Glossary of Terms

Health Service Delivery in BC – At A Glance

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The Ministry of Health
The Ministry of Health (the Ministry) has overall responsibility for ensuring that quality, appropriate, cost effective and timely health services are available for all British Columbians. The Ministry is responsible for provincial legislation and regulations related to health care, including the Medicare Protection Act and the Health Professions Act. The Ministry also directly manages a number of provincial programs and services, including the Medical Services Plan, which covers most physician services; PharmaCare, which provides prescription drug insurance; and the BC Vital Statistics Agency, which registers and reports on vital events such as a birth, death or marriage, etc.  For more information visit: http://www.gov.bc.ca/health

Provincial Health Authorities
The province’s health authorities are the organizations primarily responsible for health service delivery. Five regional health authorities deliver a full continuum of health services to meet the needs of the population within their respective geographic regions:

A sixth health authority, the Provincial Health Services Authority, is responsible for managing the quality, coordination and accessibility of services and province-wide health programs. The Ministry also works in partnership with the First Nations Health Authority to improve the health status of First Nations in British Columbia.

Source: Adapted from the BC Ministry of Health 2016/17 – 2018/19 Service Plan.  Available at: http://www.gov.bc.ca/health


Levels of Health Care

Health care is the diagnosis, treatment, and prevention of disease, illness, injury and other physical and mental impairments.

Health care refers to the work done in providing primary care, secondary care and tertiary care, as well as in home and community care and public health.

Primary Care
Health care provided by health care professionals who act as a first point of consultation for patients within the health care system. This is usually a general practitioner or family physician, or a non-physician primary care provider such as a nurse practitioner, but can also include speaking to a pharmacist or calling a health information line.

Depending on the nature of the health condition, patients may then be referred for secondary or tertiary care.

Secondary Care
Health care services provided by medical specialists and other health professionals who generally do not have first contact with patients, for example, cardiologists, urologists, and dermatologists.

Secondary care includes acute care: the necessary treatment for a short period of time for a brief but serious illness, injury or other health condition, such as in a hospital emergency department. It also includes skilled attendance during childbirth, intensive care, and medical imaging services.

The term “secondary care” is sometimes used synonymously with “hospital care.” However, many secondary care providers do not necessarily work in hospitals, such as psychiatrists or physiotherapists, and some primary care services are delivered within hospitals.

Tertiary Care
Specialized consultative health care, usually for inpatients and requiring a referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment.

Examples of tertiary care services are cancer management, heart surgery, treatment for severe burns, palliative care, and other complex medical and surgical interventions.

Home and Community Care
A range of health care and support services for individuals who have acute, chronic, palliative or rehabilitative health care needs.

Home and community care services are designed to complement and supplement – but not replace – the efforts of individuals to care for themselves with the assistance of family, friends and community. In-home services include home care nursing, rehabilitation, home support and palliative care. Community-based services include adult day programs, meal programs, treatment for substance use disorders, as well as assisted living, residential care services and hospice care. Case management services are provided in both the home and community.


Glossary of Terms

Patient (with regards to Patient Engagement)
A person who is receiving, has received, or has requested health care. This term includes caregiver: a person(s) whom the patient wishes to be involved with them in care, and acting on behalf of and in the interest of the patient. It refers to all other terms for patient including client, resident, person, consumer,etc.

Key Organizations & Programs
BCPSQC – BC Patient Safety & Quality Council
Created in 2008 by the BC provincial government, the BCPSQC provides leadership across BC’s health care system to efforts that support improvements in the quality of care.

CEAN – Community Engagement Advisory Network
CEAN is a group of members of the public who support patient and public involvement in health service planning and decision-making at Vancouver Coastal Health.

Divisions of Family Practice
Divisions of Family Practice are community-based groups of family physicians working together to achieve common health care goals. There are currently 35 Divisions of Family Practice in BC that encompass more than 230 communities.

Doctors of BC (Formerly the BC Medical Association)
The Doctors of BC is a professional body of doctors in British Columbia.

