Province acts to enhance health care, support providers in Surrey

“Since June 2023, Fraser Health and the Ministry of Health have collaborated with staff and medical staff to move quickly on solutions we committed to in our 30-point plan to meet the evolving care needs of Surrey’s growing population,” said Adrian Dix, Minister of Health. “People living in Surrey will start noticing the changes and experience better care as we make substantial progress on key actions to improve Surrey Memorial Hospital and connect patients to heart, kidney and other complex care south of the Fraser.”

In the coming weeks, pre-construction will begin for a new standalone renal hemodialysis facility located on the northwestern corner of the Surrey Memorial Hospital campus. It will feature state-of-the-art equipment and will be able to treat more patients with kidney disease by adding 21 new renal services beds, bringing the total to 60. Construction is expected to be complete in 2025 with operations to begin soon after.

Planning and design work is nearly complete and decanting moves are underway for the new cardiac catheterization suites and interventional radiology suites that will be located in the Critical Care Tower at Surrey Memorial Hospital. These expanded services will allow patients to stay closer to home for cardiac and interventional radiology procedures and the hospital will begin serving as one of two regional cardiac catheterization centres for Fraser Health.

In addition, 13 completed actions and 17 in-progress actions are already benefiting patients, families and staff, as well as medical staff at Surrey Memorial Hospital. Highlights include:

• expanded internal medicine bed capacity from 30 beds to 90 beds;
• implemented a Child and Youth Mental Health Emergency Response Team for Surrey Memorial Hospital and Fraser South;
• filled all 15 relational security officer positions at Surrey Memorial Hospital that are now working to prevent and respond to workplace violence, emphasizing customer service, trauma-informed practices and cultural humility and safety;
• recruited 21 resident clinical associates to support the work of hospitalists and internal medicine physicians;
• recruited 75 internationally educated nurses to enhance staffing levels at Surrey Memorial Hospital;
• recruited 70 physicians to work at Surrey Memorial Hospital;
• hiring 117 new nursing graduates and 164 employed student nurses at Surrey Memorial Hospital;
• implemented an expanded overflow waiting area for Surrey Memorial Hospital’s pediatric emergency department;
• opened a new transitional housing space that provides accommodations for patients who require a short stay in a transitional housing environment; and
• enhanced Fraser Health’s successful in-house learning institute to close critical gaps in allied staff and nursing. More than 50 additional nursing seats have been enrolled to date and the Health Career Access Program in acute has expanded to 66 program seats from 50.

“The dynamic growth and transformation of the Surrey community underscore the importance of the significant strides we have taken in implementing our 30 priority actions,” said Dr. Victoria Lee, president and CEO, Fraser Health. “These actions are laying the foundation for expanded, accessible health services to support our patients and their families, while equipping our staff and medical staff to deliver exceptional care for many years to come. I appreciate the continued partnership of the Ministry of Health and our staff and medical staff for their steadfast dedication to completing this vital work.”

Fraser Health has also made significant progress to support women and babies at Surrey Memorial Hospital. Highlights include:

• Launching the Families and Babies Program to connect eligible families with midwives at Surrey Memorial Hospital who provide resources, education and support. The program reduces the length of a patient’s hospital stay and improves access and flow in the Family Birthing Unit.
• Starting work to transform six single-occupancy rooms in the Family Birthing Unit to double-occupancy post-partum rooms, which will provide six additional patient-care spaces for post-partum care. Upon completion, this project will increase the Family Birthing Unit’s bed capacity from 42 to 48 beds, helping support more families with accessing the care they need.

“We are very grateful to the staff and medical staff at Surrey Memorial Hospital as well as our operational and community partners for their dedication to the health and well-being of our patients and their families,” said Dr. Marietta Van Den Berg, site medical director, Surrey Memorial Hospital. “We are all collaborating to bring the new roles and services to fruition, whilst still providing care to our patients. We are committed to making Surrey Memorial Hospital a great place to receive care and a great place to work.”

