Tri-Cities - Fraser Health Authority

TriCitiesValerie SpurrellExecutive DirectorFebruary 2011

TriCities at a glancePopulation: 220,60026% = under age 19 (similar to FH average)10% = seniors (FH is 12%)• From 2010 – 2020, seniors population expectedto increase by 74%• Highest increase of any LHA in FH2

Determinants of health inTriCities …TriCitiesBCAv Income $77,000 $67,675University grad 25% 22%Low Income 17.6% 17.3%Vulnerablechildren27.2% 28.6%3

Diversity in TriCities …34% of residents are immigrants• BC = 27%Language spoken in home is non-English for21.6% of residents• BC = 15.7%1.5% are of aboriginal ancestrySource: FH Community Health Profile 2010 and 2006 Census Statistics Canada4

TriCities is comparatively healthyLower incidence of obese or overweightadults -Fraser North 40.5%Fraser South 51.8%Fraser East 50.0%BC 44.5%Lower incidence of death from ischemic heartdisease and stroke, compared to other LHAsin FH.Source: FH Health Profile 2010 and FH Community Profile 20095

TriCities is comparatively healthyTriCitiesFH BCLonger life expectancy: 82.5 81.5 81.4Lower incidence of smoking (%) 14.0 14.9 15.1Lower rate of hepatitis C(per 100,000) 38.0 47.2 55.7(FN)TriCities has the 2nd lowest teen pregnancy rate in FH.6

Opportunities for improvementHigher rate of diabetes in seniors 23.4%BC = 21.9% FH = 24.8%Higher incidence of cancer in men over 65second highest of all LHAs in FHLower rate of breast cancer screening 46%BC = 50%Source: Cdn Community Health Survey 2007/09 and FH Seniors Health Profile 20107

What we are doing• FH worked with Port Coquitlam to develop afood policy to ensure healthy food in municipalfacilities• FH worked with Coquitlam and Port Moody topass bylaws banning smoking in parks, patiosand around buildings.8

TriCities range of servicesMental Health and AddictionsAmong the local services:• Psychiatric liaison nurse in the ERH emergency department• Community Mental Health Centre• Collaborative Care Program• Contracted addictions outpatient counselling/prevention programserving adults and youthAmong the regional services:• Emergency Services• Withdrawal Management Services for adults and youth• Specialized Mental Health and Addiction services for infants,adolescents and youth• Developmental Disabilities Mental Health Services for adolescents andadults• Tertiary Care beds on the RVH grounds – 64 beds in Connolly,Cottonwood, and Cypress Lodges9

TriCities range of servicesHome HealthServices include –• Home Care Nursing• Community Rehab/Social Work• Community Palliative Care• Case Management• Home Support Services• Health services for Community Living• Adult Day Programs• Hospice• Acquired Brain Injury Program• Home Health is continuing to build capacity to meet demand andhave access seven days per week to Home Health Services• As of February 2011, redesign of Home Health Liaison services willprovide seven day per week support for clients with complex multiservicereferrals.11

TriCities range of servicesPublic HealthServices include but are not limited to –Health Promotion and Prevention• Early Childhood Screening, Assessment, development programming• Best Beginnings programs for prenatal and postpartum, as well asNursing support for children with complex care needs at home• Immunization and supports around management of communicabledisease• Improving population health through community development andpartnershipsHealth Protection• Environmental Health Services ensuring safe food, pools, personalservice establishments, drinking water, and air quality• Community Care Facilities Licensing promoting and protecting thehealth and safety of children and adults in licensed residential andchild care facilities.12

EAGLE RIDGE HOSPITAL13

Who we are• Eagle Ridge Hospital (ERH) is a communityhospital and part of Fraser Health’s acutecare network• 1,205 staff• 150 physicians• 406 volunteers14

Hospital Services• 24/7 emergency service15

Hospital Services• 6 operating rooms16

Hospital Services• 127 inpatient beds• Monitored Care Unit• Medical• Surgical• Rehab• Subacute• TCU75 - Residential17

Hospital Services• Ambulatory Care program (endoscopy,surgical/medical procedures)• Outpatient services (counseling, therapies)• Diagnostic Imaging• Laboratory18

Stats – Last Year• ER visits – 42,006• Patient admissions – 4,958• Patient days – 39,919• Surgeries – 6,261• Medical Imaging visits – 43,062• Laboratory visits – 612,51519

AuxiliaryThis group raises approximately $100,000 peryear and supports the purchase of muchneeded equipment, as well as other sitepriorities - in the past year, the renovatedand refurnished patient lounges and lobby.20

FoundationThis group raises approximately $1.5 million per year to supportthe needs of the hospital.Examples of equipment purchased in the last two years include:• OR light, table, laser, and equipment• Ultrasound for Emergency and Cardiology• Medication carts• Ceiling lift• Ice machine• Intubation system• Mobile c arm for Medical Imaging• Chair and stretchers• Ventilator• Treadmill21

FH Capital RenovationsIn last year, includes –• $2.2 million electrical upgrade• $500,000 chiller replacement• $200,000 medical vacuum and medical airupgrade• $180,000 cooling tower replacement22

FH Capital Investments …Examples of Fraser Health capital equipmentinvestments:• Ceiling lifts• Intravenous pumps• Colonoscopes• Lab Centrifuge and refrigerator• Stretchers/Beds• C.T. Scanner upgrade• Blanket warmer23

