Slow But Steady Capacity Improvements: EOC Update

Posted on: January 20, 2023

Each January, we are used to seeing increased capacity in our hospital occupancy, and this year we are saw historical census highs at a couple of our sites. This experience is consistent throughout BC and as a result the Minister of Health directed all health authorities to stand up Emergency Operations Centres (EOCs) with a focus on reducing hospital capacity. 

Island Health's primary Operations EOC, and System Capacity sub-EOCs in acute, community health, long-term care and HHR, were stood up on Monday, January 9th. We are also meeting provincially on a daily basis to share what's working and learn from one another.

Our primary focus has been to respond to the immediate pressures in the hospital system, review processes and identify what road-blocks there are to safe patient discharge. Extraordinary work is happening on the ground that is making positive impacts and helping us cool our overall capacity to more manageable levels. 

We've had a few of our sites drop their occupancy by 10-15% in a short timespan, which is excellent. Overall, we've dropped approximately 3% as a system since January 9th and we'll be continuing this focused work through to mid-February.

The reduction we've seen so far is the result of the commitment of clinical leaders and care teams, working together to create and consider innovative ways to safely discharge patients and support care closer to home. Some examples of the steps being actioned in the health authority include:

  • Concentrated physician engagement and increasing physician clinical resources where appropriate to help manage acute care loads, while understanding that medical staff may not have a resource each day to do so
     
  • Opened convalescent and/or transitional care beds in Victoria, Nanaimo with the establishment of rapid-response teams to support
     
  • Established CHS support for additional beds for under-housed and discharge to community (see also: accessing CHS services)
     
  • Front loaded ED teams with Geriatric Evaluation Management (GEM) support, Community Health Services (CHS) and additional staff to redirect patients to appropriate levels of care and prevent admissions
     
  • Working with surgeons and site directors around evolving surgical slate planning to help manage capacity
     
  • Rapidly sourced and deployed needed supplies and equipment in acute care sites
     
  • Implemented MHSU rapid rounds at RJH with medical director support
     
  • Increasing the Addiction Medicine Consult Service (AMCS) team operating hours from three to five days per week at RJH and increasing AMCS presence at VGH
     
  • Increasing physician Fast Track hours (+6) per day to help with ED, discharges, physician hand-over delays
     
  • Exploring improved access to follow-up care for unattached patients, resolving barriers to discharge. 

Going forward, there are more solutions being discussed and explored, and we're looking forward to continued improvements so that we can continue to provide safe, quality care.

Your collaboration through this period is critical to our success. If you have ideas or identify areas of urgent need, please reach out to your site director to discuss and they will escalate through to the Operations EOC.

​Thank you.