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UBC Hospital prepped for cuts Savings modest as patients face inconvenience Pamela Fayerman Vancouver Sun Thursday, December 19, 2002 The long and drawn-out saga over the fate of the University of B.C. Hospital is expected to culminate today with an announcement that it is to be downgraded to a site offering only elective surgery and limited service for urgent, not emergency, care. A decade of speculation should come to an end when the Vancouver Coastal Health Authority (VCHA), whose representatives would not comment when asked to do so Wednesday, is to deliver news of the impending changes to health professionals today. The authority scheduled an all-day private meeting Wednesday to finalize the decision about the 20-year-old hospital which has an $80 million a year budget. The VCHA has a $1.9 billion annual budget and the cost savings associated with the UBC changes are not expected to reap more than a few million dollars in the first year. The public won't find out specific plans for patient care until later today or Friday but it is expected that many routine surgical procedures will be shifted from Vancouver General Hospital's West 12th Avenue site to UBC. The two sites will swap cases, with VGH taking the most serious cases. The changes are not expected to be implemented until the first quarter of 2003. The UBC emergency department, which had 20,000 visits last year -- compared to 50,000 at the VGH site -- is expected to be designated as an urgent care centre, which will treat only patients who don't need surgery and aren't in a state of trauma. Essentially, that means it will be for the walking injured, and ambulances would take seriously ill patients to VGH or St. Paul's Hospital. Dr. John Cairns, dean of the UBC medical school, who last week expressed alarm, said Wednesday he is not as worried about the reconfiguration of the UBC hospital because he has been assured that any changes will not compromise the training of medical students, residents and post doctoral fellows. "Any change is always a cause for concern and we felt our concerns from the perspective of education and research, weren't being addressed initially, but now they have been taken into account," he said, adding that changes will present more of an inconvenience to patients and students alike. "Essentially, our residents will have to move around the system, getting experience in various places," he added, referring to the fact that other hospitals in the region, like the one in Richmond, will have to play more of a role in teaching medical students. "The thing that everybody needs to understand is that there are financial constraints in the system and we must face this reality that they are trying to achieve operational efficiencies," Cairns said. While UBC will see a shift from being a full-service hospital to a sub-acute facility doing planned, elective surgery, it will retain its brain research centre, student health services, psychiatry services (55 beds) and outpatient clinics, which include those for neurology, Parkinson's disease, and multiple sclerosis. The Purdy Pavilion, which has nearly 200 long term care patients, will also be unaffected. VCHA background documents estimate the cost savings at $5 million a year with a one-time cost of upgrading the emergency department at VGH at about $3 million. Cairns said apart from the cost savings, there should be improved efficiencies to patient care. He said if elective surgery is consolidated at the UBC site, there won't be as many cancellations due to emergency cases bumping the elective cases out of the operating room. That is a frequent occurrence at VGH. The changes the VCHA makes to the hospital will cap a long- standing and continual erosion of the UBC hospital's mandate. In 1994, a year after the closure of Shaughnessy Hospital, the rumour mill was rife with speculation the UBC Hospital would be closed. At that time, the hospital had 200 acute care beds open; today it has just over 100. The uncertainty over the fate of the hospital, especially in the past six months, has meant that doctors have been leaving en masse, jostling to secure privileges at other hospitals so they wouldn't be caught without a place to treat patients when the final decisions about UBC were made. The panic reached such a point that there have been times in the past few months when there were no anesthesiologists or internists available for surgeries at UBC and the severe drop in patients meant that there was less teaching going at the UBC site. Discharge records show that last year, there were 5,687 patients who stayed in the hospital, compared to 6,207 in the 2000/2001 period. Dr. Lynn Doyle, the vascular surgeon who is president of the B.C. Medical Association, said she doesn't know what kinds of surgery the hospital will do but expects it can be little more than "lumps, bumps, hemorroids and hernias" without an emergency department and without intensive care beds or a broad range of specialists. She said even some of her straightforward vascular cases have been impossible to do at the UBC site lately, because of the shortage of anesthesiologists. Even more uncertain is how the health authority proposes to shift more burden on the already strained VGH site where it is not uncommon for emergency department delays of several hours, and where even urgent surgery cases are delayed for days or weeks. Judith McGrath, a UBC psychiatric nurse who is also a chief steward of the B.C. Nurses Union, said there are 616 registered nurses working at the UBC site (compared to 2,500 at VGH) and "it would be nice if the people making these decisions sought the advice of the professionals working at the patient bedsides." [log in to unmask] SOURCE: The Vancouver Sun http://www.canada.com/vancouver/news/story.asp?id=4466142E-2D95-4D21- A83C-0BDC0E64294D * * * Murray Charters <[log in to unmask]> http://www.geocities.com/murraycharters/ ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn