After extensive consultation with local residents, Island Health has published a far-reaching plan for Royal Jubilee Hospital. The blueprint is a testament both to how far hospital care has come, and how far it still has to go.
Since 2000, the number of hospital beds in the capital region has declined to 868 from 1,028. With the increase in population, the number of beds per capita declined by a third over that period.
That鈥檚 not a bad thing. It was accomplished by working more efficiently. Despite the reduction in beds, more people than ever are being treated.
However, the challenge for Island Health is to build on this track record. Despite a growing population, no additional construction is planned for the immediate future.
Lessons already learned will go part of the way. In the past, surgery patients often spent days recuperating in hospital. Better anesthetics and clever technology now permit many patients to go home the same day.
Mothers used to stay three or four days in hospital after giving birth. The standard now is one day. And new imaging machines like MRIs have made exploratory operations a thing of the past.
The new plan for Royal Jubilee expands on these measures. Less complex procedures (those that don鈥檛 require a general anesthetic) will be shifted to day-surgery clinics. And some will be contracted out to private providers.
Over the next two years, this should allow the number of hip and knee operations to triple 鈥� a major priority, because wait times are unacceptably long at present.
More than 9,000 additional colonoscopies can also be accommodated in this way. That is an important step toward reducing the incidence of colon cancer.
These efficiencies come with a cost 鈥� not financial, since they save money, but stress-related. As non-emergency patients are moved out of hospital wards, those who remain are, on average, much sicker. That puts pressure on nursing staff.
Even so, there are limits to the savings that can be found by internal efficiencies. One huge problem is the number of elderly patients who occupy hospital beds because community care is inadequate.
Part of the new blueprint calls for rapid response teams to provide care at a patient鈥檚 home. A registry of frail seniors is being compiled that will allow for early intervention before hospitalization becomes necessary.
More effort will also be focused on mental illness and substance abuse. Here, too, the objective is to treat patients in the community, rather than in hospital, where possible.
Still, this is a mammoth challenge. And aging, in particular, will shake our medical system to its foundations.
Country-wide, annual health-care expenditures on 91原创s aged 15 to 64 average $2,600. But the amount spent on those aged 80 and older is $21,000. And the size of this group is projected to more than triple in the years ahead.
Medical science may help. One possibility is organ tissue regeneration, which may be nearing reality. That might bring an end to kidney dialysis, for example, and free up hospital space at the same time.
But one reality stands out: Every member of staff, from caregivers to planners to administrators, has their work cut out for them. Basically, they have to reshape their entire organization.
The new blueprint for Royal Jubilee has been embraced by most local residents, a significant accomplishment by Island Health staff. Hospitals are rarely beloved of the community around them. Their size, their noise (24-hour ambulance arrivals, helicopters coming and going) and their impact on traffic density all irritate neighbours.
It鈥檚 a good start to a good plan. Seeing the plan through will be the hard part.
