Welcome to the Summer Edition of the Vancouver Island Health Authority’s CEO Update

Since the start of our new fiscal year in April, VIHA’s Board and senior leadership team have been reviewing and updating our annual and longer-term plans.  This year, we have established four priority initiatives that will improve the way we deliver services, improve the quality of care, and help us manage our limited human resources. 

The four organization-wide priorities are:

• Improving patient flow by ensuring the right patient is in the right bed at the right time;
• Increasing our system wide focus on infection prevention and control;
• Improving staff safety and creating an enhanced culture of safety; and
• Addressing the shortage of health care professionals by redesigning how care is delivered to patients and ensuring that staff members are working to the full scope of their practice.

In addition, several exciting projects and initiatives continue to take shape throughout VIHA:

• the new hospital/Patient Care Centre at Royal Jubilee is gaining height by the month;
• the new Emergency Department at Victoria General is almost completed;
• shovels will soon be in the ground for the new Emergency Department and renal centre at Nanaimo General;
• plans for a primary health care/urgent care centre in Oceanside or moving forward; and
• in the Comox Valley and Campbell River, VIHA recently reached an agreement with the Comox Strathcona Regional District to build two new hospitals in those communities.

Over the past year, elections at the federal, municipal and provincial level have resulted in some shifts among local elected representatives, and some new faces.   I look forward to working with each of you.

Fiscal Update

In recent weeks, there has been public and media focus on the fiscal challenges facing health authorities across British Columbia.  With increasing demands related to a growing and aging population and rising costs related to inflation, labour, new technology and pharmaceuticals, the challenges faced across the health care system are real and they include VIHA.  VIHA will address these pressures by ensuring that costs are managed and alternate, more effective, ways of delivering service are implemented.

In the longer term, VIHA's leadership team will identify ways to manage pressures while meeting the health needs of our communities, and we will be tapping into the talent and ideas of our employees and physician partners to achieve this. In the shorter term, VIHA is controlling costs by reducing spending on conferences, consultants and non-clinical travel.  We are also requiring executive approval for all new or expanded programs or services, and for new hires external to VIHA.  As is the case in the provincial civil service, a process is underway to give non-contract staff the option to request voluntary, non paid, days off from work. 

Despite significant investments in health care in BC in recent years, we are facing challenging times. The global economy has not yet turned around, and budgets at all levels are under pressure. As more information regarding budgets becomes available, VIHA is committed to working with local communities and sharing information. Access to patient care and service is, and will remain, our number one strategic priority. 

Royal Jubilee Patient Care Centre Takes Shape

Rapid progress is being made on the construction of the new 500-bed Patient Care Centre (PCC) at Royal Jubilee Hospital.  Concrete is being poured on the 8th floor.

To celebrate the 120^th anniversary of Royal Jubilee Hospital, then Health Minister George Abbott unveiled a commemorative cornerstone at a special ceremony in April – 120 years after the cornerstone of the original building was laid. The Minister also launched the collection of items for a time capsule to be included in the new building.

More than 80 percent of the patient rooms in the PCC will be single-bed rooms each with an ensuite bathroom and a family zone.  VIHA is working hard to create a safe and therapeutic environment with the needs of the elderly in mind.  The design is creating an environment with a residential feel, which will provide a comfortable healing space for patients and their families, and a safe, effective work environment for staff.

While construction of the new building moves forward, the design team has been working on the layout of rooms and shared areas by building a "Mock Up Suite" on Royal Block 5. This full scale representation includes inpatient bedrooms, a care team station, a clean and dirty utility room, and other common areas which will be found on each ward.

This process has involved VIHA staff and physicians from all levels and programs, who have identified key design features that should be included in the patient rooms. Over the past few months, the room design has been revised several times to reflect their input. A series of open houses will be held over the summer months to allow staff to check out the new rooms, and to continue to offer their suggestions and feedback.

Victoria General Hospital's New Emergency Department Nears Completion

Construction is almost complete on the new $18.8-million Emergency Department at Victoria General Hospital.  Extensive planning is underway to ensure a smooth transition to the new facility this Fall.

