Last month, BC’s Mobile Medical Unit (MMU) packed up from its temporary location at 58 West Hastings Street in Vancouver’s Downtown Eastside after more than six months supporting health care workers on the frontlines of the opioid overdose crisis.
On Monday, June 26, 2017, the team, which included health care professionals from Vancouver Coastal Health (VCH) and the Provincial Health Services Authority (PHSA) were the grateful recipients of the BC Health Care Award of Merit for Collaborative Solutions. The award recognizes project or best practices that harness the collective efforts of a collaborative team that has yielded positive outcomes.
The MMU was deployed in December 2016 as an emergency measure to help care for an unprecedented number of overdose patients in the downtown core in partnership with VCH, Providence Health Care (PHC), City of Vancouver, and BC Emergency Health Services (BCEHS). The unit served as a satellite emergency department for patients who overdosed and helped to take pressure off local hospital emergency departments.
With less than two weeks from official request to deploy to being operationally ready, the MMU team worked closely with the City of Vancouver, PHSA (IMITS), BCEHS, VCH and PHC to coordinate logistics including preparing the site, implementing appropriate security, arranging clinical staffing, telephones, IT network support, power, as well as ongoing logistics such as restocking medication, clinical consumables and staffing.
Initially operating 18 hours per day, seven days a week, and staffed by an emergency physician, emergency nurses, an addictions physician and outreach workers, the deployment allowed BCEHS paramedics to transport some overdose patients to the MMU rather than St. Paul's Hospital to help alleviate emergency room congestion at the already overwhelmed facility.
This was the first time BCEHS transported patients to the MMU when it wasn't situated alongside a hospital site.
"Having the MMU set up in the Downtown Eastside meant BC Ambulance paramedics had a closer option to get patients immediate, necessary treatment which allowed them to transfer patients more quickly and get back on the road to help other people needing urgent care," said Linda Lupini, executive vice president, BCEHS. "Through learnings and relationships built from this pilot, BCEHS established alternative pathways to outreach clinics and facilities in the community so some overdose patients can access specific care and supports more quickly than going through a hospital emergency department."
Over the course of the 163-day deployment, over 3,000 patients were cared for at the MMU, with nearly 20 per cent arriving via ambulance.
But it wasn't just overdose clients who came to the unit for care: as the word got out about the unique clinic and team, an increasing number of clients came to the clinic to seek opiate replacement therapy and counselling support including methadone or suboxone, drugs that treat opioid addiction, a naloxone kit or requested a meeting with an outreach worker.
As the deployment continued, it evolved and changed based on the needs of the community. A Telehealth link for instant access to emergency physicians, outreach support and services were all part of the patient-centered care provided at the unit.
In April, the MMU's focus shifted to transitioning services to new and established community resources, and staffing changed to have an outreach team and registered nurse on site from Monday to Friday from 9 a.m. to 5 p.m. The MMU no longer received ambulance transfers, and physicians were no longer on site. Services were provided to individuals walking in to the facility seeking support with addiction service referrals and connecting to other permanent services and clinics in the community. The MMU clinic closed its doors on May 19 and departed from the site on May 24.
"Our experience and access to resources, and ability to rapidly plan, implement and deploy made the MMU an ideal temporarily solution to help support this vulnerable patient population during the opioid overdose crisis," said Peter Hennecke, clinical operations director, MMU and RN with VCH. "We were pleased to partner with Vancouver Coastal Health, Providence Health Care, BCEHS and the City of Vancouver to support this crucial project and are honoured at the recognition from the BC Health Care Awards."
Congratulations to the MMU team on this honour: Kathy Steegstra, Peter Hennecke and Michelle de Moor (Team leaders) and Alyshia Higgins, Dara Davies, Jay Francescutti, Robin Gardner, Jamie Carballo, Jesse Sheridan, Landon James, Alex Wong, Tracy Johnson, Fariba Wilson, Barb Harvey, Mike Flesher, Ross Brown, Dr. Eric Grafstein, Lori Korchinski, Dr. Keith Ahamad, Dr. Annabel Mead, Miranda Compton, Caitlin Etherington, Afshan Nathoo, Dr. Ross Brown, Dr. Stan de Vlaming, Dr. Michael Norbury, Tim Chu, Joe Acker, Randy Slemko, Dr. Christy Sutherland
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