GPSC – The General Practice Services Committee
GPSC was formed in 2002 as a partnership between the Ministry and Doctors of BC. The Committee supports BC doctors by developing and implementing programs that improve job satisfaction for family doctors and primary health care for patients. (See also SCC, SSC)

IAP2 – International Association of Public Participation
IAP2 is the preeminent international organization advancing the practice of public participation. It created the well-known “Spectrum of Public Participation”.

IPCC – Integrated Primary and Community Care
Includes efforts to shift the management and delivery of health services so that clients receive a continuum of preventive and curative services, according to their needs over time and across different levels of the health system.

Patients as Partners
A Ministry program and philosophy that promotes and supports the creation of patient- and family centred care through health care improvements. The principle driving the program is “nothing about me without me.”

PSP – Practice Support Program
A joint initiative of the Ministry and Doctors of BC, this program helps doctors and their staff make improvements in their practices.

SCC – Shared Care Committee
A joint committee of Doctors of BC and the Ministry that is working to address the care provided by both family physicians (FPs) and specialist physicians (SPs).

SSC – Specialists Services Committee
The committee was formed in 2006 and supports the delivery of specialist services and support improvement of the specialist care system in BC. See also GPSC, SCC.

SPOR – Strategy for Patient-Oriented Research
SPOR is an initiative of the Canadian Institutes of Health Research(CIHR) Patient-oriented research refers to a continuum of research that engages patients as partners, focuses on patient-identified priorities and improves patient outcomes. In BC, SPOR is being activated through the BC SUPPORT Unit (BC Support for People and Patient-Oriented Research and Trials Unit), a multi-partner organization led by the Academic Health Science Network.


Key Terms

Acute Care
Usually delivered in a hospital-like setting, acute care is the type of care that your healthcare team will provide if you are sick or injured, or recovering from a treatment such as surgery. When you are admitted to an acute care hospital to receive care, you are usually called an “inpatient”.

Ambulatory Care
All types of health services that are provided on an outpatient basis, in contrast to services provided in the home or to persons who are inpatients.  While many inpatients may be ambulatory, the term ambulatory care usually implies that the patient must travel to a location to receive services that do not require an overnight stay.

Assisted Living
A broad range of residential care services that includes some assistance with activities of daily living and instrumental activities of daily living but does not include nursing services such as administration of medication.  Assisted living facilities and in-home living care stress independence and generally provide less intensive care than that delivered in nursing homes and other long-term care institutions.

Attachment
Recognizes the importance of continuous doctor- patient relationships and aims to connect an individual with a primary health care provider who provides him/her with comprehensive, ongoing care.

Community Health Centres (CHC)
CHCs provide a wide range of health services which may include prenatal, postpartum, health promotion, disease and injury prevention, bereavement services, communicable disease and school health, immunization and many other community care public health and wellness programs.

CME
Continuing Medical Education for doctors.

EMR/EHR – Electronic Medical Record/Electronic Health Record
A computerized medical record that may include medical history, medication lists, lab results, etc.

Engagement Opportunity
Any process, event or committee in which patient partners are invited and supported to share their experiences and perspectives, with the goal of contributing to health care system improvement.

ER/ED – Emergency Room/Emergency Department
Emergency services are available 24 hours a day in regional and community hospitals across the province.  Emergency departments are intended to care for individuals experiencing a health crisis or urgent medical condition. Examples of urgent medical conditions include but are not limited to: signs of heart attack or stroke, extreme pain, severe bleeding, broken bones, shortness of breath or respiratory distress, etc.

Family Physician or Family Practice Physician
A doctor who specializes in family medicine and provides health care to people of all ages. Family Physicians are sometimes referred to as General Practitioners (GPs).

Group Medical Visits
Groups of patients get together with their doctor to learn about their condition, ask questions, share knowledge with other patients, and gain confidence in themselves and their ability to self- manage their chronic conditions.