Over the long-term, actions with active planning underway to support Surrey Memorial Hospital include adding a new MRI and CT scanner with cardiac capabilities to increase access to diagnostic services, as well as renovating existing operating rooms to expand capacity.

“We are committed to continue improving health care in Surrey and I want to thank all of the health staff and physicians at Surrey Memorial Hospital for having met with me last summer over six days of discussions to identify these 30 actions we now have underway to support the health care teams and patients at Surrey Memorial Hospital,” added Dix.

Learn more:

To learn about the progress on the short-, medium- and long-term efforts underway to support patients and health care workers in Surrey, visit: https://www.fraserhealth.ca/your-community/surrey/transforming-health-care-in-surrey

To learn about the June 2023 announcement regarding actions to improve health care services in Surrey, visit: https://news.gov.bc.ca/releases/2023HLTH0081-000894

A backgrounder follows.

Backgrounders

Update on progress to improve health services in Surrey

British Columbia’s population is growing and changing especially in Surrey. As people move to the Fraser Health region, the Province is investing in health services to keep up with growing demand. The Province and Fraser Health are working on 30 priority actions to transform health care at Surrey Memorial Hospital. Progress on initiatives:

Completed actions (13)

1. Work with hospitalists to stabilize their physician workforce and sufficient service levels to ensure continued access to inpatient medicine services by building their capacity and establishing a new contract.

• Surrey hospitalist contracts:
  • Surrey hospitalists agreed to the Interim Stabilization Agreement effective July 12, 2023, to provide a consistent schedule for hospitalists.
  • Health Employers Association of BC is discussing the long-term contract with the Ministry of Health.
• Access to inpatient medicine services:
  • Surrey Memorial Hospital expanded the Internal Medicine Department from 30 to 90 beds in 2023.

2. Increase funding for additional physician coverage, nursing and allied health services, including opening a care and triage unit in the emergency department.

• Increased funds to add more staff for Surrey Memorial Hospital emergency department:
  • Since July 2023, a total of 281 new positions have been posted for all Surrey Memorial Hospital and Surrey communities, including pediatric emergency and emergency clinical staff, as well as support services and more.
  • As of February 2024, 165 of the 281 new positions have been filled, including 22 out of 27 pediatric emergency positions. In September 2023, two nurse practitioners specializing in internal medicine were recruited. Refer to action numbers 5, 6 and 17 for physician recruitment updates.
• Care and Triage Team in emergency department:
  • The Care and Triage Team, formed in July 2023, oversees patients admitted to the emergency department waiting to see hospitalists. This team provides prompt and safe care, eliminating potential service delays.

3. Introduce an interdisciplinary team for child and youth mental health for emergency care and staffing for the Pediatric Emergency Department.

• Staffing at Surrey Memorial Hospital pediatric emergency department:
  
  • A total of 27 new positions have been posted since August 2023 to expand pediatric emergency nursing staffing (see action number 2 for a recruitment update).
• Child and Youth Mental Health Emergency Response Team to support timely assessment and collaborative care planning with families:
  
  • Surrey Memorial Hospital and Fraser South communities – team started Nov. 6, 2023.
  • Fraser East and North communities – recruitment in progress for both teams.

4. Focusing on psychological and physical health and safety of staff and medical staff with onsite psycho-social support services and hiring of additional relational security officers.

• An onsite psychological and organizational wellness lead was hired at Surrey Memorial Hospital, effective July 2023, to support the mental health of staff and medical staff.
• All 15 relational security officer positions have been filled at Surrey Memorial Hospital and are now working to prevent and respond to workplace violence, emphasizing customer service, trauma-informed practices, and cultural humility and safety.
• All 13 of the recommended actions from the Violence Risk Assessment done at Surrey Memorial Hospital in July 2023 are now complete.
• Close to 80 per cent of Surrey Memorial Hospital emergency department staff have completed annual violence prevention training.

