Blog: Past, present and future at West Lincoln Memorial Hospital

By Rebecca Repa, Vice President, Clinical Support Services and Community Surgery, and Executive Lead, West Lincoln Memorial Hospital

The past, the present and the future are all important and interconnected here at West Lincoln Memorial Hospital (WLMH). Within a single day we’re simultaneously thinking about how best to meet current community needs while planning our vision for the future. And somewhere along the way we’re bound to be reminded of the incredible history of this little hospital in the Niagara North West community.

It’s the future that is getting most of the attention these days. Hamilton Health Sciences is part way through a planning exercise for the care we’ll provide and the facilities we’ll need for the next 20 years. As part of that plan, we propose redeveloping our Hamilton General and Juravinski campuses, and rebuilding WLMH with a focus on community medicine and day surgery.

Here at WLMH, our long-time integrated primary care model is one of our greatest assets, and foundational for the population of our community. It means that if you need to be in hospital, your family physician admits you and remains responsible for your care. It lessens the chance of gaps in service and awkward transitions as people move in and out of hospital care. This model is something from our past and our present that we very much intend to keep into the future.

The past, the present and the future are all important and interconnected here at WLMH, but it’s the future that is getting most of the attention these days.

Along with community medicine and day surgery, we propose having 24-hour emergency care, maternal and newborn care for low-risk births, and specialty outpatient clinics. We will continue to be strongly integrated with programs and services at the other hospitals of Hamilton Health Sciences, transferring patients from WLMH who need more specialized care than we can provide here.

The linchpin to our future planning for WLMH is a new facility, which our Niagara North West community has had its heart set on for years. In the recent provincial budget HHS received a commitment that its redevelopment projects are in the queue for capital funding. This doesn’t mean we have approval, but it’s definitely good news, and a very positive vote of confidence in the direction we’re heading. We are on track and on schedule with our planning process.

Even as we plan for the future we still need to pay attention to quality and safety measures for our patients and staff today. A good example is the new electronic health record system, which allows diagnostic and lab results to be more quickly and accurately communicated among the care team across any HHS site.  This is a significant project for us and is being implemented over the next few months, beginning in the Emergency Department.

HHS receives major funding commitment

Our vision to build a healthier community got a significant boost today. As part of the 2017 Provincial Budget, Hamilton Health Sciences (HHS) has received a commitment from the Government of Ontario for funding toward the redevelopment of our hospital system. This is part of a 10-year plan to invest $20 billion in hospital infrastructure project.

HHS is in the process of seeking government approval for a series of proposals to reinvigorate our hospital services and facilities over the next 20 years, as part of an initiative called Our Healthy Future.

“Today’s announcement brings us one step closer to securing that care for generations to come.”

While there is still a lot of planning and discussion to come, this early commitment by the government to our priority projects is a significant vote of confidence in the direction we are pursuing. Additionally, HHS will share in further commitment by the government to increase operating funding to hospitals by $518 million.

“We’re proud of the care we provide to people and families from our local communities and across Ontario,” says HHS president and CEO, Rob MacIsaac. “Today’s announcement brings us one step closer to securing that care for generations to come.”

The hard work of our staff, physicians and community partners has helped get us to this point, and we are looking forward to a very bright, healthy future.

 

 

Restorative Care Program at St. Peter’s Hospital

The Restorative Care Program at St. Peter’s Hospital (SPH) does a lot with a little.

Patient rooms are on the small side and that makes it difficult for individuals to maneuver their wheelchairs and walkers around. Also, patient therapy takes place in a converted hallway, which makes privacy a challenge.

“Many years ago, they basically transformed the end of the hallway into useable space by putting a door and walls around it,” says Sarah Ferguson, an Occupational Therapist and Physiotherapist Assistant. This can make patients feel like they are put on display while they are trying to get better. It can be embarrassing.

“It would be great to have as much space and equipment as we can to help the patients meet their goals.”

