Royal Jubilee Hospital will activate its full electronic-health-record system today, with extra nurses and doctors, an army of IT experts, a 24-hour command centre and overflow emergency room ready to get the hospital through the massive transition.
Fifty-two nurses from across the Island were at the Victoria hospital on Friday feeding paper charts into electronic charts over a 12-hour shift to prepare for the switchover around 6 a.m. today. That’s when pen-and-paper instructions, medication, lab and radiology orders, faxes and telephone orders will shift to a computer-based system, said Marko Peljhan, Island Health’s vice-president of clinical services for central and south Vancouver Island.
“If somebody is writing orders on a patient at 6:01 a.m., they’re not picking up a piece of paper, they’re doing it electronically,” he said.
Nanaimo Regional General Hospital made the same move in 2016, while Victoria General Hospital is set to implement the transition in September.
Peljhan said more than 90 per cent of physicians and staff are trained for the switch, and everyone who is working the first week of the transition is fully trained. “It’s been a lot of work, it’s been a very busy week,” said Peljhan.
An emergency overflow space — a kind of urgent care clinic operated by family physicians — opened Tuesday at Royal Jubilee to relieve pressure on ER physicians and staff while they adapt to the new system.
The overflow space saw about 24 patients the first day, followed by 15 and 30 patients the following days.
“That’s kind of the numbers we were anticipating,” said Dr. Brian Mc Ardle, medical director and chief of staff at the hospital. “I don’t think it will increase massively.”
The command centre opened Friday evening, with IT specialists and clinicians on hand to navigate any “glitches” or staffing issues. “We’ve got all our experts there,” said Peljhan.
While people can still visit the ER, Island Health is encouraging patients who are unsure if their case is urgent to call 811 for around-the-clock advice from a registered nurse or other health care professional, including what to do and who to visit.
Other resources include Urgent and Primary Care Clinics and pharmacists, who can prescribe medication for 21 minor ailments, from urinary tract infections to pink eye.
Those with non-emergency mental-health needs can call the Vancouver Island Crisis Line at 1-888-494-3888.
Mc Ardle said “we obviously ask for your patience and understanding” and to be pragmatic about where you seek medical care, but “also know that the hospital is still there if you need us.”
He said hospital administration will be especially careful in its usual oversight practices during the transition to monitor for any patient-safety irregularities.
“So we will be monitoring for things that might be different, because obviously there’s unanticipated effects, we can’t anticipate everything, and so if we’re seeing trends that are happening, I think we are mindful of that, and we have to be ready to respond very quickly,” said Mc Ardle.
Peljhan said while there may be “inefficiencies” as staff adapt, significant training and preparation has been done. The health authority has permanently increased the number of clinical pharmacists and recently doubled or tripled the number of clinical technicians at Royal Jubilee to support patient safety, he said.
“We’re confident through all the system testing that we’re not going to run into a significant IT issue,” said Peljhan. “I think the biggest issue is that our staff just need the time to learn the system, to be comfortable and confident with it.”
The Victoria and South Island divisions of family practice sent a letter to members on May 23 warning that Island Health expects “a temporary 30-50 per cent inefficiency” in the emergency department during the transition.
Saanich family physician Dr. Jennifer Lush is concerned that it was left until recently for family doctors to notify their patients of the ER slowdown and “to treat urgent conditions as much as possible” to keep patients out of the overburdened ER. “It is not easy for already hard-working family doctors to just add extra capacity, so I would suggest lessening administrative burden during this period would free family doctors to focus on medically necessary care,” said Lush.
Lush said that could include employers temporarily waiving the requirement for illness documentation or functional evaluations for return-to-work forms.
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