News Release – Service Changes for Yellowknife Primary Care to Support Best Care in new Łıwegǫ̀atì Building

(Yellowknife, May 23, 2024) - As we prepare to begin services in the Łıwegǫ̀atì building, the Northwest Territories Health and Social Services Authority (NTHSSA) is providing important information about operational changes in Yellowknife that will happen as part of the new way of working in this new facility.

Transition to Four Integrated Care Teams in Yellowknife

When the Łıwegǫ̀atì facility opens for first patient day on May 30th, 2024, there will be four integrated care teams. This is a shift from the previous model that included ten mini-teams.

This change will see all teams more equitably staffed, which will help balance workloads while also increasing options for access to care for the public. These changes lay the foundations for achieving the longer-term vision of primary care reform. This vision means that over time we will ensure all residents have a circle of care – or a Health Home – provided by an integrated care team that is well resourced to meet their needs. This will help increase access whether that means seeing a physician, nurse practitioner, community health nurse, holistic wellness advisor, or simply talking to a familiar program assistant to understand your needs and who can serve you best.

This work continues under principles that have informed Primary Care Reform in the Northwest Territories (NWT) over the past several years. This process is driven by a commitment to building a system based on principles of cultural safety and anti-racism. Over time these changes aim to provide equitable access to care for all residents based on their own health needs. This will be possible through assigning individuals to integrated care teams who have different skills and expertise to serve the needs of clients and patients quickly, effectively, and over time with enhanced opportunities for relationships and continuity of care. This change will also enable Yellowknife region to address the waitlist for a family doctor by allowing the teams to assign all residents currently on the waitlist to a team. Primary care today for the majority of NWT residents is not about “who is my doctor” but rather, “who knows me?” and “who can help me look after my healthcare needs?” Yellowknife’s primary care team model aims to eventually answer that question for every resident seeking primary care services.

QUOTE

“Effective primary care is the foundation upon which the rest of the healthcare system is constructed. As we continue to focus on system improvement, primary care reform will be a key initiative to ensure we can advance our goals related to cultural safety and equitable access to care. These changes in the Yellowknife region are just one part of broader efforts to enhance primary care services across the territory that we will continue to advance and highlight as we make changes to deliver on NTHSSA’s vision of Best Health, Best Care, for a Better Future.”
 

- Kimberly Riles, Chief Executive Officer, Northwest Territories Health and Social Services Authority
 

QUESTIONS AND ANSWERS

When do these changes come into effect?

The shift to four teams will start immediately when operations begin in the Łıwegǫ̀atì building, which begins operations May 30, 2024.

What is the composition of an Integrated Care Team?

Integrated Care Teams are multidisciplinary teams that include a number of people that have different expertise, each team is composed of:

  • Program Assistants – This is the main point of contact for your team and one of the key members who will work with patients/clients to understand their needs, direct them to the correct provider and schedule appointments and follow ups.
  • Physicians – Family Physicians are doctors that provide whole person medical care and who helps manage your health needs. They can assess, treat, prescribe and refer you for other services based on your concerns.
  • Nurse Practitioners (NPs) – Are registered nurses who have extra education and training that allows them to independently diagnose and treat illness, order and interpret tests, prescribe medications, perform certain medical procedures, and refer you for other services based on your concerns.
  • Community Health Nurses (CHNs) – Are registered nurses who have a broader scope of practice informed by extra training and competencies. They can assess a variety of common health conditions, and dispense medications to treat them based on clinical practice guidelines. They are often the main provider of care and services in NWT communities without resident physicians or nurse practitioners.
  • Registered Nurses (RNs) – Have an important role in providing comprehensive and continuous care to patients. Responsibilities include clinical tasks, patient education, and case management duties.
  • Licensed Practical Nurses (LPNs) – Provide direct patient care, supporting the integrated care team and ensuring smooth operation of the clinic. They are able to take appointments for minor procedures such as injections or wound care.
  • Holistic Wellness Advisors (HCWs) - Provide comprehensive support focused on integrating physical, mental, emotional and spiritual health and triage for mental, emotional and behavioural health concerns, they may provide referrals to treatment programs or other providers. They collaborate with healthcare providers to offer personalized wellness plans and promoting overall wellbeing.

With the shift to 4 equitably-resourced Integrated Care Teams the goal is to provide access to an entire team of providers that can best meet your needs. Each team will work together to best serve patients and clients and refer them to other providers within the team if they have needs that cannot be met by the person you are seeing at your appointment. They also have the ability to refer to other providers within the system if you need more specialized care or services.

What does this mean if I am already assigned to a team or a doctor?

Anyone who is assigned to a specific practitioner – or family doctor – will follow that physician to their new team. Anyone who is assigned to an Integrated Care Team – but not a specific physician – will be matched to the most appropriate team. In either case team names, and some of the providers on these teams, may change. A letter to communicate this change will be sent to those assigned to a team.

What does this mean if I am not assigned to a team or a doctor?

There will be no immediate changes, you will continue to access services as you have either through a same-day appointment or a scheduled appointment with the provider who is available soonest and who can best serve your needs.

Going forward we expect this shift – which will include four teams who are more equally resourced – to allow us to ensure everyone is able to have a Health Home by being assigned to a team.

This sounds familiar; why are you announcing this change if it’s already in place?

Integrated Care Teams have been implemented as part of Primary Care Reform initiatives in the past, and they do exist in the current system. This change – from ten mini-teams to four better-resourced teams – is an evolution of the work to make primary care services more efficient, effective, and most importantly more equitable and easily accessible for all residents.

Changes have been informed by the successes of the teams that have already been operating, and we have seen past success that pointed out more positive patient and staff experience related to teams that were fully resourced. These changes will also be refined over time by being responsive to feedback from those who work in the system and those who access care and services.

What will teams be named?

At this point we have not yet named our teams; we are working with staff and the Department of Health and Social Services’ office of Community Culture and Innovation to determine the best process to decide on names that are easy to remember and that are appropriate and respective of local culture and knowledge. In the interim teams will simply have numerical identifiers. This will be communicated in letters to anyone assigned to a team.