Archive for the ‘Departments & Services’ category

It All Started With A Few Test Tubes

December 5, 2012

There are few if any departments at any hospital that do not depend on laboratory services to be able to function safely, efficiently and effectively. But “laboratory services” have changed dramatically over a relatively short period of time.

Lab tech hand

The function of laboratory services was first provided at the Royal Columbian Hospital in 1918, but it was not done on site. Mr. Gooding, a bacteriologist, was contracted at the rate of $30 per month, and worked at his laboratory at the Public Hospital for the Insane. His lab work consisted primarily of analysing specimens using only a few test tubes, reagents and a microscope.

The lab at Royal Columbian Hospital itself began in 1920 in a vacant room in the basement of the 1912 building. Mr. Louis A Breun was appointed as Chief Bacteriologist to manage the laboratory, X-ray and pharmacy departments with the assistance of one technician – Miss Isobel Barr.

Sixteen years later, the following article appeared in The British Columbian, Royal Columbian Hospital 75th Anniversary Edition, 1937.

Fine Laboratory Built Up During 16 Year Period

One of the proudest assets of the Royal Columbian Hospital is the up-to-date laboratory, started with a few test tubes 16 years ago by L.A. Breun, chief bacteriologist and gradually built up by him into the very complete and efficient department it is today. It is the lab that diagnoses thousands of cases by testing blood, tissues or fluids taken from a sick patient.
Mr. Breun is assisted by Miss I. Barr, technician, and shortly the laboratory will be expanded and the quarters doubled. The basal metabolism department will be extended and Mr. Breun will be given additional assistants.
The laboratory may handle between 650 and 800 cases every month, some specimens requiring numerous special tests.
Since the laboratory was started, Mr. Breun has handled 32,023 pathological tests. These are not the routine tests, which run into a large number more. In the past five years, the number of monthly tests made in the lab have doubled. Besides tests for germs and tests of cultures, Mr. Breun does section work, such as studying tissues for cancer and so forth.
In addition to all sorts of pathological and routine hospital tests the department makes any tests required by the city department of health, such as tests of milk and water and for infectious diseases.
In 16 years the department has gradually acquired a fine array of microscopes, culture incubators and similar equipment. Mr. Breun has also accumulated an unusually complete range of pathological exhibits and a fine library.”

As the hospital grew, so did the need for a histological department and in 1948, Dr. P.S. Rutherford became the first permanent pathologist at RCH. He had a staff of 8, including himself, 6 technologists and 1 stenographer. Eventually, in 1952 the lab moved from the basement to the top floor of the old wing of the 1912 building, and included a training school for technologists.

The concept of a Regional Laboratory Service was introduced in the mid-50s, and the role of a lab technologist began to change with automated equipment and computers becoming a standard part of the work.

Would Adrian Breun or Isobel Barr recognize any of the equipment in a hospital laboratory today? What would they make of the partial list of procedures available from Outpatient Laboratory Services at Royal Columbian Hospital that includes “blood and urine collection for chemical analysis to determine glucose/lactose tolerance, cholesterol level, HDL/LDL and triglyceride level, and blood gas analysis; sweat chlorides, bone marrow testing, H. pylori breath tests, fine needle aspirates, coagulation testing and endocrine simulation tests?

Diane Oberg RCH Lab Technologist 1998

Diane Oberg RCH Lab Technologist 1998

They might well wish that they could have been part of the exciting and complex world of laboratory medicine of 2012, but without the groundwork they and others did in the first half of the 20th century, none of today’s services would be possible.

They would certainly have been impressed if they had seen the full double rainbow on December 4, 2012 clearly indicating that RCH really is worth its weight in gold!

Double rainbow Dec 4, 2012 over Royal Columbian Hospital. Courtesy of A Sense of History Research Services.

Double rainbow Dec 4, 2012 over Royal Columbian Hospital. Courtesy of A Sense of History Research Services.


Do You Remember RCH in the 90s?

