UBC Hospital (UBCH) physicians work in a unique environment and cover diverse specialties in Koerner Pavilion, Purdy Pavilion, Detwwiller Pavilion, and the Djavad Mowafaghian Centre for Brain. Physicians from these distinct communities came together on April 3 for VPSA’s Breakfast with Leaders session with VCH President and CEO Mary Ackenhusen. It was an opportunity for those attending to talk with top leadership about many pressing issues.
UBCH Urgent Care Centre
Several emergency physicians attended the meeting and all were concerned about the significant rise in patients visiting the hospital’s Urgent Care Centre over the past year.
“Our acuity numbers have gone through the roof; patients come here with complex emergencies and think we are the best place because we’re a university hospital… they think we’ll have the answers,” said Dr. Robert Anthony. “When put under the strain of so many patients, the department becomes quite dysfunctional. We are a tertiary care hospital with an urgent care that has only primary care capabilities, and we don’t have the back-up resources such as consultations and transportation.”
“Patients don’t understand what an urgent care centre is and this needs to be communicated better,” said Dr. Cindy-Ann Lucky. “We’re also seeing a change in demographics: the population is aging, but we’re also seeing an increase in pediatric visits and we are not the best hospital to treat child emergencies. Also, patients have huge expectations that we aren’t resourced to meet.”
To address the concerns raised by her, Dr. Lucky volunteered to be part of a working group that collaboratively will provide solutions and be proactive to meet the needs of a changing medical environment.
“What’s happening in the emergency department is symbolic of the pressure being put on the whole health care system,” said Mary. “With limited resources, this is challenging and innovation will be critical to move us forward. We need to change and we need to change quickly. Our roots, history, and culture create inertia. We need to do a better job of tapping into our staff; we’re not leveraging you enough.”
Growing physician influence
Remarking that high performing health care centres such as Mayo and Kaiser have organization models and structures that ensure strong physician influence, Mary also noted the physician voice at VCH’s leadership table has been missing for too long. Associations like VPSA, other Facility Engagement Initiative groups in other parts of VCH, and the Health Authority Medical Advisory Committee provide engagement opportunities but, she said, “We need these to come together with a coordinated physician voice. I want to hear how you want to work together.”
Mary has been meeting with the Specialists Services Committee to talk about the issue of physician burnout. She acknowledges we need to move beyond simply offering wellness classes and instead get rid of the pebbles in the shoe—the small, nagging issues—that hold everyone back.
“We’ve all seen areas where turnaround can happen quickly and a place can go from being a crummy place to work to fantastic,” she said. “We need to identify and develop our physician leaders and pair them with partners to make a difference.”