BURNABY HOSPITAL MSA
2020-2021 ANNUAL REPORT
Coming together is a beginning, staying together is progress, and working together is success -Henry Ford
2
CONTENTS 4 MSA PRESIDENT'S MESSAGE 5 SITE MEDICAL DIRECTOR'S MESSAGE 6 EXECUTIVE DIRECTOR'S MESSAGE 7 MESSAGE FROM THE FOUNDATION 8-9 STRATEGIC GOALS 10-15 AREAS IN FOCUS 17 FACILITY ENGAGEMENT 18 FACILITY ENGAGEMENT 17-20 PROJECT HIGHLIGHTS 21 ALIGNMENT AND OPERATIONS
10 COLLABORATION & PARTNERSHIP WITH HEALTH AUTHORITY
22 COMMUNICATIONS 23 QUALITY IMPROVEMENT 24 EDUCATION AND LEADERSHIP 25 INFORMATION TECHNOLOGY 26 WELLNESS 27 THE PEOPLE BEHIND OUR MSA 29 FINANCIAL HIGHLIGHTS
MSA
14-15 REDEVELOPMENT
12-13 PERSEVERANCE
The objectives of the Medical Staff Association (MSA) include the promotion and advancement of medical staff involvement in the provision of the organization’s medical services and to represent and advocate for the interests of the Medical Staff.
MEDICAL STAFF ASSOCIATION OF BURNABY GENERAL HOSPITAL The MSA activities are funded from two primary sources: Collection of nominal dues from Medical Staff members. Support from the Doctors of BC Facility Engagement Initiative.
The MSA and Fraser Health Authority are partners and work together to provide quality patient care by collaborating in a proactive and supportive workplace environment.
3
PRESIDENT'S MESSAGE DR. PAUL JOHAR
My fellow medical staff members: Welcome to our 2020-21 Annual MSA Report. Within these pages, we aspire to provide you with an informative overview of the activities of Burnaby Hospital Medical Staff Association this past year. I hope you find this document both illuminating and inspiring. Suffice to say, our hospital and our staff have undergone considerable stressors this past year. COVID-19 has pushed us as individuals and our collective system to the limit. Furthermore, the 2020 Cascade fire decimated key parts of our hospital infrastructure and continues to have ramifications. Through all of this, our spirit and our will may have bent, but it did not break. Our medical staff, our leaders, and our partners in care have shown resilience and adaptability. We have stepped up to the proverbial plate again and again. We have done our best to provide quality patient care and support one another.
"Through all of this, our spirit and our will may have bent, but it did not break." Each one of you has contributed in some way to these efforts, and for that, I thank you. To paraphrase a sailing quote, “rough seas test the mettle of a ship better than calm seas”. We have been tested and we have shown the strength of our hull. We have shown that our steel and rivets are strong. We have held fast. As we now look forward, we will use our collective and individual strengths to confidently navigate our future, using our vision as our “true north”: Engaged Medical Staff Providing Exceptional Patient Care. There is exciting and important work to be done: How do we adjust to a COVID-19 endemic? How do we optimally redevelop Burnaby Hospital? How do we thoughtfully integrate I.T. initiatives? How do we smooth transitions in care? How can we become more inclusive and diverse? How can we further build wellness and resiliency? How can we improve the quality and experience of care? These and other questions await us. We have been tested and we are ready to search for the answers...together. Sincerely, Paul
4
SITE MEDICAL DIRECTOR'S MESSAGE DR. SARAH OSTLER Finally, with the steady supply of vaccines, there is light visible at the end of the long and winding pandemic tunnel. Reflecting on the many accomplishments and contributions of Burnaby Hospital’s medical staff during this 15-month journey, I would like to express my profound appreciation for your excellence in leadership and quality improvement and for the Burnaby Hospital culture. The pandemic highlighted the essential role physician leadership plays in our healthcare system and physicians stepped into many new leadership roles, such as pandemic planning, vaccination leads, simulation development, surgical rescheduling, and bed access and patient flow. It was amazing to see how rapidly physicians developed a medical emergency team (MET) that enabled Burnaby ICU to grow and accommodate the need for regionally expanded ICU capacity. In addition, with COVID outbreaks on the patient units and the additional impact of the Cascade Building fire, physicians adapted and joined administration to create the lateral transfer process. Now, when hospitals are suddenly faced with significant bed capacity challenges, we have a process to move patients to another facility to enable them to receive timely care. Our process is now being used throughout the region and will continue to improve and benefit patients. I am so proud of this legacy of our pandemic. It was a pivotal point for us. Burnaby physicians have shown themselves to be leaders and I am excited to continue the collaboration and continuing education opportunities such as the Insights Discovery and Women in Leadership courses. I look forward to bringing more Burnaby-centered leadership courses to our site. Before the start of the mass vaccination clinics, Burnaby hospital provided the most first dose vaccinations in all of Fraser Health. In addition, we rapidly adopted the use of virtual health, for example in the preoperative assessments, and further continued to discover areas where this method of patient consultation can be incorporated. Both our vaccination clinic and the use of virtual consultations are examples of Quality Improvement in action. Physicians are uniquely placed to do such Quality Improvement work: they work on the frontline, are in direct contact with patients, and have a clear view of the changes that need to be made in the system. My vision is that all Burnaby physicians will develop a basic understanding of quality improvement. Teaming with the PQI (Physician Quality Improvement program) we are developing “B-QI” (Burnaby Quality Improvement) here. There are opportunities to take online funded courses, to attend more advanced courses as part of a Burnaby team, and to join a regional course. Currently, there is funding for your time and CME credits. We are known for our positive, supportive and collaborative culture. It makes us stand out from other hospitals and attracts and retains physicians. An example that stood out for me in the last year was the shared care management of high acuity COVID patients among ICU, hospitalists, and internal medicine on our medical wards, which enabled the optimization of ICU capacity and again, has been replicated throughout our region. We need to be aware of how special our culture is, support and foster it and take it with us to the new building. I am so moved by the commitment, hard work, and perseverance of everyone at Burnaby Hospital. Special acknowledgment of the incredible dignity and grace the members of our surgical team have demonstrated and continue to demonstrate in dealing with the constant changes and adjustments to their schedules and surgical slates. Also, a huge recognition of our mental health team who on top of everything else lost their workspace as a result of the Cascade fire. In these exceptionally difficult conditions and while they work on developing an inpatient space they continue to provide excellent care. I am deeply grateful to all for your commitment and involvement during this time of incredible change and growth. Thank you.
