With funding support from the Rural Continuing Medical Education (RCME) Community Program and Cowichan District Medical Society (CDMS), CDH emergency physicians recently participated in a working retreat. The day created space for collaborative learning, care planning, team connection and wellness. Special thanks to Dr. Ava Butler for organizing this family-friendly event. Agenda highlights included:
Tools to Improve Workflow Efficiency. The retreat began with dedicated time to personalize Computerized Provider Order Entry (CPOE) templates—supporting faster, more efficient documentation and reducing time at the computer during busy clinical shifts.
Practice Change from Evidence Review. ED, Internal Medicine, and Respiratory Therapy teams reviewed recent literature on intubation pre-oxygenation (including the PREOXI trial). The teams co-developed a plan to improve practice by:
- Preloading PEEP valves onto BVMs in trauma/intubation rooms.
- Promoting a shared mental model of preoxygenation (denitrogenation with high-flow nasal prongs >15L/min, preoxygenation with PEEP valves on BVMs and gentle bagging during the apneic period), based on the most up to date evidence.
Interdisciplinary Conversations:
- IM Q&A with Dr. Jansz explored common clinical challenges in emergency settings.
- Suction thrombectomy for submassive PE was discussed with interventional radiology (Dr. Kotha)/CDH ED/CDH ICU—initiating a plan to explore transfer-return workflows to ensure patients in the Cowichan District with submassive PE have access to this exciting and relatively novel treatment.
- Overnight imaging resource use was discussed with Victoria radiologist Dr. Pauranik.
Wellness & Team Cohesion. Physicians engaged in lake/pool swimming, kayaking, and quiet recovery activities. The day ended with a family dinner, and opportunities to connect outside the clinical environment.
Open Space Planning. Afternoon unstructured time led to high-yield peer conversations around:
- Summer shift coverage planning.
- Departmental QI project for ED flow.
- Exploring AI scribes to support physician efficiency.
- Improving collaboration with nursing colleagues.