November 28, 2012

A couple of weeks ago we posted several photos from a photo album of Royal Columbian Hospital events in the late 1980s and 90s, and asked if anyone recognized the people in them. We had an overwhelming response and many requests for more photos.

Here are a few from the same album. It’s amazing how many of the people in the earlier photos are still around – maybe some in these are too.

This one is the only one fully captioned, so we know it’s Dr. Gittens showing some of the neurosurgical equipment in March of 1998, but we don’t know what the event was.

This was taken at the official lab opening January 21, 1997, but there’s no name given.

And this is just captioned MRI 96 10 01, so we assume it was the opening of the MRI unit we described in a post here in October.

The following 2 photos are from the Surgery Open House Day December 01, 1991 and obviously represent Plastic Surgery and Orthopedics respectively, but we don’t have the names of the doctors.

This last image was taken at the celebration of the 15th anniversary of the RCH Foundation in 1993. Just can’t work for a foundation without being an expert at serving at cake!

Again, if you know any of these people, or can add details of the event shown, please share your comments.

RCH Medical Record Librarian School First in BC

November 14, 2012

The Canadian Health Information Management Association (CHIMA) celebrated its 65th anniversary in 2007.

CHIMA represents more than 3,700 certified Health Information Management (HIM™ ) professionals from across Canada in addition to 1,300 affiliate, student and retired members. HIM professionals are employed in hospitals; in the community health and extended care sectors; government; health and education institutions; the private sector including insurance and pharmaceutical companies; technology vendors; and consulting firms. The skills and knowledge of the HIM professionals support clinical research and provide information for medical and health care statistics. But this area of health care is relatively new.

In 1913, the American College of Surgeons was founded with the goal of enhancing the quality of surgery performed through better surgical training. To standardize the training performed, quality health records were deemed an essential factor. In the 1920s, Royal Columbian Hospital had difficulty with case history reports and medical record keeping to the extent that in 1922, it was removed from the list of standardized hospitals. By 1931 RCH, along with ten other BC hospitals, regained “approval” by the American College of Surgeons, based on what the College described as “competent medical staff keeping accurate and complete records of all cases”. However, because of a shortage of both funds and trained staff to organize and maintain medical records, RCH again lost its “approved” status.

Probably as a direct result of the inability to obtain and keep accreditation, RCH instituted a Medical Records department in 1949 with the appointment of Mrs. Ruth Melby as Chief Medical Record Librarian.

During the following year, she established a cross index based on the standard classification of disease and operations, as well as numbering and filing medical records by the unit system. The next year, the hospital purchased a dictating-transcribing machine for the use of medical staff and 75% of admissions had type-written histories. Mrs. Melby could now state in the annual report, “with the accumulation of two years of cross indexing of diseases and operations, statistics are now available for the first time for any physicians who wish to carry out medical research projects.”

In 1954, RCH was approved for training by the Canadian Association for Medical Record Librarians and the school, the 7th in Canada, opened September 26, 1954. Four students began classes the following year after arrangements had been made for them to receive their training in anatomy and physiology with the student nurses. The Vancouver Sun of May 16, 1956 published the following article describing the school and the careers it made possible.


Hospital authorities aren’t just being nosey when they ask you all those questions. The fact that you’re allergic to artichokes might help someone engaged on an important research project. First of its kind in BC, a school for medical record librarians at Royal Columbian Hospital in New Westminster trains people to make use of all the information a hospital collects.

After a 52-week course, graduates are equipped to make quantitative analyses of medical records, to classify, code and index diseases and operations, to prepare statistical, medical, insurance and Blue Cross reports and to do research for doctors and medical associations.

In session now, with the first graduation ceremonies scheduled for August, the school opens up new job opportunities for those who qualify as trained specialists in the profession of medical record science. There is a big demand for medical record librarians in hospitals throughout Canada and the US, with the result that posts are plentiful and starting salaries, approximately $250 a month. Based on requirements of the board of registration of the Canadian Association of Medical Record Librarians, the course of training is divided into two parts, Junior and Senior, with one week’s vacation at Christmas. During the first three months most of the student’s time is spent in practical training. Classes commence in September and January and hours are from 9 to 4 weekdays and 9 to 12 on Saturdays. Lectures are given by members of the hospital’s medical record department staff and School of Nursing instructors. Guest lectures also are given by members of medical record departments of other hospitals in the greater Vancouver area.

