Dr. Julian Marsden
Physician, Emergency Department, St. Paul’s Hospital
Dr. Marsden completed his medical degree at Queen’s University in 1988 and obtained a Canada Emergency Medicine qualification from the College of Family Physicians at UBC. He has been a member of the Emergency Department at St. Paul’s Hospital (“SPH”) since 1992, was appointed a Clinical Instructor in the UBC Department of Family Practice in 1994, and was the UBC Emergency-Family Medicine Residency Program Director from 1996 to 2006.
Dr. Marsden has been an integral member, both clinically and administratively, of the Emergency Department at St. Paul’s Hospital. He has been the conference chair for the annual SPH Emergency Medicine conference, which is now the largest Emergency Medicine Conference in Western Canada.
At the September 2007 conference, Dr. Marsden was integral in launching the provincial Evidence to Excellence project. Evidence to Excellence, or “E2E”, aims to accelerate improvements in clinical and operational practices in emergency departments across the province to ensure excellence in emergency health care for all British Columbians. Success will be achieved through the development of a community of practice to provide an on-going network for spread, and the use of collaboratives that provide structure to enable the translation of ideas into action.
Dr. Marsden, in conjunction with his colleagues at UBC and SPH and working with funding provided by the Ministry of Health, developed a plan for how to share knowledge and expertise (both faculty and tools) across the province using collaborative work. The expected benefits of the community of practice were identified:
- Increase in capacity of the Emergency Department (ED), reduction in time to physician, ability to respond to changes in demand and other stresses on the ED
- Ensure adherence to evidence-based practice despite disparate sites, and improvement in patient outcomes;
- Create a community of interdisciplinary emergency staff across BC to share knowledge and guidance creating a coordinating environment that respects multiple sites;
- Improve access to care and quality of care through implementation of cost-effective strategies;
- Create consistent performance indicators to determine implementation success; and
- Provide evaluation reports of the implementation effectiveness and strategies.
The first two collaboratives that are underway target improvements in the Emergency Department triage process and in the clinical management of sepsis. There are approximately 33 teams from 26 emergency departments around BC currently participating.
As Chair of E2E, Dr. Marsden has dedicated time and energy since its inception to access funding, coordinate and facilitate the preliminary planning meetings, create agendas, bring together experts in Learning Sessions to develop the educational components of the collaboratives, partner to present the learning sessions, facilitate monthly teleconferences and develop the website.
Dr. Marsden has been innovative in embracing technology to support the work of the collaboratives. Key rounds have been disseminated via teleconference to assist in participation. He has been using Webinars and an interactive website to connect clinicians and administrators from the community of practice.
Dr. Marsden is leading the way in promoting the idea that Emergency Department staff do not work in a vacuum – they part of a system – and need to work together to improve patient care. He is passionate about improving the quality of care for patients in emergency rooms across the province, but particularly in rural sites, which should be enabled to “tap” into resources that are not currently available to them.
It is Dr. Marsden’s vision, passion and leadership that has enabled him to link this broad community, the university and the Ministry in such a successful partnership. We believe Dr. Marsden demonstrates excellence in promoting quality and evidence-based best practice and continues to demonstrate outstanding leadership.