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Creating a HUB of care

We know that transforming care takes time. But when a need for change is so apparent, rather than time, sometimes transformation just requires a little grit, a lot of innovation and a handful of partners.

At Providence, the desire for a “hub” concept of care—an umbrella of services that encompasses acute care, rapid access to substance-use treatment and a centre to support patients in their transition from acute to community care—is one that has been discussed since 2006; however, the cost of retrofitting an aging hospital and the announcement of a new St. Paul’s put the brakes on creating such a concept at the current site.

And then an anonymous $750,000 donation to the Vancouver Police Foundation, earmarked for Vancouver’s mental-health and substance-use patient care, changed all of that.

Back in motion

With the donation as a catalyst, the Vancouver Police Department approached Providence about working together on a solution to address the significant increase in Emergency Department volumes, police wait times, and the inevitable revolving door of crisis that comes from unsuccessful patient transitions and a lack of access to treatment.

“By bringing emergency care, rapid access addiction treatment, and a transitional care centre together under the HUB, Providence aims to ease the current ED congestion, turbulent transitions to community care, and increased police wait times with patients to an innovative approach that can also be used at the new St. Paul’s.” Dr. Bill MacEwan, psychiatrist, St. Paul’s Hospital.

Set to open at St. Paul’s later this year, the concept – now officially named the “HUB” – will be the first emergency care model of its kind in Western Canada. Located in close proximity to the hospital’s Emergency Department (ED), the HUB’s specialized staff will provide culturally appropriate, trauma-informed care for patients from their arrival at the ED to their transition back to their community.

This ground-breaking service for people with mental health issues and problematic substance use will include the following services, treatment and support:

  • HUB ED: a new, fully equipped clinical unit with 10 beds, designed to provide seamless acute care to mental health and substance-use patients who are triaged through St. Paul’s Emergency Department (ED).
  • Vancouver Police Foundation Transitional Care Centre: a transitional, up-to-12-bed centre for discharged patients, to facilitate patients’ return to their community and connection to vital services, such as housing, counselling, financial support, and continuing medical care. This centre is the second-of-its-kind in Canada, modelled after the Rotary Centre at St. Michael’s Hospital in Toronto.
  • Rapid Access Addiction Clinic (RAAC): Launched in September 2016, the RAAC is a low-barrier outpatient clinic for those dependent on a variety of substances, including opioids. Specialized addictions nurses and physicians can provide opioid-dependent patients on replacement therapy such as Suboxone or methadone in as few as 24-hours after referral.

 Setting the bar high

We have high hopes for what is possible when we transform how we care for our patients. We aim to triage 6,000 patients out of the current ED flow into the HUB, improving care for patients, reducing wait times in the ED for all patients, and decreasing police wait times by as much as 66%.

The following partners are helping to make the HUB a reality:

Vancouver Police Department and Vancouver Police Foundation; Providence Health Care; Vancouver Coastal Health; City of Vancouver; St. Paul’s Foundation; PHC Office of Innovation and Strategic Partnerships; Ministry of Health; Weatherhaven Global Resources Ltd.; Streetohome Foundation; Donors.

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