Sincerely,
Sarah
5
EXECUTIVE DIRECTOR'S MESSAGE LEANNE APPLETON On behalf of our Burnaby Executive Director and Director Team 2021/2022 Highlights – Advancement, Innovation, & Compassion We are fortunate to have such incredible support & leadership from our Medical staff during this Pandemic year. The medical staff participated in early morning and evening meetings to discuss how we responded to Wave 1, 2, and 3. Frequent phone calls were answered during weekends or statutory holidays to improve our Patient Access and Flow, and physicians saying “call me or text me anytime” and were available to discuss the challenges of the pandemic and how to improve together. Advancement There were countless examples of advancement through this partnership together. The expansion of our ICU beds to 15 from nine to support the Region with the critical care demand during Wave 3 and the development and implementation of the MET are such examples. Our ICU team and the success of the DCD Program has led to an increase in organ donations here, and increase in referrals to BC Transplant, and our BH donation program represents the collaborative efforts of multiple departments from the OR to Anesthesia, ICU, nursing and allied health. Our 3B/3D Covid Cohort Units, with the important Hospitalist and ICU collaboration, and upskilling of the nursing team & RTs maintained a high acuity level of care for patients with Airvo/Optiflow outside of our ICU. The adversity we faced with the Cascade Fire, and now the construction of the Interim Inpatient Psychiatric Unit on 4WA will be ready soon. The commitment of our MHSU team is remarkable with many medical staff and staff being so flexible in working in other locations in the region for the interim. Innovation Our BH Clinic team vaccinated over 16,000 staff, medical staff and members of the public with their first doses of Pfizer & Moderna. Many of our physicians picked up shifts working in our clinic with their beaming smiles, on top of their normal working hours. The Burnaby Division of Family Practice, who in a number of weeks set up the Covid 19 testing drive-thru site at Central Park and was so successful for an entire year. With vaccination in high gear, an even larger location at BCIT was required. Our Emergency Team for the duration of Waves 1 thru 3 imbed simulation into their practice and adapted to each wave which presented its own unique challenges. The genesis of a new Emergency patient lateral transfer process was developed for decompressing our hospital after the Fire and during the height of the covid-19 inpatient outbreaks. This has now become a regional protocol. Virtual Health and our surgical and anesthesia team was nimble and innovative in shifting to virtual health visits within Pre-Admission, as well as other outpatient areas (Cardiac Rehab, Outpatient Rehab, MS Clinic, and Diabetes as other examples). Compassion Hundreds of Burnaby School children made incredible art to say “thank you” and a short video. We appreciate the significant and selfless devotion our medical staff and staff have maintained over this past extraordinary year. Advancement, Innovation, Compassion in action equips us well in this partnership in how we conquer new challenges together this year and the many exciting years ahead. Sincerely,
Leanne
6
MESSAGE FROM THE CHIEF EXECUTIVE OFFICER OF BURNABY HOSPITAL FOUNDATION KRISTY JAMES
As I write this note, and as I reflect on the past year, I find myself feeling extremely grateful to be here, at Burnaby Hospital. The fire that ignited just steps from our office might have changed everything Burnaby Hospital Foundation has been working on. So might have the pandemic that continues to challenge us all (none more than you). But because of the heroics of those who care most about this hospital and this community – firefighters, volunteers, medical staff, support staff, donors, and of course, our physicians, the Foundation has been able to make significant progress in our goal to raise $30 million in support of the facility’s redevelopment.
I’m excited that we are now so close to finally having a modern health care campus with the upgraded technology and equipment you need to continue providing outstanding care. I want to express my thanks to you, the doctors of Burnaby Hospital, who have sacrificed so much for us over the last 14 months, working countless, stress-filled hours in a hospital that hasn’t had a major upgrade in 40 years. And I’m excited that we are now so close to finally having a modern health care campus with the upgraded technology and equipment you need to continue providing outstanding care. Our doctors have always been our leaders, and that is why I’m overjoyed, but not surprised, by the physiciangiving program now being championed by the MSA: Physicians for a Bright Future. Under this banner, we have the opportunity to raise another $1 million toward the redevelopment, and the early participation we’ve already seen has proven once again how much you care about your patients, each other, and the wellbeing of our community. If you haven’t yet had a chance to learn about the program, I encourage you to visit bhfoundation.ca/doctors. Thank you, once more, for all that you do. Warm regards,
7
STRATEGIC PLAN 2020/2021
Engaged medical staff providing exceptional patient care.
VISION
The MSA strategic plan
STRATEGIC GOAL #1
was initially developed in
Improve professional and collegial
2016
communication with Health
by
group.
the
The
working
goals
and
activities
are
evaluated
annually
to
determine
progress.
The
plan
a
in
is
key
guiding
decisions evaluating changing
strategic tool
day-to-day
and
also
progress
for and
approaches
when moving forward.
