SSC Enhanced Recovery Bridge Fund: applications now accepted

The Specialist Services Committee (SSC) is a joint committee between Doctors of BC and the BC government, with regular representation from health authorities. SSC formed in 2006 under the Physician Master Agreement to help the Doctors of BC, BC government and health authorities collaborate on the delivery of specialist services and support improvement of the specialist care system in BC. www.sscbc.ca

The Ministry of Health, health authorities, SSC, and BC Patient Safety and Quality Council are currently exploring the development of a provincial approach to support the sustainability and spread of Enhanced Recovery. During this development period, the SSC has approved a short term Enhanced Recovery Bridge Fund of $221,000 to be used by March 31, 2017 to:

  1. Maintain the Enhanced Recovery infrastructures already in place;
  2. Support the launch of Enhanced Recovery in new sites; and
  3. Help keep momentum going while provincial conversations take place.

The Enhanced Recovery Fund is designed to boost or supplement a site’s current strategies, not address ongoing, operational needs.

In addition to the bridge fund, the SSC is maintaining a network of multi-disciplinary Enhanced Recovery advisors who are available to provide ad-hoc support and clinical, quality improvement, or implementation advice (appendix 1 lists current roster of advisors). The SSC is also maintaining the www.enhancedrecoverybc.ca website, which will continue to serve as a hub of BC Enhanced Recovery resources.

Applications are now being accepted on a rolling basis, as long as funds are available. Applicant sites are encouraged to submit one application with all anticipated activity for the fiscal year 2016/17, as funding may not be available for later submissions.

Review and approval of applications will begin on May 23, 2016.

Details on the SSC Enhanced Recovery Bridge Fund can be found in the attached information sheet.

Questions? Contact Angie Chan, SSC, Project Manager, Surgical Improvement.

Read more

Enhanced Recovery highlighted in Joint Collaborative Committees’ Digital Narrative

A partnership of the BC Ministry of Health and Doctors of BC – Joint Collaborative Committees (JCCs) provide a collaborative working structure to co-create health care improvements and deliver patient care. The Joint Collaborative Committees (JCCs) have prepared a Digital Narrative that shares some of the success stories that emerged from its Showcase held at the end of February.

The Enhanced Recovery Collaborative is a featured story in the Digital Narrative. Follow the link above and click on ‘2 Outcomes of Collaboration’ at the bottom of the page, then click on ‘Enhanced Recovery.’

Research: Provincial ERAS Implementation – Alberta’s experience

Implementation of Enhanced Recovery After Surgery (ERAS) Across a Provincial Healthcare System: The ERAS Alberta Colorectal Surgery Experience

World J Surg (2016) 40:1092–1103

Gregg Nelson, Lawrence N. Kiyang, Ellen T. Crumley, Anderson Chuck, Thanh Nguyen, Peter Faris, Tracy Wasylak, Carlota Basualdo-Hammond, Susan McKay, Olle Ljungqvist, Leah M. Gramlich

Background

Enhanced recovery after surgery (ERAS) colorectal guideline implementation has occurred primarily in standalone institutions worldwide. We implemented the guideline in a single provincial healthcare system, and our study examined the effect of the guideline on patient outcomes [length of stay (LOS), complications, and 30-day post-discharge readmissions] across a healthcare system.

Methods

We compared pre- and post-guideline implementation in consecutive elective colorectal patients, C18 years, from six Alberta hospitals between February 2013 and December 2014. Participants were followed up to 30 days post discharge. We used summary statistics, to assess the LOS and complications, and multivariate regression methods to assess readmissions and to estimate cost impacts.  Read more

Tools: Pain Service Resources

Thank you to Vancouver Coastal Health and Providence Health Care for sharing the following resources:

Patient Education:

VCH/PHC Patient Booklet: Pain and Ways to Manage It

PHC Patient Discharge Continuity of Care Plan for Complex Pain Patients

Staff Education:

PHC Nursing Practice Standard on Ketamine (low dose) Continuous Intravenous Infusion

Order Sets:

VGH Ketamine Infusion Orders

These resources can all be accessed under the Tools menu.

If you apply any of the documents found on this website to your own settings, please acknowledge the organization that originated the documents in your own versions.

 

 

 

Could you benefit from a summer student for your Enhanced Recovery program?

The BC Patient Safety & Quality Council is now accepting applications for the 2016 summer studentships in quality improvement.

The BC Patient Safety & Quality Council is offering funding to support summer students to work with teams across the province to improve care. Teams from any publicly-funded health organization are eligible to submit a project proposal. This program offers students an opportunity to conduct meaningful quality improvement projects while gaining valuable experience in the BC health care setting.