The new VGH Emergency Department is triple the size of the current facility and features:

• state-of-the-art equipment for trauma and paediatric patients;
• more patient treatment spaces with greater patient privacy;
• a separate paediatric waiting room and paediatric resuscitation room (which can also be used for adult trauma if required);
• specialized paediatric trauma equipment, and a "quiet room" for paediatric psychiatric emergencies;
• three separate entrances to better accommodate walk-in patients, patients arriving by ambulance and patients with infectious diseases who require isolation;
• the latest infection control standards;
• three new isolation rooms;
• separate waiting and treatment areas for ambulatory patients, to improve patient flow through the department and reduce "door to doctor" waiting time; and
• an improved working environment for health-care workers.

Renal Unit and Expanded Emergency Department approved for NRGH

In April, then Health Services Minister George Abbott and Nanaimo-Parksville MLA Ron Cantelon joined representatives from VIHA, the Nanaimo and District Hospital Foundation and the Regional District of Nanaimo to announce $46.3 million to double the size of the Emergency Department, build more treatment rooms and add a renal dialysis centre at Nanaimo Regional General Hospital. Work on the $36.9 million emergency department is slated to begin this summer.

The Emergency Department expansion will more than double the size of the existing Emergency Department from 963 square metres to 2,300 square metres, increasing treatment rooms from 24 to 41. The expansion will ensure the emergency room can keep up with patient demand. Currently 48,000 patients visit the department each year and this is  projected to increase to 56,000 by 2021. The project also includes new psychiatric services for patients at NRGH.

The full-service renal dialysis centre will be located on the first floor of the new perinatal wing. Work on the $9.4 million renal dialysis centre is also expected to begin this summer.

The provincial share of the $36.9 million for the emergency department is $20.1 million with the remaining funding coming from other sources, including the Nanaimo Regional Hospital District (NRHD) and the Nanaimo and District Hospital Foundation.

The cost of the renal centre is being split 60 / 40 between the Province and NRHD and includes $1.5 million for renal equipment. The first phase was completed in 2007 and cost $4.3 million to prepare the site for the centre completion.

VIHA's People Plan: A Catalyst for Change

The People Plan is accomplishing its goals of helping VIHA to recruit and retain staff through innovative strategies that address staffing shortages – a challenge facing health care jurisdictions throughout Canada – and the health authority’s approaching wave of retiring baby boomers.

Among 2008/09 highlights:

• A successful VIHA-sponsored health career fair attracted 1,400 visitors, sparked 300 enquiries and encouraged high school students to consider VIHA and health in their future career plans;
• New injury prevention coaches and mentor champions are supporting their peers in various program areas;
• A redesigned scheduling system is establishing more efficient and consistent staffing services and practices;
• Care Delivery Model Redesign (CDMR) is improving both patient care and the working environment through effective use of staff and resources; and
• VIHA has a new work force planning tool to predict the "who, when and where" of health professionals' need throughout the organization.

Reports Lead to Enhanced Infection Control Processes in VIHA

Two new reports, including one by Dr. Richard Stanwick, VIHA's Chief Medical Health Officer, is resulting in new processes and practices around infection control in island hospitals and care facilities.  

Following an outbreak of Clostridium difficile (C Diff) at Nanaimo General Regional Hospital (NRGH) that began last summer, VIHA commissioned two expert reports to provide recommendations on how to improve the health authority’s response to, and management of, the outbreak. The outbreak at NRGH was declared over on May 12. The first report, from the BC Centre of Disease Control, characterized the epidemiology of the outbreak and recommended additional interventions for NRGH specifically. All five recommendations in this report have either been implemented, or are in the process of being implemented.  

The second, broader, report was commissioned by the VIHA Board. Dr. Stanwick was asked to conduct an internal review of the NRGH C Diff outbreak and make recommendations on how VIHA could improve systems and processes around responding to in-hospital outbreaks throughout the health authority. Dr. Stanwick’s recommendations have either been implemented or are being reviewed.  The reports and VIHA's responses to the recommendations are available at: http://www.viha.ca/about_viha/news/publications/infection_control_processes_reports.htm.