Island Health is bringing two of its Victoria hospitals into the digital age and ditching pen and paper in favour of computer orders.
Currently, if you visit the Royal Jubilee Hospital or Victoria General Hospital the medical staff will write up medication orders and other instructions on paper.
“Anything that I, as a doctor, want to do for a patient is written down as an order on a piece of paper that is then faxed to the various locations in the hospital,” Dr. Brian Mc Ardle, medical director at Royal Jubilee Hospital and an internal medical physician told CHEK News in a Zoom interview.
“Good example would be a patient who’s sick on a ward who needs an antibiotic, that antibiotic has to be sent from the pharmacy for that to happen in order has to be written on paper then faxed by somebody else to the pharmacy received by that pharmacist, then put it into a computer, then the medication is sent, and then as it’s documented on a separate piece of paper that the medication has been given.”
The new digital system will streamline things in the Victoria hospitals.
“By doing computer order entry, we eliminate all those steps, I as the doctor, say you need this medication, I put it into the computer, the pharmacist immediately sees that and can dispense the medication and then the nurse can document on the computer that it’s been given,” Mc Ardle said. “So it creates more efficiencies in our system.”
The system will be used to enter medication orders as well as some other orders like bloodwork and Island Health estimates it will result in a 55 per cent reduction in medication errors and 50 per cent reduction in administration time.
The new system will be rolled out in Royal Jubilee on June 8 then Victoria General on Sept. 14 and while this will be an improvement in the long run, Island Health is expecting and planning for some bumps in the road as staff gets used to the new system.
Mitigation of the impacts include that over the past few months, staff at the Royal Jubilee Hospital has received training ahead of implementation to try and prepare them as best as possible for the rollout.
“We are bringing in additional staff, we have reduced some of our occupancy in relation to booked and planned procedures, so we’ve done a surgical slowdown, and an Ambulatory Procedure slow down as well,” said Marko Peljhan, vice-president of clinical services for Central and South Island at Island Health.
“And we’re opening up an urgent care center at the Royal Jubilee Hospital for the first couple of weeks after implementing Computerized Provider Order Entry that will be evaluated whether we need to continue it.”
“But the intent there is that we’re adding additional capacity, particularly for people that are presenting to the emergency department who have non urgent needs that can go to an alternate location to support patient care for our community.”
Mc Ardle added that they have reached out to primary care providers in the community asking for them to add capacity in the ensuing weeks as a way of supporting the transition to the new digital system by helping avoid emergency room visits and hospitalization.
However, Mc Ardle stressed, during the transition to the digital system the Victoria hospitals will remain open and accepting those who come and no one will be turned away.
“No patient will be turned away from our emergency departments, our emergency departments are going to be open 24/7. And we’re going to be ready to respond to people when they need us,” Mc Ardle said.
“We want people to know that the hospital will be there for you, but also to know that there are potential other avenues to have their needs met, that might not involve coming to the emergency room on a particular day.”
Mc Ardle acknowledges that there is a primary care shortage so visiting a primary care provider is not available to everyone, but other resources people can access include calling 811 for medical advice or to deal with acute needs and pharmacists who can now prescribe for some medications.
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Royal Jubilee and Victoria General hospitals are the next ones to have this system rolled out for, but there are still hospitals in Island Health that it has not yet been implemented. Nanaimo Regional General Hospital is one of the first to have had it rolled out in 2016.
Not calling a Code Orange
Recently online, it was spread that during this transition Island Health was expecting to call a “Code Orange,” which is a mass casualty event where patients would be turned away from a hospital, however both Peljhan and Mc Ardle deny that is the case.
“We would reserve a Code Orange for a significant catastrophic event. So it’s a disaster response at a hospital, we would reserve that for when we were not able to manage incoming patients and community need,” Peljhan said.
“We are putting significant measures in just to support our staff and support our patients and ensure everyone’s getting the care that they need. I just want to differentiate that approach from a full Code Orange.”
“We’re putting every strategy in place that we can to help support our staff to what will be a difficult change, and I don’t doubt for a second, that is going to be hard,” Mc Ardle said. “But we are not planning to have a Code Orange whereby we’re degrading patients from our emergency room.”
Laura Brougham
