Rural Surgical and Obstetrical Network

The Rural Surgical and Obstetrical Network (RSON) initiative stabilizes, supports, and enhances the delivery of quality surgical and obstetrical care to rural communities and Indigenous Peoples in British Columbia (BC). It provides sustainable local/regional surgery programs closer to home, in geographic areas served by Enhanced Surgical Skills Family Physicians or a solo General Surgeon, by enhancing existing care networks shared with referral centres. 

Through this work, these rural surgical and obstetric networks support enhanced critical care, emergency, and trauma services, while also supporting closer-to-home maternity care, including vaginal birth and Caesarian sections. RSON’s work is divided into five pillars: Clinical Coaching, Continuous Quality Improvement, Remote Presence Technology, Evaluation, and Scope and Volume.

Our Achievements

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Two new working groups joined RSON

There are now active RSON working groups in 10 communities across the province, with Sechelt and Powell River forming working groups in 2021 to join Revelstoke, Fernie, Creston, Golden, Vanderhoof, Smithers, Hazelton, and Port Alberni. In collaboration with local and regional administration, Quality Improvement nurses are now in place in all four participating Health Authorities, supporting local QI data collection initiatives and projects supported by Health Authority teams.

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Supported rural FPAs through virtual coaching program

Remote Presence Technology (RPT) has fostered a virtual Regional Anaesthesia coaching program, creating a provincial network of FPAs supported by the specialist Anaesthesiologists at St. Paul’s Hospital. After initial needs assessments, rural teams are invited to webinars focussing on best practices around Regional Anaesthesia, then a virtual coaching session is booked during an appropriate procedure in the rural operating room. Connecting the output of the bedside ultrasound to the remote-control RPT camera, the specialist can coach the local FPA through an ultrasound-guided nerve block in real-time.

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Performed analysis showing value of rural surgical centres

The RSON Evaluation team, led by the Centre for Rural Health Research, performed a facility level cohort analysis using PopDataBC outcomes data to show that rural facilities exhibit lower overall rates of complication compared to referral facilities for hernia repair, appendectomy, and colonoscopy. The analysis compared outcomes from RSON facilities and regional referral facilities in Interior Health and Northern Health, controlling for co-morbidity and other confounders. 

Making a Difference

RSON continues to show value, with team members who are part of a working group reporting better functionality, communication, and efficiency.   

“I just couldn’t believe how well we’re functioning as a team and the communication, the dynamics, the efficiency, flow in our [operating room], and just the willingness to be open-minded and try different things. So I’ve noticed a huge change,” said one participant.  

Dr. Nancy Humber says that, in the future, the group will be looking to expand remote presence technology use in simulations and coaching. 

“We have been fostering coaching relationships to sustain local, regional, and provincial networks and will continue to do that,” she adds.   

Dig in Deeper

Team Members

Dr. Nancy Humber
Dr. Nancy Humber
Tom Skinner

Tom Skinner

Project Manager

Kim Williams

Kim Williams

Networks Director