OCP crash cart

Issue: BCMJ, vol. 57, No. 3, April 2015, Page 94 Editorials

I sprang into action when the loud voice reverberated through the hospital corridors. Grabbing my white coat I sprinted down the hall, stethoscope trailing in my jet stream, startled visitors and knowing staff scattered in my determined wake. Sliding around a corner I met Dr Smith and we headed toward the emergency together. Our anticipation grew the closer we came. I mentally refreshed the required steps and algorithms. Bursting into the assigned room we headed for the bed nearest the door. Knowing the situation was dire we decided to grab its occupant and run. Critical situations call for desperate action so we headed toward the intensive care unit, pushing furiously. We blew past the full ICU and the overflowing emergency department, eventually dumping the surprised patient out the front door. “Sorry, we are full,” Dr Smith advised. “Really full,” I added. “Didn’t you hear the OCP level 3 announcement over the loudspeaker?”

A recent development in hospitals across our health region is the daily announcement of our over-capacity protocol (OCP) levels 1, 2, and 3. The message is triggered by the number of occupied stretchers in the emergency department and is sent over the hospital PA system at 9 a.m. Level 1 means the hospital is full, level 2 that it is more full, and level 3 that the hospital is really full.

The message OCP level 1 is stated loudly and repeated, similar to the code blue announcement. I was visiting an older unwell patient of mine when she was startled by the loudspeaker. “Oh my goodness,” she exclaimed, “what does that mean?” On hearing that it meant that the hospital is full she observed, “Well, that’s just silly. Why would you announce that out loud?”

I completely agree. I wonder which administrator or committee came up with this idea. Nothing changes after the announcement is made. No one seems to move any faster; none of the staff look concerned or even flinch. I have yet to see an OCP crash cart fly past. The hospital remains just as full. Maybe it’s a reminder for us physicians to discharge all the patients we have in the hospital unnecessarily, because that sure happens frequently. I’m sure some juggling and opening of temporary beds is required when the hospital is full, but couldn’t this be managed with a phone call? I’m not sure a general announcement to make everyone a bit anxious is the best approach. It reminds me of Chicken Little’s cries of “the sky is falling!”

I’m going to try to stop this process at my hospital, but I’m not sure I will have much success. I have been given the contact information for the vice president of community hospitals and programs, so I’ll do my best. I was hoping to get contact info for the vice president of patient experience (yes, Fraser Health has one of those) because I would really like to know what this person does.

As an aside, I might start a daily proclamation in a loud, firm voice over my hospital patients’ beds that they are sick, getting sicker, or really sick!

David R. Richardson, MD. OCP crash cart. BCMJ, Vol. 57, No. 3, April, 2015, Page(s) 94 - Editorials.

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