On successful completion of the course, graduates receive a diploma and pin and become eligible to write Canadian registration examinations. When they have passed these exams, they are privileged to write RRL(Registered Record Librarian) after their name.”

A Medical Record Librarian from the Regina General Hospital who had graduated from the RCH school, described her career in glowing terms, “No two days are ever the same”, she said. Her daily work included analyzing medical records, classification, coding and indexing diseases and operations, statistical and medical reports and research work for medical associations and doctors. “One of the advantages of being a medical record librarian is that you know you are serving others – patient, doctor and hospital.”

OMG! Did I Really Look Like That?

November 7, 2012

Old scrapbooks and photo albums are a great way to learn about the past. If they’re fully captioned and labelled, they can be a great source of information, and if they’re not labelled at all, well, they can still be fun. A large photo album came our way recently with lots of unlabelled photos of past events designed to raise funds and public awareness at Royal Columbian Hospital in the mid-to-late 1980s and ’90s.

Many are pretty self-evident, but some are a little puzzling. We’re hoping that some people will recognize themselves or others in the following, or at least be able to tell us more about the event at which they were taken. Even if that doesn’t happen, they provide a great glimpse at the kind of events that were happening about 25 years ago.

RCH Fundraising Thermometer Being Installed on Woodward’s Roof 1988

This “thermometer” was installed on the roof of the Woodward’s store at 6th & 6th in uptown New Westminster in 1988 to keep track of funds raised for Royal Columbian Hospital. The slogan was “Catch Our Fever: It’s Your Turn to Care” and the top of the thermometer showed $6.0 million – did they reach it?

1989 Get-Away Van

This Get-Away Van was the Grand Prize in a fundraising project in 1989. Not sure why this man is having his blood pressure taken – did he just win the prize?

Raymond Burr as Key-Note Speaker 1988

There was great excitement when the famous New Westminster-born actor, Raymond Burr, visited RCH in May, 1988. Here he is shaking hands with then-Mayor Tom Baker, while Norm Grohman looks on. Burr has just finished his key-note speech.

Raymond Burr Chatting With Staff

Raymond Burr obviously enjoying a friendly chat with RCH staff in the cafeteria.

CKNW Orphans Fund Presentation

Jim Fair, President and CEO of RCH, explains a piece of equipment to Judge Tom Fisher in an undated CKNW Orphans Fund presentation – probably 1988 or 89.

The following 5 photos were all taken at the Surgery Open House Day December 01, 1991 at which almost every department had a table or booth, or was open to the public. It was obviously very successful judging by the crowds in other photos in the album. Recognize anyone?

The sign on the wall may say “It doesn’t have to hurt”, but the young man in the red sweater doesn’t look very convinced.

Auxiliary volunteers always at the centre of the action!

Certainly a happy group!

Even with all those balloons, some of that equipment looks pretty scary.

She looks like a natural, so did she eventually become a surgeon?

If you know any of these people or attended these events and can add details, please share your comments.

Monster Magnet

October 24, 2012

In light of the opening of the new Multipurpose Interventional Suite this week, it interesting to look back a mere 16 years to another major new piece of technology. In June 1996 some pretty dramatic images recorded the installation of a $2.3 million Magnetic Resonance Imaging (MRI) unit planned to improve diagnostic services at Royal Columbian Hospital.

A Royal City Record/NOW article explained that MRI is a non-invasive imaging technique that produces cross-sectional pictures of the head, body and spine without the use of X-rays or radioactive materials. MRI uses strong magnetic fields and radio frequency waves; a computer processes the signal information and displays it as an image on a video screen.

