Dr. Rod Tukker aided in the development and introduction of a regional policy and decision-support tool (DST) to help medical staff navigate challenging conversations related to requests for non‑beneficial interventions in care. Non-beneficial interventions in care are interventions that are not expected to improve a client’s health outcomes and/or may cause harm. The policy and DST are designed to support early, thoughtful and compassionate conversations with clients, substitute decision-makers and support people about goals of care, expectations about health outcomes and appropriate care options. They aim to promote shared understanding, consistent communication and careful documentation, helping teams have these conversations with greater confidence and clarity. He established a regional Non‑Beneficial Interventions in Care Review Team to collaborate with clinical teams and system partners to offer additional perspectives and support.

iCARE rounds are daily interdisciplinary meetings led by a Care Team Management Leader (CTML) to create action plans, identify barriers to discharge, and initiate tasks that safely transition patients out of acute care.
Dr. Adam Soares identified and improved on collaborative Inefficiencies reducing time spent in meeting from 75 minutes to 55 minutes and allowed staff involved to have more time for other tasks (e.g. patient assessments). Outcomes included better patient experience, more time for staff to work of disposition planning, reduced stress and reduced after hours time.

CST was a massive, multi-year joint initiative across VCH, the Provincial Health Services Authority (PHSA), and Providence Health Care (PHC) to replace paper-based patient records with a single, unified Electronic Health Record (EHR) system powered by Cerner (referred to as CST Cerner). Many of our members provided peer to peer support at “Go Live” at various sites in Vancouver Coastal Health (VCH) helping peers adapt Cerner to clinical realities, escalate system issue to the IT and provide psychological safety that leads to burnout during major tech rollouts. Hospitalists from the group participated in CST launch at several VCH and PHSA sites including Powell River Hospital, Richmond Hospital, BC Children’s and Women’s Hospital, and St. Pauls Hospital.

Hospitalists served on the Steering Committee for the Time Reporting Solution (TRS) project. The initiative was launched to evaluate and procure a mobile and web-based application to manage time and project reporting, ensuring compliance with Physician Master Agreement (PMA) obligations. We assessed the proposed software solutions and collected extensive feedback from physicians regarding the system's interface, workflow friction, and overall user experience. VCH executive sponsors accepted the Steering Committee’s recommendation against proceeding with the rollout in February 2024 and discontinued the vendor-based TRS. Consequently, the organization formalized the use of standardized Excel-based templates to meet the reporting requirements instead of forcing a flawed software solution on the medical staff.

Pushing the boundaries of technology, Hospitalists served as a clinical testers and evaluator of innovations in Cerner including PowerChart Touch (PCT - a mobile version of Cerner) and Oracle Health Clinical AI Agent (CAA - a mobile Cerner connected AI scribe) to assess their viability for wider clinical deployment. The PCT pilot began in July 2024 and closed with a formal debrief interview in March 2025. During this evaluation, we reported that the application successfully improved documentation accuracy, efficiency, and clinical safety, particularly during on-call scenarios. The CAA pilot commenced June 2026 and we continue to give feedback to Oracle Health.

Dr Aneesh Vaghadia

Clinical studies have shown adhering to standardized management plans leads to less mistakes, less forgotten orders, more evidence based care and hence better care. Hospitalist members have served on numerous committees to develop PowerPlans (Standardized Plans within Cerner) that affect Providence Health, PHSA and VCH. These have included General Medicine Admission Powerplans, Geriatric Frail Elderly Powerplans, COVID 19 Powerplans, and Urinary Trial of Voiding PowerPlans.

In fall 2018, VCH adopted the Interdisciplinary Learning Review, a system process review which helps to identify system-level opportunities for improvement lead by Dr. Rod Tukker. The ILR approach utilizes a systems-level lens to identify, learn, understand and share opportunities for improvement through a process of examining patient journeys. The goal is to make these improvement opportunities thoroughly understandable, measurable​ and actionable. This new collaborative approach has fostered a culture of learning across disciplines and specialities at VCH. It has brought together point-of-care clinicians from all parts of the organization to have conversations on how to provide the best possible care for the patient/client and their family, elevating the traditional chart review processes to a more meaningful mechanism that utilizes frontline expertise in a truly multidisciplinary, no-blame setting.

Our members collaborated with the pharmacy department, as well as the Vancouver Division of Family Practice, leading a large QI project on implementing comprehensive medication reviews for frail elderly patients admitted to the service. In line with the Choosing Wisely Campaign, this project aimed to implement a recommendation by the American Geriatrics Society to not prescribe a new medication before conducting a comprehensive review. The project resulted in a significant increase in identifying medication related concerns. The results were presented at national conferences and published in peer-reviewed journals.