Monday, May 21                                ALL ROUNDS CANCELLED - VICTORIA DAY STAT HOLIDAY

Tuesday, May 22 

0730 hours                                Medical Grand Round:  Rehabilitation Medicine*

                                "Hit or Miss?  The Medically Impaired Driver"

                                Dr. E. Weiss and L. Kristalovich, Lecture Theatre

0830-0915 hours                                Combined Neurology-Neurosurgery Rounds, Radiology Library

0930 hours                                Professor Rounds for Senior Residents, Dr. G. Meneilly, 7CD Conf. Room

1200 hours      Immunology Round:  "Nasal Allergies, Polyps, and Associated Disease"

                                Dr. R. Schellenberg, Hurlburt Auditorium

1400-1530 hours                                CTU Multidisciplinary Rounds

1500 hours                                10C Rounds, 10CD Conf. Room

Wednesday, May 23

0800 hours                                CTU Morning Report, Dining Room 3

1300 hours      Medical Student Pharmacy Teaching Session, Dr. M. Legal, Dining Room 3

Thursday, May 24                         

0700 hours      Medical Student Teaching Session, Dr. S. Millington, Chief Resident, Dining Room 3

0730 hours      Cardiology/Cardiovascular Surgery Round: "Case Review and Discussion"

0800  hours                                "Smoking Cessation"*

                                Guest Speaker:  Dr. A. Pipe, Hurlburt Auditorium

0730 hours                                Medical-Surgical GI Rounds, GI Clinic Conf. Room, Level 2, Providence Bldg.

0730 hours                                Pulm X-Ray Rounds, 8AB Conf. Room

0800 hours                                CTU Morning Report, Dining Room 3

0900-1100 hours                                Rheumatology Rounds:  "Case of the Week and Topic Review", 7CD Conf. Room

1200 hours                                Noon Round Not Assigned

1200 hours                                CCU Teaching Rounds, CCU

1215 hours                                Infectious Diseases Round, Conf. Room 7, Level 1, Providence Bldg.

Friday, May 25

0800 hours                                CTU Morning Report, Dining Room 3

1130 hours                                iCapture Seminar Series:  "Growing Problems:  The Signaling Events that Underline Cardiac Hypertrophy"

                                C. Proud, Gourlay Conf. Room

1200 hours                        HIV/ID Round:  "TBA"

                                          Dr. M. Hull, Hurlburt Auditorium

1300 hours                                Clin Path Radiology Pulm Round, Gourlay Conf. Room, Hugh McDonald Research Wing

1300 hours      Medical Student ID Teaching Session, Dr. M. Hull, Dining Room 3

1315 hours      Junior Resident Bedside Teaching, Dr. S. Millington, Chief Medical Resident, 7CD Conf. Room

*"This event is an accredited group learning activity as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada"

Monday, May 7    

0700 hours      Medical Student Teaching Session, Dr. S. Millington, Chief Resident, Dining Room 3

0800 hours                                CTU Morning Report, Dining Room 3

0900 hours                                General Surgery Pathology Rounds, GI Clinic Conf. Room

1200 hours      General Internal Medicine Round:  "TBA"

                                Hurlburt Auditorium

1315 hours                                Medical Student Bedside Teaching Session, Dr. S. Millington, Chief Resident, 7CD Conf. Room

Tuesday, May 8   

0730 hours                                Medical Grand Round:  Critical Care Medicine*

                                "Age, Sex, and ICU:  Access and Outcomes"

                                Dr. P. Dodek, Lecture Theatre

0830-0915 hours                                Combined Neurology-Neurosurgery Rounds, Radiology Library

1100 hours                                Neurology Professor Rounds, Dr. R. Keyes, 7CD Conf. Room

1200 hours      Neurology Round:  "CT Head Scan Review"

                                Dr. R. Keyes, Hurlburt Auditorium

1400-1530 hours                                CTU Multidisciplinary Rounds

1500 hours                                10C Rounds, 10CD Conf. Room

Wednesday, May 9

0800 hours                                CTU Morning Report, Dining Room 3

1300 hours      Medical Student Pharmacy Teaching Session, Dr. M. Legal, Dining Room 3

Thursday, May 10     

0700 hours      Medical Student Teaching Session, Dr. S. Millington, Chief Resident, Dining Room 3

0730 hours      Cardiology/Cardiovascular Surgery Round: "Case Review and Discussion"

0800  hours                                "TBA"*

                                Dr. R. Carere, Hurlburt Auditorium

0730 hours                                Medical-Surgical GI Rounds, GI Clinic Conf. Room, Level 2, Providence Bldg.

