Our Journey
Stories of Collaboration
and Care

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xpey’, red cedar
Serves many medicinal purposes, including treating infections, fevers, and joint pain.

Important Note Shared with respect for Coast Salish healing traditions. For cultural awareness only. Please consult a healthcare or traditional wellness provider before using plants medicinally.

Credit: Luschiim’s Plants: Traditional Indigenous Foods, Materials and Medicines: A Hul′q′umi′num′ (Cowichan) Ethnobotany
XPEY’

The Cowichan Primary Care Network thrives on collaboration, innovation, and improving access to care. Since 2020, we’ve adapted, learned, and celebrated milestones. Explore stories and insights from the people and communities building a stronger, more connected primary care system for Cowichan.

Supporting family docs Play

Supporting family doctors and nurse practitioners

Building Team Approaches To Patient Care In Partnership With Physicians And Nurse Practitioners

Patients

Lena was financially unable to afford dentures and used whiteout on her teeth to mask dental flaws. A medical professional, recognizing the severity of the issue, enlisted the help of a PCN Social Worker. The social worker helped navigate healthcare options, resulting in Lena receiving proper dentures.”

FN Play

FN/Metis/Inuit partners

Focusing On Relationship And Service Solutions In Partnership With Fn/métis/inuit People

FPs/NPs

“It has been such an asset to work collaboratively with [the extended team] to enhance patient care management and outcomes and I appreciate just being able to discuss patient cases with them. I cannot imagine not being able to access their expertise and skills.”

Access/attachment to primary care

Eva, who resides in the Ladysmith area, was delighted to finally have a family provider within convenient reach. This addition will unquestionably enhance their access to necessary medical services, which is something to celebrate indeed.”

Social Determinants Play

Social determinants of health

Broadening Family Healthcare Teams To Proactively Serve People With Social Needs

Access/attachment to primary care

Don won’t go to the doctor. A community paramedic visits him in his home. One day the paramedic discovered a boil under Don’s arm. He contacted the new Nurse Practitioner, who promptly visited the patient’s home to treat Don, and provided daily follow-up until resolution. The mobility of the Nurse Practitioner served this patient extremely well.”

Patients

Jim was overwhelmed by his MSP premiums. His doctor referred him to a PCN social worker and she helped him apply for retroactive reimbursement. Upon receiving a cheque from them, he expressed great happiness and relief that he was, “taken care of” by the clinic.”

Access/attachment to primary care

“Don won’t go to the doctor. A community paramedic visits him in his home. One day the paramedic discovered a boil under Don’s arm. He contacted the new Nurse Practitioner, who promptly visited the patient’s home to treat Don, and provided daily follow-up until resolution. The mobility of the Nurse Practitioner served this patient extremely well.”

Social workers

“[Without my role] There would be even more homelessness. [For example]… a building manager wouldn’t talk with a client directly, but she would talk with me. She ended up giving my client an apartment.”

Patients

Phoebe required supportive care for an extended period. Phoebe had turtles, birds, and cats, but lacked a caregiver for her pets, which hindered her willingness to receive necessary treatment. The PCN Social Worker at the clinic successfully arranged care for all the animals, enabling Phoebe to accept the needed support.”

Access/attachment to primary care

Lenny, who moved to the island from the lower mainland, had been unable to find a local doctor or NP despite living on the island for several years. He remained connected with his previous doctor and traveled to the lower mainland for appointments. When he got attached through the registry and heard about the PCN vision in Cowichan, Lenny expressed excitement at seeing his tax dollars were “finally being put to good use!”

FPs/NPs

“It makes me feel like I can keep going; there’s less burn out. It’s been such a stress reliever to have a social worker. For me, the support has reduced my stress, and I can now think about staying longer in my practice instead of retiring early.”

Collaborating with partners Play

Collaborating with partners

Strengthening Connections Across Patients’ Network Of Care

Better patient outcomes Play

Enhancing Patient Care

Improving Service Coordination And Continuity Of Care For Patient

FPs/NPs

“[Having team-based care has]… made a huge difference! I’ve realized how much of what I was doing was social work stuff. I’ve also realized how much of a load that takes off me, so I can focus on clients’ medical issues.”

Social workers

“I had one person living in a tent who was calling for an ambulance regularly. With support he now has housing and is stable.”

Acute care Play

Acute care benefits

Enhancing Proactive Health Care And Improving Patient Transitions From Hospital To Community

Social workers

“At times I can be a go-between, help clients ask for what they want or need, support clients to book appointments, or clarify information with physicians.”