VPSA/VMDAS board and staff meet regularly with VCH senior leaders to develop a collaborative relationship between medical staff and the health authority. The April meeting included a presentation on the 2023 Health Authority Engagement Survey results as well as discussion about the need for more awareness about the Code Silver violence prevention and mitigation process.

Engagement survey results

Doctors of BC Manager of Regional Advocacy Elisabeth White made a presentation on the results and key highlights from the eighth annual Doctors of BC Health Authority Engagement Survey. VPSA members had the opportunity to take part in the survey between September 12 and October 11, 2023.

The survey had a 20 per cent response rate, with 2,625 physicians throughout the province participating. The VCH participation was 696 physicians, down somewhat from the 2022 survey (807 responses). The overall engagement trends for VCH in 2023 were close to those reported in 2022. VGH saw a 40 per cent (242 physicians) participation rate in 2023 (35 per cent in 2022), while UBC Hospital had a 30 per cent (19 physicians) response rate (45 per cent in 2022). No physicians from GF Strong took the survey in 2023.

Responses varied widely between VGH and UBCH:

Statement	% VGH physicians agreed	Change from 2022 survey	% UBCH physicians agreed	Change from 2022 survey
I am satisfied with this health authority as a place to practice medicine.	61	+4%	58	-6%
I feel I belong to a collaborative, patient-centred team/unit.	61	+2%	53	-2%
I have access to the facilities, equipment, and other resources I require to meet patients’ needs.	51	+7%	37	-13%
I have adequate opportunities to improve patient care, quality, and safety.	51	+11%	53	-11%
I have meaningful input into changes affecting my practice environment.	35	+6%	5	-38%
Senior leaders communicate the health authority’s plans to physicians in a clear and timely way.	27	0%	11	-15%
Senior leaders seek physicians’ input when setting the health authority’s goals.	24	+5%	11	-16%
Senior leaders’ decision-making is transparent to physicians.	14	+3%	0	-27%
The health authority values physicians’ contributions.	34	+6%	32	-9%

It was noted that the survey was active during the deployment of CST at UBC Hospital and during the move of the UBC Student Health Clinic and several medical offices. Regardless, the results from UBCH are concerning and it will be important to see if these were a point in time or the beginning of a trend.  

There was discussion about the broad view of the results provide compared with the detailed level VPSA and VCH hope to achieve with the regional wellness survey that will launch on May 1. One of the goals of that survey is to reveal engagement at the department/division/service area levels where actions can be taken.

The group reviewed the three statements related to senior leadership, as this has been an area where results have been consistently low. Recommendations included putting senior leadership more front and centre by leveraging various communications channels. Members need to hear what senior medical leaders are working on and how these leaders are a voice for physicians. VCH expects its leaders to engage with the people they represent and to share and solicit information. This may require senior medical leaders to attend department/division meetings on a more regular basis.

Code Silver promotion

It was noted during the February meeting of the senior leadership group that members were concerned about the lack of awareness of the Code Silver module (violence prevention and mitigation process) on the Learning Hub.

VCH Director, Strategy Deployment Lori Benning has investigated and provided the following information.

A Code Silver is defined as an individual actively engaged in seriously harming, killing, or attempting to kill others with a weapon. A Code Silver response seeks to divert health-care staff away from the scene.

Education and support regarding Code Silver are available:

VCH intranet site for violence prevention.

Support and delivery of joint education/facilitation sessions with HEMBC advisors and VCH Workplace Safety teams are available:

• For the VGH Campus, contact Jennifer LeSage, and for the UBCH campus, contact Matthew Cheung; for Vancouver Community, contact Tamara Revita
• Learning HUB
• HEMBC has a variety of resources for education
• The Code Silver course on the Learning Hub is a top recommendation.
• There are various resources online at the HEMBC site, including a discussion guide, FAQ, and key messages
• HEMBC is currently working to create a video with a security expert presenting an in-service that can be shared once complete

Code Silver initiatives are developed in partnership with the VCH People Safety team, the Ministry of Health, police, and HEMBC. This Provincial Working Group is working on additional resources.

Code White is defined as the behaviours of the individual(s) are harmful to self or others or may damage property, that may or may not include a weapon. The behaviours of the individual(s) are escalating toward physical violence. The behaviours of the individual(s) cannot be managed by the health-care workers and/or resources present. A Code White response seeks to bring additional health-care staff (de-escalation teams) to the scene.

Resources for Code White education and support are also available.

The rollout of Code Silver has highlighted a gap in the Code White procedures and the confusion about Code White versus Code Silver especially when a weapon is involved. Code White can include a range of situations and can include a weapon. Currently there is a group that is looking at updating the Code White process to better address Code White with weapons.

Other business

Following on a question raised in earlier meetings about give cards not being used for VCH long service awards because of tax implications, Lori Benning noted that VCH has a catalogue of vendors that offer gifts and that this is updated annually. Anyone having questions can reach out to CHRecognition@vch.ca.

This was also the first meeting attended by VCH’s new Manager, Provider of Strategic Initiatives and Experiences, Laura Mc Evoy.

Next meeting

The group next meets on May 9. If you have an item you wish to be brought forward at these meetings, please contact VPSA Operations Director Andrew Pinfold.