Sustaining Pediatrics in Rural & Underserved Communities

Sustaining Pediatrics in Rural and Underserved Communities (SPRUCe) is a network that connects community pediatric providers with an interest in supporting and sustaining excellence in pediatric care in rural and remote communities across British Columbia.  The goal of SPRUCe is to support those providing rural pediatric care so that provider care gaps are filled, education and mentorship supports are available, and pediatric residents have a mechanism for exposure to rural pediatric practice and contact with rural pediatricians.

Drs Jenny Retallack, Katharine Smart, Melissa Paquette, Kirsten Miller & David Wensley

Achievements

Successful Collaborations

SPRUCe’s collaboration with UBC CPD to deliver the HOUSE Ped curriculum led to a successful ‘pilot’ two-day session for eight pediatricians from Northern Health in Prince George in June 2023. Then a one-day session for ten RSA pediatricians from various communities occurred in Vancouver in early November 2023. The course in November was financially supported by funding from the Specialist, Sub-specialty, Indigenous and Funding for Innovation (SPIFI) program.

There was a 90% response rate in participant evaluations for the course in November 2023; respondents were unanimous that the course increased their confidence in using PoCUS in their clinical pediatric practices. 100% of the evaluation respondents agreed or strongly agreed that the learning objectives were covered, the information was taught at the “right level”, the course length was appropriate and the volume of information provided was appropriate. All respondents (100%) rated the course as being very worthwhile in terms of value for the time spent.

Successful Presentations

SPRUCe collaborated with CHARLiE RTVS to prepare and deliver a presentation (both Kirsten Miller and Jenny Retallack) at the Children’s Healthcare Canada Annual conference in December 2023. This session, “Bridging The Distance: Innovative Strategies for Pediatric Care in Rural and Indigenous Communities”, was one of only six sessions accepted for presentation. This national conference attracts leaders in pediatric health care, including medical administrators, executives, clinicians, researchers, patient families and patient partners.

SPRUCe has also had presentations and posters accepted for upcoming forums, including:

March 1, 2024: “Supporting Specialty Care in Rural Settings”, presentation (Kirsten Miller) at the Rural and Northern Healthcare Leadership Conference in Toronto.
April 20, 2024: “Sustaining Pediatrics in Rural and Underserved Communities: A Model to SPRUCe Up Support”, breakout session (Jenny Retallack and Kirsten Miller) at SRPC’s 31st Annual Rural and Remote Medicine Conference in Edmonton.
April 23, 2024: JCC Pre-forum 2024 Storyboard “SPRUCe-ing up Rural Pediatric Service in BC: Could a Rural Pediatrics Clinical Network Make a Difference for Rural General Specialists?”, presented by a pediatric resident on behalf of SPRUCe.
May 2024: BC Rural Health Conference in Whistler – planned poster submission
June 6-8, 2024: “Supporting Rural Pediatricians in British Columbia: Could a Rural Pediatrics Clinical Network Make a Difference?”, poster presentation by a pediatric resident at the Canadian Paediatric Society’s Annual Conference in Vancouver.

Research Development

SPRUCe is developing research as an area of focus. Through the summer of 2023, SPRUCe conducted an online survey of the pediatricians working in RSA communities in BC. Responses from this survey are being compared to those from a survey done in 2021 and this data is being shared in some of the upcoming presentations planned for 2024.

In addition, the SPRUCe co-leads have been asked to serve as research supervisors for two residents training in pediatrics. Dr. Sarah Fletcher is undertaking a project entitled “Evaluating the Experience of Residents and Pediatricians with Rural Pediatric Outreach Trips in BC”. Dr. Jenna Treissman is the Northern Health Investigator with the “READAPT Kids BC: Clinical Characteristics and Outcomes of Hospitalized Children with Acute Respiratory Infections” study, and plans to evaluate the challenges faced by northern, rural residents in accessing high level pediatric care through the pediatric respiratory surge of 2022-2023.

Explore the numbers

38 Pediatricians

Working in 13 RSA Communities

21 RSA Pediatricians

Attended the SPRUCe networking meeting

18 Rural Peditricians

Completed one of the HOUSE-Ped courses

4 Upcoming presentations

Planned for 2024, including oral and poster presentations for SPRUCe

Partnership Work

SPRUCe partnered with the BC Pediatric Society (BCPS) to identify BC rural pediatricians (those living and working in RSA communities) as unique and worthy of special recognition at the annual BCPS conference in November 2023. At the conference (Children’s Health Today 2023), SPRUCe provided rural pediatricians with buttons stating, “I’m a Rural Pediatrician” and provided pediatricians who support rural communities (such as by providing locum coverage or by offering visiting specialist clinics in rural communities) with SPRUCe stickers to wear on their nametags. Any conference attendees interested in supporting rural pediatrics and/or interested in getting to know the province’s rural pediatricians were invited to join SPRUCe for lunch on the first day of the conference. This resulted in some lively conversation and sharing of experiences, and allowed SPRUCe to solicit input from the lunch attendees about what they feel SPRUCe could and should be doing to better support the provision of pediatric service to rural BC. It has been impactful that RCCbc has been a sponsor at this conference for the past two years, as the presence of the RCCbc table encourages all attendees (who are almost all BC general pediatricians, from both urban and rural communities) to consider the needs of rural British Columbians, and supports the possibility of urban-rural bilateral learning. It is hoped that this partnership will continue to grow, as will the recognition that pediatricians practising in rural communities have a great deal to their colleagues who work in more well-resourced areas.

Making a Difference

Participants of the HOUSE-Ped course provided positive feedback and praise for the experience:

“This course would be useful to pediatricians even the ones not working in a rural setting. Thank you!”

HOUSE-Ped participant

“Thank you for a great course and all the patience.”

HOUSE-Ped participant

Plans for the Future

Disseminate Findings and Promote Networks: Share the insights from the June 2023 follow-up survey of rural pediatricians and advocate for the establishment of clinical networks to support rural specialists in fields beyond pediatrics.
Establish the Rural Pediatrics Special Interest Group: Implement this group through the Canadian Paediatric Society to foster collaboration among rural pediatricians and those interested in supporting rural pediatrics nationwide.
Enhance BC Pediatric Society Collaboration: Continue sponsoring the BC Pediatric Society (BCPS) conference and consider organising a “SPRUCe Dinner” to enhance in-person networking among rural pediatricians, those providing rural outreach clinics and locum services, and pediatric residents keen on rural practice.
Evaluate and Improve Pediatric Outreach: Assess the rural pediatric outreach clinic experiences of pediatric residents and practicing pediatricians through the research of pediatric resident Dr. S. Fletcher. Use this data to identify and seize opportunities for improving the service and enriching the experiences of pediatric residents.