Inquiring minds want to know — and now they do!

Here, in our third installment, we answer five more questions staff submitted in advance or during Vancouver’s All-Staff Forum. Over the coming weeks we’ll continue answering your questions, and we thank you for your patience as we do our homework to give you accurate and thoughtful responses.

If you have a question about delivering quality health care services while tackling our budget challenge, email VancouverAll-StaffForum@vch.ca. Previously published answers can be read in our August 8 and August  1 articles, and information about our plans and direction are available in our interactive Vancouver Strategic Plan.

Today’s answered questions

Q.  As we close preventative programs, is it possible that we are moving deficit to another authority? Ex. Closing newborn hotline may increase visits to ER at children’s hospital which is not part of VCH. What are your comments?

A. Protecting patient/client safety while maintaining the long-term sustainability of essential health care services is our priority, and we believe we can do this within VCH and in concert with our health care partners.

Closing the Newborn Hotline in favour of HealthLink BC, for example, allows us to avoid an unnecessary duplication of service while providing parents access to preventative advice and support to keep babies healthy at home.

The Newborn Hotline was established in the 1990s (long before HealthLink BC existed), and it did not serve all VCH residents. Only VCH residents in Vancouver and Richmond had access to the hotline, while parents in the rest of our region have been calling HealthLink BC or their local health unit.

HealthLink BC offers many advantages for new parents: it is available 24 hours a day, seven days a week, and it offers support from nurses and other professionals such as dietitians and pharmacists. It’s also available for clients who require translation or who are deaf or hearing impaired.

Deciding to discontinue a service is not easy, but we do so with the best information we have at the time. Going forward we will monitor to determine whether there are any impacts on other programs and services within VCH and across health authorities.

Q. A lot of money is spent on car allowance, parking, and mileage. Would there not be some savings by having a vehicle at each team? This would be a short term expense but in the long run probably save money. This would also be an environmental benefit.

A. Actually, we’ve just begun looking into the cost/benefit of teams using shared VCH vehicles instead of individuals using their personal vehicles for work transport. We believe it may make sense for some teams to use, for example, the highly fuel-efficient smart car. We see the potential for economic and environmental benefits, but first we need to do our homework. Please stay tuned!

Q. Private practice psychiatrists are often inaccessible to our clients through centralized intake or to our clients graduating from e.g., MH Teams, VGH/SPH Outpt, EPI.  How is VCH addressing this utilization gap with the Ministry of Health and College of Physicians and Surgeons?  How can we access this resource?

A. Providing a seamless continuum of care benefits all patients and assists mental health and addictions clients in their journey of recovery. That’s why we’ll be consolidating inpatient and outpatient mental health and addictions services in the new Joseph and Rosalie Segal Family Health Centre scheduled to open in 2017. Regarding access to private practice psychiatrists, we are actively exploring with the Ministry of Health and the B.C. Medical Association how we can work more collaboratively to improve access for clients most in need across VCH and across the province. Work is underway but like all efforts involving multiple parties, formulating a practicable solution won’t happen overnight.

Q. How can you not change the quality of care when people are afraid to lose their jobs and consequently burn out through stress?

A. Protecting patient/client safety is a priority, and we know it’s yours, too. We’re confident that we can adjust without compromising the quality of care for three important reasons:

1. We’ve done it before, and we’ll build on our success. For five straight years — from 2005/06 to 2009/10 — Vancouver ended the year with a deficit. In other words, we spent more than we had. In 2009/10, our deficit reached $12.4 million. But, thanks to a lot of hard work and innovation on the part of staff and physicians, we turned this situation around. In fact, we not only transformed Vancouver’s financial position, we enhanced our quality of care and services at the same time, as evidenced by our recent Accreditation Canada results (read the story here). We met an unprecedented 98% of the almost 2,300 criteria evaluated. In the surveyors’ own words, VCH achieved “outstanding compliance, proving itself as one of the very best organizations in Canada for integrated health systems”.
2. Staff have told us they’re motivated to help. During the Vancouver All-Staff Forum on July 25, we polled participants about helping us move forward to deliver quality care and balance our budget. The majority — as high as 73% — said: “I feel really motivated. I can’t wait to help.”
3. We have faith in our people. We were pleased but, quite frankly, not surprised that most staff said they’re motivated to help us achieve our goals. We have a proven record of innovation and a stellar accreditation rating — thanks to the ingenuity and dedication of our people.

Together with your help, we’re confident we can continue delivering quality care, even enhance care and services, and operate within our budget. Having said this, we also recognize that living with uncertainty and adjusting to change can be difficult, and we encourage anyone who feels that they could benefit from counselling support to consider contacting the Employee and Family Assistance Program.

Q. In Emergency, is data collected from patients and families about what patient supports would help them to not need to come to Emergency?

A. All VCH Emergency Departments (EDs) participate in a provincially standardized survey: the Patient Experience Survey (read our July 2013 results). The survey is mailed out to individuals who visit the ED and responses are collated and shared with departments each month. Among the survey questions, people are asked if they tried to access other health services prior to visiting the ED. The survey does not ask what services could be provided that would prevent the use of the ED.

Prior to launching our regional ED Wait Times public website, a small study of the reasons people choose to visit the ED was conducted. The most predominant factors were proximity to home and convenience. Again, this survey did not specifically ask what would need to be available to prevent admission, but data for Canada shows a strong correlation between low availability of GPs outside standard office hours and ED use. The ED Wait Times website provides the public information related to ED wait times, but also the services offered, when to visit and available options, including other EDs. The goal of this site is to mitigate ED demand and, when possible, divert cases to less congested EDs.

A new initiative under development for the VGH ED will involve conducting rounds on ED patients likely to be admitted but could be discharged home with added supports. The goal is to reduce inpatient admissions through the ED and to more effectively support individuals in their homes.