List of Projects

Objectives of Engagement Activity:

To improve ACLS education and delivery to physician and allied staff in the hospital and community setting. Improving physician engagement in cardiac arrest management using simulation as well as feedback and ACLS education on current literature/guidelines, post simulation. With the hope to stimulate an interest in physicians and allied staff engaging in full renewal of ACLS education through the HSF leading to improved participation, adherence to current guidelines and increased inter-professional collaboration, ultimately leading to improved patient outcomes.

Description of Engagement Activity:

To establish a program for regular, circulating ACLS simulations in a variety of hospital departments and potentially medical offices where cardiac arrest is more likely to occur, such as GP offices, medical wards, OR, PAR, ICU, ER. To disseminate current ACLS literature/guidelines through effective knowledge translation. To improve a multidisciplinary team approach to cardiac arrest cases, establishing roles and fluid team dynamics during often chaotic scenarios. To provide feedback to participants on current status and future improvements

Objectives of Engagement Activity:

The RADU will build on models currently operating in VIHA including Cowichan and more recently RJH, using similar guidelines and funding models. These units show faster discharge rates for a specific cohort of patients due to onsite physician care and specific ERP skill sets. The ERP running the RADU during daytime hours would also be available for procedures and specific help to the ED when needed, helping with ED flow as well as decreasing admission rates and hospital overcrowding.

Description of Engagement Activity:

Working group to investigate and initiate the creation of a RADU to replace/improve on the CDU that wasn't moved over to the new hospital. The unit will be ERP run for patients expected to stay a short period of time.

Objectives of Engagement Activity:

Greater understanding of the causes, impacts, and protective factors of burnout on hospital physicians. Recommendation for supports that could be focused on for improving physician wellness

Description of Engagement Activity:

A qualitative investigation is proposed to allow a deep exploration of complex individual experiences and the interplay of local structures and supports. Individual semi-structures interviews will be conducted, data analyzed, and continued comparison employed to develop both the research question, and the interview guide.

Objectives of Engagement Activity:

To ensure physicians, nurses, respiratory therapists, and other members or the multidisciplinary team have the opportunity to practice together, and improve upon situational management of a variety of clinical scenarios.

Description of Engagement Activity:

Physician run process improvement sessions to take place monthly. This will take place in form of high-fidelity simulation, protocol review and revision, as well as regular engagement with the multidisciplinary staff to ensure that all team members are prepared for critical situations in the ICU and elsewhere in the scope of Internal Medicine care delivery.

Objectives of Engagement Activity:

We hope to generate discussion and improve our knowledge on clinically relevant topics which will ultimately transcend into possible change and/or validation of practice which will improve patient care. We are requesting funding for project contributors to attend the above-mentioned meetings and potentially conferences where updates to current practice could be obtained and shared with the remainder of the Division at a later time.

Description of Engagement Activity:

Our division is planning on meeting on a monthly basis for educational, interactive, and networking discussion of relevant topics to clinical practice. The project is approved by the RCPSC.

Description of Engagement Activity:

Providing practicing members to attend Medical Advisory Committee meetings at all levels, that are allowed as MSA internal and external meetings that are not required for maintaining privileges or related to quality assurance activities as per the Funding guidelines Provide MSA practitioners the opportunity to attend workshops as per the MOU guidelines

Objectives of Engagement Activity:

Our objective is to standardize the delivery of telemetry services at the Comox valley hospital, we can improve patient care, hospital flow of telemetry patients, and the efficient use of hospital resources while improving health care provider satisfaction. We hope to align tele unit administration with the health care principle, "right patient, right bed, right time". More specifically, we hope to ensure that the appropriate patients are admitted to the tele unit in a timely fashion and are managed by the most appropriate physician/service.

Description of Engagement Activity:

In its current state, there is a discordance between the patients that would most benefit from telemetry monitoring or cohorting in a single unit, and those that are actually admitted to the telemetry beds. Specifically, many ward patients inappropriately receive telemetry monitors for days and others are inappropriately admitted to the telemetry unit, while patients with life threatening conditions remain in the emergency department for days awaiting a bed in the telemetry unit.

Objectives of Engagement Activity:

Policies and procedures on how suspected cases move through the hospital starting in the ED. Developing an understanding with our colleagues regarding who will be MRP and undertake certain procedures. Develop a manpower plan in the event of a decrease in the availability of ED physicians due to illness or quarantine.

