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Struggling Hospitals

  |   Jo Brant Hospital   |   No comment
(originally published in the Toronto Sun)

Ontario’s hospitals are struggling. There can be no doubt about that, given the steady stream of news about infectious outbreaks, deficits, service reductions and restructuring.

There can also be no doubt about this: there’s no quick fix. The cupboards are bare, at both the provincial and federal levels. When a Conservative government contemplates running deficits, we know there’s been a seismic shift in “the way things are.”

And that’s good news. Because the current challenges in healthcare require new ways of thinking and doing.

As a member of the board of governors of just one of those hospitals – Joseph Brant Memorial Hospital in Burlington – I’ve seen those challenges up close. But this isn’t Joseph Brant’s challenge alone. It belongs to every hospital in the GTA, and beyond, and to every one of us these hospitals serve.

“We’re really at a tipping point in health care in this province,” said Peter Vankessel, chair and spokesperson for Joseph Brant’s board of governors, who direct and oversee the hospital’s strategic planning, quality control and fiscal accountability.

“I understand that most Ontario hospitals are facing annual cost growth that exceeds their annual revenue allocations. But we’re all working hard to maintain safe, quality care for our patients in this new reality.”

How did we get here? Here are just some of the issues that have created the perfect storm in health care:

  1. Increased costs due to infection control. Joseph Brant alone has added $1 million to its annual budget for better infection control.
  2. Costs outstripping funding. Funding is at 2.1 percent, but annual costs are going up 4 to 5 percent, in part because of new infection protocols, and in part because of outdated and aging facilities that cost more to run. Joseph Brant is predicting a $5.5 million shortfall this year, and other hospitals are also predicting deficits. New provincial legislation requires hospitals to balance their budgets, so everyone is reexamining their operations to find ways to provide services within existing resources.
  3. An aging population, combined with a shortage of beds in appropriate facilities. Many elderly patients in hospitals have concluded their treatment but can’t find a bed in a long term care home, retirement home or other appropriate place. These patients, called Alternate Level of Care – ALC for short – number over 70 patients at Joseph Brant, one-quarter of available beds. That creates backlogs in admissions, ambulance off-load delays, and cancelled or rescheduled surgeries, because no beds are available. According to October 2008 statistics from the Ontario Hospital Association, every day there are about 2,967 patients in an acute-care bed waiting for ALC placement – about 19% of beds. And there are 674 patients waiting in emergency for admittance to an inpatient bed.

“The ALC situation is not unique to Joseph Brant, but at times we are overwhelmed,” commented Don Scott, CEO and President of Joseph Brant. “We’re all going to have to work together to help build capacity in the hospital and in the community to meet the health-care needs of these patients.”

Challenges can bring out the best in us, and hospitals are rising to the occasion. I’ve seen:

  1. a commitment to cooperation. Hospital CEOs meet regularly with each other and with government officials, to find ways to fix the problem, not fix “the blame.”
  2. a commitment to problem solving. The best strategic planning advice I ever got was this: face the brutal facts. It does no good to wish the situation was different; you’ve got to plan for how the situation is. Hospitals aren’t hounding governments for more money simply because there isn’t any. Instead, they’re trying to find ways to serve their communities with the resources they have.
  3. a commitment to openness. Hospitals are telling the community of the situation, and its impact. To that end, Joseph Brant is holding a community meeting Tues., Dec. 2 at 6:30 pm at the Burlington Art Centre, with participation from government, health and community officials. This will be of interest to anyone wondering what’s happening in healthcare in the GTA. For information: call 905-632-3730 or visit www.jbmh.com.
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