A simple yet powerful idea

​Dr. David Agulnik, an Emergency Physician at St. Paul’s and Mount St. Joseph’s Hospitals, recently launched a project to provide early access to food and water in the ED at St. Paul’s Hospital in an effort to reduce aggressive behaviour.

Serving from a perspective where he “treats patients how [he] treats a family member” and recognizing that most of the population he serves are marginalized, low income and individuals with mental health/addiction issues, Dr. Agulnik believes that tensions in the Emergency Department that lead to escalating behaviour, can be mitigated by providing patients with early access to food and water while they are in the waiting room and he was able to test out his theory with support from the Physician Led Quality Improvement Program (PLQI), a partnership between Vancouver Coastal health, Providence Health Care and the Specialist Services Committee (SSC) designed to address gaps in quality structures relating to physicians participating in QI activities. ​​

Learn more about the Physician Led Quality Improvement Program
A preliminary survey of more than a dozen nurses and registration clerks found that they believed the initiative introduced by David could lead to improved behavior of patients, more compassionate care, addressing food needs and fewer staff interruptions. The project has also allowed for significant learnings from realizing that “registration clerks often gave the ‘don’t eat or drink’ dictum”, to recognizing “persistence of misinformation/bias that is difficult to overcome and require education”.

Although seeming to be a simple change, the impact can be significant. Dr. Agulnik believes it will take much more time to fully realize the benefits, including a reduction in the number of code whites, or security incidents involving verbal or physical aggression by patients.

Dr. Agulnik recently completed the PLQI Program, where he received project support, training, and funding for this quality improvement project. Physician Led Quality Improvement projects provide an opportunity for physicians to improve their quality of care locally. The program was established across Providence Health Care and Vancouver Coastal Health and the support team works with medical staff to promote quality and practice improvement. QI initiatives begun in one location may also be shared and expanded in other locations across the health authority.


PLQI certificate.jpg
Dr. David Agulnik receives his certificate for completion of the Physician Led Quality Improvement
Program from Enrique Fernandez, program coordinator, Physician Quality.

David’s career has been dedicated to providing excellent care to a wide range of patients, including some of the most marginalized citizens in our community. In recognition of his continued passion and commitment to improving health care delivery through innovation and collaborative initiatives, David received the BC Health Care Hero Award at the recent BC Health Care Awards.

Congratulations, Dr. Agulnik!​


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