The project term will be 225 hours of work that can take place between June to August 2016. Deadline for applications is April 29, 2016.

Please see the BCPSQC website for details.

Critical Steps to Implementing an Enhanced Recovery Program

This poster captures the key lessons in Enhanced Recovery implementation learned from the 11 Collaborative teams. Check out the poster to learn more about effectively investing in a core Enhanced Recovery team, staff education, data infrastructure, patient education resources, and making the work fun!

This poster was presented by Angie Chan (Specialist Services Committee), Nancy Garrett-Petts (Royal Inland Hospital), Brenda Poulton (Royal Columbian Hospital), and Garth Vatkin (Kelowna General Hospital) at the 2016 Quality Forum and was a Storyboard Winner!

ERAS-Summary-Poster-Feb-2016_v3-final

Thank you to Drawing Change for the excellent artwork.

 

Research: Impact of 24-hour post-discharge telephone follow-up

Call to Care: The impact of 24-hour post-discharge telephone follow-up in the treatment of surgical daycare patients

Shay-Anne Daniels, Amanda Kelly, M.Sc., Deborah Bachand, R.N., B.A., Elizabeth Simeoni, R.N., Christine Hall, M.D., M.Sc., F.R.C.P.C., Scott M. Hofer, Ph.D., Allen Hayashi, M.D., M.Sc., F.R.C.S.C. (January 2016)

Background

Patient satisfaction and effective management of post-operative complaints are important factors in determining the success of outpatient surgery programs.

Methods

In September 2013 a 24-hour post-discharge telephone follow-up (TFU) call, was initiated by surgical day care nurses at the Royal Jubilee Hospital in Victoria, B.C. The study group was contacted to evaluate the effectiveness of the TFU in identifying and addressing post-operative complaints and determining the level of satisfaction with discharge instructions and care. Read more

Personal Perspective: ERAS – Ongoing Quality Improvement Changes to Surgical Care

“Personal Perspectives” provide a space for practitioners and patients to offer their personal views about any aspect of enhanced recovery. “Personal Perspectives” do not necessarily reflect the views of the ERAS Collaborative in general. If you would like to contribute your personal perspective, please contact the Project Manager

ERAS – Ongoing Quality Improvement Changes to Surgical Care

By Deborah Bachand, RN, BA; formerly Manager of Quality Improvements for Surgical Services at Island Health and Member of BC Enhanced Recovery Collaborative Advisory Panel

Change.  I love words, and I’ll bet that many of you are tired of that one. The Oxford English Dictionary tells us it is an old word with Celtic origins; that it can be used as a noun, and a verb both with and without direct objects, that an altered form is also an acceptable adjective.

I have seen a lot of change in my 40 plus years of nursing – mostly good and mostly beneficial to people – our patients. Some changes I have disagreed with.

I disagreed with the move to the BSN program, which purports to train bedside nurses with limited access to the bedsides of real patients. I disagreed with the ‘primary care’ nursing model, which broke down the bonds of teamwork and in my opinion made a hard job harder. But I came around. And then I recently sat in on a local forum where our university community met with the nursing professional standards body to discuss what to do about nurses coming out of the current BSN programs, none of whom at that table considered ‘practice ready’. And most of us are aware of, or have been embroiled in the conflict between health authority administrators, staff, managers and nursing unions over the change back to team nursing – aka CDMR – Care Delivery Model Redesign.

Change is difficult but as someone once said: Change is inevitable – resistance is futile. We can’t undo the changes to university degree nursing or the changes brought about by resource stresses in health care but we can change the way we deliver care to ensure that patients are getting the best we can provide based on statistical evidence, carefully measure outcomes, and by being attentive to the needs of our patients and their desire to get back to life as they knew if before they heard the words “you will need surgery”.

By now you may all be wondering what this has to do with ERAS. Reflect for a moment on ERAS as the new change for surgical care – spreadable, sustainable. Think about how we can never go back to the way things were.

Read more

Tools: Patient Education Video Translated Into More Languages!

The Enhanced Recovery Patient Education Video is now available in English, Mandarin, Cantonese, and Punjabi!

Many thanks to the multi-disciplinary working group that helped to make this video a reality and to our Collaborative community for your valuable feedback over the development process.

Please feel free to use and share these videos widely. We hope that it serves as a useful addition to your patient education materials.

These videos can be applied to multiple procedures using the Enhanced Recovery protocol.

Video screen shot 2