5. Funding for additional workforce such as clinical associates, associate physicians and nurse practitioners.

• Twenty-one new resident clinical associates have been hired to date to support hospitalist and internal medicine groups. Five professional clinical associate positions have been posted for the Surrey Memorial Hospital internal medicine group.
• Twenty-three associate physician positions have been posted, four have been hired to date with one offer currently pending (for Surrey Memorial Hospital Family Birthing Unit, with a start date of March 2024), as of February 2024. Regional position in medical affairs to oversee clinical associates and associate physicians is in place as of Sept. 18, 2023.
• Eight new nurse practitioners have been recruited regionally since July 2023, including two for Surrey Memorial Hospital internal medicine, one for the Jim Pattison Outpatient Care and Surgery Centre’s Heart Function Clinic, and one for Surrey Memorial Hospital general surgery.

6. Targeted international recruitment of medical and health care staff.

• Seventy-five internationally educated nurses have been hired at Surrey Memorial Hospital with a total of 268 hired across Fraser Health since January 2023.
• Seventy physicians have been recruited to Surrey Memorial Hospital with a total of 294 hired across Fraser Health (including locum physicians) since January 2023.
• One-hundred-seventeen new nursing grads and 164 employed student nurses have been hired at Surrey Memorial Hospital. A total of 444 nursing grads and 585 employed student nurses have been hired across Fraser Health since April 2023.

7. Refresh the Clinical Service Plan for Surrey to look at the growth and specialty needs of the population as well as how and where services should be located at Surrey Memorial Hospital and across the region.

• The Clinical Services Plan and Surrey Memorial Hospital Site Master Plan are on track.

8. Build and enhance the current Emergency Operations Centre structure and existing bed management strategies to support flow through the health system.

• Surrey Memorial Hospital has a detailed over-capacity plan, which includes the use of an emergency operations centre to manage patient load when the hospital is beyond maximum capacity.

9. Enhance patient care supports that provide physical, emotional and cultural care in the context of high volume and wait times.

• Emergency department wait times across Fraser Health were made available to the public as of May 24, 2023.
• The Surrey satellite emergency department opened in December 2022 at the Surrey-Whalley Urgent and Primary Care Centre. Since November 2023, there have been approximately 500 patient visits to the department each week. Since opening, it has treated about 23,800 patients referred from Surrey Memorial Hospital emergency department and Urgent and Primary Care Centres.
• Surrey Memorial Hospital hired 10 patient ambassadors to comfort patients and help them find their way around the hospital and access onsite wheelchairs.

10. Increase the number of personal support workers and clinical social workers to better support patients and reduce pressure on existing health care workers.

• Social worker and care aide positions are being added over the next two years as part of the net new positions under action number 2.

11. Renovate the pediatric emergency waiting areas.

• An expanded overflow waiting area for Surrey Memorial Hospital’s pediatric emergency has been in place since December 2023.

12. Increase access to transitional beds for vulnerable patient populations by purchasing new care spaces.

• A new leased transitional housing space opened on Dec. 20, 2023, which provides accommodations for patients who require a short stay in a transitional housing environment. These patients typically no longer need acute care services and can be safely discharged from Surrey Memorial Hospital to receive more appropriate care in a transitional housing environment where they will be offered onsite community supports such as nursing, allied health and security.

13. Enhance Fraser Health’s successful in-house learning institute to close critical gaps in allied staff and nursing.

• Increase Nurse Practitioner Residency Program seats by 50 per cent:
  
  • As of October 2023, 10 nurse practitioners have completed the Nurse Practitioner Residency Program.
• Expand in-house allied and nursing programs by 50 seats:
  
  • Enrolled more than 50 additional nursing seats to date; allied health initiatives (social work, physiotherapy, mental health and substance use) are in progress.
• Expand Health Career Access Program in acute (emergency department cohort two) (August 2023):
  
  • Expanded to 66 program seats from 50.
  • Out of 66 positions, 64 have been hired.

