Duncan ER Team Puts Teamwork at Heart of Their Care

During a year in British Columbia in which we’ve experienced a continuation of the COVID-19 pandemic, the ongoing climate crisis leading to fires and floods, and news of the discovery of 215 Indigenous children buried on Tk’emlúps te Secwe̓pemc territory, for many, the mental load can be overwhelming. 

And if you’re a healthcare worker, on top of record low staffing levels, you may also be dealing with backlash to vaccination and mask mandates, and the urgent need to respond to the In Plain Sight report on anti-Indigenous racism in healthcare. 

So it would be understandable for healthcare workers to simply want to hunker down and go into survival mode. 

But one Emergency Department team on Vancouver Island decided to do whatever it took to ensure the care they provided the community could continue—and that the team at the centre of it was functioning at its best. To help with this, they accessed Quality Team Coaching for Rural BC (QTC4RBC), a pilot program run by the Rural Coordination Centre of BC, and the results have been remarkable.  Since starting the program, the team has reported feeling less stressed, having better communication, and working with each other at another level that they haven’t before. 

Dr. Ava Butler, an Emergency doctor in Duncan who was instrumental in bringing the program to the team, said: “What we’re trying to ignite is a sense of empowerment.”

“One way that you make people feel loved and respected is you listen to them.”

She said they had a great team, but that it wasn’t always simple for individuals to make positive changes in the system and that can lead to low morale and feelings of helplessness. “Sometimes we get so frustrated that we stop trying to make change,” she said. 

 “There are people who have worked in this environment for decades. They know what needs changing, but it could be that no one has asked them.” 

“When you present them with the ability to make change, they make change.” 

Dr. Butler added: “The ultimate goal is this is going to improve how we function, and then it’s going to affect how we give care, and the end goal is it will improve how we provide culturally safe care.” 

And that’s just what the program is designed for, says physician lead Dr. Rahul Gupta, who coached the group. 

“There’s a huge emphasis on creating spaces and carving out styles of communication that foster support and belonging so that people could feel that this was a safe place to not only share their challenges but also work together to design a way forward,” he said. 

While the program was originally envisioned as a one-day, in-person coaching workshop, due to COVID, it pivoted to being six online, two-hour modules. The modules are facilitated by one of two certified physician coaches—Dr. Gupta and Dr. Cecile Andreas—to lay the foundation for highly effective teams. 

Once this is complete, participants are offered up to four virtual team coaching sessions at approximately one month, two months, four months, and six months. 

In the current iteration of the program, there’s also a concierge service linking each team to programs and resources in British Columbia and financial support of up to $40,000 that may be used towards further team training and/or Quality Improvement projects.

For the Duncan Emergency Department team, they chose to organize a series of interdisciplinary Emergency Room simulations, with an intention of optimizing outcomes and cultural safety. They used the opportunity to also build team camaraderie through sharing leadership roles and practice peer coaching each other.

 Nurse Terra Lee said the program came along at an important time. She said: “The project has been super important for us and the feedback has been very positive. We’ve seen a change in the way we are functioning. I’m so grateful that we have this opportunity to do this in a time of crisis. It’s providing safer care when we are working under such challenging circumstances.”  

 She added: “There’s so much in our world that is out of our control so we have to shift and just focus on the things we can control, like ensuring cultural safety, practicing to our best self, and learning how we can work as a team.”

 Dr. Gupta said: “A lot can be achieved with an environment of appreciative inquiry. A lot of creativity can be harnessed and people access answers for themselves. I think Duncan is a great example of a team that is galvanizing together and making changes to their system.”

While the QTC4RBC is still a pilot program, there are plans to open another intake for the program in 2022. 

Anyone with interest in the program can contact Adrienne Peltonen atapeltonen@rccbc.ca, or visit www.rccbc.ca/qtc4rbc.

Additional Resources:

Watch the video to learn more about the program.