Administration and other medical staff
Develop the MSA website to improve communication to/from Physicians MSA Executive to continue to develop and maintain working relationships with local Health Administration Working Group, Subcommittee Leads, and/or frontline line Medical Staff to develop and maintain working relationships with Local Health Administration
Advance broad and meaningful physician relationships that serve to enrich interphysician communication and better unify the voices of Burnaby Hospital physicians.
MISSION
Institute evidence- based patient care initiatives that enhance quality, safety, satisfaction, and/or value. Develop a constructive partnership with local and regional administration that seeks to create, improve, and maintain effective and efficient healthcare delivery at Burnaby Hospital.
8
Foster relationships with community healthcare providers and other stakeholders that serve to heighten patient care via education, coordination, and collaboration.
STRATEGIC GOAL #2 Promotion of culture that supports appropriate medical staff advocacy for both patients and changes to Health Care
Develop an open-door program for discussion with MSA leadership to discuss issues of concern Conduct regular MSA forums to discuss and disseminate MSA values, attitudes & behaviors that are important to each member Providing MSA members with leadership opportunities/courses
Have regular MSA attendance at
STRATEGIC GOAL #3
HQOMC, MHCC to identify potential projects / issues that would benefit
Participating in significant decisions that affect
from MSA involvement. Continue to improve the Project Application process to ensure early
medical staff and the
and regular Local Administration
delivery of services
involvement for appropriate projects Increase participation in Medical Staff led initiatives in collaboration with the Health Authority
STRATEGIC GOAL #4 Advocating for a culture of wellness, and supporting initiatives that create a healthy, resilient and valued community of medical staff in Burnaby Hospital
Conduct wellness workshops to provide Medical Staff with tools to deal with workplace/daily stressors Communicate to Burnaby Hospital medical staff about educational activities and team building events, in order to inspire participation
9
AREAS OF FOCUS THREE KEY AREAS OF FOCUS WERE HIGHLIGHTED THROUGHOUT THE YEAR IN ORDER TO MEET OUR STRATEGIC PRIORITIES: FRONT LINE PERSPECTIVE ON A FIRE COLLABORATION AND PARTNERSHIPS WITH THE HEALTH AUTHORITY REDEVELOPMENT
AREAS OF FOCUS
COLLABORATION AND PARTNERSHIP WITH HEALTH AUTHORITY Burnaby Hospital’s MSA leaders and members continue to advocate for and work towards the strategic goal of participating in significant decisions that affect medical staff and the delivery of services. As communication & engagement is a key area of focus for the MSA, it is imperative to start with a shared understanding of the term ‘engagement’. Engagement is a nuanced concept with varying levels along a continuum. Effective organizational engagement is predicated on clear and aligned expectations, ideally agreed upon between stakeholders at the beginning of the engagement process. The IAP2 engagement framework below, adopted by the Ministry of Health/Health Authorities – Doctors of BC Joint Clinical Committees, offers a tiered approach to specify the level of participation and degree of decision-making influence for those affected by a decision. A generally accepted principle of engagement is for stakeholders to aim for higher levels of engagement when there are higher levels of impact expected as a result of organizational decisions.
2
The goal is to increase meaningful physician involvement in health authority decisions about their work environment and the delivery of patient care. How are we using this framework? Key ways in which we are integrating this framework into the work of BUH MSA include: Presentations for Fraser Health colleagues (e.g. at the BUH MSA Working Group meeting and Fraser Health MSA Presidents’ Council) to raise awareness of the value of this framework and offer suggestions for its application Application of this framework across the Burnaby MSA Subcommittees Integration of this framework into planning meetings at BUH (e.g. Redevelopment) as well as for Region-wide projects (e.g. MEDITECH Advance) Dialogue with our HA partners to resolve any divergent expectations regarding the level of MSA engagement within the context of specific decisions to be made The intent is to continue embedding this framework into future MSA activities as applicable.
11
AREAS OF FOCUS
FRONT LINE PERSPECTIVES It's been a challenging year and the BH fire has impacted various departments in our hospital in major ways. Thank you to the following MSA Members, BH staff and Foundation for sharing their experience and perspective with us: Gail Baker (Housekeeping) Kristy James (Foundation) Dr. Bal Khosa (Psychiatry) Dr. Neil Long (Emergency) Dr. Anna O'Malley (Emergency) Dr. Patrick Oxiano (Emergency) Dr. Ryan Uy (Hospitalist) Dr. Galina Vorobechik (Neurology)
HOW DID THE FIRE IMPACT YOUR DEPARTMENT? AO: We often do hear alarms, but work continues and it doesn't usually escalate more than that. It started to feel quite real when we smelled smoke in the Emergency Department as the hallway was filled with smoke. Fire arrived quickly and responded right away by instructing us to close all doors to the ED. Many things came together very effectively. The PCC got a list of all patients, staff, physicians and nurses to prepare for us in case of evacuation. PO: Immediately, there was some worry among staff in the ED around the safety of staff/patients already admitted to the hospital. We had all the confidence in the fire fighters to control the situation and at least alert us to evacuate if necessary. The charge RN and myself reached out to the admin for permission to divert EHS away from the hospital. Our charge RNs definitely dealt with the situation with appropriate calmness, which is important to portray in times like this RU: I was on the evening shift taking a ward call on the 5th floor of Cascade around 9:30-10pm. After assessing the patient I started smelling a hint of smoke. Very soon it became clear that the smoke was coming up from the stairwell. As the smoke got worse, we started moving patients, at first to the other side of the ward to get them as far from the smoke as possible. Eventually anyone who could walk and go down the stairs were being evacuated outside the building.