Description of Engagement Activity:

COVID 19 has made its way to our shores. It has officially been called a pandemic and the first case has been reported on the Island. ED physicians are on the front line of identifying and treating patients with this virus while trying to protect themselves and other patients/families from falling ill. This will require an intense review of our isolation and treatment procedures in the ED. It will also require working with our Internal Medicine, Anaesthesia and Paediatric Physician colleagues to ensure agreed upon local responsibilities and procedures. The ED will also need to develop a manpower plan for staffing the department if multiple physicians are either ill or quarantined.

Objectives of Engagement Activity:

Review and update existing pre-printed order sets used at our facility Initiate new order sets based on up to date guidelines and protocols Reassess order sets after a pilot trial at CVH Facilitate VIHA-wide engagement in order sets as appropriate

Description of Engagement Activity:

Multi-disciplinary team of physicians committed to reviewing, updating and initiating new guidelines and protocols in the form of pre-printed order sets. Plan to review pilot projects and facilitate VIHA-wide engagement in these order sets.

Objectives of Engagement Activity:

To create a standardized, evidence-based guideline for interpretation of the new Troponin assay results which will enhance patient care across sites and specialties that use different assays.

Description of Engagement Activity:

To liaise between Emergency and Internal Medicine departments at CVH, as well as these groups at other VIHA hospitals (excluding Victoria) to review the new Troponin assay specifics and create a workable protocol for interpreting the new results. This will also necessitate working with biomedical lab colleagues locally and in Victoria, and also with Cardiology in Nanaimo and Victoria so that we are all on the same page.

Objectives of Engagement Activity:

To improve involvement of family doctors in discharge planning by educating doctors on increased home supports and to improve overall morale in hospital surrounding discharge planning

Description of Engagement Activity:

To improve the culture to encourage the "Home is best" approach by providing improved communications with doctors and enable family meetings near the beginning of an admit(which is what we are supposed to be doing with predicted long stay patients);To ensure that patients are not waiting longer in hospital now that they must go through the cDOC and eDOC reviews prior to getting approved for placement.

Objectives of Engagement Activity:

Ultimately our goal is that parents in the Comox Valley (and specifically the Mat-Child unit of the Comox Valley Hospital) are able to receive services and work with supportive providers, feel confident in their parenting role, and form strong, resilient attachments with their children. Breaking down the goal: - Touchpoints training will be delivered by local certified Touchpoints trainers to 75 physicians and allied providers in the Comox Valley by March 31, 2019. - This will result in a significant shift in experience and ultimately outcomes for families when interacting with services in their community.

Description of Engagement Activity:

Touchpoints is an evidence-based model created by Dr. T Brazelton, a world-renowned pediatrician. Touchpoints improves provider knowledge of early childhood development and reflective practice. As provider knowledge improves, the experience of families at the NIH-Comox Valley Mat Child unit as well as at community agencies should improve. This engagement activity will train physicians and allied providers in the Touchpoints approach. The aim is to strengthen provider - family relationships and, in turn, child - caregiver relationships. Dr Theresa Wilson will work as a trainer in preparatory work, trainings, and working group meetings, and Dr Sara Sandwith will work as an evaluator. Physicians who attend trainings will be compensated for the office overhead expenses accrued while they attend trainings.

Objectives of Engagement Activity:

We intend to meet and create a working group to; - establish ground rules for surgical assists - discuss rationale for surgical assist call schedule - create a surgical assist "course"

Description of Engagement Activity:

Surgeons and Gp's at CVH are struggling with finding appropriately trained and available surgical assists for after hours and weekend coverage. Physicians who are covering in hospital during these hours may not be available or have the necessary OR experience to support the increasing operative demands of these afterhours surgery.

Objectives of Engagement Activity:

Review articles, pre-printed order sets, revamp some aspects of our pre-admission clinic, improve organization within the department, meet collaboratively with other departments to develop shared goals.

Description of Engagement Activity:

Create a collegial working group within our department to facilitate process improvement activities. Work collaboratively with other departments and the health authority to streamline excellent anesthetic care.

Objectives of Engagement Activity:

A more sustainable and optimally functioning DOD program. Recommendations and advice to Purple/Rainbow Groups and other stakeholders are to be developed by the working group. These would then be reviewed by DOD program participants, and implementation would proceed as appropriate.