On June 4, a 90-ton crane helped hoist the 22,000 lb magnet into the hospital, where it would be housed in a specially protected room in the Medical Imaging department. The magnet had a magnetism of 10,000 gauss (the magnetism of the earth is 0.5 gauss).

Workers, above and below, position the machine as they attempt to move it into RCH.
Source: Royal City Record/Now June 5, 1996.

RCH, the referral hospital for diagnostic services for all residents of the Fraser Valley, would then be the only hospital in the Fraser Valley with the MRI service. The first patient was scheduled to be scanned on September 3, 1996.

The renovations for the MRI room and support areas cost $513,000, which was shared by the Ministry of Health (60%) and the Greater Vancouver Regional District (40%). The MRI equipment cost $2.3 million, with the Ministry of Health contributing $1.38 million and the RCH Foundation contributing the remainder.

Isolated But Not Alone

October 17, 2012

The process of isolating patients with communicable diseases has varied widely over the years at Royal Columbian Hospital. In 1862 even before the original Royal Columbian Hospital was finished, the Board of Managers had to build a small separate building to house a couple of smallpox patients. There were, at different times, a number of separate isolation hospitals in different parts of the city such as Poplar Island and the area at 8th Street and 8th Avenue near the Douglas Road cemetery. They dealt primarily with smallpox, but patients with any communicable disease could have been cared for there.

In 1908 three isolation cottages were added to the 1889 hospital building for patients with infectious diseases, including scarlet fever and tuberculosis. The 1912 hospital has an isolation ward as part of the main hospital rather than having a separate building for that purpose. However, by 1940 there was no isolation ward at all at RCH and patients had to be sent to Vancouver due to the lack of facilities in New Westminster. Ald. W. Cook lobbied in November 1940 for the Dominion government to contribute toward an isolation ward at least for the army cases in the military wing.

In 1943, the scarlet fever isolation building was renovated and brought back into service. The interior of the building was redecorated, the electric wiring system overhauled, the exterior painted and extra fire escapes added. By the 1960s, there was an isolation ward on the ground floor toward the rear of the old 1912 section of the hospital.

In 1964 an 18-year old young man suffering an infectious disease was admitted to that isolation ward. Thinking back to that time, he now has only vague impressions of the admission process, or the ward outside his room. During the first 24 hours, he was too ill to pay much attention to what was happening, but as he began to feel better, he wondered what was happening outside his room in the general ward. He could hear muffled voices, a child crying, the rattle of equipment, but not much else. Finally the day came that the nurses told him that he had visitors. Some school chums had come to see him, but visiting a patient in isolation wasn’t like seeing any other patient. The patient sat in his room in front of the open window, while his friends or family sat or stood outside on the other side of a wire fence. This way they could see and hear each other without any possibility of transmission of the disease. The system worked well during the summer months, but when it was rainy or cold and snowy it had some pretty obvious problems.

Visiting patients in the isolation ward of Royal Columbian hospital can be an uncomfortable ordeal. To prevent contact with patients with infectious or contagious diseases, visitors are kept outside the building and away from the windows by a wire fence. Among new facilities included in current plans for expansion of the hospital is a new isolation ward with an indoor visiting room. Source: The Columbian Oct 29, 1964

Today, technology makes everything different. Patients in isolation now can still be in constant touch with the outside world via TV, internet, email, etc. – things we all take for granted. But back in 1964, it was an exciting step in his recovery when our 18-year-old patient was told he could have his transistor radio brought in as long as it was in a plastic case that could be properly cleaned, and not a leather case. The disposable earphones provided by the hospital weren’t as good as his own, but now he could listen to the hit parade, his favourite programs, and the news and begin to feel once more part of the world outside the hospital walls. Anything else (books, paper, pens etc.) that was brought in for him had to be destroyed when he was discharged so that there was no chance of “taking the disease out” with him when he returned home.

Today there are isolation beds right in the middle of intensive care wards – the barrier now being differences in air pressure rather than solid walls and wire fences, but the concept remains the same. Give the best care possible to the ill patient, while protecting the general population from whatever has caused the disease.