12
GB: We lost our housekeeping office space and a lot of equipment with it which affected the way we work in many ways. COVID has already caused work overload and the fire added to that. KJ: The significant fire that closed the Cascades building and nearby offices at Burnaby Hospital, including those occupied by the Foundation, certainly compounded the challenges of an already very difficult year. GV: The Neurology department was totally closed due to the fire for a few weeks and we had no idea if anything was damaged. We have been conducting clinical trials and we have quite a bit of sensitive clinical equipment too. Luckily nothing was badly damaged and when we returned several weeks later, the office actually sparkled. I have never seen the office so clean before.
We do the best that we can and we can overcome any challenge because that's who we are and that’ s how we roll. Gail Baker Housekeeping
Heroes are...the people who repeatedly show up knowing that there is danger.
The fire was an interesting acute event in the context of the pandemic. But it’ s really the wear and tear of COVID that has the larger impact. Dr. Patrick Oxiano Emergency
GB: In housekeeping, we sometimes feel under appreciated because we’re not often recognized. But we enable the rest of the hospital to function, if we don’t do our job properly, nobody else can do theirs. GV: With the closure of the neurology clinic, we had major IT issues such as faxing for referrals and signatures for prescriptions. With the help of IMIT we were able to convert to electronic fax and create an esignature. We also had to call every pharmacy to ensure that they would accept our signatures. COVID and the fire has helped to get us into using more technology and make IT adjustments and improvements. Sometimes we need challenges in our lives that push us to do things better.
WHAT WERE SOME OF THE BIGGEST CHALLENGES AND HOW WERE THEY OVERCOME?
AO: It’s been a lot through the whole pandemic. There have been lots of challenges, and the fire was just another thing. It was a surreal experience that doesn’t happen very often at BH. But it also showed that people can come together and rally. Tuning into Dr. Ostlers Tuesday meetings, being present and banding together really helped.
PO: Flow was the biggest challenge. During the code red, there was no movement of patients out of the ED and we had no room for incoming patients once we were at capacity. Therefore, the calls for diversion and eventual closure of the ED were appropriate.
KJ: Having just launched our Proud History, Bright Future Campaign in support of the campus redevelopment, the fire, in addition to the pandemic, threatened to stall our early momentum and make our fundraising efforts more complicated for a myriad of reasons. But inspired by our brave medical staff fighting COVID-19, we knew we must press on in our mission with determination and perseverance. The most important thing is that along with hospital personnel and patients, our staff were all safe and well. We went back to working from home, and eventually were able to arrange for temporary off-site office accommodations.
Dr. Neil Long Emergency
BK: Our biggest challenge is having our entire Psychiatry department completely displaced. Our department had 28 inpatient beds, seclusion rooms and offices. We lost our entire outpatient department as well. Although we are able to transfer people immediately within FH, it’s not ideal for patients.
Redevelopment will give us an pportunity to take care of more people that need inpatient care" Dr. Ryan Uy Hospitalist
WHAT CONTINUES TO BE CHALLENGING AT THIS TIME?
BK: Being displaced has continued to be a challenge for the Psychiatry department. We have continued to do consults in the ER and transfer patients that need to be admitted to other hospitals. We are looking forward to the opening of 4 West which will be a 21 bed space for us until the new site is developed. It will be nice to have the ability to provide safe and effective care again. NL: Our biggest continual challenge is access and flow. The department runs very efficiently when there are empty beds, but runs into access issues when there is a surge in patients. PO: The fire was an interesting acute event in the context of the pandemic. But it’s really the wear and tear of COVID that has the larger impact. GV: Our continual challenges are more due to COVID than the fire. Virtual patient care continues to be an adjustment. We really cherish the in-person patient appointments and prioritize acute/critical patients for those slots. GB: Supplies vs demand on housekeeping continues to be a challenge. We are still trying to recover from the loss of equipment due to the fire. Staffing shortage is still a challenge too.
While the fire hasn’t made the past several months any easier, I must reiterate that we did not let it get us down, and we most certainly did not give up. We once again readapted our processes, and we have pressed ahead with our campaign, successfully raising $18.5 million of our $30 million goal so far. The need for an updated facility has never been in question, but I think this year and recent events have taught us just how vital our community hospital truly is. Kristy James Foundation
WHAT DID YOU LEARN ABOUT YOURSELF AND YOUR CO-WORKERS THAT SURPRISED YOU THIS PAST YEAR?
BK: The amount of resilience among my colleagues. Their display of hardwork and willingness to work outside the box to adapt to the situation was motivating to see and that motivated me too. NL: It’s amazing how everyone keeps turning up to work, even with chronic stress and fatigue. Heroes are not necessarily the ones that jump into a burning building to save people but also the people who repeatedly show up knowing that there is danger. RU: As a locum, I’ve been here for 6-7 months and the hospitalist team is top notch. People have each other's backs. It's been a challenging year for providers, for wellness and burnout. But the fire has affirmed what I already knew about my coworkers, there is a great amount of resilience, camaraderie and teamwork among the group.
Thanks to the leadership for guiding us through a VERY challenging pandemic, specifically with the fire and all the challenges that came along with it, they bore the brunt of it. Thanks to ICU for having to take on more work in light of COVID and Psychiatry for all the challenges they went through with the fire. And all the colleagues for the continual friendly culture and the support they’ve shown to everyone. Dr. Anna O'Malley Emergency
GV: We worked together really really well and people were very supportive. We tried to keep things light by sending memes and jokes to each other. Things during COVID got really difficult and our department dealt with it well. GB: I must say that the staff I work with in the ER have been incredibly supportive and understanding. They are very sympathetic, they recognize our worth, they recognize our value and they appreciate us which makes it much easier to be here during this time. I'm actually proud to work with the Burnaby Hospital emergency staff
COVID and the fire has helped to get us into using more technology and make IT adjustments and improvements. Sometimes we need challenges in our lives that push us to do things better. Dr. Galina Vorobechik Neurology
WHAT OPPORTUNITIES ARE YOU LOOKING FORWARD TO IN BH REDEVELOPMENT PROJECT?