0730 hours                                Pulm X-Ray Rounds, 8AB Conf. Room

0800 hours                                CTU Morning Report, Dining Room 3

0900-1100 hours                                Rheumatology Rounds:  "Case of the Week and Topic Review", 7CD Conf. Room

1200 hours                                General Medicine Outpatient Round:  "Everything in the Known Universe Tagged Weakness"

                                Dr. J. Andrade, Hurlburt Auditorium

1200 hours                                CCU Teaching Rounds, CCU

1215 hours                                Infectious Diseases Round, Conf. Room 7, Level 1, Providence Bldg.

Friday, May 11

0800 hours                                CTU Morning Report, Dining Room 3

1130 hours                                iCapture Seminar Series:  "Bcl-2 Family Proteins With Functions Unrelated to Apoptosis"

                                V. Duronio, Gourlay Conf. Room

1200 hours                      Nephrology Round:  "Fascinating Case Presentation"

                                          The Renal Team, Hurlburt Auditorium

1300 hours                                Clin Path Radiology Pulm Round, Gourlay Conf. Room

                                Hugh McDonald Research Wing

1300 hours      Medical Student ID Teaching Session, Dr. M. Hull, Dining Room 3

1315 hours      Junior Resident Bedside Teaching, Dr. S. Millington, Chief Medical Resident, 7CD Conf. Room

*"This event is an accredited group learning activity as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada"

Providence Health Care celebrates its 7th anniversary on Wednesday, May 2nd.

Let us join together to celebrate our rich diversity of people and professions that enable Providence

to continue its tradition of compassionate care, teaching and research.

Please join us at:

St. Paul's Hospital for Pastries from Around the World on May 2nd, 10 am - 11 am in the Cafeteria.

Join us Mother's Day, Sunday,
May 13th for the BMO Bank of Montreal PACIFIC SPIRIT RUN.

ST. PAUL'S HOSPITAL - DEPARTMENT OF MEDICINE
1081 BURRARD STREET, VANCOUVER, B.C. V6Z 1Y6    Tel 682-2344 Ext. 62676
Web address:  www.emedicine.bc.ca

Rounds April 9 - 13, 2007

Monday, April 9    ALL ROUNDS CANCELLED - EASTER MONDAY STAT HOLIDAY

Tuesday, April 10 

   
0730 hours    Medical Grand Round:  Allergy/Immunology*
    "The Rise in Allergy"
    Dr. A. Kanani, Lecture Theatre

0830-0915 hours    Combined Neurology-Neurosurgery Rounds, Radiology Library

1100 hours    Neurology Professor Rounds, Dr. R. Keyes, 7CD Conf. Room
        
1200 hours    Neurology Round:  "TBA"
    Dr. S. Clarke, Hurlburt Auditorium

1400-1530 hours    CTU Multidisciplinary Rounds

1500 hours    10C Rounds, 10CD Conf. Room

Wednesday, April 11

0800 hours    CTU Morning Report, Dining Room 3

1300 hours    Medical Student Pharmacy Teaching Session, Dr. M. Legal, Dining Room 3

Thursday, April 12  

 
0700 hours    Medical Student Teaching Session, Dr. S. Millington, Chief Resident, Dining Room 3

0730 hours    Cardiology/Cardiovascular Surgery Round: "Case Review and Discussion"
0800  hours    Distinguished Speaker Series:  "Obesity-related Metabolic Risk Factors for CHD: Nature versus Nurture?"*
    Dr. R. McPherson, Hurlburt Auditorium

0730 hours    Medical-Surgical GI Rounds, GI Clinic Conf. Room, Level 2, Providence Bldg.