Modular Building makes debut at Royal Columbian Hospital

October 10, 2012

New two-storey medical wing of Royal Columbian hospital hides the ancient original building from view of passersby on East Columbia street. The new building was erected in a nine-month crash program to replace a structure dating back to 1912 and now condemned as a fire hazard. Entrance is at far right. Photo from The Columbian Oct 6, 1971

From The Columbian newspaper, Oct 6, 1971

The long-awaited modernization program of Royal Columbian Hospital in New Westminster takes its first tangible step tomorrow with the official opening of a new building for medical patients, constructed in a crash program from factory-built modular components.

The Modular Building, as it is named by hospital authorities, will accommodate 153 adult patients and 21 children for a total of 174.

The accommodation is to replace an ancient structure first built in 1912 and now condemned for hospital use by fire officials. A major portion of the 1912 building is to be demolished and eventually equipped for Royal Columbian’s role as the principal referral hospital of the lower Fraser Valley.

The modular building, though considered temporary, and designed to be dismantled and moved to some other community in the future, is nevertheless completely and well-finished and equipped. It has a full basement, with storage, heating, garbage and laundry-handling facilities, and two nursing floors. It is connected to the permanent buildings by two covered walkways, for comfortable movement of patients, staff and meals. It has some private rooms, but the majority of patients will be housed in nine to 12-bed wards, with the usual movable drapes to give privacy to each bed when required.

Comfort of the patients is assured by new and up-to-date beds and other furnishings. Each bed has its own lamp, hooded to prevent glare in the eyes of other patients. Each has a nurse call switch, which lights an indictor at the nursing station and over the bed. All have piped oxygen outlets, and a plug-in for cable television.

Construction started on Jan. 20 this year, after many other plans for expanding and updating the hospital had been made and turned down by regional and Victoria authorities because of cost. The modular unit system was finally chosen and approved because of speedy construction and the possibility of dismantling and moving the building at some future time. Prime contractors, Van Construction of Burnaby, built the 80 modules in the firm’s own shops, trucked them to the site, and fitted them into a steel framework erected on the basement foundation.

The majority of the modules are 10 ½ by 40 feet, and had electric wiring and piping systems installed and ready for hookup at the plant. On-site jobs included exterior cladding, roofing, flooring, installation of fixtures and trim, and decorating.

Cost came to approximately $28 per square foot for a total of $2,395,000, only slightly higher than a comparable wood frame or cement block building, and considered well worth the extra amount for the gains in time and portability.

The building is designed to accommodate patients suffering an illness, rather than those hospitalized by injuries or for surgery, who require more of the sophisticated electronic equipment for their care. The modular unit has no operating room, x-ray or cardiovascular equipment. Patients requiring treatment in thee departments will be taken to the main building through the connecting corridor.

But every facility to help provide the best nursing care has been included. Nursing stations are large, with an attached “medi-prep” room with stainless steel fixtures. They are fitted with intercom to all wards, call system and convenient storage for patients’ records. Each floor has its own food service center, with an ice-making machine, refrigerator and other facilities for serving between-meal snacks. Each floor has day rooms for “up” patients to lounge and receive visitors.

The children’s ward is at one end of the second floor to eliminate through traffic. Isolation for patients with communicable diseases is in the same location on the first floor, but has an entrance from outside for visitors, locked for control.

From related article:
The present remodelling was done in order to relocate offices, medical records, the cafeteria and other service departments housed until now in the portion to be demolished. Virtually untouched in the present program is the central building constructed in 1950, containing 235 patient beds, the operating theatres, and the trauma unit added recently.

Total patient capacity in the 1912 and 1950 wings of the hospital was 445, until remodelling forced removal of 53 beds temporarily. When the modular unit replaces the 1912 wing, capacity will be stabilized at 409. Planners speak of the possibility of topping-off Royal Columbian with a capacity of 700 in the future.

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