Dr. Eric Grafstein is a curious man, which always served him well. It is curiosity that led him to submit a proposal to the SSC’s Quality and Innovation (Q&I) Initiative to pilot a project to make physician telephone consultations available for more urgent calls – considered ‘red calls’ made to the HealthLinkBC 8-1-1 line. He was curious to know if adding a physician would reduce the number of ‘red calls’ ending up in the emergency department (ED). SSC funded the five-month pilot through the Q&I Initiative.
Physician Quality Improvement (PQI) (previously called: Regional Quality Improvement) is an SSC-funded initiative that provides $1.3 million annually to each health authority to support physician involvement in QI. The initiative supports physician participation in QI activities through QI training and completion of a QI project. Although the focus of PQI is to increase physician involvement – many people can participate and benefit. Anna Hwang, a recent graduate of SFU is one such person.
It was one particular moment in medical school that propelled Dr William Siu, President of the BC Radiological Society, to venture into the field of Radiology. “While attending rounds as a senior medical student, I was blown away by what I saw an Interventional Radiologist do for a particular case – a case that highlighted the cutting edge and futuristic potential of Interventional Radiology. This was what led me to choose Radiology for my residency.”
Inspired by a TED Talk, Dr. Marilyn Thorpe, a Victoria psychiatrist working through the University of Victoria (UVic) Health Services began the Psychiatrist-led Interdisciplinary Team (PIT) project. Funded by SSC, a 30-minute PIT appointment is structured to incorporate the family doctor’s knowledge of and experience with the student-patient and a psychiatrist’s immediate assessment and care planning. If a more comprehensive review is needed, full psychiatric consultations are scheduled.
As part of SSC’s strategy to support physician engagement, SSC is funding and partnering with each Health Authority to help build physician quality improvement (QI) expertise and leadership skills through the Regional QI Initiative. The Physician Quality and Regional Safety Team (PQRST) at Fraser Health (FH) was the first to get going in April 2015. More than a year later, the first PQRST cohort has completed an evaluation of their activities, gaining some impressive results and learnings.
About 400,000 people in BC suffer from diabetes. While the disease sounds simple – high blood sugar – the long-term complications are not. Those complications include heart disease, chronic kidney failure, eye damage and circulation issues, and have a major impact on BC’s health care system.
The SSC’s mandate is to facilitate collaboration with Doctors of BC, the BC government and BC’s Health Authorities on the delivery of specialist-physician services to British Columbians and supports the improvement of the specialist care system. But the big question is “how”?
In the words of Sophocles, “no one longs to live more than someone growing old.” Thanks to medical advances over the last decade, nowadays it seems living longer is inevitable. But with longevity comes an aging population – one that encounters health problems typically specific to older adults. That’s where Geriatricians come in.
Did you know that a health crisis requiring a trip to Emergency (ER) may include being shackled and escorted by police? That’s what can happen when it is a mental health crisis that occurs in public, usually with vulnerable populations, such as the homeless. Recognizing this issue, Dr. Matthew Chow, a psychiatrist with Providence Health teamed with Inspector Howard Tran of the Vancouver Police Department to determine a better response and treatment approach.
For more than a year, 11 BC surgical sites across all health authorities worked together as the BC Enhanced Recovery Collaborative to improve patient recovery after colorectal surgery by implementing 21 evidence-based processes of care. Compliance to these processes resulted in reducing complication rates from 32% to 22% and shortening hospital stays by two days without affecting readmission rates.
Dr Martin Fishman, President of the BC Society of Gastroenterology, became interested in his specialty for two main reasons: “Because it offers a balance between cognitive and procedural work, and because I had great mentors.”
Dr. Carolyn Shiau, a pathologist working out of Royal Columbian Hospital (RCH) was tired of hearing “because that’s the way it is always done” when looking to make improvements. In April 2015, she joined the Physician Quality and Regional Safety Team (PQRST) – an initiative funded by SSC to support physician engagement through quality improvement in Fraser Health.
About 400 people registered – including 80 specialist physicians. They all took part in the first ever Joint Collaborative/Clinical Committees (JCCs) Showcase this February in Vancouver. Participants shared the successes and lessons learned from the range of collaborative work being done in partnership with Doctors of BC, the provincial government, health authorities and local communities
For most, spring means blooming flowers and blossoming trees. But for the 20% of the population who suffer from allergies, the season means sneezing, congestion, itchy eyes, even asthma. While many allergies can be controlled with the occasional use of an over-the-counter medication, some can interfere with day-to-day activities, can decrease a person’s quality of life and in certain circumstances even be life threatening. That’s where an Allergist or Immunologist comes in.
Diversity is great for our eco-system. The same can be said for our health care system – diversity makes it stronger. Recently, a diverse group of specialities came together for a learning session in Victoria. The specialities are embarking on a Quality Improvement (QI) project that will enhance access to specialist consults through centralized referrals across five specialities from different BC regions.
Desire – it’s the key ingredient to make change happen. The Enhanced Recovery Collaborative is a collection of physicians, nurses, administrators, and allied health care providers with the desire to build the Enhanced Recovery capacity in BC’s surgical programs. Enhanced Recovery protocols are multi-modal perioperative care pathways designed to achieve early recovery after surgical procedures.
The mind is the most complex part of us. And while we can pinpoint the origin of illness in practically every organ of our body - psychiatrists are more challenged. How do they locate a mood, thoughts or what drives behaviour?
It took two external evaluations, along with consultations with individual specialists, two-thirds of the specialist sections and a number of other stakeholders to identify ways to improve the SSC fees. The enhanced fees focus on increasing Specialists' capacity, improving coordination of care, and improving patient access to Specialists’ expertise. The fees become a reality in the next month or so.
SSC approved the funding of over 30 projects through its Expression of Interest process. Recognizing that big changes can come from small ideas, SSC is supporting physician- driven ideas and prototypes that have the potential for broader health system impact. $15M has been put towards supporting and growing specialists’ quality improvement ideas.
We’ve seen television shows like ER glamourize the life of an emergency room physician. Depicting a scene of coordinated chaos in which everything – more or less – always goes according to plan. But the reality is much different. From minor cuts and bruises to traumatic life and death situations, ER physicians never know what will come through the doors. Every shift and every patient is like a game of chance.
Therefore, ER doctors must be prepared for all situations and be able to function under some of the most extreme circumstances – all while performing at the top of their game.