PO: Clearly this hospital needs an update. The population we serve has markedly outgrown this department's footprint. It’ll be exciting to have more patient space. Our hospital plays a huge role in the region, a new hospital should be developed with that in mind. We can play a larger role in Fraser Health. It’ll draw a lot of talent. GV: I’m looking forward to seeing the dramatic changes, and looking forward to using more technology. Doing more assessments electronically and to make things more comfortable for patients. RU: Opportunity to take care of more people that need inpatient care. Increasing the capacity will give us the ability to care for each subset of conditions better. We also have a great specialist group, and if we increase capacity we can have more specialists join us at Burnaby too. NL: I’d like to see an education center in the new build. A practical education space with sim labs, debrief room, computer space, work area, etc that provides staff with opportunities to grow. So that people show up to work knowing they can engage and make changes. AO: I’ve been involved with meetings for redevelopment on simulations. It’s really important for us. We sometimes do see challenging situations and it's nice to practice them through simulation to prepare for emergency situations.
I am looking forward to having a new place to work where we can provide safe and effective care where psychiatric patients feel comfortable and safe coming to. everyone. Dr. Bal Khosa Psychiatry
13
AREAS OF FOCUS
REDEVELOPMENT GOVERNMENT APPROVED $1.3 BILLION FOR A TWO-PHASE REDEVELOPMENT PROJECT June 2020 Request for Proposal materials issued to the shortlisted qualified teams August - November 2020 Collaborative sessions held with the designbuild teams to review and clarify requirements January 2021 Technical propsals submitted for evaluation
March 2021 Financial proposals submitted for evaluation
April 2021 Proposal evaluation completed and designbuild team (Preferred Proponent) selected for contract negotiations
As redevelopment physician lead, I’ve had the pleasure to collaborate with medical staff on the redevelopment plans that will transform Burnaby Hospital into a state-of-the-art medical and surgical campus. Over 40 physicians are engaged as subject matter experts to provide input into the future spaces and care delivery models. This past year, we reached a significant milestone for Phase 1 with the completion of the Request for Proposal stage. This involved a rigorous and competitive evaluation process of the submitted proposals. We also launched the Phase 2 Business Plan development. This upcoming year, we look forward to the exciting changes on site as Phase 1 construction begins as well as the innovative discussions to inform the Phase 2 Business Plan. Thank you to the MSA executive for their support and continued advocacy for excellent patient care. Sincerely, Dr. Brian McGowan
14
AREAS IN FOCUS
REDEVELOPMENT December 2020
WHAT'S NEXT?
Business plan development initiated with Fraser Health and BC Cancer teams
March 2021
Clinical service planning sessions began to gather input from our clinical and operational teams
June 2021
Phase 1 Contract award for the selected design-build team will be announced this summer with construction expected to start shortly. Detailed designs will be shared with staff and medical staff for input as we finalize design. Phase 2 Business plan development continues with ongoing planning sessions to inform space, equipment, technology and design needs. ·Business plan will be submitted to Ministry of Health for approval in early 2022.
FACILITY ENGAGEMENT Facility Engagement was launched by the Specialist Services Committee in 2016 as a BCwide initiative to strengthen communication, relationships and collaboration between facility-based physicians and their health authorities. The goal is to increase meaningful physician involvement in health authority decisions about their work environment and the delivery of patient care. Through this initiative Medical staff are getting to know colleagues, connecting across programs to work on clinical priorities, and exploring ways to reduce burnout. With trust and teamwork growing, many small wins are starting to add up to big changes.
16
NUMBER OF PROJECTS APPROVED
NUMBER OF PROJECTS COMPLETED AND CLOSED
1 9 20
FACILITY ENGAGEMENT
PROJECT HIGHLIGHTS QUALITY IMPROVEMENT PROJECT: “WHAT DRUGS ARE YOU ON?” Studies show that Medication errors are common and often occur when patients move between healthcare settings. Around half of hospital medication errors occur on admission, transfer and discharge and 30% of these have the potential to cause significant patient harm. Dr. Sarah Ostler, a hospitalist and Medical Burnaby Director along with several Hospitalists led a quality improvement project to streamline the medication reconciliation process. Over the past year, the QI team provided awareness and education to the hospitalist group and the percentage for medication reconciliation completed at discharge significantly increased from 52% to 80%. Figure 1 (left): A Control Chart representing the number of Hospitalist Medication Reconciliation Completed
Figure 2(below): Distrubtion of the Medication Reconciliation Completed by Hospitalist
The next phase of the project is sustaining the improvement and spreading the project to the other departments. If you are interested in knowing more about the project or are interested in participating in the next phase of the project, please contact Dr. Sarah Ostler.