This program, along with the other three programs located at SPH, is slated for relocation to the re-built Juravinski Hospital as part of Hamilton Health Sciences’ 20 year Our Healthy Future vision. With custom-built space and a new configuration, patients will be able to receive more direct therapy in better surroundings. This could significantly reduce their length of stay.

“It is much easier to show someone how to put cans on a shelf in a kitchen setting than it is to ask them to imagine putting cans on a shelf.”

Staff are already getting excited about the future space which would include social areas, communal dining and more storage.

Patients will get better faster in a home-like setting because their brains will be able to make the connections they are used to making at home. “Think of any object you use day to day and we want two here in our program,” says Ferguson. “Look around your house. That is what we need to encourage people to get back to their own homes. It is much easier to show someone how to put cans on a shelf in a kitchen setting than it is to ask them to imagine putting cans on a shelf.”

Brenda St. Amant, clinical manager of Restorative Care, agrees. “We always set goals because that is what rehab is all about. It would be great to have as much space and equipment as we can to help the patients meet their goals. I am so proud of what we do with what we have – in our space. Everyone is proud.”

To read more about the Our Healthy Future vision, click here.

BLOG: Our fast-growing Children’s Hospital will need a new home

McMaster Children’s Hospital, emergency department, childrens healthcare, mcmaster university medical centre, hamilton ontario, community, hamilton general hospital, our healthy future, dr. peter fitzgerald

Imagining a new hospital in a new location

By Dr. Peter Fitzgerald, President, McMaster Children’s Hospital

As any parent knows, kids grow up fast. One  minute you’re snapping them into a onesie and the next, they’re asking for the car keys.

I often get the same feeling about our McMaster Children’s Hospital. It seems like yesterday we were celebrating an official designation as Ontario’s newest children’s hospital; now, our 30th anniversary is only a year away. And talk about growing before your eyes: We are the fastest-growing of any children’s hospital in the province and are now second only to the Hospital for Sick Children in size (for number of patients and level of acuity).

During the last five years at our Children’s Hospital, we’ve seen an overall 25 per cent growth in inpatient activity, with a particular growth spurt in the Emergency Department (ED), where the number of visits ballooned by 120 per cent. The McMaster Children’s Hospital ED is now the busiest in our HHS family of hospitals.

As busy as we are today, we’re also thinking ahead to how we’ll serve the next generation of children and youth. Over the last two years we’ve been working on a long-range plan for all of Hamilton Health Sciences, called Our Healthy Future. The plan forecasts the services we’ll provide, and the facilities we’ll need, over the next 20 years.

“It seems like yesterday we were celebrating an official designation as Ontario’s newest children’s hospital; now, our 30th anniversary is only a year away.”

We have a bold and exciting vision for McMaster Children’s Hospital. Over the next 20 years we will see an increase of 1.2 million children in Canada, which equals the current population of Manitoba! So we know the growth we’ve seen will continue as the population of Hamilton and surrounding areas continues to rise. Although our services are by no means limited to inpatient care, let’s look at our projected bed counts as a simple example of predicted growth: today we have 161 Children’s Hospital beds and in 20 years we expect to need 231.

So, when we look down the road, we envision a new facility that is designed specifically for the needs of children and their families, and including women’s health services such as our high-risk obstetrics program. We see this new facility being located adjacent to the Hamilton General Hospital campus.

McMaster Children’s Hospital, emergency department, childrens healthcare, mcmaster university medical centre, hamilton ontario, community, hamilton general hospital, our healthy future, dr. peter fitzgeraldThere are many reasons why this location would be ideal – expectant mothers who need acute care services will have them immediately at hand, while children and their parents will benefit from close proximity to our beautiful new Ron Joyce Children’s Health Centre, with its extensive list of outpatient programs for children and youth with special needs.

“Best of all, we’ll have room to grow and develop.”

Best of all, we’ll have room to grow and develop. Our current location at McMaster University Medical Centre, where we share space with the university, just can’t handle the long term needs we foresee. I’m excited about our vision for the future of our Children’s Hospital and I look forward to sharing more information as planning continues.

