Memo sent on behalf of Ben Williams ~ Frequency of MRP Assessment

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The following has been sent on behalf of Dr. Ben Williams, Vice President Medicine, Quality, Research and Chief Medical Officer

  

Colleagues,

 

I am writing to follow-up on the memo sent last week by Deputy Chief Medical Officer, Dr. Michelle Weizel. This memo outlined the pressures facing Most Responsible Practitioner (MRP) services and the need for flexibility to ensure that all patients are cared for by an MRP. 

 

Traditionally, Island Health has required daily MRP assessment of “acute” patients and as-needed assessment of “Alternate Level of Care” (ALC) patients. In the current context, this is not the most effective use of MRP resources.

 

We trust your clinical judgment regarding the frequency of MRP assessment in our hospitals and we acknowledge that there is a spectrum. As Chief Medical Officer, I ask you to implement the changes below immediately to ensure best use of limited MRP resources:

 

  • Newly admitted acute undifferentiated patients need to be seen daily, or more often.
  • Stable acute patients, who would access subacute units in other jurisdictions, likely need to be seen every few days.
  • Patients who are ALC awaiting home support, likely need to be seen every few days.
  • Patients who are ALC and awaiting placement in long-term care (LTC), likely need to be seen at a similar frequency to LTC in the community - at most, on a weekly basis.

We understand that clinical status can shift - thank you in advance for your flexibility in trialing this approach, and for your responsiveness to other members of the care team who may contact you, should a patient require more urgent assessment.

 

With these changes, I ask that you indicate in your progress notes, where possible, when the patient will next be seen. 

 

Colleagues have identified that moving away from daily assessments could have the unintended consequence of increasing length of stay. As we adjust to new models of care, it is important that MRPs continue to support discharge planning, regardless of assessment frequency.

 

Over the coming weeks, we will bring formal suggestions to the Health Authority Medical Advisory Committee (HAMAC) to codify this more flexible approach and recommend changes to the Medical Staff Rules to the Island Health Board of Directors.

 

Thank you for your ongoing commitment to patient care.

 

Sincerely,

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Dr. Ben Williams