B12 - Sunday, September 4, 1983 - North Shore News

“It is part of the human spirit to continually develop new and better
ways - new discoveries, new technology - to support the dream of a

better life.”

New drugs
sophisticated and
expensive

Advances in surgical and therapy procedures have been
accompanied by sophisticated new drugs The LGH phar.
macy {fs dealing with an increased demand for these drugs
brought about by the hospital’s high occupancy rate of
acutely ill patients and the increase in surgery and chemo
therapy. The use of powerful expensive new antibiotics in
surgery has increased greatly in the last 10 years making
many procedures much safer Prescriptions for antibiotics
now account for 25 to 35 per cent of the hospital's phar
maceutical budget

Also very expensive are the drugs used by cancer patients
undergoing chemotherapy The number of prescriptions tor
chemotherapy drugs for inpatients and medical day patients
has quadrupled during the past year and the phannacy fills
$8, or $9,000 worth each month Oncology ts a con
stantly changing field and new chemotherapy drags will con
tinue to make thetr appearance in the fight against Cancer

Tightening the
purse strings

When the financial crunch hits us as tndividuals we usually
respond by looking at areas where we may be able to tighten
up and reduce expenses — does the attic need insulation ’
shoule we Invest in a more economical natural gas furnace ’

John Borthwick
LGH Administrator

We start to turn off lights and take a hard look at our grocery
shopping lists. The same kinds of questions are asked at a
hospital -- only the scope is a lot bigger!

The hospital’s maintenance department trimmed
$100,000 off its energy budget last year by fine-tuning the
system -- tuming off air conditioning and lights when areas
were not in use, lowering the hot water temperature 15
degrees, improving the controls on heating, ventilating, air
conditioning and steam delivery equipment and capturing
wasted heat from used hot water in the laundry. Further heat
recovery measures are being investigated to utilize the heat
from boiler flu gases, the gas-fired laundry dryers and the
garbage incinerator.

Some of the economy measures in the hospital kitchen are
ones that we as individuals have also adopted in deference
to a new awareness of nutrition as well as for financial
reasons. There is less meat and more vegetables, fewer rich
desserts and more fruit on the menu and night snacks have
been curtailed.

Food preparation and service is labour intensive 66 per
cent of the department's budget is labour, 28 per cent food
costs It has been necessary to reduce the hot meals and
hours of service in both the Terrace cafeteria and main
cafeteria Many entrees are prepared in large batches and
frozen very rapidly with liquid CO, to preserve the quality
The availability of these stored meals also means a more
flexible diet for the hospital's long term residents

Pioneer work
proves a boon

“Le ongratulate all the vanous departments tn the bospttal tor
thei Contmumg excellent service to Our patents

Dr NS Mad
President Medical Sotatt
16977 24.3

The North Shore community ts luckier than many com
munities in that it began to explore alternatives to expensive
inpatient hospttal care several years ago LGH has a well
established ambulatory « are program of medical and surqic al
day care services

Lions Gate was the first hospital in Canada with a Medk al
Day Centre designed for the exclusive use of a range of day
hospital programs and has been studied as a model for the
past year by a joint proving ial federal task force charged with

developing guidehnes for medical day centres tin Canada
Day care medicine can provide an alternative to Inpatient
care and shorten the length of stay in hospital for other pa
tents who can be discharged but attend day programs at the
Centre Wt also provides scope for health education and
preventive medicine

Last year 5 700 inpatients entered the LGH Surgical Day
C entre and retumed home the same day This was an in
crease of 700 over last year's day surgical procedures and an
Increase of 167 percent in the past 10 years

However, some procedures cannot be dealt with on a day
surgery basis and the elective surgery waiting list at LGH still
stands at more than 1,600. “Elective” is a term used for con-
ditions that require surgery but are not life threatening. Some
of the conditions, however, are deteriorating ones, such as
the cataracts and urology problems common in an aging
population such as the North Shore's. Elective surgery can
mean a great deal to the quality of life for these patients.