We envision a new Children’s Hospital to meet our community’s needs – one designed specifically for kids and their families.

BLOG: “Our Healthy Future” vision deserves time and scrutiny

By Kelly Campbell, Vice President, Corporate Services and Capital Development

Kelly Campbell is vice president of corporate services and capital planning at Hamilton Health Sciences.

The size and scope of Hamilton Health Sciences means our capital redevelopment planning process is both complex and lengthy.

We’re following the five-step capital process required by the Ministry of Health and Long-Term Care (MOHLTC) for any hospital seeking major redevelopment funding. As a multi-site operation, we must plan as a system of hospitals and demonstrate how our programs and services across all sites are well-integrated for the best patient care. This makes perfect sense – but it makes our planning process a logistical feat involving countless people both within and outside our organization.

At HHS the planning initiative we call “Our Healthy Future” has involved more than 2,000 people to date and together, we have created an exciting vision for the future. We propose focusing our acute care services at the Hamilton General and the Juravinski. The Hamilton General site would include a rebuilt Children’s and Women’s hospital.  Purpose-built space for the programs currently located at St. Peter’s Hospital would be developed at the Juravinski or the General, or both. We want to rebuild West Lincoln Memorial Hospital. And we see more HHS outpatient services being provided in community settings, often enabled by partnerships with other health and social service organizations.

This vision – the formation of which was the very first step in our planning process – was tabled last June with the Hamilton Niagara Haldimand Brant LHIN and the MOHLTC for review. We anticipate the LHIN board approval sometime in 2017. LHIN approval would give the green light to HHS to continue planning in this direction – it does not indicate  approval for a specific project within our vision.

Our vision is big and bold and it deserves all the time, scrutiny, participation and effort that we can collectively bring to it.

Coming up to our second anniversary in this planning process, we are now on part two of the first stage, which will take us until approximately the end of 2017 to complete. Most hospitals in Ontario do the first and second part of stage one at the same time, but HHS is so big that we needed to separate them out.

Charting our course for the future – with the programs we’ll provide and the facilities we’ll need – is indeed a lengthy undertaking. But when you think of the fact that we serve a population base of 2.5 million people, have 700,000-plus ambulatory visits and admit 52,000 people annually– it’s hard to imagine doing our long-range planning any other way. Our vision is big and bold and it deserves all the time, scrutiny, participation and effort that we can collectively bring to it.

To learn more about Hamilton Health Sciences’ long-term vision, visit ourhealthyfuture.ca.

Health Links: Bob’s story

Before Bob met Jana, he visited his local emergency room (ER) often. Bob has multiple chronic health conditions, including problems with his heart. When he wasn’t feeling well, he turned to the ER for help. But, in many cases, the ER wasn’t the best place for him.

Through the support of Health Links – a community-based program intended to support some of the more vulnerable patients in our community who have complex health needs – Bob has found ways to better manage his health care and to avoid unnecessary trips to the ER. He works closely with his Health Links coordinator, Jana Cochrane, who helps him manage his medical appointments and other responsibilities that Bob sometimes forgot, like taking his medications.

By working closely with and truly understanding the needs of their patients, the Health Links team acts as a facilitator between the patient and health/community services. Coordinators develop customized care plans that enable and empower patients to better manage their health, with on-going support.

In Bob’s case, Jana’s support has meant fewer trips to the emergency department and a more coordinated approach to getting the type of care he needs, when he needs it.

Click below to watch Bob’s story.

BLOG: Breaking the cycle of crowded hospitals

By: Rob MacIsaac, president & CEO, Hamilton Health Sciences

The Ontario government recently re-introduced the province’s health system restructuring legislation, the Patients First Act, now known as Bill 41. The Bill, once enacted, will be an important enabler for us in Hamilton to change the way our health care is coordinated and delivered. In so doing, we have a chance to deliver better care for people in our community while also creating a more sustainable health care system.