0730 hours    Pulm X-Ray Rounds, 8AB Conf. Room

0800 hours    CTU Morning Report, Dining Room 3

0900-1100 hours    Rheumatology Rounds:  "Case of the Week and Topic Review", 7CD Conf. Room

1200 hours    General Medicine Outpatient Round:  "TBA"
    Drs. E. Stadnick and J. Udell, Hurlburt Auditorium

1200 hours    CCU Teaching Rounds, CCU

1215 hours    Infectious Diseases Round, Conf. Room 7, Level 1, Providence Bldg.

Friday, April 13

0800 hours    CTU Morning Report, Dining Room 3

1130 hours    iCapture Seminar Series:  "CTAG - Not Just Another Pretty Nucleotide Anagram"
    Dr. J. Brunstein, Gourlay Conf. Room

1200 hours        Nephrology Round:  "Fascinating Case Presentation"
    The Renal Team, Hurlburt Auditorium

1300 hours    Clin Path Radiology Pulm Round, Gourlay Conf. Room, Hugh McDonald Research Wing

1300 hours    Medical Student ID Teaching Session, Dr. M. Hull, Dining Room 3

1315 hours    Junior Resident Bedside Teaching, Dr. S. Millington, Chief Medical Resident, 7CD Conf. Room
   
*"This event is an accredited group learning activity as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada"
 

Rounds April 16 - 20, 2007  BELOW

The AARC Conference is packing up today in Las Vegas. We will have a recap of events and any ground shattering breakthroughs once the haze has settled: Until then, here is an EXCLUSIVE photo of a new mode of ventilation developed here in Canada, NAVA [Neurally Adjusted Ventilatory Assist]  Dr. Christer Sinderby with a demonstration of NAVA in operation at the Maquet Booth at the Las Vegas Conference. (©2006-2007 Peter Daugulis )

For some background info you may check out the following link

Click to enlarge:

Starting next Tuesday, November 14th we will start switching two of our Heparin Products to different formats.

Heparin 10,000 unit/mL (5mL) multidose vials will be switching to single dose 1mL amps same concentation of 10,000 units/mL.  For the Wardstock Techs when making the switch please consider that 5 doses were available from the multidose vial and only 1 dose from the new single dose amp so multiply the quantity given by 5.  I will not be making the switch in RxTFC until Tuesday morning so on Tuesday the 5ml vials will still appear as wardstock but will be switched out of RxTFC that day.  The switch will happen over the weekly top up schedule so as you come across wards over the week that carry the 5mL vials please switch them out with the amps at that time.

The other switch will be the Heparin 100 units/mL (10mL) vial to a Heparin 100 units/mL (3mL) Preloaded Syringe.  Please see memo attached from Jocelyn Hill & Steve Barnes regarding this.  For the wardstock Techs we again will be making the switch over the regular top up schedule next week.  The CNL's were notified and suggested that at SPH the bottom drawer on the med carts could be used (where mini-bags are kept now) and at MSJ the second bottom or bottom right hand deep drawer could be used on each med cart for storing these on the "wardstock" side of the carts.

Please be aware that the Heparin Syringes look similar to the Saline syringes they have now so please make sure they are put in separate drawers.  I will stock the Heparin Lock syringes today in RxTFC so the wards that will be stocking them will have them listed next week.  We have tried to best estimate usage by ward but we may have to continue to adjust quotas as we figure out usage by med cart.

 
If you have any questions please contact myself or Steve.

Thanks,


Ian Quinn
Technician Manager
Pharmacy Department, Providence Health Care
1081 Burrard St, Vancouver, BC V6Z 1Y6
Ph: 604-806-8185
Fax: 604-806-8154
Internal Pager: 54178
External Pager: 604-205-8602

Here is a 'Mark your Calender' notice and 'Call for Abstracts for the Imagine 2007 Nursing Conference, which is being coordinated by the PHC Nursing Councils.

