Success Story Thursday: ERCP Service Improvement

Dr. Denis Petrunia, Dr. Alan Buckley and their gastroenterology colleagues wanted to improve access and availability of endoscopic (ERCP) procedures at Victoria General Hospital. This was a seemingly complicated task involving radiology, gasteroenterology and the surgical day care staff, with implications for patient transfers between RJH and VGH, nursing overtime, physician call schedules, and surgical recovery room distribution. They used their grant from the South Island Facility Engagement Initiative to meet, discuss, and build support for the necessary changes with all key stakeholders.

 

The outcomes of the project are numerous: there are now three recovery beds allocated to ERCP patients, instead of the previous two. More efficient turnaround between cases has meant that up to three patients can be accommodated per day, which has reduced the costs associated with paying staff to stay overtime or work on weekends in order to meet patient demand. Better communication with physician colleagues up and down the island has also led to greater efficiency. “Physicians know who to call, when to call”, states Dr. Buckley.

 

The FEI funding was instrumental in making these changes possible, “by making physicians feel as though their efforts are valued for these kinds of projects”, says Dr. Buckley. “Physicians have been working off the side of their desks for many years, and this funding enables them to allocate time to do this work properly”.

 

A recent shift in staffing, however, has created new challenges to the ERCP service. Whereas previously, the surgical day care nurses had been responsible for recovery of the ERCP patients, at present patients are cared for in a variety of departments, depending on bed availability. Dr. Petrunia feels that this does not result in the best patient care, as the nurses tasked with caring for these patients may not have specialized knowledge about ERCP-related complications.

 

“We are still trying to address this significant deterioration in care”, says Dr. Petrunia. “The funding provided for the quality improvement effort was very useful in development of the team required to address this complex but important issue”.

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