“I’ve always been focused on fixing things,” said Dr. Shannon Fraser when asked what draws her to her multifaceted work at the Jewish General Hospital (JGH). She is fixing a lot of things in her vital dual roles of Head of General Surgery and Medical Director of the hospital’s trend-setting Command Centre.

Launched in 2021, at the height of the pandemic, the Command Centre uses real-time data and predictive software to provide a panoramic view of what’s happening throughout the JGH’s healthcare network (the CIUSSS West-Central Montreal).

“We realized very early that to coordinate the flow of COVID patients we needed information dashboards, but they didn’t exist,” she recalled. “So we created them ourselves and as a result ended up with great infometrics. The Command Centre idea was clearly coming, but this kicked it into high gear.”

Creating a ‘Team of Teams’ model of care

The Command Centre provides information tools everyone can access. “It’s a game-changer,” said Dr. Fraser. “Everyone is now on the same page with data and information – how to get patients to the right place at the right time for the right care.”

“It is bringing people together to shift thinking.

They’re not ‘my patient’ or ‘your patient’ anymore,

they are ‘our patients.” – Shannon Fraser

For example, doctors can reach out for information such as when a patient might be able to get a specific service or when they can be transferred.

“It’s an important tool,” said Dr. Fraser, “It is bringing people together to shift thinking. They’re not ‘my patient’ or ‘your patient’ anymore, they are ‘our patients.’ It’s a team approach now.”

Donors to the JGH Foundation played a major role in making the Command Centre possible.

“Thanks to the generosity of donors, the Foundation provided major help in the development of the tools that make the Command Centre work,” said Dr. Fraser. “They’ve been wonderful partners.”

The Command Centre greatly helps with the coordination of care across the CIUSSS. Different teams have worked with it to develop the statistical tools that are most meaningful to them.

“We at the Command Centre provided the recipe, but each team developed what they needed,” said Dr. Fraser. “This work has really helped gel different teams from across the CIUSSS, to make the ‘team of teams’ concept work.”

One weekend last summer, the hospital received 10 new patients with hip fractures and more than 10 who had experienced strokes. Thanks to the Command Centre, the rehabilitation team realized all these patients would soon need rehab facility beds. As a result, they were able to start planning ahead rather than being blindsided at the last minute.

Along with her work for the Command Centre, Dr. Fraser is also busy leading the hospital’s Department of General Surgery.

“My team has been an early adopter of new ways and new equipment to do minimally invasive surgery using our Da Vinci robotic surgery system, which was financed by Foundation donations. This has allowed our experts in surgery for different cancers to help patients get a better surgical result with less invasiveness and shorter healing times, which also helps hospital capacity.”

Pandemic accelerated need for change

The Command Centre at work

The Command Centre positively impacted patient flow across the CIUSSS West-Central Montreal. For a period in 2022, because of the Command Centre:

• The number of psychiatric patients waiting for admittance each day went from an average of 15 to 18 down to between 5 and 10

• The number of hospitalized patients who no longer required acute care and were awaiting transfer went from an average of 67 patients to 43

• Lengths of hospital stays in wards including surgery, psychiatry, geriatrics and rehab dropped by a full two days

• Delays of admissions from the Emergency Department to a ward in the hospital dropped from 31.8 hours to 23.8 hours

How will the JGH and the healthcare system emerge from its current challenges? According to Dr. Fraser, “The pandemic accelerated our need to respond to two major trends that were already happening before – the aging of baby boomers and hospital personnel supply issues.”

Two keys to that response, she added, are for hospital personnel to be working as teams, which is now being facilitated by the Command Centre, and to keep fewer patients in-hospital for treatment.

“For many patients, the best place for them to get care is at home, but monitored closely by our hospital and CIUSSS teams,” she said.

“We need the infrastructure and tools to be able to treat patients in more ways at home. Donations to the Foundation will help us get the infrastructure in place, such as remote monitoring, so we can treat more eligible patients in their home where they are most comfortable and at ease.”

Dr. Fraser’s quest to fix things persists.

To make a donation to the Jewish General Hospital Foundation, please go to www.jghfoundation.org