Partially complete actions (10)

14. Use nearby community health care services to relieve patient demand at the emergency department, including additional resources to expand hours of the Urgent Care Response Centre and Primary Care Centres.

• Hours have been extended at the Surrey-Whalley Urgent and Primary Care Centre to increase patient access to services as of July 2023.
• Expand Surrey-Newton Urgent and Primary Care Centre in 2024.
• Abbotsford Urgent and Primary Care Centre opening hours were increased by three hours per day, Monday to Wednesday, as of Nov. 13, 2023:
  
  • Additional nurse practitioners and physicians are working to cover extended opening hours five days per week as of mid-January 2024.

15. Effective and immediate triage for more frail older patients and Mental Health and Substance Use (MHSU) patients with immediate collaboration with Home Health services and Mental Health and Substance Use community services.

• Increased capacity of the regional Mental Health and Substance Use Access and Flow Team to ensure care is consistently available for 12-hours-per-day, seven-days-per-week, as of Nov. 6, 2023.
• Continuing to hire substance use patient assessment nurses and an additional psychiatric liaison nurse across multiple sites for increased support for substance use concerns in emergency departments:
  
  • Four addiction assessment nurses hired for Surrey Memorial Hospital.

16. Increase additional clinical capacity to support patient care and flow by building out critical health care supports, along with more effective and timely referrals to community services.

• Increased support for frail seniors through early intervention such as social prescribing and community connectors as of December 2023.

17. Increase the number of internal medicine positions to support admitted patients and build out an Internal Medicine Clinical Teaching Unit to support recruitment.

• Since January 2023, a total of five internists have been hired at Surrey Memorial Hospital (26 regionally).
• There are 15 internal medicine positions available at Surrey Memorial Hospital, with an additional 21 positions available throughout the region.
• Two nurse practitioners hired and started at Surrey Memorial Hospital to support internal medicine bed expansion, as of Sept. 5, 2023.
• University of British Columbia has confirmed the allocation of five internal medicine residents to Fraser Health starting July 2024.

18. Increase capacity in outpatient and community services to discharge patients safely 24-hours-per-day, seven-days-per-week.

• Increased long-term care beds in select communities by adding 29 beds as of November 2023.
• New medical services model developed to increase physician coverage in palliative care to seven-days-per-week.
• Planning initiated to develop a new seven-days-per-week medical services model for assisted living facilities:
  
  • The model has been developed and implementation has begun across the region.
  • Ten new physicians and one program coordinator have been hired to support this new model.
• Increased enrolment of individuals with chronic obstructive pulmonary disease (COPD) into remote monitoring program upon discharge. The goal is to work with different clinical areas in the earlier identification of COPD patients, connecting them to community respiratory services for remote monitoring.
• Clinical service plan completed as of Dec. 15, 2023.
• Four new community respiratory therapists (RTs) have started at Surrey Memorial Hospital as of December 2023.
• Since December 2023, the RTs have seen 161 patients at Surrey Memorial Hospital:
  
  • One-hundred-fifty-one had been referred to community respiratory services, 105 of which were net new referrals;
  • Ninety-eight patients had been referred to the Lung Health Clinic; and
  • Remote patient monitoring has increased from 37 patients to 70 patients at its peak.

19. Ensure Family Birthing Unit at Surrey Memorial Hospital continues to serve as the highest tier of services for maternity and women’s health care.

• Planning is underway with Fraser Health and Perinatal Services BC to outline requirements for Tier Six Maternity Program at Surrey Memorial Hospital.

20. Build out capacity of the Surrey Memorial Hospital Family Birthing Unit through several specific actions.

• Implemented a midwifery-led Early Patient Discharge Program on Oct. 12, 2023.
• Working to increase Midwifery Team support for Indigenous people and special populations (women escaping violence) through Maxxine Wright Centre.
• Short-term solution for centralized prenatal registration system implemented Sept. 11, 2023.
• Developing and implementing a new maternity and pediatric pod in Surrey Memorial Hospital Neonatal Intensive Care Unit that will add six neonatal/newborn and six maternity beds to overall capacity.