17
FACILITY ENGAGEMENT
PROJECT HIGHLIGHTS QUALITY IMPROVEMENT PROJECT: UNIT 2C MUSIC & MEMORY PROJECT Our main objective is to reduce the incidence of behavioural and psychological disturbance among patients with dementia and delirium through a non-pharmalogical approach within the hospital setting. To achieve this, we aim to implement a personalized music program for patients on Unit 2C Medicine, by September 2021. Previous research has proven that music therapy may offer many benefits including reducing anxiety & depression and providing stimulation, which in turn can reduce the need for psychotropic medications or restraints in cases of agitated or disturbed elderly. Fraser Health has granted our project special permission to trial a Spotify streaming music account, allowing for the real-time assessment of patient-specific songs. The BH Foundation has supplied several iPhones that when paired with wireless headsets can offer an easy and safe method of music delivery. This project has the potential to offer endless joy and entertainment to patients in the hospital with the added benefit of reducing risk of depression, anxiety and delirium incidences to name but a few. Many stakeholders have expressed interest and excitement with this project including the Burnaby Hospital Volunteer department, who have sponsored our Spotify account and have provided volunteer support in assembling family-informed music playlists. Our hope is that this proactive, non-pharmalogical process may help mitigate the adverse behaviours related to delirium/dementia and improve the patient and provider experience
EDUCATION AND LEADERSHIP PROJECT: WOMEN IN MEDICAL LEADERSHIP CONFERENCE On May 7th and 8th, Burnaby’s Medical Staff Association sponsored the Women in Medical Leadership conference, a Physician Leadership Institute (PLI) initiative developed by CMA Joule. The conference was led by two exemplary speakers, Dr. Mamta Gautam, and Monica Olsen, both with extensive experience in coaching, leadership, and career development. The speakers engaged a group of 30 women, with both medical and administrative backgrounds, from the Burnaby Hospital staff. We discussed the importance of confidence, grit, and resilience in overcoming gender barriers in leadership, and how to build these habits in both ourselves and colleagues. Despite the increasing numbers of women in medical school and residency positions, there are still a number of barriers that exist for women entering leadership positions as staff. At Burnaby Hospital, although female physicians make up 39% (146/377) of physician staff, only 1.6% of women (6/377) hold leadership positions, such as division/department heads. We are hopeful that the insights provided from the course, as well as the communication and teamwork fostered between participants, will help pave new pathways for women interested in leadership positions at Burnaby Hospital. We also look forward to organizing networking events in the future that will help the collaborative effort in opening more doors for female leaders at our site. Stay tuned!
18
FACILITY ENGAGEMENT
PROJECT HIGHLIGHTS WELLNESS PROJECT: PEER CONVERSATIONS WEBINAR On February 24, 2021, Burnaby Hospital MSA’s Wellness Committee hosted “Peer Support Conversations” webinar. Registration was full at 20. Actual number of participants was 18. The webinar was led by Dr. Elizabeth Froese and Dr. Anne McNamara. This webinar was prompted by last year’s survey of medical staff which indicated 32% to be significantly more stressed due to the covid-19 crisis, and 76% turned to their colleagues/peers for their wellbeing. The intent of this webinar was to improve culture and capacity of medical staff to look out for each other, and therefore build medical staff resilience. Participants learned and practiced communication tools on how to support colleagues and be supported. Feedback was positive and most felt they learned something that they will integrate into work/home practices. Most would recommend this to their colleagues. Since the webinar, medical staff have “checked in” with their colleagues or have been “checked on” by their colleagues. Here is what some of these participants had to say about the webinar: “I feel more confident about approaching colleagues who I feel may need support.” “I will try to be more aware of my listening styles and practice more empathic listening with my peers.” “I better understand the pitfalls of listening traps.” “This topic is an important one and since taking part last night I have spent a lot of time thinking of the colleagues I have failed by not approaching when I knew they needed support.”
The MSA Wellness Committee may consider hosting this webinar again next year to continue promoting this culture of medical staff looking out for each other.
19
FACILITY ENGAGEMENT
PROJECT HIGHLIGHTS IT PROJECT: WORKSHOPS IN COLLABORATION WITH IMIT Information Technology plays an increasingly important role inpatient care. Currently there are various tools that are made available to BH MSA users and this project aims to connect users to IMIT and IT solutions. The IT subcommittee lead by Dr. Andy Chan has teamed up with FHA IMIT to host 2 workshops in 2020-2021, FESR and Meditech ADVANCE. The FESR workshop on January 20, 2021, gave attendees an overview of the FESR system. Implementing ESR a Burnaby is one step forward towards the new EMR System, ADVANCE. 24 MSA members attended to ask questions and to learn more about FESR from the IMIT Team and Dr. Hassanali. Overall, feedback was positive and some participants connected with the IMIT team afterwards for FESR training session. The Meditech ADVANCE workshop on April 13, 2021, was a high level primer presented by Dr. Hassanali and the IMIT Team. The purpose of this workshop was to introduce ADVANCE to our members and engage in the development stages of this new EMR system. 15 MSA members attended. This project has been renewed for 2021-2022 and the IT Subcommittee is looking forward to hosting more workshops with FHA IMIT.
20
FACILITY ENGAGEMENT
ALIGNMENT & OPERATIONS SUBCOMMITTEE LEADING ALIGNMENT THROUGH COLLABORATION In alignment with the Ministry of Health, Fraser Health and Burnaby Hospital administration, this subcommittee is focused on promoting the awareness, involvement, development, implementation, and advancement of initiatives that positively impact the delivery of quality care.