Keeping pace

“We have moved from house call medicine to space age
medicine in one generation When Lions Gate Hospital
opened in 1961. it was considered ‘state of the art’ If it had
not changed and advanced it would now be considered a
third rate cottage hospital ”

Dr J W Corbett. Medical Coordinator

When Lions Gate Hospital opened its CT Scanner last
November we entered a new era of medical imaging. The
$960,000 Computerized Tomographic Scanner, which has
been described as the most important X-ray development
since the advent of the X-ray itself, can provide doctors with
accurate and detailed information impossible to obtain with
conventional X-ray techniques. The CT Scanner produces a
computer reconstructed picture of a “slice” of the patient's
anatomy with a complete and detailed view of all organs,
tissue and bone contained within that slice without subjec-
ting the patient to invasive techniques.

Demand for the services of the CT Scanner are heavy.
The Scanner is in operation nine hours a day, five days a
week and on 24-hour emergency call every day, averaging 15
procedures a day. Although the Ministry of Health funds 75
per cent of approved hospital equipment, the LGH Aux-
iliary’s contribution of $256,000 was a vital component in
the hospital’s ability to purchase the scanner.

It is becoming impossible to efficiently run an operation as
complex as a modem hospital without the aid of computer
programs. LGH is making an investment in the future by
establishing the first building block of a computer system
now. This summer the hospital’s accounting functions and
the Patient Registration and Admissions, Discharge and
Transfer (ADT) systems were computerized.

The computer system will coordinate the patient records
for inpatients and day surgery patients located in some
150,000 file folders in the hospital’s central medical records
department and the patient records kept by individual
departments such as radiology and rehabilitation and the
Medical Day Centre Each LGH patient will be assigned a
medical record number for life and all information on that pa
tient from any area in the hospital can be assessed and
verified and updated at any time

For the interest of computer enthusiasts the hospital's
IBM 4341 Computer System has 2400 million characters of
on line storage on disks that are accessible at any time It
has tape drives for backing up online disk files or
transferring information and a high speed printer capable of
1,200 lines a minute

Once the Patient Registration and ADT systems are in
place, the hospital can move towards Its goal of setting up
<«omputerized operational and patient care systems. Com
munication links between nursing stations and areas such as
radiology. pharmacy and the lab will provide immediate
transfer of vital information and computerized operational
systems will be tailored to enhance the efficiency of in
dividual departments

Canadian hospitals are about ftve years behind the
Americans tn putting the computer to work on operational
and patient care systems but several programs similar to the
one planned for LGH are tn the works in B C hospitals

The computerized system that LGH will build block by
block over the next few years will make accessible a wealth
of information on both the hospital and the community it
serves This will prove invaluable to the hospttal’s ad
ministrators tn planning and managing the hospital's

resourg¢es to anticipate and meet the demands of the com
munity.

The challenge of
the future for

health care

Demands for health care are infinite. Resources are finite.

I

The restraint policies of the Ministry of Health have placed
LGH under a great deal of stress during the past year and
there is little reason to believe that there will be much relief in
the near future. Operating funds for 1983/84 total
$48,293,600, an increase of only 2.2 per cent over last
year’s budget of $47,263,000. Once again, hospitals in B.C.
did not receive their operating budgets until the end of the
first quarter of the fiscal year.

The absence of a contract with the Hospital Employees
Union for more than two years added another unknown fac-
tor to planning. It now appears that wage increases will be
considerably less than anticipated and therefore less than
LGH administrators had budgeted for. If this is the care the
‘surplus’ will enable the hospital to pay off its deficit from
prior years and maintain its present level of services for the
coming year. Without this cushion the 2.2 per cent increase
allocated by the Ministry of Health would not be sufficient to
meet the costs anticipated for 1983/84. The Ministry has
suggested that the surplus be used to open 20 discharge
planning beds and has agreed to increase the hospital's
operating grant for the next year to allow the beds to remain
open if there is a zero or minor increase only in wages in the
collective agreement for 1983/84.

There will be tough times ahead as hospitals like Lions
Gate struggle to balance the needs of the communities they
serve against the funds that are given to therm to provide ser-
vices. Medical knowledge and technology will continue to
grow, equipment will become more sophisticated and expen-
sive, drugs will become more powerful, diagnostic and treat-
ment capabilities will be enhanced -- all calling for highly
trained technical and nursing staff. Members of our society
expect to have access to the latest and best quality health
care and members of the health care professions wish to
provide it.