“Everyone knows where the hospital is, we never close, and we don’t turn anyone away. As a result, we have become the provider of a very broad range of health care and social services.”

Why is change needed? For starters, we are using our hospitals too much and for too many things. That’s not surprising. Everyone knows where the hospital is, we never close, and we don’t turn anyone away. As a result, we have become the provider of a very broad range of health care and social services.

If you have multiple, chronic health conditions, if you are living in poverty, or if you often need health services after hours, there is a good chance you’ll turn to a hospital for service on a regular basis. Some people visit the Emergency Departments at Hamilton Health Sciences multiple times each week. This might seem like an abuse of the service, but these people really do need help – they are often in genuine crisis.

To the credit of our frontline workers, hospitals respond with compassion. We assess people on the spot, provide them medical attention, admit them to a bed when necessary, help them through their crisis, and send them home. But then they come back and the cycle repeats itself.

“[Population health] addresses the reality that our community’s health is profoundly affected by factors far removed from the medical care offered by a hospital.”

What if we could instead help break the cycle by working collaboratively with social services and other health service providers in the community? What if we began proactively intervening to help people better manage their health to reduce the chance they will need hospital care? This concept is called population health. It addresses the reality that our community’s health is profoundly affected by factors far removed from the medical care offered by a hospital.

Housing, income, education, and family support are all significant determinants of how much you will use a hospital. If you don’t have a roof over your head, if you aren’t eating properly, if you don’t have a family member around to catch you when you fall, you are very likely to become a frequent user of hospital services.

At Hamilton Health Sciences, we are using a population health approach to plan the development of our hospital services and the long term redevelopment of our facilities (OurHealthyFuture.ca). This is not a quick or easy fix. But we believe that, over the long-term, a population health approach will make our community healthier and help us better manage the growing demand for hospital services.

There’s no universal definition of population health. At Hamilton Health Sciences, it means that we want to get ahead of the demand for hospital services by addressing the numerous factors that put people at risk for hospitalization. This will require taking a coordinated approach to providing the broadest range of health services to our community – from disease treatment to prevention, rehabilitation to management, and also health promotion and protection.

“We’ll know we have succeeded in this effort when our hospitals are no longer filled beyond their capacity.”

Two important examples of health conditions that can be better managed using a population health approach are Chronic Heart Failure (CHF) and Chronic Obstructive Pulmonary Disorder (COPD). Together, they are the leading causes of potentially preventable hospitalization in our community. These are progressive health conditions that, when left untreated or mismanaged, can require numerous and lengthy visits to the hospital. The better response, though, may be teaching someone how to properly use and better manage their medication, or ensuring they have appropriate housing, or simply providing them with access to a friendly voice who understands their challenges and provides good advice.

This kind of approach is pretty far from today’s reality. If we are to change this channel, we’ll need to change the way family medicine, home care, first responders, social services and hospitals work with each other. At HHS, we are now actively collaborating with the City of Hamilton to boost supportive housing in our community because we know that a lack of housing creates an over-reliance on our services. Similarly, we want to work with family doctors, home care and social service providers, as well as public health to find new ways to serve the community together.

Sustaining these efforts will mean acknowledging our shared responsibility for providing the best possible care to our community. It will also require openness from all sides to finding new ways of working together. We’ll know we have succeeded in this effort when our hospitals are no longer filled beyond their capacity.

Rob MacIsaac is President and CEO of Hamilton Health Sciences

Community Report: Major Highlights from 2015-2016

 

Hamilton Health Sciences is pleased to release the 2015-2016 Community Report. We made great progress in achieving the goals and objectives set out in our Strategic Plan.

