Members gathered in person and online for VMDAS’s February 23rd quarterly meeting. This is the first meeting under a new format that will see themes and topics explored in depth. The focus this time: planning for a busier future with guest speakers Dr. Vinay Dhingra, Senior Medical Director, Vancouver Acute, Yasaman August, Executive Director, Clinical Operations, and Shelly Fleck, Operations Director, OR Slating and Booking, and Director, Strategic Initiatives, Vancouver Acute.
To gather input, members were encouraged to submit questions anonymously prior to the meeting. Questions were also taken following the presentations.
Our speakers arranged their discussions around seven themes to describe what the coming years may look like across Vancouver Acute:
- Impact of population growth and aging
- Emergency Department demand trends
- ICU demand and capacity trends
- Mental health presentations to the ED
- Vancouver Acute initiatives for winter 2026
- Security
- Campus rezoning and development vision
Population growth and aging projections
Recent estimates see our health authority’s population growing by six per cent by 2035. When it comes to residents 70 and older, the projections are much higher: 36 per cent. Fraser Health Authority is growing at a much faster rate that than of the Vancouver region: 16 per cent overall and 51 per cent for those age 70-plus. Fraser Health residents use a significant portion of Vancouver Acute resources, so this greater rate of growth will also impact us.
Emergency Department demand trends
There was an average of 255 daily visits to the ED between February 2025 and January 2026; these volumes are approaching pre-pandemic levels and represent an increase in geriatric patients. The admission rate, complexity of cases, and acuity are all trending higher. Over this time, the VGH Emergency Department had an average of 56 daily admissions. (UBCH’s average was two per cent; St. Paul’s Hospital was around 15 per cent.)
More than a quarter of our ED visits are from patients aged 70+ and 25 per cent of ED visits are from patients who live outside of the Vancouver region. A dramatic shift has been in the “left without being seen” rate, which has almost doubled over the past 10 years.
The City of Vancouver’s Broadway Corridor Plan and the subsequent population growth along its route will impact VGH significantly. At the 95th percentile, daily Emergency Department visits are modelled to increase from 380 to 441 visits by 2035.
Recent Emergency Department initiatives include eight net new care spaces. Updates in Zone F (PEAT) have improved patient and staff experience and there’s ongoing improvement for space there. There is some optimization work with the medical staff coverage and some innovative work with new allied staff including a harm reduction nurse clinician and a peer support worker to connect substance use patients.
ICU demand and capacity trends
There are not enough beds in the ICU with an increase of only four beds over the last 10 years for a total of 36 beds. During peak times, we need about 40 beds with 36-37 beds needed on average. ICU admissions are about 1,500 per year (an increase from 1,400 in 2015/16) and the median length of stay has also increased from about four days to just under six days. There are often delays in transferring patients out of the ICU.
Looking to the future, to achieve 85 per cent occupancy, we will need 48-50 ICU beds.
Mental health presentations to the ED
There are 94 funded Segal and PAU beds and 12 unfunded ones for a maximum capacity of 106. The additional spaces are in non-ideal care spaces (e.g., closets). There are also 16 funded beds at UBC Salas.
We have initiated detailed ALC reviews for patients in Segal; long length of stay for admitted patients is a concern. Weekend discharges are another area of focus for inpatient beds. In addition, a lot of work needs to be done with community partners to identify patients who can be discharged earlier with supports in their homes.
An analysis of the issues affecting ED flow is ongoing; however, the two emerging themes are length of stay and ALC patients. There are a limited number of tertiary beds and there are patients waiting for these and/or mental health supportive housing beds. There are several reasons why patients are staying longer including concurrent use disorders, multiple medication trials, and use of clozapine and ECT.
Vancouver Acute initiatives
Multiple strategies are unfolding including adding additional capacity to inpatient units with enhanced surge beds in place throughout VGH. We are working with Vancouver Community to prevent long-term care admissions, and we have opened the flow and transitions unit with 12-14 beds. VC has done a lot of work to try to keep patients in place. There are personalized support and stabilization teams and Hospital at Home has increased capacity.
In November Seniors Remote Monitoring launched with 70 patients across VCH now on this technology. The hope is this will make a significant difference in keeping frail, elderly people at home as opposed to in long-term care. A transitional care unit opened at Bamfield with 42 beds so, instead of patients waiting at VGH for long-term care they can be transferred there with allied health support.
Signal 1—a new pilot program—is beginning. This is machine learning that can predict medical stability within 72 hours of discharge. This is currently being trialed on the internal medicine and hospitalist units.
Surge plans have been updated, and we are developing a regional surge plan where, when one site is busy, we help each other out.
Security
Violence is increasing in our facilities, and we work closely with our integrated protection services on strategies to minimize violence and to respond quickly when it happens. Information is being entered into Cerner so, if there is an alert on a patient, teams will know.
VCH is developing site-specific standard operating procedures for violence and violence alerts. Security Services has a benchmark of within three minutes to respond to any Code White situation.
Security officers continue to do walkarounds on a regular basis to prevent people from smoking or vaping close to our buildings.
Rezoning overview
VCH submitted a rezoning application to the City of Vancouver last fall, and we expect to have our first text amendment approved by the current city council by summer 2026. (The council will not take on any new business between July and the fall 2026 municipal election.) Our application will be back with the council in early 2027 for final approval.
Rezoning applications do not finalize building designs, but they do set parameters such as building height, density, setbacks, and parking requirements. Prior to the City’s Broadway Corridor Plan, we were limited about how high we could build (maximum eight storeys). Under the new plan, where the Heather Pavilion is now, we could go as high as 24 storeys.
The VGH vision for the next 35-40 years includes Site A, which will be our first building and will include a new Emergency Department expansion and an inpatient building. This will be located where the laundry building and research pavilion are currently located, with those buildings being torn down. The new building will be attached by a bridge to the current Emergency Department. There will also be approximately 250 net new beds and about 250 underground parking stalls. The helipad will be moved to this new building.
Phase 2 of the vision for VGH is replacing the Heather Pavilion with a new building that would ultimately replace the Leon Blackmore Pavilion, the Willow Health Centre, and the GF Strong inpatient beds. This building would have in the neighbourhood of 1,200 parking stalls. This phase also includes a new energy centre.
Phase 3 (in about 35-40 years from now) will be the replacement of the Jim Pattison Pavilion, the north podium as well as the tower. This would happen after the Heather Pavilion replacement building is complete. This site will also include underground parking and another helipad.