As costly inpatient hospital care is more and more
restricted to the acutely ill, we will have to develop alter
native methods of delivering health care services. And as a
society we will have to take more responsibility for pro-
moting and maintaining health Lions Gate Hospital and the
people of the North Shore share a common goal to ensure

that high quality health care ts available to all members of
our community. The continued support and involvement of
the North Shore community with its hospital will be more im
portant than ever as we work together to meet the
challenges ahead

B13 - Sanday, September 4, 1983 - North Shore News

**‘We can be proud of our hospital and the medical care offered to
our community and I look forward to seeing the same level con-

tinued as we adapt to new stresses and challenges that we may not
even have thought of yet.”’

Board of Directors of the
North and West Vancouver
Hospital Society

1982/83

ELECTED OFFICERS

Municipality of City of
West Vancouver North Vancouver

D. Brousson H.V.B. Anderson

K.C. Bruce

- deceased March/82
H. Clark D. Burbidge
F Russell S. Simpson
- from June/83
A. Waghom
d.W. Wame
District of
North Vancouver
W Crompton
M Fellis
BE McCrea
PA White
MUNICIPAL REPRE SE OSE ATIVES
Ald D Blackburn
Mayor JF. Loucks
Ald J Lakes
PRCOONTTING TAL GOK TE RN ME ON TORE PRR SEND AN TINE
JR Kangtit
AUIRIL LARS KE ETE Soh oe LA TINE
S Larson
ME LOR AL CSL ARE ORCE ECRSE ES EN TINGE SS
C thnet otf Statt
I) W Panhkrats
President of Stalft
[or NS Maactill
EXECUTIVE STARPD OF LIONS GATE Elser AL

John Wo Borthwick
tre td O'Dell

Dr James W Corbett
Joyce M Campbell
Tomb McMillan
Thomas B Crimp
Gerry A Martins

Administrator

Semor Assistant Adiints trator
Medical Coordinator

Nursing Director

Assistant Admintstratur
Asststant Adminis trataor
Comptrotler

Dr. W.J. Pankratz
LGH Medical Chief of Staff

1982/83
STATISTICS
1978 1983
BEDS - Set up at end of
fiscal year
Acute 456 401
ECU _—s—id169 si
Total (excluding
bassinets) 625 ——“‘i‘CS‘TIO“N:
Newborn 36 36
INPATIENT ADMISSIONS .
Acute 15,649 13,846
Extended Care 93 77
Long Term Care — 75
Newbom 1,341 1,604
Total 17,083 15,602
PATIENT DAYS
Acute 145,628 128,097
Extended Care 62,344 , 61,509
Long Term Care — 8,154
Newborn 8,229 8,938
Total 216,201 206,698

OCCUPANCY RATE

Based on beds set up
Acute 87% 91%
Extended Care 100% 100%
AVERAGE LENGTH OF
STAY (days)
Acute 9.3 9.3
Long Term Care — 113.5
Extended Care 569.0 823.1
EMERGENCY PATIENTS 39,675 45,449
PHARMACY (# of
prescriptions) 64,289 76,228
OUTPATIENTS’ INPATIENTS*
1978 1983 1978 1983
Laboratory (incl. Lab, ECG
& EEG) - units
818,310 1,410,120 2,829,611 2,815,475

Imaging (Radiology, Nuclear
Medicine, Ultrasound, and
Computerized Tomography)

visits
25,833 31,974 19,122 28,915
Rehabilitation Medicine
(Physical/Occupational
Therapy) - units
690,194 1.019.457 1.766.143 1,621,030

Surgical Procedures

2.773 5,688 9.158 7.228
Medical Day Care Visits
1,183 5,601
Psychiatric Day/Night
Care Visits
11.041 11.212
L978 1983
Dtetary Meals 821.556 773,529
Therapeutic Diet Meals 99.957 —-:1103,191

Laundry
Pounds of Linen Processed

8.482.052 6,190,306
* Note Inpatents those patients admitted to a hospital
bed
Outpatients those patients not admitted to a
hospital bed, but who have undergone a treatment
or diagnostic procedure at the hospital