The report highlights some major accomplishments from the past year:

  • The opening of the new Ron Joyce Children’s Health Centre
  • Our Healthy Future: Hamilton Health Sciences’ 20-year clinical visioning process
  • A new partnership with IBM to find sustainable solutions that will improve health outcomes for patients
  • Visit Any Time: Open visiting hours now offered at all sites
  • The rare feat of having three studies published in a single issue of the prestigious New England Journal of Medicine

Read the 2015-2016 Community Report (pdf 4MB)

Our 20-Year Vision – A Letter from Rob MacIsaac

Hamilton Health Sciences would like to address the following misleading statements made by the Canadian Union of Public Employees (CUPE) 7800 and the Ontario Council of Hospital Unions (OCHU) at a news conference held this morning outside Hamilton General Hospital. It’s important that HHS staff, physicians, patients and partners have the correct information. For background information on HHS’ planning initiative, Our Healthy Future, see the bottom of this message.

“Hamilton Health Sciences (HHS) is seriously considering closing an entire hospital rather than rebuild hospitals.”
• HHS is 100% proposing to re-build hospitals over the next 20 years. We are not proposing to close any of our hospital services.
• In fact, over the next 20 years we’re planning for the need to grow our physical footprint by 50 per cent, which is expected to require additional staffing.
• By 2036, HHS is, among other things, proposing:
¬ A newly constructed Children’s & Women’s Hospital
¬ New purpose-built facilities for seniors
¬ The redevelopment of old wings at Hamilton General Hospital & Juravinski Hospital
¬ The redevelopment of West Lincoln Memorial Hospital

“[HHS] also proposes dismantling the under-one-roof model of hospital outpatient clinics, to what appears to be non-hospital, privately-run clinics all over the city and increasing ‘virtual’ access to services.”
• HHS is proposing to create and run more urgent care and ambulatory services in more places across the city.
• We’ve never suggested creating privately-run clinics as a replacement for hospital services.
• We want to bring care closer to the people we serve. This means offering new online services and virtual consultations with HHS health professionals.

“The poll gives us solid numbers to show how frequently residents use the hospitals. Shutting one down or closing hospital clinics would seriously harm a lot of people who are ill and need to be admitted to hospital or who need to be able to access care and tests at hospital clinics under the safety of a hospital which also has fully functioning emergency department.”
• We agree that hospital services are absolutely critical for our community. That’s why we’re planning to make our services accessible in more places.
• There is no cutback of service identified in our 20-year vision.

Background on HHS’ Our Healthy Future planning initiative:
Over the last year and a half, Hamilton Health Sciences has been working to define a long-term vision for the future of our hospitals. This initiative, which we have named Our Healthy Future, is the starting point of the Ministry of Health & Long Term Care’s planning process for the redevelopment of any Ontario hospital.

After many months of research, analysis and engagement with our staff, physicians, partners and the people who use our services, we’ve developed a series of recommendations based on the nature and volume of the patient care HHS will need to provide in our region over the next 20 years and a big-picture view of the facilities we think we’ll need to deliver that care.

In June, we will ask our Board of Directors to approve these recommendations for submission to our Local Health Integration Network (LHIN) in the form of a Ministry planning document called a Master Program. The LHIN Board of Directors will then need to consider and approve the HHS Master Program for submission to the Ministry in the fall. At that point, HHS would begin discussions with the Ministry about the next stage of the planning process, which is to determine the prioritization, sequencing and physical/architectural design criteria that would be required for the redevelopment ideas proposed in our Master Program.

We expect it to take a year or more of further input and discussion before we have a formal redevelopment plan that is agreed to by the HHS Board of Directors, the Local Health Integration Network and the Ministry of Health & Long Term Care. It will take many more years before the whole of the plan is built out.

For more information, including background on Our Healthy Future planning, please go to www.OurHealthyFuture.ca.

Sincerely,

Rob MacIsaac

President & CEO
Hamilton Health Sciences

Night owls gather for coffee and conversation

Come for the coffee, stay for the conversation.

That was the premise behind #hhscoffeetalk – a recent recognition and engagement initiative that provided leaders and evening staff from Hamilton Health Sciences (HHS) the opportunity to discuss frontline and corporate initiatives over coffee and cookies.

