12.Vancouver General Hospital starts intensive home treatment service in July 2009

Canada has been extremely slow to take up the intensive home treatment model , and so it is very significant and encouraging to see that the country’s second largest hospital-Vancouver General-in Vancouver British Columbia, started a team in July 2009. In a bold move, chief of psychiatry Dr. Soma Ganesan spearheaded a plan to close  an 18 bed ward, enabling the creation of the team with no new money. Of course, bridging funding was required, and was enable through not filling staff positions plus they went into deficit. With full backing from the hospital administration and the Vancouver Coastal Health Authority, they created the team first, and over the next three months, the beds were closed. Fortunately, they had complete flexibility, with only one funding envelope. Project management assistance was provided by the consultancy Accenture. The provincial acute psychiatric bed ratio is very stingy-17 per 100,000, making this achievement even more impressive. As the attached brochure explains, 1428 bed days were saved in the first year . At first, they confined admissions to patients who had been admitted, enabling early discharge. Now, they are taking patients from the emergency department, enabling them to avoid admission altogether. This team is the third one to be developed in British Columbia in the last decade, making the province the leader in developing intensive home treatment. The first team in BC was started at the Royal Jubilee Hospital in Victoria in 2001, followed by the team in the communities of Langley and White Rock/South Surrey developed by the Fraser Health Authority in 2006. Crisis Intervention Program year one is a success