 This day is a great opportunity to spotlight all the work being done by PHC Nurses in different areas. We encourage all nurses who want to share their work to submit an abstract, regardless of whether they have ever presented before.

PLEASE POST FOR YOUR STAFF
Your Unit / Area has been identified as an area that uses heparin (100 units/mL) in a 10 mL "green" vial for CVC flushing.

In an effort to reduce the risk of medication errors, eliminate partial vials and wastage, while also reducing preparation and administration time for nursing staff, these vials will be replaced with:

Pre-filled syringes of 3 mL heparin 100 units/mL (in a 10 mL syringe)
 
These syringes will be used for non-tunneled (Arrow) and tunneled (Hickman) CVCs. In situations where 5 mL of heparin 100 units/mL is required, i.e. Implanted Venous Access Devices (Port or dome), two syringes are to be used.

Stock of the vials on the units (i.e. in the medication carts, etc.) will be removed and replaced with the new pre-filled syringes starting Tuesday, Nov. 14, 2006.  The goal is to have all stock of the syringes in place by the end of the week - Friday, Nov. 17, 2006.  Pharmacy will be responsible for continued stock levels of the syringes on the units.

Please contact Jocelyn Hill (Local 62693) if you have any problems or concerns.
 

Changes to this form include:
* renaming the form to acknowledge the prescribing privileges of various disciplines enabled by the Health Professions Act; please refer to the formulary http://phcconnect/program_9713/subprogram_9719/index.htm for specific policies regarding medications and their ordering

* a listing of unsafe abbreviations known to be commonly implicated in medication errors and their safe alternatives to be used when writing medication orders

* deletion of the Automatic Stop Order listing; this information can be accessed from the formulary at the hyperlink above

* a listing of anti-infective doses and current costs on the reverse of the form to support the cost-effective prescribing of these agents
The decision to delete the "Antibiotic Orders" form was based on the safety advantage of using a common, chronological order process for all medications. With the deletion of the "Antibiotic Orders" form, clinicians may find it challenging to isolate the names, durations, sequence, and combinations of anti-infective agents used in an individual patient from their healthcare record. Therefore, Pharmacy has created a report that will allow the printing, in chronological order, of all anti-infective agents prescribed for an individual patient during their current admission; please contact the Pharmacy to request this report (entitled "PHC Anti-infectives All Orders") for a specific patient.
Please do not hesitate to contact me, or Suzanne Tytler (604-682-2344 x.62956) if you have any questions.

Fruzsina Pataky
Regional Medication Safety Coordinator
VCH-PHC Pharmacy Services
Phone: 604-875-4111 x.67607
Mobile: 604-551-7888

What is Code Silver?

Code Silver will be called in the event of a sys-tems failure. These systems can include electric-ity, water, vacuum, medical gases, suction, eleva-tors or computer systems.

Many of these systems (e.g. water) are located in one facility, but with the increase of computer sys-tems in use throughout  PHC, some Code Silvers may affect multiple sites at the same time.

Sequence of Events
The Call Centre is notified regarding the system that is down. They will then notify the Incident Commander (who is the Clinical Coordinator, the Site/Ops Leader or designate until relieved by the Leader On-Call).

The notification is then sent out from the Call Centre via the P.A. with the name of the service and location (e.g. "Code Silver - Suction - Area)".

Roles
Incident Commander - Notify the Leader On-Call and Senior Leader On-Call; establish the Emergency Operations Centre (EOC) as required; request briefings from Security Leader, Physical Plant, and Nursing as required.
Call Centre - Contact Incident Commander; Leader On-Call; Physical Plant; Emergency Pre-paredness and Communications. Continue paging at intervals.
Staff - Follow EPP procedures for the system that is down. See procedure guides on PHC Connect. Depending on the situation, you may need to re-port back to your work area, check on pa-tients/residents to assess the situation and/or report problems to the EOC.
Security - Follow EPP procedures for the system that is down. See procedure guides on PHC Con-nect.


