Minister announces 150-day campaign for improvements

NEW WESTMINSTER - Health Minister Michael de Jong today announced the formal start of work on the redevelopment of Royal Columbian Hospital (RCH), while acknowledging its 150th anniversary and announcing immediate actions for improvements in all Fraser Health hospitals.

"Royal Columbian Hospital is at a crossroads in its history," said de Jong. "Now is the time to celebrate its past, create a vision for the future and take immediate concrete steps in the present to ensure the best care for patients both in RCH and throughout Fraser Health."

The Ministry of Health and Fraser Health will be finalizing the redevelopment concept plan between now and October, followed by a more detailed business plan next year prior to the formal procurement process. The Royal Columbian Hospital redevelopment timeframe will be determined through the business plan process.

The redevelopment is anticipated to include hundreds of additional beds, a larger emergency department, a new surgical suite and consolidation of critical care beds. As well, it is anticipated there will be renovations and upgrades to existing spaces to improve recruitment to the site.

A project of this magnitude will take a number of years to complete and the infrastructure at Royal Columbian Hospital has been cited as a factor in the hospital's ability to fulfil its provincial and regional role. Moving forward with redevelopment over the long term will not address immediate concerns around patient care and quality within Fraser Health. The minister's concerns include high numbers of patients in hallways and other non-patient care areas, higher than normal C. difficile and other infection rates, and unacceptable delays experienced by some elderly patients requiring orthopaedic surgery to repair broken hips.

"While work relating to the redevelopment of Royal Columbian Hospital is underway, we need immediate action to ensure staff can continue to deliver the quality and timeliness of care that patients in Fraser Health expect and deserve," added de Jong. "That is why, after consultation with the Fraser Health board chair, David Mitchell, the board will take immediate action on a number of priority measures to improve congestion and infection control in Fraser Health."

A directive issued by the minister to Fraser Health lists measurable improvements in five key areas of care to be achieved within 150-days. Measures and targets include decreased hallway care, decreased hospital infection rates, faster admittance from the emergency department to hospital wards, faster hip fracture repairs and reduction in average of length of stay in all Fraser Health hospitals. A ministry-led team will offer their expertise to Fraser Health as well as monitor progress.

While 2012 marks the 150th anniversary of Royal Columbian Hospital, it is also a pivotal time in preparing for a future that includes redevelopment and expansion. RCH opened in 1862 with 30 beds for men only. Today, it serves one in three British Columbians.

"RCH, in particular, is celebrating a historic milestone this year as we work on planning ahead to ensure a strong future," said Fraser Health board chair David Mitchell. "Fraser Health will continue to work in co-operation with the ministry to ensure the best possible patient care at all of our hospitals."

RCH is a referral hospital and increasing the number of beds through redevelopment will allow patients to be moved from community hospitals to RCH, easing congestion throughout Fraser Health.

Currently, Fraser Health receives the largest share of operating funding from the Ministry of Health of British Columbia's six health authorities with $2.413 billion in funding for 2012-13. This is an increase of 91 per cent from $1.263 billion in 2001-02.

In addition, a number of major health capital projects have been completed or are underway. Capital projects include a new $475.8-million Abbotsford Regional Hospital and Cancer Centre, the $237-million Jim Pattison Outpatient Care and Surgery Centre and a $512-million critical care tower and emergency department at Surrey Memorial Hospital combined with additional hospital beds.

A copy of the Fraser Health congestion report can be found at the following link: www.health.gov.bc.ca/cpa/mediasite/index.html.

Two backgrounders follow:

Media Contacts:

Ryan Jabs
Media Relations Manager
Ministry of Health
250 952-1887 (media line)

Fraser Health
604 450-7881

BACKGROUNDER 1

RCH: past, present and future

RCH past:

• In 2012, RCH is celebrating 150 years of excellence - a historic milestone for B.C.'s first hospital. Oct. 7, 2012 will mark the official 150th anniversary.

• RCH opened in 1862 with 30 beds for men only. Today, it serves one in three British Columbians, men, women, children and babies, and is the busiest air ambulance hospital in B.C.

• RCH is a University of British Columbia teaching hospital, a provincially designated referral hospital for trauma, critical care, cardiac, maternity, neonatal intensive care, and neurosciences for B.C.