Health Care Partner (HCP)
Any health authority staff member or similar stakeholder who, in the course of their work, seeks out, supports, and facilitates patient engagement opportunities.  These HCPs are often the main point-of contact for patient partners taking part in engagement opportunities.

Inpatient
If you are admitted to a hospital or healthcare facility to stay overnight (for at least one night or longer), so  as to receive the care and treatment you need, you are called an “inpatient”.

IPCC – Integrated Primary and Community Care
Includes efforts to shift the management and delivery of health services so that clients receive a continuum of preventive and curative services, according to their needs over time and across different levels of the health system.

Lean
Lean is an approach to improvement that focuses on maximizing value by eliminating waste and inefficiencies from workflow.

Long Term Residential Care 
Long-term residential care services provide 24-hour professional supervision and care in a protective, supportive environment for people who have complex care needs and can no longer be cared for in their own homes or in an assisted living residence.

Outpatient
When a person is not admitted to the hospital for an overnight stay, but still comes to a physician’s office, clinic, hospital, day surgery office or other health care facility for diagnosis, treatment or to receive care, that patient is considered an “outpatient”. See also: inpatient

Palliative Care
Care and supports for patients and families who are dealing with a progressive, life-limiting illness.

Patient Advisors
Individuals who represent the patient perspective at all system levels. It includes champions, advocates, representatives, etc.

Patient-Centred Care(PCC) &  Patient & Family Centered Care(PFCC)
PCC and PFCC are closely related approaches that guide all aspects of planning, delivering and evaluating clinical care decisions and services. The focus is always on creating and nurturing mutually beneficial partnerships among the care providers and the patients they serve. It means providing care that is respectful, compassionate, culturally safe, and competent, while being responsive to patient needs, values, cultural backgrounds and beliefs, and preferences.

According to the Institute for Patient & Family Centered Care, “patient- and family-centered practitioners recognize the vital role that families play in ensuring the health and well-being of infants, children, adolescents, and family members of all ages. They acknowledge that emotional, social, and developmental support are integral components of health care. They promote the health and well-being of individuals and families and restore dignity and control to them. Patient- and family-centered care is an approach to health care that shapes policies, programs, facility design, and staff day-to-day interactions. It leads to better health outcomes and wiser allocation of resources, and greater patient and family satisfaction.”

Patient Engagement (PE)
Involvement of the patient perspective in decision making and active participation in all aspects of design, planning, delivery and evaluation of health services at all system levels.

Patient Safety
The pursuit of the reduction and mitigation of unsafe acts within the health care system, as well as the use of best practices shown to lead to optimal patient outcomes.

PDSA
PDSA represents the four phases in small tests of changes: PLAN a small test of change, DO (test) that change, STUDY the results – what happened, and ACT – decide whether to adapt, adopt or abandon the change.

Primary Care Home
A primary care home is a collaborative primary care network or co-located team of full service family practices, whose services are enhanced by linked or integrated health authority delivered primary care services.  Primary care homes aim to provide accessible, continuous, coordinated and client-centered care.

Public Health
The science and practice of protecting and improving the health of a community according to the public health principles of disease prevention, health promotion, and public policy.

Quality of Care
The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. Seven dimensions of quality, as outlined in the BC Health Quality Matrix include: acceptability, appropriateness, accessibility, safety, effectiveness, equity and efficiency.  See more at: www.bcpsqc.ca

Self-management
Self-management, or self-care, refers to what we do every day to maintain our health and manage long-term health problems.

Teleconference
A phone call that multiple people can participate in. Everyone dials into a common number and, once connected, all participants can hear each other.

Triple Aim
A framework developed by the Institute for Healthcare Improvement (IHI) that describes an approach that simultaneously pursue three dimensions, (called the “Triple Aim”):

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

Webinar
Short for web-based seminar, a webinar is a presentation, lecture, workshop or seminar that is transmitted over the internet. In a webinar each participant sits at his or her own computer and is connected to other participants via the internet and/or teleconference.