The Department of Medicine (DOM) is supporting four new projects as part of its Innovation Platform. Each project proposes new services or processes that will transform patient care at PHC. This brings the total to 24 projects supported by the platform since it began in 2019.
You can learn more about past projects on the Department of Medicine website or by checking out Daily Scan articles on the St Paul’s Immunotherapy in Neurology (SPIN) Centre and the Aspirin Exacerbated Respiratory Disease (AERD) clinic. The DOM Innovation Platform is part of Innovarium, PHC’s innovation engine, which unites various elements of innovation, fostering a cohesive environment that offers resources and support.
New approach aims for coordinated care and earlier prevention of infective endocarditis
Physician lead: Dr. Simone Cowan, Division of Cardiology, Department of Medicine
Goal(s): Reduce readmissions, reduce length of stay, improve treatment course
St. Paul’s Hospital treats approximately 150 people a year with infective endocarditis (IE). IE is an inflammation of the heart caused by a bacterial or fungal infection of the heart valves or the inner lining of the heart. Complex to treat, this condition usually affects people with underlying heart problems, people who have had a heart valve repair or replacement, people who use injection drugs, or people who are immunocompromised due to an organ transplant or HIV. In 2019, close to seventy percent of the patients admitted to St. Paul’s Hospital’s with IE also had a substance use disorder.
Dr. Cowan and team have developed a multi-disciplinary approach to improve care for these patients. The team will engage primary care providers and other community resources who can play a larger role in supporting populations vulnerable to poor health outcomes. Within the hospital, the team will focus on removing barriers to earlier intervention for IE.
St. Paul’s Hospital is one of only a few centres in Canada to develop a team-based approach to caring for people with IE. The team is continuing to innovate the care for people with IE and is considering a Value Based Healthcare approach to the program, to ensure it meets the needs and outcomes that matter to patients.
New clinic aims to improve diagnosis of rare genetic disorders
Physician lead: Dr. Anthony Gador, Division of General Internal Medicine, Department of Medicine
Partners: UBC Department of Medical Genetics
Goal: Reduce time and cost of diagnosing rare conditions
Patients with rare conditions often struggle to have their condition accurately diagnosed. They visit multiple specialists and often receive conflicting diagnoses, which can make treatment challenging. The new Providence Undiagnosed and Rare Conditions Clinic will support collaboration between an internal medicine specialist, a case manager and a subspecialty expert panel. The team will have access to previous consults and diagnostics. They plan to harness the power of genomics testing to reduce the time and the cost of diagnosis. Genomics testing opportunities are being explored in partnership with UBC Department of Medical Genetics. This is the first time this approach has been taken in BC and it has the potential to improve diagnosis and care for people living with rare conditions.
Streamlining biopsy processes for colorectal cancer screening
Physician lead: Dr. Eric Lam, Division of Gastroenterology, Department of Medicine
Goal: Reduce time needed to deliver biopsy results
Patients receiving a biopsy to screen for colorectal cancer are waiting three weeks or more for their test results. This causes significant patient anxiety and a potential worsening of the disease if they do have colorectal cancer. DOM Innovation will be supporting Dr. Lam and colleagues in the Division of Gastroenterology by bringing together the PHC Quality Improvement and the CST-Cerner teams to streamline this process. Within six months, the team aims to reduce the time to receive results to around one week. They plan to make changes to electronic requisitions, streamline processes within the clinic and expedite how samples get to BC Cancer for testing.
Intestinal Failure Short Bowel Syndrome Clinic
Physician lead: Dr. George Ou, Division of Gastroenterology, Department of Medicine
Goal: Improve access to parenteral nutrition for people living with Short Bowel Syndrome.
Short bowel syndrome is a condition in which the body cannot absorb enough nutrients from foods because part of the small intestine is missing or damaged. Many patients with this condition often end up repeatedly in the emergency department or in hospital for treatment. The proposed clinic would provide long-term management of these patients and enable expedited access to the BC Home Parenteral Nutrition (HPN) program. The HPN program is a provincial resource based out of St Paul’s Hospital but is operating at full capacity. Work is underway with PHSA to expand access to the provincial HPN Program, which will allow for the development of the proposed clinic.
The Department of Medicine Innovation Platform is the avenue for Department members to address a gap in care at PHC. Initiatives can span divisions, departments and beyond. The DOM Innovation Platform is one of the elements of Innovarium, PHC’s innovation engine. If you are from the Department of Medicine and want to learn how to move your great idea forward, visit the DOM Innovation Platform website.