How the Madawaska Valley Family Health Team has adapted health care to serve the community

The Madawaska Valley Family Health Team (MVFHT) has served patients through the COVID pandemic and continues to provide services during the Stage 3 COVID restrictions. This article will help to clarify the scope of practice provided by our Nurse Practitioners who have expanded services within our community. Shown above are members of the MVFHT from left: Stacie Wojick, Medical Receptionist; Elser Lee Archer, Registered Social Worker; Susan Farrar, Executive Director; Tanya MacGregor, Office Administrator; Jessica Valentine, Nurse Practitioner; Liz Polatynski, Nurse Practitioner; Chelsea Greenough, Nurse Practitioner student (graduating October 2020). Absent from photo: Angela Zhu, Registered Dietitian.

Madawaska Valley Family Health Team Mission, Vision and Values

• Mission: MVFHT delivers team based comprehensive primary care in Madawaska Valley and area.
• Vision: Patient centred primary care that helps everyone in Madawaska Valley and area achieve their optimal health.
• Values:  Respect, Compassion, Integrity, Collaboration, Quality, Honesty

COVID-19 – Providing primary care to our community during the pandemic

MVFHT Executive Director, Susan Farrar is proud to report that “our primary care services have not lapsed during the COVID-19 pandemic” because of a commitment to Madawaska Valley and a willingness to seize creative opportunities. She added, “Our team has risen to the occasion during this very challenging time utilizing telephone and virtual technology to provide the best possible care to our patients.”

During COVID’s peak, the MVFHT worked closely with local paramedics to continue to facilitate primary care to patients. Matthew Cruchet is a Paramedic and a member of the FHT Board of Directors. He shared that, “Community Paramedics integrated into the Madawaska Valley Family Health Team to help provide timely, appropriate and comprehensive medical care to patients in their homes (including) assessments and any needed testing or treatments and then reported back to the care provider.” Since COVID-19 began early this year, there have been 165 referrals to Community Paramedics from the team. This demonstrates that the FHT has utilized best practices to adapt to the changing landscape of health care when needed.

The team strongly praises the implementation of RC VTAC (Renfrew County Virtual Triage and Assessment Centre) in providing primary care to the many unattached patients as well as rostered patients in Renfrew County. This has alleviated the demand on our local emergency departments during the pandemic.

MVFHT – Exciting announcement regarding increased services

Currently the Family Health Team consists of six Physicians, Interdisciplinary Health Professionals (IHP), Executive Director and administrative staff. The MVFHT has now been open for 20 months and in that time the IHP team has had a total of 5950 patient appointments.

Madawaska Valley has more than 1400 patients in need of a primary care provider according to the numbers from the MVFHT waiting list.  “We are thrilled to announce that our nurse practitioners are expanding their services by growing their own shared practice from the waiting list,” says Farrar. Experienced Nurse Practitioner, Elizabeth Polatynski, says, “We are rostering unattached patients in the community with a holistic approach and specializing in vulnerable populations without timely access to primary care by providing home visits.”

Stacie is the warm friendly voice who will greet you most days on the phone to schedule an appointment. She shares that, “The practice now consists of some home visits with assessments for patients with mobility or transportation issues.”

Team NP, Jessica Valentine, joined the team in 2020. During an interview she reflected on the scope of practice offered by primary health care NPs. Nurse Practitioners (NPs) are Registered Nurses in the Extended Class who have attained a higher level (8+ years) of education and clinical training who work alongside their physician colleagues to provide primary care to patients in the community. What can a Nurse Practitioner do? Here is a summary:

• Work in a community setting to provide care to patients of all ages
• Talk to you about your health history and do a physical exam
• Diagnose any illnesses you may have
• Order and interpret diagnostic tests like bloodwork, x-rays and ultrasounds
• Prescribe all medications
• Manage any chronic diseases you may have, such as diabetes or high blood pressure
• Refer you to other healthcare professionals and specialists as needed
• Provide health teaching and counselling (e.g. if you are trying to plan a family, or have a mental health condition)
• Immunizations and health promotion (e.g. well baby clinics, high blood pressure clinics)
• Preventative health care, including screening for certain cancers

• • “In a small town, primary care allows for connections with the patient’s family vs. a brief relationship in a gown while in the emergency room,” says Chelsea Greenough currently completing NP training with NP Liz Polatynski.

The team’s Social Worker continues to work with both rostered and unattached patients in identifying and setting goals to address mental health and social needs. This service aims to provide patients with ways to cope with emotional, physical and mental distress or practical assistance completing forms or navigating access to services like the Ontario Disability Support Programs. Pre-COVID, the Social Worker did home visits with the Community Paramedics monthly, to address the needs of vulnerable community members with transportation or mobility challenges.

The team’s Dietitian discusses with patients how to adapt their lifestyle for improved weight management and assists patients with nutritional needs in order to help manage chronic diseases like diabetes. Self-referrals to the dietitian are accepted. Pre-COVID, clinical staff provided group and individual sessions and they hope to resume programming through new formats.

The MVFHT continues to actively participate in physician recruitment. “The MVFHT has been an excellent selling point for new physician graduates looking to start a practice, and we have hosted some very interested candidates for a clinic visit,” says Dr. Jason Malinowski, Lead Physician of the MVFHT. The team is a teaching site for medical students, residents and nurse practitioner students which assists in recruitment by introducing them to our community and clinical setting.

“We continue to grow and evolve as our team matures, identifying the needs of the community and adapting to meet those needs,” says Farrar. As the months progress the MVFHT will work diligently to serve the community going forward into 2021.