January 2010 - President's Letter

President's Letters | Jan 23, 2010

Saturday, 23 January 2010

Dear Colleagues,

Introduction: The last two months since my last letter have seen a number of developments:

Province-wide emergency overcrowding has worsened, with new local high-water marks for boarded patients (both for number and acuity) set at several hospitals. This clearly has an impact on patient comfort and safety and, at the most badly affected sites, harms staff morale and makes recruiting of nurses and physicians problematic. Recent cutbacks in surgery, acute care beds and other outpatient and inpatient services are clearly forcing more (and sicker) patients to seek care at the place of last resort: the ED.

The EMC committee expired December 31^st 2009. Our Letter of Agreement to work with Government to create an ED “Work-Load-Model” (an objective tool with which to efficiently and fairly anticipate needed ED physician staffing at APP sites) expires March 31^st, 2010.  We had been anticipating a return to local site-by-site negotiations to determine staffing levels, but, with the help of the BCMA, have engaged with government in an intense, review of the issues facing APP site Emergency Departments, with clear deliverables and strict timelines.

Vancouver Coastal Health Authority has quietly and independently developed a complex model of Regional Medical Departments for a number of specialties, Emergency being one, that will allow: “more equitable resource distribution”, “enhanced academic commitment”, “more efficient, effective and appropriate manpower planning”,  “collaboration & integration of medical leaders”,  “implementation of clinical standards, professional and practice accountability and problem solving will continue to sit with the Associate Head, Senior Medical Director, and AMAC leadership”,  “Unified staff with single leadership reporting to both boards” and the “establishment of a standard grid” for “payment for Departments and Divisions”.

We had several small successes and have undertaken several modest initiatives on your behalf:

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