Current Members Chair - Dr. Donna Sue Members: Dr. Sarah Ostler, Dr. Paul Johar, Dr. Sonia Paul, Dr. Bal Khosa, Burnaby Hospital Executive Director Leanne Appleton, Dr Dennis Bhui, Rita Cormier Projects BH MRP Working Group (IM, Hospitalist & ER) , Lee, Mitch Chest Tube Working Group, Luke Armstrong COPD Pathway, Tiffany Winstone COVID-19 MSA Plan, Paul Johar Critical Care Group, Neil Long Dept Head Hours Project, Paul Johar Enhanced Recovery After Surgery (ERAS), Gavin Gracias Home First Residential Care Optimization, Julia Stewart Hospitalist & PCC Collaboration Committee Meetings, Sarah Ostler Primary Care Network - Urgent Primary Care Clinic Collaboration, Charlene Lui Psychiatric and Emergency Department Collaboration Review Project, John Ronsley Redevelopment Department Head Hours , Paul Johar Team Building Project - Obs & Gynecology, Jenny Muir Medication Expenditures Kickstart, Joel Bluman/Bal Khosa Improving Accuracy of Minor OR Data Kickstart Rebecca Nelson
Three meetings were held during the year to review projects & discuss how to best align MSA and Fraser Health priorities. To address the urgent need for preparation, communication, and education in the early days of the COVID-19 pandemic, a multi-pronged COVID-19 MSA Plan was launched to support MSA members. While rising to meet the challenges of the pandemic, we also aligned the needs of our hospital, community and MSA and ultimately strengthened the relationships that we have worked hard to build over the past several years. We continued to support the ongoing work of the Burnaby Hospital Redevelopment, initially with a Medical Staff task group, as well as the appointment of the Physician Redevelopment Lead and the creation of Departmental Redevelopment Advisors to contribute to Phase 1 of the Redevelopment. Despite the enormous focus on COVID in 2020/2021, we initiated preliminary work examining medication expenditures at Burnaby Hospital in collaboration with our site Pharmacy team, demonstrating our active contribution towards the Fraser Health Strategic Priority Value for Money. Plans for 2021/2022: Moving forward in 2021/2022 the subcommittee will continue to look at ways to partner with Fraser Health to focus on key priorities for the site. Redevelopment at Burnaby Hospital remains a core focus as our MSA continues to contribute and collaborate in building the future centre of health care for our community. Working together to achieve Access and Flow throughout the healthcare system is another key collaboration with the Health Authority which was challenged by COVID-19 and represents opportunities for change and major improvements. We also look forward to exploring best practices for Equity, Diversity and Inclusion. In all of the work we do, we would like to be guided by our outcomes and measures of success.
21
FACILITY ENGAGEMENT
COMMUNICATIONS SUBCOMMITTEE
MAKING CONNECTIONS THAT MATTER Current Members
Chair - Dr. Thomas Luo Members - Dr. Iram Yunis, Dr. Chris Bozek, Dr. Andy Chan,
Dr's Lounge Digest Engagement
Dr. Colin White, Dr. Gary Baxendale, Dr. Colin White, Dr. Evelyn Dunn, Carrolyn Sami, Lisa Tam, Kelsey Jay
November 2020-March 2021
2020/2021 was a challenging year with waxing and waning covid19 restrictions. In-person events remain on hiatus. Building on the foundation from the previous year, phase 1 of BHMSA.ca website content development has been completed. We have logged 2486 pageviews in the past year and aquired 651 new users.
60.9% Average Open Rate compared to an industry average of 36.9%
Announcements to MSA membership have been consolidated into monthly Dr’s Lounge Digest digital newsletters. We strive to maintain an accurate email distribution list [and newsletters have % open rate]. We are continuing to develop our digital toolkit to strengthen connections between members and developments in our MSA.
11.2% Average Open Rate compared to an industry
We plan to further expand the BHMSA.ca website to highlight milestones and achievements from active projects championed by our members. Our digital presence remains the focus of our efforts until restrictions ease on in-person gatherings.
average of 6.6%
Projects
BHMSA.CA Page Views
BH MSA AGM Dr's Lounge Digest Monthly Newsletter
October 2020-March 2021
750
Annual Report 500
250
0
22
October
November
December
January
February
March
FACILITY ENGAGEMENT
QUALITY IMPROVEMENT SUBCOMMITTEE GUIDING CHANGE TO IMPROVE THE QUALITY OF CARE FOR ALL PATIENTS IN BURNABY HOSPITAL Current Members
The projects under this subcommittee’s portfolio include the monthly QI cafe sessions, QI Coaching and projects that support Fraser Health quality and safety priorities such as
Chair: Dr. Melissa Allan Members: Dr. Sarah Ostler, Dr. Christopher Bozek, Dr. Ishtiaq Ahmed, Janice Eng, Ron Hall (patient voice), Ryan MacKay, Yasmeen Sayeed
Delirium, Access and Flow, Pneumonia, UTI, sepsis. Over the past year, this subcommittee has been focused on developing a pathway for physicians to easily participate in QI initiatives/projects and access support for data analysis. The subcommittee has also developed tools staff can use for
Projects
Access & Flow-Admission to Ward Transfer Regional
Quality Improvement projects. www.bhmsa.ca/committees/qicommittee
Collaboration, Allan, Melissa BH QI Project Coaching 2021, Allan, Melissa Decreasing In Hospital UTI 2021, Allan, Melissa Managing Delirium, Abidin, Zareena
Plans for 2021/2022: Moving forward in 2021, the subcommittee will focus on:
Quality Cafe 2021, Allan, Melissa Pancreatic cancer pathway, Monkewich, Gregory What drugs are you on?, Ostler, Sarah Examining Impact of Team-Based Care in Orthopedics Kickstart, Colley, Pamela Restraint use in ED Kickstart, O’Malley, Anna Reducing length of stay for complex shoulder
Key activities and future goals Integrating MSA QI activities with BH and Fraser Health priorities and resources (contributor at HQOMC, partner with togetherQI). Having MSA QI projects related to a minimum of 3 of the FH Patient Safety Priorities by December 2022. Integrating QI methodology in activities of 2 other
operations - pain management with shoulder
subcommittees by November 2021.
catheters Kickstart, Faraji, Reza and Chuang, Mike
Recruiting 2 new MSA members to the QI subcommittee by
Who are you? Improving Physician Signature
September 2021.
Legibility Kickstart, Ostler, Sarah
Having 3 MSA staff enroll in the Fraser Health Physician Quality
Improvement
(PQI)
certificate
program
by
September 2021. Making QI accessible, easy and fun for MSA members.
