - launching soon!
• FPSC has a virtual guide to support the Ministry of Health’s Nurse in Practice Program. https://fpscbc.ca/integrating-nurse-practice
• BC Nurse in Practice Program is BC’s primary care strategy designed to expand team-based primary care by integrating more nurses into family practices. https://www2.gov.bc.ca/gov/content/health/nurse-in-practice-program

This episode focuses on Stage 5 of the Learning Pathway: Team Evaluation, and the importance of evaluation in the context of team based primary care. The hosts explore how evaluation acts as both the end and beginning of the cyclical process of enhancing primary care teams. Sarah and Morgan delve into the distinctions and overlaps between Quality Improvement and evaluation, methods of performing meaningful evaluations, and the introduction of evaluation tools aimed at measuring team effectiveness. The episode emphasizes that evaluation is not a linear process but a continuous circle that can commence at any stage of team development. Morgan highlights how it is often best to begin evaluating sooner than later because it is easy to spend far too long planning what to evaluate. You can always complete another evaluation cycle. The hosts then share the plan for a TBC evaluation project in BC that is going to engage 30 clinics in evaluation over the next few months.

The episode ends with a call to action focused on starting your evaluation journey by looking at available resources, reminding listeners to check back in the show notes of previous episodes periodically as more the learning pathway will continue to evolve. The season wraps up with a bit of a teaser for the next season of TeamUP!

Special thanks to Amie Hough, a Leader in Health System Improvement for Primary and Community Care with Health Quality BC, and one of the creators of the learning pathway, who we will be hearing from throughout the season.

Links and Resources

For more information on the Team Based Care Learning Pathway check out https://teambasedcarebc.ca/team-based-care-pathway/

Measurement Plan Worksheet

Small worksheet to help identify what to collect, when and how to measure.

https://teambasedcarebc.ca/resources/measurement-plan-worksheet/#details

Team Effectiveness Tool

Taking us back to where we started with S06- check out the Team Effectiveness tool, a short multiple choice assessment to help huide your learning on team based care.

https://teambasedcarebc.ca/team-effectiveness-tool/

Through the TeamUp network we are working to advance supports for team based primary care. Please reach out to [email protected] if you would like to learn more!