VGH Chest Centre makes history with iCARE & ITH
The VGH Chest Centre is making history. The centre’s team is the first to apply our award-winning model of care — iCARE & ITH — on a surgical unit. And everyone — yes, everyone —benefits.
“A win-win is rare in any sphere of activity,” says Dr. John Yee. “A triple win is even rarer, but iCARE and ITH clearly supports improvements in quality of care, the in-hospital patient experience and cost-efficiency,” says the thoracic surgeon. “It’s an actual, real-life example of a win-win-win for patients, the care team and VCH.”
Lynn Paddon agrees. The patient services manager for the Respiratory Medicine and Thoracic Surgery unit admits feeling nervous excitement on day one of implementation — with emphasis on the word excitement.
“It’s a compliment, an honour, really,” she says. “We’re leading the way for Vancouver’s surgical units, and our experience will enrich expansion to other surgical units going forward.”
Focused, practical and efficient rounds
Consistent with our Home is Best philosophy, iCARE & ITH helps patients resume their lives at home safely, better informed and with the supports they need. For staff and physicians at the VGH Chest Centre, this is a particular concern.
“Many of our patients have complicated discharges,” explains Lynn. “And as a provincial referral centre, our patients can come from anywhere in B.C. Achieving a smooth discharge and connecting our patients to the services and care they need in their home community is essential.”
Daily rounds are central to delivering quality care and discharge planning, and these meetings were already part of the unit’s practice. But with iCARE & ITH, Lynn and others say daily rounds are more inclusive, better focused and more goal-oriented.
“I see a tightly structured daily meeting that brings together our team of caregivers for a focused, practical discussion of patient needs, whether they be medical, surgical, pharmaceutical, rehabilitative or social,” says John. “Problems are identified and a timeline for resolution is set. The daily goal is to meet patient needs and lower the risk for re-admission by improving communication among the in-hospital team, and between our team and the community caregivers throughout the province.”
Alyson Chin, nurrse practitioner, says she appreciates the new focus, and how everyone has an opportunity to speak. “Our surgical patients have very predictable clinical pathways,” she says, “but for those cases that go sideways, iCARE rounds are particularly useful in getting them back on track.
“Now, we can see more of a light at the end of the tunnel for those long length-of-stay patients. Now, I can see them returning home,” she adds.
A safe return to the comforts of home
Before discharge, Alyson or fellow nurse practitioner Lisa Kolkman will teach the patient about the signs and symptoms of his or her condition and how to manage them. And, each patient returns home with a personal My Discharge Plan providing information onfollow-up tests and appointments, community health providers and other medical care resources.
Priscilla Sin, care management leader, updates the family physician, arranging for an appointment within 48 to 72 hours of discharge. “Before,” says Priscilla, “when patients left the hospital, they left our caseload and there was no follow through. With iCARE and ITH, I follow up with the GP, community providers and the patient.
“It feels good knowing that patients will be OK at home,” she says. “There’s no need to worry and wonder if they’re having any problems because the goals of care established in hospital will be carried through in the community. Patients, families and staff are more comfortable knowing that the transition from hospital to home is smooth and safe.”
By helping patients return — and stay —home, we’ve freed 40 medicine beds per day. With the VGH Chest Centre leading the way, we’ll free more beds for surgical patients in need.
“Not only is iCARE and ITH a great tool for quality assurance and quality improvement, but it will also help drive efficiency and accountability — all in real time,” says John. “In an era of scarce resources and increasing demand, iCARE and ITH will help us treat more patients even better.”
Watch our video (with staff outtakes) to learn more about iCARE & ITH, or check out the initiative’s page on VCH Connect.