2
23
FACILITY ENGAGEMENT
EDUCATION AND LEADERSHIP SUBCOMMITTEE
DEVELOPING LEADERS AND PROFESSIONALS FOR BURNABY HOSPITAL The Education & Leadership subcommittee is focused on promoting
the
awareness
and
advancement
of
educational and leadership development opportunities for the Burnaby Hospital medical staff. Projects under this subcommittee’s portfolio, such as the Insights Leadership courses & various educational workshops, have enabled medical staff to continue to develop key leadership skills. For the upcoming year this subcommittee is focused on providing the medical staff with opportunities to further
Current Members
Chair - Dr. Colin White Members - Dr. Vishal Gupta, Dr. Jack Jay, Dr. Tym Frank,
develop leadership skills. Our goal is to be able to provide
Dr. Elizabeth Chuah, Dr. Mark Dickeson, Dr. Cory Toth,
the ability to elevate our practice as physicians and to
Dr. Susan Kwan, Dr. Aliff Jamal, Carrolyn Sami, Kelsey
thrive in our culture of excellence. We are hoping to get
Jay
back on track with many development projects that were
Projects
temporarily sidelined by the pandemic.
Burnaby Hospital Education Forum Burnaby Hospital Financial Forum Burnaby Hospital Learner Education Panel Crucial Conversations Club Grand Rounds Sponsorship Hospital Wide Simulation Steering Committee ICU In-Situ Simulation Program In-Situ Simulation Program Leadership Book Club MAiD Working Group Medical Education Forum for Doctors Operating Room In-Situ Simulation Program Research Cafe 2 Using media to assists code status discussions
FACILITY ENGAGEMENT
INFORMATION TECHNOLOGY SUBCOMMITTEE
WE MAKE IT HAPPEN
The Information Technology subcommittee is focused on promoting the awareness, understanding, development, and implementation of information technology healthcare solutions for the Burnaby Hospital Medical Staff. Over the past year, this subcommittee put on IT workshops, provided recommendations on Virtual Healthcare and supported the development of our BHMSA.ca website. Current Members
Chair: Dr. Andy Chan Members : Dr. Galina Vorobeychik, & Dr. Katherine Stuart, Lisa Tam, Janice Eng, Kelsey Jay 2019-2020 Projects
Moving forward in 2020/2021, we will continue to host workshops with IMIT on IT solutions that matter to our members such as appointment reminders, secure messaging, and email. We also look forward to collaborating with Dr. Ostler and the IMIT team on the FESR implementation to prepare for ADVANCE.
BH MSA Website Content Management, Chan, Andy Information Technology Subcommittee, Chan, Andy Information Management / Information Technology (IMIT) Workshops, Chan, Andy Secure Messaging – Rules of Engagement and Department Specific Needs, Chan, Andy Virtual Care Task Group, Yu, Simon
25
FACILITY ENGAGEMENT
WELLNESS SUBCOMMITTEE CONNECT, SUPPORT ENGAGE, THRIVE We have seen how this pandemic has caused increased strain and stress to our medical staff in many different ways. The BHMSA and The Wellness Group has recognized the reality of this distress and focused on medical staff safety. In terms of improving medical staff connections, we have promoted a culture of collegiality and peer support. Last year and earlier this year, we hosted a webinar, “Peer Support Conversations” – this course was fully registered and felt to be particularly useful during this time of increased stress. In terms of improving personal resilience, we have promoted the importance of basic self care. Last month, we hosted a webinar, “Managing Personal Energy” – this course was also fully registered and well received. At the regional level, we have helped contribute ideas to the FHA Physician Wellness Working Group in developing its “Vision”, “Mission”, “Values” and “Strategic Plan” – this was finalized and presented at the FHA Physician Wellness Conference in November 2020. Our BHMSA Wellness Group was also featured at that conference, as an example of how to build wellness teams in communities. As the pandemic appears to be settling, we ask “how will we move forward from the impact of this pandemic?”
26
Current Members
Lead: Dr. Clement Fung Members: Dr. Donna Sue, Dr. Jack Jay, Dr. Anna Kang, Dr. Christopher Wu, Dr. Kristel Lobo Prabhu, Dr. Anna Nazif, Dr. Joshi Urvi, Carrolyn Sami, Kelsey Jay
THE PEOPLE BEHIND OUR MSA THANK YOU FOR ALL OF THE TIME AND EFFORT SPENT TO SUPPORT OUR MEDICAL STAFF ASSOCIATION
EXECUTIVE TEAM
Dr. Vishal Gupta, Society Treasurer Dr. Gurp Johal, MSA Treasurer Dr. Buldip Khosa, WG Chair
Dr. Paul Johar, President Dr. Donna Sue, Vice President Dr. Scott McGuffin, Secretary
WORKING GROUP
Dr. Dr. Dr. Dr.
Bertrand Lau Vishal Gupta Charlene Lui Ed Dubland
Dr. Dr. Dr. Dr.
Linney Lin Susan Kwan Chris Bozek Salim Lalani
Dr. Dr. Dr. Dr.
Buldip Khosa Andy Chan Kristel Lobo-Prabhu Jack Jay
PROGRAM SUPPORT STAFF
Carrolyn Sami, Program Manager Rita Cormier, Project Consultant Janice Eng, QI Consultant Kelsey Jay, Program Administrator
Lisa Tam, Communications Consultant Davis Sue, Bookkeeper Angela Sue, Physician Lounge Manager
27
28
FINANCIAL HIGHLIGHTS
29
ENGAGED MEDICAL STAFF PROVIDING EXCEPTIONAL PATIENT CARE.