Some Royal Inland Hospital staff are concerned about the rollout of digital charting at Royal Inland Hospital.
The advancing care electronically (ACE) project aims to shift the hospital away from paper-based patient records to an electronic system. The hospital’s emergency department previously implemented the initiative and it is expanding hospital-wide in June.
Concerns from within the hospital, however, suggest it may have not been the right time for the shift.
BC Nurses’ Union president Christine Sorensen said nurses support electronic charting, but noted the problem with the ACE implementation is that it was planned prior to the COVID-19 pandemic.
Sorensen said the initiative should have been delayed until the fall, when more people are vaccinated, case counts are down and system pressures are, hopefully, reduced. She called the decision to implement ACE in June “tone deaf.”
“Nurses are stretched too thin already and their workloads are excessive,” Sorensen said. “Nurses are working significant amounts of overtime in order to support the health-care system and deliver patient care in the middle of a pandemic with a surgical renewal plan that the government has implemented, while they are short staffed.
“It seems very insensitive and unaware of the health authority to implement additional demands on the nurses’ time for an electronic charting system without any consideration for the level of pandemic exhaustion and overwork that these nurses are under.”
Two nurses spoke to KTW on the condition of anonymity.
One nurse reached out before Mother’s Day, which she said is known to be a challenging staffing weekend, and said Royal Inland Hospital is overstretched and understaffed, with ongoing shortages exacerbated by staff leaving to work in public health or vaccine clinics. Although the hospital is not overrun with COVID-19 cases, the nurse said staff continue to face pandemic-related staffing pressures.
Another nurse noted staffing levels are based on bed counts and some units regularly have more patients than beds, further fuelling the situation. Staff are stressed and burnt out, the nurse said.
“Unfortunately, as nurses, often times we’re empaths and we feel guilty and we feel like we are letting down our co-workers,” the nurse said.
“And so we adapt and we do the best that we can and then they seem to think that is completely fine, so it kind of compounds … It feels very much like the responsibility is on our shoulders as staff, here in the moment, instead of on management to look at the bigger picture.”
The staffing challenges have some on the frontlines questioning the administrative push to implement digital charting at this time, which has required staff to take an additional 16 hours of training on their own time. The training time is paid, but the nurses argued ample overtime hours are available and extra hours of work are better served helping patients.
One of the nurses who spoke to KTW detailed one situation in which a unit was down to half the normal staff. Instead of picking up shifts to aid the unit, staff members who could have lent a hand were stuck in ACE training, the nurse said.
“It’s just the timing of it, how it’s being rolled out and the lack of insight into how this pandemic and the staffing levels, where they’re at right now,” the nurse said.
Questions have been asked about why the project is being implemented now.
Interior Health told KTW the new system will improve patient safety and care by allowing immediate access to patient records and reducing delays and errors.
“Pausing this work would mean postponing these important improvements to patient care,” Interior Health said in a statement. “The ACE project has included many phases and the project’s timelines have been reviewed and assessed several times over the past year, recognizing the impact on hospital operations.”
One of the nurses who spoke to KTW said administration wants the new procedures in place before RIH’s new patient-care tower opens in the summer of 2022.
The nurse said there is concern about two big changes happening at once. However, the nurse pointed out both initiatives were planned prior to the pandemic and the timeline has not been amended accordingly.
In addition, the nurse said the ACE project is being touted as a project that looks good for the hospital, as RIH is the first large hospital in Interior Health to roll out the initiative. The nurse believes optics are at play.
“It looks good to the public. We have a new hospital, we’re really cutting edge, we have a new tower… there’s just huge time-sucking commitments that are happening when we’re in a pretty acute crisis of short staffing going on and lack of support for that,” the nurse said.
Interior Health said it monitors staffing levels at Royal Inland Hospital. The health authority said it is “maintaining full service levels at RIH” and continues to recruit permanent and casual staff. It said hospitals across Canada are experiencing staffing challenges. Interior Health added that it created online modules to provide flexible training and that staff are paid as per their collective agreement.
For more information on the ACE project, click here.