I sat down with Michael Marchbank at the Fraser Health Corporate office. Mr. Marchbank has an extensive history with BC healthcare and has held several important leadership positions throughout his career. He was appointed President and CEO of Fraser Health in January 2015. During our conversation, Mr. Marchbank shared his views on quality and opened up about his Change Day BC experience with home and community care.

Q: You have a long history in BC healthcare. What made you come back to Fraser Health?

MM: I’ve lived in the Fraser Valley for 20 years now, so I saw this role as a good opportunity for me personally. But this position means much more to me than that. As you move through your career you talk a lot about what you think should happen, so one of the pleasures of being a CEO is that now it’s on you to make it happen.

I see this role as an opportunity to move things forward at Fraser Health, so we’ll see how we do.

Q: What would you like to see move forward?

MM: Well, quality of care is at the heart of it. And when I speak about quality I look at it in a very broad spectrum. I could be talking about quality for an individual patient, but I can just as easily be talking about quality in terms of how we’re treating certain segments of our population – our seniors and the South Asian community, for example.

For me, the bigger picture of quality is…are we providing the right services, in the right place at the right time?

We have a very diverse population in Fraser Health and we’re growing, so there are many opportunities to improve quality.

Q: So has quality of care improved at Fraser Health since you came back a year ago?

MM: I think it’s important to appreciate the context one is in. We’re a huge organization. We have 26,000 employees, 2,500 medical staff, and we’re spread across 12 communities. Change is relative when you’re an organization this big – you don’t change on a dime.

But what you can do is start a journey and I think we’ve started that journey. I’m seeing incremental improvements all the time. We’ve made tremendous strides in reducing our C. difficile and Care Sensitive Adverse Events rates.

The one thing I’m very impressed with is that we have a lot of very dedicated and talented staff who are doing a lot of very good things for patients, residents and clients. That gives me a lot of optimism for where we’re going as an organization.

Q: For Change Day BC you had an opportunity to see another part our healthcare system. What was that like?

MM: My Change Day BC pledge was to spend half a day with a home support worker and half a day with a home care nurse, so I did that over the summer. It was very interesting to see that part of our healthcare system. The value those clients see in their home support worker and nurse is incredible. And it means we’re caring for people in the right place – in their own home – as opposed to other places.

If there was ever any doubt in my mind about the value of home and community services, it disappeared entirely by going out and seeing the impact on patients.

The interactions between the home support worker and the nurse with their clients was fantastic to see.

Q: What about BC PSLS? Has it had an impact on quality at Fraser Health?

MM: Definitely. BC PSLS is extremely valuable because it gives people a way to report safety events in real time. And we’ve integrated the system into our organizational structure so we can identify trends and improve safety across all areas of care.

What it comes down to is being responsive. I receive an email when there’s a serious event, so we deal with those situations right away. Our Executive Committee and Board also review safety events so we can discuss trends and improve quality of care.

If we didn’t have a system like BC PSLS it would be very difficult to know what our safety record looks like. We’ve definitely improved and we’re seeing progress in several areas.

Q: You personally write to thank every staff person who’s featured on our blog. Why?

MM: To me that’s an important part of a safety culture. The whole organization must be behind it and part of it. It’s important that people get recognized.

Sometimes we’re awfully quick to tell someone when they’ve done something wrong and we’re less quick to tell them when they’ve done something right, so we make an effort to do that.

I’m pleased to know that our staff appreciates this small token of recognition for their great work. It’s something we’ll continue doing.

Q: What concerns you about our healthcare system?

MM: Well, I tend to worry about the bigger system pieces. So I pay a lot of attention to the shift we have going on now with moving from an acute care focus to a more balanced system with stronger services in the community. We need to do a better job of caring for our seniors, for example, so we have a whole variety of efforts going on in home care, home support and residential services.   

We also need to pay more attention to mental health and substance abuse services. Those are very important, so I think those are areas where we can do better. 

And we need to make sure we’re making the best use of the resources we have. That should always be a part of our thinking. And with that we need to make sure we have the right structures in place to ensure all of our services are providing the best quality of services we can.

Q: What are you goals for next year?

MM: More of the same, more of the same focus. We’ll continue to make that shift toward better community care services with a constant lens and focus on patient care quality.

Philosophically, we must make the best decisions in the interest of patients and families – that has to drive everything we do.

More often than not, the best quality decisions are the best resource decisions as well. We’ve made terrific progress over the past year so I’m looking forward to seeing that continue.