Emergency room delays expected as Royal Jubilee Hospital moves to digital system

Victoria’s Royal Jubilee Hospital is going live with a new digital system that could cause temporary delays and diversions from an already busy emergency department, beginning on June 8.

Island Health says the technological upgrade is a necessary component to modernizing the system away from a reliance on paper and fax machines, ushering in the digital system known as computerized provider order entry.

“[The] doctor says ‘You need this medication.’ I put it in the computer, pharmacy gets it right away. They send it and [a] nurse clicks on the computer that it’s given and it’s done,” says RJH’s medical director and chief of staff, Dr. Brian McArdle.

Royal Jubilee Hospital is not the first to roll out the new system. Island Health says the team has already trained to use it but they’ll need time to adjust to use it under pressure in live settings at the site.

“The implementation is obviously necessary. We need to continue digitizing British Columbia medical records. But we need to do it together in a healthy way that supports everyone,” says BC Healthcare Matters co-founder Camille Currie.

The patient advocacy group obtained documents, which have been reviewed by CTV News, that were written by the Victoria Division of Family Practice and distributed to its members – forewarning the potential scale of the impact to patients.

“During the implementation, Island Health expects a temporary 30-50 per cent inefficiency in the emergency department," the documents say.

It anticipates 40 to 50 patients could be diverted away from the emergency department each day over the six-week implementation period. And given the hospital is already operating over capacity, the memo says medical leads at the emergency department are asking for “an impending code orange” through the process.

“We do expect some inefficiencies particularly at the outset,” says Island Health’s acute care services vice-president Marko Peljhan. “And that’s why we’re opening up additional capacity at the Royal Jubilee Hospital effective June 8. We’ll have it there in place for those first couple weeks and we’ll be assessing how long we need to continue it – and that’s an urgent care centre there to be able to create additional capacity to manage the needs of our patients.”

BC Healthcare Matters is critical of Island Health’s handling of the message since it didn’t come to patient and public attention through them first.

“It just furthers our question about whether the health authorities are really always being transparent and accountable to us,” says Currie. “I think that there is an error in assuming that the one stakeholder that you’re leaving out of these conversations doesn’t need to be involved.”

Island Health says its plan has always been to install signage around the hospital next week.

“The hospital is still there for every member of this community who are having a crisis,” says McArdle. “The doors are not closing.”

The public is asked to support staff through the six-week go-live period by understanding the options for medical care, should they need it – such as calling 811 to reach a physician for non-emergencies.

“We want to continue to encourage people that require emergency care to come to the emergency department,” says Peljhan.

Victoria General Hospital will be the next Island Health site to go live with the system in September.