RCH present:

• Within 150 days, the Minister of Health expects the Fraser Health to achieve the following five targets:

• Fewer patients cared for in locations not designed for clinical care, such as hallways.

• A decrease in the rate of cases of C. difficile in all hospitals.

• A decrease in the average length of stay in Fraser Health hospitals.

• 90 per cent of hip fracture repairs in Fraser Health done within 48 hours.

• An increase in the per cent of admitted emergency room patients being transferred to the hospital ward within 10 hours of the physician's decision to admit the patient.

RCH future:

• Clinical service planning for RCH got underway in summer of 2011.

• The Ministry of Health is working with Fraser Health to update the concept plan.

• After a final concept plan is approved by the Province, a more detailed business plan is expected to be undertaken in 2013. This will lay everything out in much greater detail including procurement options, financing and scheduling.

• The redevelopment timeframe will be determined through the business plan process.

• Functional programming is expected to get underway shortly with a Request for Proposals to be posted on BC Bid. This will determine sizing and program adjacencies based on services and estimated number of patient visits. Once that is determined then Fraser Health and the Ministry of Health can confirm the clinical scope of the project.

• After the business plan is approved, the next step is getting the green light to proceed to procurement with issuance of a Request for Qualifications, followed by a Request for Proposals, and then negotiating and signing a final agreement with the successful proponent. Once an agreement is signed, then on to construction to redevelop and expand Royal Columbian Hospital.

Media Contact:

Fraser Health
604 450-7881

BACKGROUNDER 2

Quality measures and targets for Fraser Health

Measure
Number of admitted patients receiving care in location not designed for clinical care.

Rationale
A key overall measure of hospital congestion. identifies a risk to patient safety and quality of care.

Current Level
Fraser Health average is 100 patients per day.

150-Days and Ongoing
Decrease by 60 per cent in each facility. No facility to increase.

Best Practice
No patients in other locations.

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Measure
Rate of health care related to C. difficile cases / 10,000 impatient days

Rationale
A preventable source of morbidity and contributor to long hospital stays.

Current Level
Fraser Health: 10.6
RCH: 12.0
SMH: 14.5
BH: 14.5

150 Days and Ongoing
Decrease from the previous period and demonstrated downward trend over preceding six months.

Best Practice
B.C. rate is 8.3.

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Measure
Average length of stay.

Rationale
Reducing length of stay releases capacity across the system and improve the patient experience. This requires proactive planning as well as proactive discharge planning.

Current Level
Average total length of stay in Fraser Health is 8.4 days.

150 Days and Ongoing
7.9 days.

Best Practice
No benchmark available. 

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Measure
Percent of surgical repairs of hip fractures within 48 hours.

Rationale
Timely hip fracture repairs are associated with reduced morbidity, mortality pain and length of stay in hospital as well as improved rehabilitation.

Current Level
Fraser Health: 79 per cent.
RCH: 76 per cent
SMH: 51 per cent
BH: 84 per cent
ARH: 88 per cent
PADH: 79 per cent
CGH: 80 per cent

150 Days and Ongoing
90 per cent with no increase in waits for other urgent unscheduled surgeries.

Best Practice
Major hospitals that scored 90 per cent or higher:
St Paul's Hospital at 97 per cent,
Vernon Jubilee Hospital at 94 per cent,
Langley Memorial Hospital at 93 per cent and
Victoria General Hospital at 93 per cent.

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Measure
Per cent of emergency department patients admitted within 10 hours of decision to admit.

Rationale
An overall measure of patient access and flow after being admitted to the hospital via the emergency department.

Current Level
2011-12 levels
Fraser Health: 51 per cent
RCH: 68 per cent
SMH: 48 per cent
ARH: 51 per cent
BH: 69 per cent

150 Days and Ongoing
Fraser Health: 61 per cent with no facility less than 50 per cent. No decrease in any facility.

Best Practice
Six hours from triage to an inpatient bed is generally accepted as best practice.

Media Contacts:

Ryan Jabs
Media Relations Manager
Ministry of Health
250 952-1887 (media line)

Fraser Health
604 450-7881