Depending on the type and degree of the system failure, other groups may need to play a role (e.g. IMIS, Shift Engineers).

What improvements have been made to this process over this last year?
After a number of major computer system out-ages, IMIS will be working with each area to re-fine the downtime procedures for each system.

The Emergency Preparedness Committee is also reviewing each system and putting in place plans to test the response for each area.

Commonly Asked Questions and Answers
Q.  How does Code Silver affect me?
A.   Depending on which system has failed, it might affect the care that you provide.
Q.    What if the computers are down? How can I access the Code Silver Procedures Guide on PHC Connect?
A.   In case of computer server failure, updated hard copies of the Emergency Preparedness Plan are kept in the Emergency Operations Centre.

Where do I find more information on Code Silver?
The above listed actions are just a general guide. For more detailed information, please see the Emergency Preparedness Plan on PHC Connect at:

PHC - Emergency Preparedness Plan

 

FLU CLINICS
St. Paul's Hospital


Outlined below are the dates and times for the standing flu clinics in Dining Rooms 1 & 2:

Dining Rooms 1 & 2    Times

6 November/06    07:30 - 16:00
7 November/06    10:00 - 14:00
8 November/06    07:30 - 13:00
9 November/06    10:00 - 16:00
16 November/06    07:30 - 13:00
17 Nov/06 in Dining Room 3    09:30 - 12:30
20 November/06    13:30 - 16:00
28 November/06    07:30 - 13:30



The roving clinics will be held on the following dates, times and locations:

Roving Clinics    Times    Locations

10 November/06    09:00 - 13:00    All Units
14 November/06    08:30 - 09:30    Emergency
    10:00 - 11:00    OR and PAR
    11:00 - 12:00    ICU, CCU, CSICU
    13:00 - 14:00    Pharmacy (Prov 1)
    14:00 - 14:30    Phys. Plant, BioMed
15 November/06    09:00 - 10:00    SPD
    10:00 - 10:30    Lab (SPH)
    11:00 - 12:00    Lab (UBC)
    13:30 - 15:00    Hornby 4th Floor Cafeteria
16 November/06    13:00 - 14:30    Radiology
23 November/06    09:00 - 13:00    All Units
24 November/06    09:00 - 13:00    All Units

 

• Outreach sees patients on 7A - D and 8A only. Other floors have unearthed the Outreach RN pager number, have asked for assistance and have received it. That's not going to work for everyone on our team and that will make this type of response unreliable. It may also make new team members feel like they're failing if they don't see these patients. I've gone to the CNLs on all the excluded wards and told them to use the old way of doing things: page the ICU CNL. If you go to these calls you go as an agent of the ICU CNL and not Outreach. Pages should be redirected to the ICU CNL to keep them in the loop, ‘cause you know these will be pre-codes more often than not.

• Document every visit, no matter how short. You are seen as a new, important hospital resource and I want to be able to show how in demand you are. I'm sure that we will see Sabeeha a hundred times and hardly do anything - but you are part of the reason she could go out.

• Really try to capture utilization times - yours and others. This isn't stopwatch stuff, just reasonable estimations. It's a big important measurement for me.

• We now have an internal and an external communication log. Internal comments are for Outreach group discussion. External comments are there for me to bring to the units we service. Outreach reps now meet weekly with the Chief Medical Resident, CNLs & OL from CTU. If you want a particularly troublesome incident discussed - write it here.

• Transfers out of ICU are automatic follow-ups. These cases can be closed went you feel they no longer need to be active. There was pressure to change this policy, but for now this is how it stands. See me for details if you need the long version of events.

• To ensure consistent and equitable vacation scheduling, carryover and payout practices;
• To maintain a consistent number of regular staff on the work unit at all times;
• To ensure staff receive vacation in accordance with the collective agreements;
• To ensure all approved vacation is taken with a minimum of disruption to patient care;
• Where relief is required, to relieve vacation at straight time, not overtime;
• To ensure sufficient vacation relief lines are built into every unit/department or service as appropriate.