Collectively, hundreds of staff and physicians participated and provided members of HHS’ executive and management team with insightful feedback about their positions, organizational challenges and opportunities, and about larger strategic projects, such as Our Healthy Future (OHF).

Coffee and cookies Ladies at coffeetalk Rob and gang

The coffee talks were one of a series of staff and community engagement events that have taken place over the last year to help inform HHS’ long-term vision. For more information, visit http://www.ourhealthyfuture.ca.

Staff were provided with handouts which mirrored the information being shared at the daytime town halls, touching on the Strategic Plan, Continuous Quality Improvement – Management System, and OHF. The handouts contained a crossword which staff were encouraged to fill out and share on social media. The shared entries were submitted into a draw and the big winner will be announced shortly.

Thanks to everyone who participated in this initiative. Stay tuned for more events coming in the Fall.

BLOG: Imagining a healthier future at Hamilton Health Sciences

By Rob MacIsaac, President & CEO, Hamilton Health Sciences

 

Hamilton Health Sciences President & CEO Rob MacIsaac

Hamilton Health Sciences President & CEO Rob MacIsaac

I’ve worked in public service for a long time, and I’ve noticed that too often our systems are designed around the needs of the people who run them, not the needs of the people who use them. At Hamilton Health Sciences, we want to change that. We’re reimagining the way our hospital system is designed, based on the needs of the people we serve. This initiative is called Our Healthy Future, and it’s our biggest planning effort in decades.

We’re putting everything on the table for discussion. We are looking at all our services and all our facilities. We want to create a bold vision for the care we’ll provide over the next 20 years. Our planning process began in March 2015 and will wrap up in June 2016. Along the way we’ve asked questions, studied data, analyzed trends and challenged ourselves to imagine a healthier future for the communities we serve.

As part of the process, we talked to hundreds of people who use the health system, and to local health and social service organizations serving people at the community level. Now we have arrived at the point where we’re starting to draw conclusions about the kind of hospital system we need to build and how it should integrate into the broader health system.

We see a future where our patients and their families play a larger role in determining the care they will receive. We envision smooth transitions between one type of care and another so that patients and their families don’t feel overwhelmed, confused or frustrated. We see better communication and stronger collaboration with community partners.

We intend to increasingly invest in better managing and even preventing illness and disease, especially for the community’s most vulnerable populations. Rather than waiting until people show up at the hospital, we will bolster community-based care and wellness programs that help people avoid the need for hospital care. This population health approach is particularly important in Hamilton, which has among the highest rates of urban hospital use of any city in Ontario.

One strong suggestion we’re hearing from community-based health partners, and from the general public, is to expand our services beyond hospital walls, bringing them closer to the people we serve. We see a future where people can receive much of their health care in convenient community locations.

That said, there will always be patients for whom there’s no substitute for the acute care provided at a hospital. Our regional programs for cancer, cardiac care, stroke, trauma and burns are good examples of programs we will enhance and grow. We will also maintain and expand the care provided by our McMaster Children’s Hospital. While these services are located in and serve the people of Hamilton, they also serve a much broader region of some 2.3 million people. People travel from as far as Thunder Bay to receive care from HHS.

These changes go hand-in-hand with our role as one of Canada’s preeminent research and teaching hospitals. We will continue attracting the most talented health-care practitioners to our community to continuously improve our care using the best medical science. Our efforts in research and development will also need to extend to innovations in technology because it will be such an important enabler of our vision.

We think we can supercharge our work in technology innovation through collaborations with the private sector — be it local entrepreneurs or technology companies. And by doing so, we intend to make Hamilton Health Sciences an even more important player in helping power a strong local economy as new businesses spring up to sell our innovations to the world.

We’re not done planning yet, but our vision is starting to take shape. It’s a vision inspired by our workforce, our partners and the communities we serve — and central to it is a health-care system that puts the patient first.

To provide your comment or question about Our Healthy Future, please go to www.ourhealthyfuture.ca

 

This article originally appeared in The Hamilton Spectator.