For Cowichan District Hospital (CDH), the era of flipping through thick paper charts and chasing faxed reports is officially over. With computerized provider order entry (CPOE) and new tools for managing equipment and patient flow, CDH is the first community hospital in Island Health to transition to an advanced electronic health record (EHR) system. Not only does this bring quality improvements today, but it will also serve the hospital and community for the longer term when CDH moves to its new location in 2027.
With electronic order entry, instructions from a physician for a blood test or medical imaging scan are sent via computer instead of by paper, phone or fax.
“What we have now, collectively, is a robust framework and foundation based on quality care and patient safety and a deeper insight into how the advanced EHR functionality supports these,” said Emma James, Executive Director for Clinical Service Delivery in the Cowichan Valley and Western Communities.
The electronic system reduces errors, supports clinical best practices and improves efficiency. For example, it is already improving medication management at CDH, thanks to new patient ID and medication bar code scanners that confirm the correct type and dosage of medication is being given to the right patient. Alerts in the electronic system also help care teams make prompt decisions for optimum care of patients; an application called FetaLink in the maternity unit enables fetal monitoring tracings to be shared and viewed remotely; and real-time sharing of information across interdisciplinary care teams helps them assess patients’ risk for certain conditions (e.g., delirium), develop plans of care and evaluate the effectiveness of interventions.
Colleagues and peers support CDH staff transition to new system
The transition was supported by clinical and medical professionals from across Island Health and beyond. Clinical nurse educator Jennifer Osborne works in the Endoscopy unit at Victoria General Hospital and was one of dozens of Island Health staff helping CDH colleagues make the adjustment. “It’s nice to come here and tell people that it’s all going to be OK,” said Osborne. “I didn’t believe it when people said that at my site, but now I know it’s true.”
Twenty-nine resident physicians from the University of British Columbia travelled to the Cowichan Valley to support their medical staff peers. Many of the residents work at Lower Mainland hospitals in the Vancouver Coastal Region and supported Victoria tertiary hospitals when they made the same change last fall—illustrating the close, collaborative working relationship between health authorities as they advance the use of electronic health records to improve and standardize patient care in B.C.
Swapping out paper for electronic orders is one of the largest changes that medical and clinical staff will make in their careers and is only possible with careful preparation, focused education and robust support. CDH thanks their colleagues in Nanaimo and Victoria for their shared learnings, as well as the Cowichan Valley community of family practice and Ladysmith and Chemainus urgent care centres, who stepped up the volume of patient care during the first weeks of adoption. In turn, CDH will “pay it forward” and support colleagues at other Island Health sites “going live” with the advanced EHR in the future.
“We are very proud of the CDH team for their hard work and professionalism throughout this whole process,” said Dr Kelsey Kozoriz, area Executive Medical Director. “Like any worthwhile change, this transition may come with some challenges, however, the teams have a shared commitment and purpose to ensure patient safety and quality are inherent in all that we do.”
