The first indication that something had to change at the Centre Hospitalier Pierre-LeGardeur in Quebec was measured in minutes.
The hospital’s staff was inadvertently keeping patients waiting an extra 15 minutes or more while they scrambled around the archives attempting to locate their files. The records had a tendency to end up misfiled or appear in the to-be-filed folder in other departments around the hospital.
Having improved access to information and attempting to minimize waiting time for patients was a huge driving force for the hospital to not only undergo an ambitious overhaul of its entire IT infrastructure, but also its April move into a brand new facility, explained Serge Boileau, IT director for Pierre-LeGardeur — the first time a hospital has ever attempted such a move in the province.
Makeshift nursing stations and patients’ beds were overflowing the hallways, and most of the hospital’s administration worked elsewhere because there simply wasn’t enough space to accommodate the “critical explosion” of the population the hospital was serving, Boileau said. The original hospital was built to serve 25,000 in the 1960s. In the 1990s that population soared to 125,000 and now there are more than 230,000 people requiring services from Pierre-LeGardeur.
The hospital, as of May 18 a centre for short-term care and ambulatory services located in Repentigny, spent $163 million on construction for the new building, which is located 4 km away from the old structure. The new building can serve ambulatory cases, one of many upgrades.
Other changes include the fact that the hospital is paperless, which has also greatly improved patient care, said Andre Couillard, managing director of Professional Computer Consultants Group Ltd. Quebec (Procom). Procom provided professional services to the project and says, without hesitation, that the Pierre-LeGardeur project is the most significant project it has taken in Quebec so far.
“Apart form overhauling all its systems and going into the latest technologies, one of the key things was the central identification for each patient,” Couillard said. Patients now receive an electronic file that is integrated with each department of the hospital and that file can move electronically and not be left in the to-be-filed folder.
X-rays are also digital now, and the entire facility is wireless. New PCs with flat-screen monitors were purchased for the new site and the project used a mix of old and newer servers for the change of location. The cost to refit the entire IT infrastructure and applications for each clinical, diagnostic and therapeutic or administrative service was another $25 million, and there was also $3.5 million set aside for personnel training in cooperation with 14 unions.
Couillard said the massive undertaking was unique because Pierre-LeGardeur didn’t hire an integration firm for the project. “Instead, they came to a company like Procom and asked us with a team of people to work in partnership,” he said, explaining that the decision had several benefits.
First, the hospital was very hands-on and involved with the process and was able to control the direction it was taking. Also there was a competent support team that came in on schedule and in budget. “It’s a much cheaper solution,” he added. “The minute that somebody’s work is done, they leave.”
There were four project managers working under the main person in charge of the endeavour and a team of five technical support people. Independent, third-party software companies, such as Bell Inc., provided the software, which Pierre-LeGardeur hand-selected. In total there were 35 systems to be implemented including five major systems for such areas as the pharmacy, electronic health records and emergency room. Some of the software on the systems was moved from the old site and others were implemented directly at the new site. All the implementations are linked to the fact that the hospital was moving to a new environment where IT was part of the concept to develop ambulatory care. Some of the systems were implemented before the move because they had to be in place prior to other systems being added. A major impetus for the IT project was to make sure all the technology was integrated.
The patient index system, the heart of the hospital, was implemented in one night, without ever shutting the hospital down — with 49 support people on standby in case of problems.
“We couldn’t ask people to stop being sick for one day,” Couillard joked. So at the quietest time of the day, between 2 a.m. and 8 a.m., the system went live.
“When they did the handover it was pretty critical because you were gong to a new system and you have to try to get it implemented and make sure there weren’t any glitches that affected patient care,” he said. It all worked without any bugs, Couillard said. Even physically moving the patients, some of whom were critical, happened in three days without a glitch.
Hospital staff was trained on an ongoing basis either before or just after the new hospital’s implementation. It was mainly conducted with online learning courses, the hospital said.
Pierre-LeGardeur’s Boileau attributes the well-oiled project, which took about one year to plan and implement, to effective management and good planning.