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Behind the scenes of myVCH Projects: Implementation of a VGH Pleural Disease Service


Above photo: Nurse Practitioner Practice Lead Bonnie Giovannetti is initiative owner of one of the first 130 myVCH Projects.

Ever wonder how our staff are making Vancouver Coastal Health a better place?

What gave you the idea for this project?

The idea for the project actually came before the myVCH Projects approach started. There was a need that wasn't being met for many patients – especially those with lung cancer – who require support with complications such as a pleural effusion. This is when water collects on the outside of the lung and increases pressure so the patient can't breathe. These patients would come to the ER because it's urgent and they need to have their lungs tapped and drained, but there would be many different people who may attend to them. Sometimes they would be treated in the emergency room, sometimes by intervention radiology, and sometimes they wouldn't get helped in a timely way.

In 2016, Dr. Frank Ryan (VCH's Lung Centre) did an audit on pleural disease patients who received treatments from services other than Respirology.  The results indicated that there were a higher percentage of complications than with patients who received treatments from a Respirologist, which was obviously a problem.

What solution did you and your team develop?

The decision was made to create a Pleural Disease Service run by a Nurse Practitioner (NP). Patients will now be seen by one consistent person (the NP we hired), and she's being trained to do all these procedures, provide better service, decrease complications, and offer more consistent treatments to this population that truly just needs quick supports for their lung complications. She will see patients in the ER as well as inpatient settings, and triage them to the Respiratory Rapid Access Clinic to provide treatment, support and education to patients experiencing Pleural Disease complications.

The new NP is currently undergoing one of the most robust respiratory training fellowships I've ever seen, and by February 2019 we will see the actualization of the service.

How did using the new myVCH Projects pathway affect your project outcome?

Support from our CEO Mary Ackenhusen and the Senior Executive Team (SET) helped elevate this vision, kept it visible and transparent and brought all the stakeholders together to expedite this new NP role. It's an amazing thing from the organization to say we are willing to put energy into these projects, and it's so cool that major obstacles are removed. I love the concept of myVCH Projects and I'm very thankful.

How did it feel when your project was implemented?

I'm so happy that we're on a new horizon of finally actualizing Nurse Practitioner positions and becoming part of the VCH team on a much wider scale – it's awesome! It feels like ever since the survey, leadership is truly all connecting with VCH employees and making us – and our ideas – count. I've always been proud to work at VGH, and now that I'm taking on this new project I feel that pride for Vancouver Coastal Health too.

Project Name: VGH Pleural Disease Service (PDS)

Initiative Owner: Bonnie Giovannetti, Nurse Practitioner Practice Lead

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