Positive developments on the healthcare front.
Over the last six months there has been concern about the
loss of ophthalmological services from our area hospital. This would include cataract
surgeries. Our North Simcoe Muskoka LHIN has been looking at different models
of service delivery that likely would have seen the service end up in Barrie or
Orillia.
Last
week, I assisted as our seniors held a second healthcare
meeting at the NSSRC. Jill Tettmann (CEO
of the NSMLHIN) attended and indicated that she understood our concerns and
would help.
This
week, there was increased concern in our community about a sub-committee meeting
to choose a service model that would leave Midland out. I contacted Jill to ensure that we got a Midland solution back into the discussion. Jill personally
intervened in that meeting and asked them to consider other models. That is now
being done. (See e-mail from Dr. McNamara below.)
Coming
together as a respectful community and engaging the LHIN has worked. We, as a
community, still have much work on this front in the days ahead. I intend to be actively engaged in the critical discussion of Midland's healthcare future.
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Subject: Good News
To the citizens of North
Simcoe:
Hello All;
Great news from last
night. Dr. Dan Scanlan has been in communication and has informed me that
the “cataract committee” has, due to the influence of Ms. Jill Tettman (LHIN
CEO), changed its mandate and is now committed to finding efficiencies within
the existing system. They are dropping the idea of having all cataracts
done at one or two centres and will allow us to continue providing this service
locally. Your work and letters have surely been one of the factors that
prompted this. Thank you for your support.
This also means that the
LHIN are committing to working at improving other areas of eye care such as the
regional ophthalmology on call coverage for emergencies and exploring other
options to cut costs and improve care with input from those who know best, our
patients and ophthalmologists. We will continue to track their
work. Dr. Scanlan advises me that he is interested in re-joining the
committee (he left when he found that he could not support their options for
one/two site regional care). I will keep you posted as events
unfold. I have sent Ms. Jill Tettman a note of thanks for her support in
changing the mandate of the committee.
I would ask for your help
in another issue and that is our hospital funding.
There have been many
instances, in the past few years, where we have been short changed by the
MOHLTC on issues such as our ER redevelopment, our complex chronic care floor,
our base funding, our ER performance funding and a number of other areas. This has resulted in the current financial shortfall facing our
hospital.
Recently, the MOHLTC and
the LHIN have determined that better performing hospitals will benefit from
increases in funding and worse performing hospitals will undergo cuts until
they improve. In spite of the fact that we have performed well in our ER
metrics, we have fallen short of some of their in hospital targets this year and
will suffer another cut from our budget. (The actual number is still
confidential.)
The MOHLTC’s new funding formula rewards
efficient hospitals and penalizes less efficient hospitals and is a new
paradigm for the MOHLTC as it is for us. It is geared to encourage all
hospitals to become more efficient and proficient at standardized care. Who wouldn’t want this? There is, however, a major difficulty in that not
all hospitals are starting the race from the same set of blocks.
We have analyzed our
performance with that of other hospitals in the LHIN and conclude the
following: adjusting for acuity, (patient illness severity) our
hospital’s staffing levels would have to increase by 35 hours of nursing care
per day per floor to even equal that of the next lowest funded hospital,
Alliston. To equal RVH, we calculate that we would have to increase our
nursing by 65 hours per day per floor. Our ER numbers are even more
telling. Patients drive from Collingwood and Barrie to be seen in our ER,
knowing that they face a >6 hour wait in their own ERs.
We see half of the number
of patients seen in RVH’s ER, yet have about 1/3 of the funding for ER
nursing that they do. We have been constantly one of the top performers
in indicators such as patient satisfaction, yet, because of our poor staffing
ratios and bed shortages, we find ourselves struggling every year with
indicators such as “time to admission from ER” and others. We are falling
behind in the race, resulting in decreased funding, resulting in decreases in
staffing and in performance, resulting in decreased funding, etc. We are
not starting from a level playing field with the other participants. How to win this race?
In the last 7 years, we
have gone from being run by a Ministry Supervisor to forming a new board, new
Director of Nursing, new CEO, new Director of Human Resources, Finances,
etc. We have improved our care and the quality of that care. We are
committed to continuing this improvement and our staff have worked very hard to
meet the needs of the community. Are we perfect? Certainly
not. Are we improving? Significantly.
We continue to struggle
with admitting patients in a timely manner because of poor bed
availability. Research has shown that rapid admissions are directly
affected by bed availability. If you have more beds, people get to the
floors more quickly. Research has also shown that patients housed in
hallways and ER beds don’t do as well.
In 1980, GBGH was a 160 bed
hospital. Our population has doubled in that time, yet we now have only
68 acute care beds. How did this happen? Why does it continue?
The lack of bed
availability also means no surge capacity in the event of another flu epidemic
or SARS. We have no capacity for ebbs and flows in patient numbers.
Our Homecare services also
runs behind that of other jurisdictions. We have difficulty discharging
patients on weekends because home care (while taking emergency referrals for IV
antibiotics and other care issues) isn’t available on weekends to arrange for
care for discharged patients. Patients perforce must wait until Monday to
go home. RVH has 24/7 home care, as do smaller hospitals such as St.
Thomas and Lindsay to name two. Why don’t we?
These are just a few of the
areas where we are being short changed. We need your help.
I encourage you all to
become informed and to advocate on your behalf. We are your
hospital. The LHIN and the MOHLTC need to hear your concerns as does your
MPP.
Sincerely,
Dr. M. McNamara
