An open letter from Kip Woodward

For the past four years, I have written in The Vancouver Sun at this time of year with a brief look at what the past 12 months have been like for Vancouver Coastal Health (VCH) and the million-plus people we serve. It has also been an opportunity to take a look at what might lie ahead, not just for us but our health system.

We provide care and support to Vancouver, Richmond, the North Shore, the Sunshine Coast, Whistler, Squamish, Bella Bella and Bella Coola. Our services are as diverse as the communities we serve.

One of the key benchmarks for health care services is what happens in hospital emergency departments (EDs). Last year, ED visits were up four per cent across VCH. In 2012? Up four per cent. 2011? Four per cent. This year? Another four per cent.

Demand is rising, but rising consistently. Thankfully, the inspiring, committed front-line ED staff and doctors are handling that demand. They’re using their experience, practices, and outcomes to produce the innovations that make our health system better.

Of the patients who required admission to hospital from the ED this year, over 60 per cent were admitted within 10 hours — better than the provincial target of 55 per cent. Despite the increase in ED visitors, our admission rate was down 11 per cent. No, people aren’t being turned away or not receiving treatment. What’s happening is that VCH is increasing the effectiveness of the community services, facilities, and supports that help people stay out of hospital. The same holds true for the average length of stay. Down four per cent across VCH acute care and 5.4 per cent in mental health, the reduced length of stays is indicative of our efforts in securing earlier alternate treatment options for those who need them.

2014 may turn out to be a milestone year for VCH mental health facilities and programs. The HOpe Centre brings together clinicians and programs into a single, central location on the grounds of Lions Gate Hospital. In addition to in-patient psychiatry, the facility will include outpatient clinics, the Djavad Mowafaghian UBC Medical Education Centre, a clinical research trials unit, and a permanent home for B.C. Ambulance Services.

At Vancouver General Hospital, ground breaking occurred for the Joseph & Rosalie Segal Family Health Centre. Designed with input from mental health patients, families, health care providers and trauma care experts, the centre will support the transformation in the delivery of mental health care when it opens in 2017. Both of these projects were enabled by the generosity of two individuals who recognized mental health is a disease still marked with stigma and isolation.

This year marked the creation of the Assertive Outreach Teams at VCH, which bring a nurse, social worker, psychiatrist, physician and Vancouver police officers together to support people with severe addictions and mental health issues in order to transition them from local EDs in Vancouver to appropriate community services. This joint initiative with the VPD has reduced the amount of repetitive visits to key ERs by “frequent flyers.”

Also in Vancouver, our primary care redesign and expansion of youth services saw Raven Song Community Health Centre officially open its High Needs and Stabilization Clinic. The clinic refocuses VCH’s primary care resources on our most vulnerable and highly marginalized clients to provide better access to home care, public health and mental health and addictions services, and will result in improved health outcomes and fewer emergency department visits. Youth will also benefit through walk-in or pre-booked primary care appointments, plus direct access to social work, counselling, and mental health and addictions services.

And the year ahead? While VCH is on track to meet budget expectations — a critical achievement in an era of unrelenting pressure on resources — cost pressures are sure to provoke more discussion and debate. Demand in mental health and addictions, community care, and technology-based services will continue to rise. Access to Primary Care services will remain an important opportunity for improvement while incentive-based funding is becoming more widespread. Experience shows it can improve service and access for many procedures while containing costs.

We’re also likely to see broader discussion on electronic medical records and how to make them portable while preserving personal information and security in a digital world. VCH and our partners in government, Providence Health and the Provincial Health Services Authority, are working toward this as part of our Clinical & Systems Transformation project.

While it’s rewarding to note some of our achievements, we know we can always do better. The demands and expectations of our health care system are very high, but it’s a dynamic that brings out the best in our skilled and dedicated employees. It’s also a dynamic that lets us know — should any of us require health care services today, tomorrow, or in the new year — that we are in skilled, professional, and caring hands.

Kip Woodward is chair of Vancouver Coastal Health.

The above was published in the December 22, 2014 edition of the Vancouver Sun.