Description of Engagement Activity:

The Doctor of the Day program has been operating in a similar fashion since 2012. Since its inception there has been an ongoing process of review and revision in response to changing conditions, and the needs and experiences of stakeholders. Over time many worthwhile program modifications have occurred as a result. In response to ongoing concerns about workload and sustainability Purple Group is considering the possibility of changing its way of operating. As with previous modifications of the program, these possible changes will require review of patient volumes, remuneration, and a number of other issues before a decision can be made about the best way forward.

Objectives of Engagement Activity:

1) Improve attendance and engagement at Hip and Knee planning meetings directed by VIHA/CVH administrators 2) Engage with VIHA representatives to move towards acquiring resources to facilitate hiring an additional Orthopaedic surgeon for CVH 3) Work with VIHA to increase resources at CVH to improve patient access to timely Orthopaedic care 4) Monthly Orthopaedic working group meetings to coordinate the above and work on improving Orthopaedic services at CVH and surrounding community

Description of Engagement Activity:

With the recent addition of the hip and knee clinic mandated by the Minister of Health via VIHA, and the inherent challenges of adopting the program, including the possibility of hiring an additional Orthopaedic surgeon, the administrative time required is putting increasing demands on the Orthopaedic group. In order to maintain physician engagement in the process, as well as improve our existing Orthopaedic services moving forward, the Orthopaedic surgeons at the CVH site are requesting funding to compensate for the time and resources taken for meetings outside of those mandated by our hospital privileges.

Objectives of Engagement Activity:

We firmly believe that this will improve patient care as well as facilitate improved communication in the operating room. The multidisciplinary discussions regarding patient safety will also support collegiality among anesthesiologists and surgical staff.

Description of Engagement Activity:

Members of the Department of Anesthesiology at North Island Hospital - Comox Valley Location propose to create a series of peri-operative simulation sessions to improve care in emergency situations. Our goal is to organize quarterly simulation sessions with anesthesiologists, perioperative nursing staff, and interested surgeons to run through a single emergency scenario in approximately 1 hour. The subsequent 1 hour would be spent debriefing and ensuring process errors discovered during the simulation are changed and upgraded. In the days following the simulation, educational materials with the results of our simulation will be disseminated to all peri-operative staff members. Examples of emergency scenarios that we propose to organize include, but are not limited to, Code pink emergency Caesarean section, intra-operative anaphylaxis, massive hemorrhage/trauma laparotomy, difficult airway/can’t intubate can’t ventilate, cardiac arrest in the operating room.

Objectives of Engagement Activity:

Improved patient care and Physician workplace satisfaction by creating working group to brainstorm mini Quality Improvement Projects to facilitate improved communication within the Department of Family Practice to positively impact patient care and collegiality.

Description of Engagement Activity:

A working group to brainstorm mini Quality Improvement Projects to facilitate improved communication within the Department of Family Practice to positively impact patient care and collegiality.

Objectives of Engagement Activity:

1. Educate Emergency Department staff about Opioid Use Disorders (OUD), Opioid Agonist Therapy (OAT) and the complexities of this Public Health Crisis 2. Develop safe local guidelines to start patients on Opioid Agonist Therapy from the ED or home 3. Develop relationships with our community prescribers 4. Develop relationships with our community pharmacies/pharmacists who dispense OAT as they have an important part in the care of OUD patients 5. Develop a referral process that is initiated in the ED that will reliably allow for our OUD patients to have an intake appointment with an OAT provider within 7 days.

Description of Engagement Activity:

The opioid crisis continues both internationally and locally here in the Comox Valley. Our HealthCare community has been developing resources to address this very complex Public Health Emergency but the Emergency Department (ED) has struggled to reliably offer a first-line, safe therapy for several reasons. These reasons include but are not limited to difficulties in educating our colleagues about buprenorphine/naloxone (Suboxone), the lack of a welldeveloped and efficient clinical order set specific to our local ED, maintaining consistency across a multitude of prescribers, barriers to prescribers, barriers for patients to be safely discharged from the ED in a timely manner, and inconsistent follow-up for the patient.

Objectives of Engagement Activity:

Our group strives to engage as many physicians as possible and help foster grass roots cultural change at our hospital. We wish to support every physician in their own personal journeys to Wellness.

Description of Engagement Activity:

We endeavour to have a Physician Wellness activity once per month. These activities will focus on all aspects of Wellness including spiritual, cultural, nutritional, emotional and physical well-being.