Vancouver, March 15, 2017 – A groundbreaking service for people with mental-health and substance-use challenges opens this spring at St. Paul’s Hospital that will unite emergency care, rapid access to treatment and a transition centre to provide better and faster care for this vulnerable client population 

The HUB, the first emergency care model of its kind in BC, will include two fully equipped units next to the hospital’s Emergency Department (ED) to care for patients, from their arrival at the ED to their transition back to their communities.

Specialists will provide these patients with culturally appropriate, trauma-informed care in a dignified, private setting separate from the ED.

The HUB also includes a clinic one floor above the ED where specialized addictions nurses and physicians treat those dependent on a variety of substances, including opioids. The team can provide opioid-dependent patients on replacement therapy such as Suboxone or methadone as quickly as possible.

The HUB, opening amid a public-health emergency in BC, with over 900 people dying from drug overdoses last year, will help St. Paul’s busy ED deal effectively with growing needs. It sees over 10,500 patients with mental-health and substance-use issues each year, the highest number of any ED in the province. The HUB will triage an estimated 6,000 patients with mental-health and/or substance-use challenges each year, or more than half the patients who visit the ED annually, ensuring they’re directed to the appropriate care they require.

It will decrease the amount of time police wait with patients with mental-health and/or substance-use challenges who require an escort to the ED until a doctor sees them and responsibilities are transferred. Police currently spend about 75 minutes per patient in the ED. The HUB is expected to reduce this time by two-thirds, to 20 minutes per person.

The catalyst for the HUB was an anonymous donation of $750,000 made to the Vancouver Police Foundation in 2015. The donor requested it be specifically used to alleviate the city’s mental-health and substance-use challenges. The VPD then approached St. Paul’s to establish a “transitional centre” based on St. Michael’s Rotary Centre in Toronto, which helps patients move back to their communities, equipped with the resources they need.

There are three components to the HUB:

Site A: The Clinical Unit

This is a clinical treatment area for patients requiring acute care, housed in a fully equipped redeployable medical unit provided by Coquitlam, BC-based Weatherhaven Global Resources Ltd. The private firm custom builds these units for medical, humanitarian, military and commercial applications worldwide. It will feature plenty of natural lighting and space plus first-class clinical facilities.

Site A provides:

• Eight to 10 patient beds.
• A nursing station area with three nurses on duty 24 hours a day.
• A social worker.
• A fully equipped medical supply room.

Site B: The Vancouver Police Foundation Transitional Care Centre (VPFTCC)

Only the second of its kind in Canada (after St. Michael’s Hospital Rotary Centre), the transitional care centre is a unit with eight to 12 spaces for those who don’t require hospital admission or patients who have been discharged. The centre, also custom-made by Weatherhaven, will provide discharged patients with a safe, supportive area to rest and recover. They will get help in navigating the system of services they need, such as supported or transitional housing, income support, counselling and connections to Aboriginal healing programs. This support is intended to slow the ‘revolving door’ of crisis response and help facilitate smoother transitions from acute to community care services.

The transitional care centre’s services will include:

• Help connecting with primary health care, specialist care and community agencies.
• Common lounge/kitchen area.
• Overnight accommodation with bathroom and shower facilities.

Rapid Access Addiction Clinic (RAAC) 

The RAAC at St. Paul’s provides treatment and support for all substance-use issues. Patients can receive treatment in as few as 24 hours after their ED discharge or clinic referral. It is staffed by physicians and nurses specializing in addiction medicine along with social workers and “peer navigators” who have recovered from substance use. The RAAC includes a comfortable quiet room for those who are ready to be treated with Suboxone or other oral opioid replacement therapy.

The HUB came together due to the efforts of these partner organizations:

• Ministry of Health.
• Providence Health Care.
• PHC Office of Innovation and Strategic Partnerships.
• St. Paul’s Foundation.
• Vancouver Coastal Health
• Vancouver Police Department and Vancouver Police Foundation.
• City of Vancouver.
• Weatherhaven Global Resources Ltd.

The HUB’s $3.5 million in capital costs come from:

Vancouver Police Foundation ($750,000 via private donor);

City of Vancouver ($1 million grant);

St. Paul’s Foundation ($1.75 million to match the VPD and City’s financial support);

Weatherhaven has entered into a research-and-design partnership with PHC to provide customized, redeployable units for Sites A and B.

Vancouver Coastal Health is providing $3 million in annual operating funds via the Ministry of Health. The HUB model was chosen for a number of reasons, including its redeployable features. Because of the current plan to redevelop St. Paul’s at a new site in the city, it did not make economic sense to build permanent new ED capacity at the current St. Paul’s. The HUB keeps the healthcare system cost-effective, while also maintaining top service levels for the clients it will serve.  As well, the innovative model of care that the HUB provides will be incorporated into the new hospital, offering a seamless transition from acute to community care.

Partner Quotes:

• Ministry of Health

“BC is a leader in substance use treatment and harm reduction, which includes creativity needed to improve treatment and support. The HUB is an example of that and we are proud to provide funding to this innovative way to streamline care for mental-health and substance-use patients.” – Terry Lake, Health Minister.

• Providence Health Care

“The HUB will provide culturally appropriate, trauma-informed care to patients and offer them dignity and privacy in a space better suited to their needs. By bringing emergency care, rapid access addiction treatment, and a transitional care centre together under the HUB, Providence aims to ease the current ED congestion, turbulent transitions to community care, and increased police wait times with patients to an innovative approach that can also be used at the new St. Paul’s.” — Dr. Bill MacEwan, psychiatrist, St. Paul’s Hospital.

• PHC Office of Innovation and Strategic Partnerships “Through solutions like the HUB, the Innovation Office is working to accelerate ways to improve both the quality of care and health outcomes for our patients. The HUB is the first of many future care-model innovations our Office will evaluate for their suitability at the future St. Paul’s.” — Shauna Turner, Chief Innovation Officer, Providence Health Care.
• Vancouver Police Department (VPD) and Foundation (VPF)
  “The HUB will not only provide better patient care but it will also greatly reduce the amount of time our officers wait with patients in the Emergency Department. The HUB will free up their time so they can get back on the road quicker to help keep Vancouver safe. I would like to thank the Vancouver Police Foundation for their generous support for the Transitional Care Centre – an integral part of the HUB.” –Adam Palmer, Chief Constable, Vancouver Police Department.”
• City of Vancouver (COV)
  “The HUB is an important next step to tackle a province-wide crisis with mental health and addictions that needs urgent, dramatic action. There’s a desperate need for more treatment-on-demand and personalized care for our most vulnerable residents suffering from mental illness and substance-use. Addiction is a health issue, not a criminal one; the HUB at St. Paul’s will help stop the revolving door with mental health and addictions services, filling a critical gap in patient care.”– City of Vancouver Mayor Gregor Robertson.
• Paul’s Foundation
  “We have been a strong supporter of the HUB concept from the start. Our donors are playing a key role in bringing this transformative health-care model to life.” — Dick Vollet, Foundation President and CEO.
• Vancouver Coastal Health

“The HUB is being established at a time when such community resources are vitally needed and is a key part of our strategy for helping Vancouver’s Downtown Eastside in the face of this public-health crisis.”  — Dr. Patricia Daly, Chief Medical Health Officer, Vancouver Coastal Health.

• Weatherhaven Global Resources Ltd.

“While we have used our redeployable units overseas in disaster-relief and other situations, we are proud to bring these custom-made units to St. Paul’s HUB to transform care to a vulnerable patient population. This is the first time the specific units to be used at St. Paul’s have been used in Canada as a medical clinic.” — Ray Castelli, Weatherhaven CEO