It’s very gratifying to see so many staff suggestions coming our way. We continue to receive your questions but more and more we’re receiving great ideas about how we can deliver best care or improve efficiencies — or both.

Some of the solutions are already in the works. Some are new, and others are, quite frankly, long overdue.

Of course, some solutions are more difficult to implement than others, but that doesn’t mean we won’t pursue them. Take the staff question below as an example. It concerns transferring mental health patients from VGH to UBCH — a cumbersome, inefficient process today. And we’re working on it.

If you have a question or idea, email us.

For past Q & As, refer to our February 27 article and previously published submissions to VCH News-Vancouver.

Today’s answered question

Please note: The following question has been edited for brevity.

Q.  I am sure what I have to say is nothing new, but I wonder if the time is “right” to “re-think” past practices?  I am “pitching” this idea/operational improvement concept for 2 reasons: first, patient/client safety and, second, it fits with VCH’s drive for doing things smarter, more efficient in terms of people, resources and workload…without extra cost.

Challenge: VCH (Psych-ER/PAU or Health Centre) transfers to UBCH (Campus to Campus). Consider removing the old practice of “discharge” & “re-admit”, keeping it in line with moves from ER/PAU to Health Centre. Many efficiencies in workload could be saved:

• physician time writing TMOs or physically coming in for after-hour transfer orders
• nurses transcribing full set of orders; no new orders needed for just a “move”
• Pharmacy having to process, fill and dispense more of the same
• clerks and Medical Records dismantling and re-designing a “UBC-designated” chart rather than just using the existing VCH chart, complete with all the histories, processing orders, etc.

As I listen to the call for ideas to streamline/improve, especially in light of the surge efforts around Psych & ER, I think of my immediate work-related challenge of developing “workarounds” when a bigger fix would be “ideal.”

A. Your question is very timely. While it’s true that people have raised this question before — and with good reason — the CST Project makes this an opportune time to revisit our patient transfer practices. When the Cerner system is implemented, a patient will have one electronic medical record across VCH, PHC and PHSA. This will eliminate the need for separate charts and will go a long way to minimizing inefficiencies and reducing risks for error.

But changing patient transfer practices will also require changes in legislation governing our hospitals — current legislation treats VGH and UBCH as distinct, separate facilities, rather than as the “virtual single site” we aspire to be. Changing legislation depends on a number of factors out of our control, including when the Legislative Assembly is in session.

Having said this, we believe there’s hope. Providence Health Care has improved its patient transfer practices between St. Paul’s Hospital and Mount Saint Joseph Hospital by treating the two as a virtual single site. It wasn’t easy but we believe we can learn from them and have begun to do just that.

Resolving this issue will take some time, but please take heart that we’re working on it. Thank you for your efforts and we welcome more great ideas.