Strengthening relationships, building new connections and experiencing what it’s like to work at a site supported by a virtual team—those were all goals of a recent visit to Bella Coola.

Emergency Medicine physician Dr. Ian Ricketson and Virtual Medical Office Assistant Hayley Bennett, both members of the Real-Time Virtual Support (RTVS) team, travelled to the coastal community in the summer to discover how RTVS could provide the best possible support.

Bella Coola, home of the Nuxalk Nation, is situated in mountainous coastal terrain accessible via a six-hour drive west from Williams Lake, a ferry from Port Hardy, or a plane ride from Vancouver Airport. It is one of nine communities that currently use the Virtual Emergency Room Rural Assistance (VERRa) pathway.

The pathway sees virtual Emergency Medicine Physicians step in when there are challenges with physician staffing levels. The virtual physicians work with on-the-ground nursing teams to safely manage patients who visit the emergency department. A doctor is available in the community if the nurses need help with an urgent case.

The team in Bella Coola had been working with the VERRa team for a few months, but none of the VERRa physicians had ever worked there, so a plan was hatched to send a small team to get a deeper understanding of their needs.

“Visiting Bella Coola and actually doing shifts there really helped me understand not only the community better, but also some of the site-specific challenges they face. Things that would have been far more difficult to understand if I did not experience them myself.”

The remote location, challenging geography, ongoing history of colonization and health system silos are just some of the realities that healthcare providers supporting Bella Coola need to be aware of.

Hayley said it was wonderful to meet the local teams and get to know the community.

“We had such a warm welcome at the Bella Coola ER, and had a great lunch meeting with doctors and administration,” she said. “We’ve already taken what we’ve learned and shared it among the team members so that we can provide the best possible support to Bella Coola.”

Hayley added that she was also able to visit the Nuxalk Administration office and Health Center. “We had the warmest welcome from RN Sophie and Health Director Kirsten, a grand tour, and I was blown away by what they are working on. Dental facility, home care, lab capabilities are just the tip of the iceberg. An elder community is also being built across the road.”

Ian and Hayley were also able to visit Ulkatcho, to the east of Bella Coola. A diverted flight meant that instead of landing in Bella Coola, they landed at an airport near Ulkatcho and picked up a bus from there. Since they were not far from Ulkatcho Nursing Station, a site that regularly calls RTVS for support, they decided to arrange a quick meeting with the clinical team there.

In addition to visiting Ulkatcho and Bella Coola, the RTVS VERRa team has visited Burns Lake and Nakusp. There are plans to connect with more communities in the months ahead.

Since RTVS started doing overnight virtual support of rural hospitals, the team has supported a total of 16 rural hospitals.

The coverage:

• Can help prevent closures and diversions.
• Means care remains accessible to rural patients.
• Supports physician retention as it means physicians can potentially avoid working back-to-back shifts and can get rest and time with family.
• Supports primary care because having VERRa will help physicians get the sleep they need to better support their primary care patients.

VERRa is a publicly funded program that works with and for communities.

VERRa Co-Lead Dr. Caroline Walker said: “Part of RTVS culture is ensuring there are strong relationships with the communities we support. The most effective way to develop these relationships is by walking in the shoes of rural doctors doing this work day in and day out and participating as part of the team.”