Eagle Ridge HospitalService ReviewThe service review identified potentialopportunities to achieve ongoing qualityimprovement at Eagle Ridge Hospital andshape the future role of the site.The review presented 27 recommendationsfor consideration.24

Where we’re at …88% complete or in progressRECOMMENDATION # COMPLETE IN PROGRESSFUTURECONSIDERATIONERH role and mandate 1 Medical governance and physician coverage 2 Medical governance and physician coverage 3 Medical governance and physician coverage 4 Core services for community hospitalEmergency Department 5 Emergency Department 6 Medicine 7 Medicine 8 Medicine 9 Surgery 10 Surgery 11 Surgery 12 Monitored Care Unit 13 Monitored Care Unit 14 Monitored Care Unit 15 Monitored Care Unit 16 Monitored Care Unit 17 Hospitalist Service 18 Hospitalist Service 19 Ambulatory Care 20 Ambulatory Care 21 Specialty services which could be offered at ERHMental Health 22 Mental Health 23 IV Therapy 24 Neurology 25 Gastroenterology 26 Other Services 27 25

Since review began we haveachieved …• Confirmed role as community hospital• Added rehab/medical beds (approx $4 M)• Increased specialist access with Rapid Access Clinic• Added surgical time including urgent/emergent generalsurgery• Added endoscopy time including urgent/emergent(renovations done to achieve this)• Added wound care specialist• Revised medical structure with ERH specific leadership• Added home health services• 24/7 internal medicine as of January 2011• Renovations to the Emergency Department• Added Hospitalist support.26

In progress …• Ambulatory Care scheduling system• Ambulance protocols• Further growth of general surgery• New MCU department head.27

Actions for futureconsiderationThe only recommendations that areoutstanding are those related to MCU. Onceinternists in roles, along with the program,they will do future planning for the MCU roleand mandate.28

What’s s next?• Continued work on recommendations• $1.5 million allocated to relocate people fromoffices from 2 nd floor wing and renovate space toprepare for future patient use (20-30 beds)• Programs are doing strategic planning and willconsider information/recommendations in thatwork• Master Planning for the site beginning this year toidentify future facility needs to meet services.29

Royal Columbian HospitalVivian Giglio,Executive Director RCHFebruary 2011

Royal Columbia Hospital:Serving Community & Province• RCH is the community hospital for the residents of New Westminster and immediatebordering areas of Burnaby and Coquitlam• RCH is a referral center for Fraser Health• RCH is the Tertiary Hospital for FH and BC providing specialized programs, such astrauma, cardiac, maternal child youth, and neurosciences• 410 Acute care beds (including 24 NICU beds)• 61,000 ER visits 2009• 2,900 Babies delivered per year• 149,000 Ambulatory Care and Outpatient visits• 23,000 CT scans• 5,600 MRIs Statistics: Decision Support 2010

Patient Populationsserved by RCHWhere Our Patients Live• 34% Inpatients live in theTriCities areaSurrey14%Maple Ridge6%Burnaby12%•15% Inpatients live in theNew WestminsterareaOther15%New Westminster15%Langley4%Tri-Cities34%Decision Support:2008-2009

RCHTertiary Services for Fraser Health andbeyond• Trauma Services• Cardiac Services• Neurosurgery• Maternal/ Infant/ Child/ Youth - (NICU)

Trauma Centre• Only Level 1 Trauma Centre in Fraser Health; servesroughly 1/3 of the population of BC and 1.6 millionresidents within Fraser Health• 10,000 trauma patients are treated in the EmergencyDepartment per year• Auto Launch program is the busiest in BC with 10transfer transports per month• 37% of BC’s Trauma Patients are seen at RCH.Statistics: 2008/09

Cardiac Care• Recognized leader in BC in providing a fullrange of cardiac services & one of the busiestin Canada• Provides the only cardiac catheterization andheart surgery in Fraser Health• One of five heart centres in the province butprovides a third of all angioplasties and aquarter of all heart surgeries in BC• 840 open heart surgeries past year• 4,900 heart catheterizations performed in onlytwo catheterization labs (10 per lab/ per dayon average)Statistics: Decision Support: 2009

Surgical ServicesNeuroSurgery• The neurosurgical referral centre for 1.6 M residents of Fraser Health• 1250 neurosurgeries per year ;30% scheduled, 70% urgent – emergentTrauma Orthopedic Surgery• 1720 cases Orthopedic Surgeries; orthopedic trauma and elective/urgent care,including complex surgery such as hand reconstruction and pelvic surgerySpecialized Vascular /thoracic and chest surgery• RCH is the only site in FH providing Vascular/ Thoracic Surgery specializing intrauma cases and surgery involving the circulatory system and the chestComplex General SurgeryStatistics: Decision Support: 2009

Maternal Infant Child YouthNeonatal Intensive Care• Tertiary referral centre for Fraser Health & theprovince, specializing in care for high-riskpregnancies & neonatal intensive care• 2900 deliveries & 612 babies admitted toNeonatal Intensive Care Unit (2009/ 2010)• Maternity care for local communities

Royal Columbian HospitalPlans for the futureWorking with Province andother partners• New Build:New ED, combined surgicalsuite & critical care tower• Vision:Overall capacity over 700beds• Renovation to the Health CareCentre