Victoria General Hospital is gearing up this month to activate a fully computerized system for health records and for sending and receiving instructions, following a similar shift at Royal Jubilee Hospital in June, and at Nanaimo Regional General Hospital eight years ago.
Victoria General Hospital, South Island Surgical Centre and Gorge Road Health Centre are switching at 7 a.m. on Saturday, Sept. 14.
That’s when physicians and nurses begin entering all instructions, medication, lab and radiology requests digitally.
Marko Peljhan, Island Health’s vice-president of clinical services for central and south Vancouver Island, said months of planning and simulations go into such a massive changeover.
Next week, the hospital will start reducing the number of outpatient clinics and procedures such as endoscopies and colonoscopies to prepare for the transition, with the biggest slowdown the first full two weeks of the transition, starting Sept. 16. The goal is to give physicians time to train and adjust to a new way of entering and retrieving orders.
Around Sept. 11, Island Health will set up an urgent-care clinic operated by family physicians to take on less-serious cases and reduce the burden on the emergency department.
Peljhan said there will be a 24/7 operations centre starting Sept. 13, the night before the switchover, that will remain in place for several weeks.
“We expect challenges so we just want to be prepared for those,” said Peljhan.
Dr. Brian Mc Ardle, medical director and chief of staff at Royal Jubilee Hospital, said physicians and staff will face delays during the switchover, but patients will still get quality care.
Mc Ardle said many of the processes he worried might be a concern in the transition at Royal Jubilee never materialized. Small glitches — such as orders being spit out of a machine in a different area than expected — popped up, but were easily corrected, he said.
“We had to brace ourselves for the change, like any change, but it’s gone better than most of us expected, and I think it’s been a positive thing, and I anticipate that the benefits will only grow over time,” said Mc Ardle, citing improved data collection.
No matter how much preparation is done, the real lessons are learned “when the rubber hits the road” and so for this next transition, staff will rely on lessons learned at Jubilee, he said.
Dr. Chloe Lemire-Elmore, Victoria General site director, said a lot of staff work at both Greater Victoria hospitals, but despite the “successful rollout” at Jubilee, the same preparation and training, and extra medical and support staff, are going into the transition at Victoria General.
“There is a mood of excitement and anticipation because it has gone so well, word travels among medical staff, allied health workers and nursing staff,” said Lemire-Elmore. “We are all aware of the stress the change will bring, but we’re in it together and doing everything we can for it to go well.”
Lemire-Elmore said it’s definitely time to make the leap to a fully electronic system.
“Many people are surprised to learn that we’re still handwriting orders,” said Lemire-Elmore, describing a process where a unit clerk still faxes orders for medications to a pharmacist.
“With the fully electronic record, the orders that are entered are visible across all care teams, things are processed more efficiently, there is less room for error, so it results in better, more transparent and safer patient care.”
While people requiring emergency care can still visit Victoria General’s emergency room during the transition period, from now to about Oct. 14, Island Health is encouraging patients where possible to use Urgent and Primary Care Clinics, to access a registered nurse through 811 around the clock, or to seek out a pharmacist 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.
“We’re doing everything we can to ease the capacity and create the space we need, because we know it takes longer as everyone transitions,” said Lemire-Elmore.
Most hospitals on Vancouver Island already keep an electronic health record on patient histories. The change now, called “computer provider order entry,” has clinicians ordering medications and tests via computers rather than written notes.
The next sites due to change to the new system include Saanich Peninsula Hospital, Cowichan District Hospital, and Comox and Campbell River Hospitals. Island Health is still figuring out the timelines.
“We don’t want to do it too quickly before we stabilize the Jubilee and Victoria General Hospital,” said Peljhan.
“Right now we’re just focused on Victoria General Hospital, and we expect that will take all of our energy and effort through the entire fall to ensure that everything’s going well, things are safe, we’re not seeing things that are cropping up, before we then look at into the new year, furthering the ihealth, electronic health record.”
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