21. Expand critical health care services such as outpatient, home health and home support services, clinical social work, physiotherapy, rehabilitation and respiratory therapy.

• Plans are underway to augment hours of operation in the community outpatient clinics at the Jim Pattison Outpatient Care and Surgery Centre.
• A phased approach is being taken to enhance home health and home support services, beginning with the Wound Care Clinic.
• The virtual rehabilitation model of care development started in August 2023 with the goal to expand services. It will be part of the overall outpatient rehabilitation services expansion and redesign.
• Home health and home support service enhancement:
  
  • New schedule developing for home support services complete, adding about 75,000 hours of home support for Surrey clients.

22. Expand the Urgent Care Response Centre and Gateway Mental Health services to 12-hours-per-day, seven-days-per-week.

• Urgent Care Response Centre:
  
  • Clinical services plan development was completed November 2023.
  • Recruitment for remaining new positions is in progress, as of January 2024.
• Gateway Mental Health:
  
  • The goal is to extend hours from eight-hours-per-day, five-days-per-week to 12-hours-per-day, seven-days-per-week.
  • Clinical Services Plan is in place.
  • Rotations development was completed as of December 2023.
  • Two peer-support workers contracted to support clients at Gateway Mental Health as of March 31, 2024.

23. Build out innovative and digital services such as Hospital at Home, Digital Front Door and Virtual Specialty consultation services.

• Establish a Virtual Hospital Program to support the expansion of Virtual Psychiatric Unit, including plans to launch a second Virtual Medical Unit.
• Expand Virtual Mental Health services.
• Establish a regional surgical patient engagement platform to reduce in-hospital demand on pre-surgical supports.

Actions with active planning underway (7)

24. Expand renal services within 18 months.

• Project and operations plans are in development.

25. Build two interventional radiology suites at Surrey Memorial Hospital that will enable stroke and cardiac specialty expansion.

• Location has been identified. The second interventional radiology suite will be located with the two new cardiac catheterization labs. Operational planning is in progress.

26. Adding two cardiac catheterization suites at Surrey Memorial Hospital.

• Refer to action number 25.
• Governance structure is in place, project plans are being developed.

27. Add new MRI and CT and replacing existing CT with cardiac capabilities to increase access to diagnostic services.

• MRI at Surrey Memorial Hospital:
  
  • MRI machine supplier to be chosen in February 2024.
• CT at Jim Pattison Outpatient Care and Surgery Centre:
  
  • The request for proposal process started February 2024.

28. Complete renovations of existing operating rooms to expand capacity.

• Feasibility study will be completed for four operating rooms requiring modernization.
• Estimated completion for all operating room modernization is spring 2026.

29. Significantly increase resident physician allocation at Fraser Health and including Surrey Memorial Hospital as their home residency sites.

• Current resident allocation from University of British Columbia:
  
  • Five internal medicine residents starting July 2024.
  • Three additional emergency medicine residents (five in total) allocated to Surrey Memorial Hospital as of July 2024.
  • Two pediatric residents starting July 2024.
• Fraser Health is prioritizing anesthesiology, cardiac surgery, emergency medicine (College of Physicians and Surgeons of BC) and palliative medicine for business proposal submission early 2024 as part of Fraser Health's Medical Education Expansion Plan.

30. Improve utilization and, where necessary, expand available operating room time for gynecology by optimizing existing operating room time at Surrey Memorial Hospital, Jim Pattison Outpatient Care and Surgery Centre and other Fraser South acute care sites to meet provincial wait time benchmarks.

• One additional operating room slate-per-week has been allocated to gynecology cases.
• Analysis for Fraser South communities are complete as of November 2023. Analysis helps show the demand and supply of operating rooms and lets us maximize use of the operating rooms.