90th anniversary flashback: Panoramic view of health care unfolds in Command Centre
As the JGH’s 90th anniversary approaches, JGH News today looks back at:
- The 2020 launch of C4 (the digital Command Centre)
- Banning tobacco sales in 1969
- Introduction of the Surgical Safety Checklist in 2010
- Montreal’s first fetal heart monitor arrives in 1967
Four new archival items appear every Tuesday in the 90 days leading up to the 90th anniversary on October 8. Everything that’s been published so far can be found in the JGH News archive.
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In December 2020, the boardroom of the JGH became the setting for the launch of the initial premises of C4, a dynamic Command Centre, where real-time data about care throughout CIUSSS West-Central Montreal is used to generate improvements in efficiency and the quality of care.
A new conference room adjoins—but is separate from—C4’s current operations centre.
The award-winning Centre—known as C4 for its focus on better Care through Communication, Collaboration and Creation—soon moved to a larger space in Pavilion B, before arriving in September 2023 in its current home, a pair of spacious rooms in a central location on the main floor.
Nearly three dozen large, wall-mounted screens monitor the complex activities of the healthcare network and its minute-by-minute changes.
By consulting these screens, decision-makers can, for example, examine how various types of healthcare users are flowing through the CIUSSS; identify potential bottlenecks; and ensure that specific users are being smoothly and promptly transferred from one facility to another, or from one service to another.
Predictive analytics plays a crucial role by enabling decision-makers to act quickly before today’s minor glitches can evolve into tomorrow’s major headaches.
Although similar command centres can be found in some of the continent’s larger healthcare systems, C4 is unique in Canada (and possibly even in North America), since it gathers and displays data about an integrated healthcare network, consisting of multiple sites overseen by multiple directorates.
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The beat goes on in Obstetrics
In 1967, Nurse Vashti McClean turns the selector switch of the JGH’s new fetal heart monitoring system, as she listens to an unborn baby’s heartbeat through an amplifier (lower left) and watches it on an oscilloscope (upper right).
The JGH was at the forefront of obstetrical care in 1967, when it became the first hospital in Montreal to install a fetal heart monitoring system.
The equipment enabled a microphone to be affixed to the abdomen of a dozen pregnant women and to have the fetuses’ heartbeats monitored at a central nursing station. Healthcare staff could listen to the unborn baby through an amplifier or watch the heartbeat on an oscilloscope.
In addition, the upper and lower limits of normal fetal heartbeats were registered on a cardiotachometer, whose alarm sounded if any of the heartbeats crossed the safety limits.
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Tobacco sales banned on JGH premises in 1969
In early 1969, Dr. Richard Margolese, who would later become JGH Chief of Oncology, wrote an impassioned letter that played a pivotal role in a decision by the hospital’s Board of Directors to ban the sale of cigarettes on its premises.
Dr. Richard Margolese
After recounting the growing body of evidence linking smoking to lung cancer and related illnesses, Dr. Margolese told the Board that “the medical profession bears a responsibility to lead the public both by education and by example. The Hospital should feel obliged to perform similarly.
“The abolition of the sale of cigarettes both from vending machines and over the counter should be seen by the administration in the same light as the enforcement of basic hygenic measures or rules in the Hospital at large. The Hospital has both a professional responsibility, as well as a moral obligation, to strike this posture.”
Taking Dr. Margolese’s comments to heart, the Board agreed that as of March 1, 1969, tobacco could not be sold anywhere within the hospital. This made the JGH one of the rare healthcare institutions in Montreal to adopt such a policy, which was a major step toward an eventual ban on smoking in the hospital.
Dr. Margolese, who was a member of the Surgery and Tumour Clinic when he composed his letter in 1969, went on to serve as Chief of Oncology from 1988 to 2007, as well as being named to the Order of Canada in 1997.
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How a few simple questions made surgery safer
Moments before an operation gets under way in 2010, members of the surgical team review the questions on the JGH Surgical Safety Checklist.
In 2009, the value of a surgical checklist was finally confirmed in research by the World Health Organization and the Harvard School of Public Health. In response, the JGH joined the growing ranks of leading hospitals around the world in 2010 by making systematic safety checks mandatory in all types of surgery.
In doing so, the JGH became the first hospital in Quebec to implement this quick, simple and inexpensive, yet remarkably effective means of preventing errors and raising the quality of surgical treatment.
The JGH’s Surgical Safety Checklist obligates the surgeon and other members of the surgical team to refer to a list of specific topics as they confirm—and, where necessary, discuss—certain key facts about the patient. Reviews are performed at three pivotal moments: before anesthesia, before the first incision, and before the patient is taken to the recovery area.
These procedures, which usually add no more than a minute or two to the operation, ensure that the team is familiar with every pertinent issue relating to the patient’s health and that every necessary precaution has been taken to protect the patient if something unexpected happens.
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