On December 7th, the site director’s Hayley Bos and Brian Mc Ardle, the Chiefs of Staff at VGH and RJH respectively, were guests of honour at the MSA’s Virtual Doctor’s Lounge. We are grateful for their generosity in speaking about their roles and about their visions for their sites. We felt that their perspectives deserved a wider audience:
What has been a surprise so far?
- Physicians input is valued, both from those in leadership roles and those working hard every day on the units.
- Many of the Health Authority priorities are dictated by the Ministry of Health.
- There is a lot of flux in staffing on the administrative side. Physician leaders provide a more constant voice.
How can non-leader physicians make change?
SIFEI and PQI have been good programs to pay physicians to lead change and to point them in the right direction.
What would you like to accomplish during your tenure?
Hayley at VGH
- Alternative funding plans for specific services (e.g. pediatric surgery – succession planning, viable career option; gyne oncology). These roles are currently funded in a patchwork manner, because these specialties fall out of one division’s jurisdiction.
- Addressing the increasing numbers in neurology
- CPOE!
- “To do this job long term takes a lot of work. I’d feel guilty leaving the position vacant again…It doesn’t benefit the site.”
Brian at RJH
- Yes, CPOE!
- To contribute to strategies to help address capacity issues we’re facing.
- Continue to work closely with the Hospitalist group. I feel that medical services should have a specific bed base and feel that dedicated units with appropriate multidisciplinary services would improve physician satisfaction and make the hospital more efficient.
- “I want to be a voice for what needs to happen.”
What opportunities do you see?
Brian: The last year and a half has felt like a fire fight, where we’ve been lurching from one crisis to the next. We now have a new leadership team at Royal Jubilee Hospital with two new site directors (Candace Keddie and Jason Price) who are engaged, collaborative and enthusiastic to make positive changes. There is also broad support from an executive level to try innovative things so I am hopeful that this will enable physicians to bring forward ideas and get some traction so that we can address things that need to change in the long term.
Hayley: There are robust existing processes and knowledge that aren’t used:
- The Patient Safety Learning System tracks incidents of near miss or patient harm, but not a lot of physicians are familiar with it. This could be a great tool for documenting things that happen, reviewing opportunities for change, and using data to improve specialty-specific challenges. In the past, PSLSs weren’t always dealt with in a robust fashion: You’d put one in and never hear anything again. Some departments are now following up. The more streamlined the structure, the better it will be. Remember: When you put in a PSLS, you’re flagging a safety issue, you’re not making a complaint.
- Also important but not well known is the Patient Care Quality Office (PCQO), which is accessed when the system didn’t provide patients with the best possible experience. If Indigenous people have taken the time to step up, we want to take the time to respond.
What about our nursing colleagues?
There is a lot of work taking place at present to look at how the health authority can improve nursing recruitment and retention and hopefully this will bear fruit over the next few years. Part of the challenge is the different levels of acuity and ratios, as well as limitations of the union contract. We’d love to see RNs and LPNs each working to full scope.
How about the hospitals’ relationships with community practitioners?
Everyone is feeling the pressure from the Family Physician crisis. Hospital at Home is a shining light, as is the Primary Care Network work. There has been a lot of change with Home and Community Care over the past couple of years. Hopefully there will be building blocks in place for improvement. I would love to have more opportunity to engage with that rollout.
Our system is still very much designed around acute care. There are leaders advocating at the Ministry level, but if we fail at primary care, our whole system will come tumbling down. If we don’t fund it or build it how it should be, we’ll be in trouble.
What is the best way for people to get in touch with you with their great idea?
Great ideas are welcome any time! Feel free to stop us in the corridors, text, or email.