• used to replace staff in baseline positions when they go on vacation
• that are not supernumerary (i.e. staff work in one of the 5/4/3 positions)
• which are funded through the unit/department/service's relief budget (Note that incumbents in these lines are regular staff - i.e. paid sick, vacation and stat holiday pay compared to casuals who are paid 12.2% for vacation and stat holiday pay and no sick)
• all nursing units/programs will have vacation relief lines that cover at least 80% of the unit/programs vacation.
• Other departments/services will have vacation relief lines as appropriate.

• Vacation leave is granted to regular employees based upon the operational requirements of the unit/department/service and the terms of the collective agreement(s).
• Vacation entitlement is to be taken in full by December 31, except as otherwise specified in the collective agreement(s).
• There is no carry over of vacation for Facilities Bargaining unit staff.
• There is no carry over of vacation for Nurses Bargaining Association staff except for operational reasons. When this occurs every effort will be made to reschedule based on a date that is mutually satisfactory.
• There is no carry over of vacation for Paramedical staff except for operational reasons or as requested by an employee and approved by the Employer.

• Concern for the health and wellness of PHC employees precludes the pay out of vacation leave, except on termination or for employees on sick leave who have exhausted all sick leave credits and are not in receipt of other income replacement (i.e. LTD, WCB). In this case they are permitted to request a payout of earned vacation leave credits from their vacation bank.
• Employees on WCB, Maternity Leave, or extended illness at the end of their leave take their vacation or may have their vacation paid out.

• October 17 & 18             1130 - 1300        MSJ (outside cafeteria)
• October 19 & 20      1130 - 1300     SPH (outside cafeteria)
• October 23                    1230 - 1430    St. Vincent's Langara (main lobby)
• *Time TBA    Marion Hospice
• October 25                   1000 - 1200      Brock Fahrni Pavilion (main lobby)
• October 25         1230 - 1430    Youville Residence (main lobby)
• October 27         0830 - 1030    Holy Family Hospital (main lobby)

If you want to attend PEP Days and do not require staffing replacement, you can register onlin quickly and easily

If you have never registered for a course online, you need to sign up first. Make sure you have your employee number available.

Open Internet Explorer and type in ccrs.vch.ca

If you have never registered online for a course before, you need to sign up. Have your employee number available (from your pay stub).

To start, click on ‘Sign Up’ at the top of the page.

Choose the appropriate option for your employment status and click ‘Submit’.

Enter your last name and click ‘Search’.

Click on your name from the list.

Type in your employee number from your pay stub and click ‘Validate’.

Complete the employee information section. Anything with an asterisk (*) is required to create your account. Don’t forget to give us a personal or a work email address so you can receive a confirmation email whenever you register for a course.

Once you complete this section, create a username and password, and provide a personal secret question, click on ‘Submit’.

The system may ask you for more information.

Once you reach the ‘Thank you for registering’ screen you are done! Choose ‘Logon’ to continue and register for your course.

Once you have signed up you can register for your course.
If you are not already there, open Internet Explorer and type in ccrs.vch.ca. Choose ‘Logon’ and sign in with your username and password.

To find PEP Days, click on ‘Courses’ and then choose ‘Search’.

Enter PEP as the term to search for and click ‘Search’.

Click on ‘PHC – PEP Days’ and scroll down to find the session you want to register for. Check the status.

Open means seats are available; wait list means the course is full and you will be wait listed. Click ‘Register’ for your session.
A message at the top of the page will tell you whether you have registered successfully. If the course is full you may be put on the waitlist. If this happens we encourage you to choose another session with seats available.

The system will email you the details of the course you registered for. It’s a good idea to also make a note of the date and location of your session. You can logon any time to see what courses you are registered for if you need to check.

If you are finished, click “Log Off” from the top menu bar.

That’s it!

If you need to change your registration, you can do it from this web site as well. When you log on the home page will show you the course you are registered for. You can choose ‘Reschedule’ to see other sessions or ‘Cancel’ to cancel your registration completely.