October 30, 2014 - The North East Local Health Integration Network (NE LHIN) has launched a publication focusing on the history and transformation of 20 community hospitals across the region.
"Not only is this a look back at their evolving role," said NE LHIN Acting Chair Danielle Bélanger-Corbin at the book launch on Thursday, "It’s also an invitation for Northerners to help us write the next chapter. We will be embarking on a series of engagements bringing the question to Northerners – How can your community hospital best serve your health care needs?"
Community Hospitals and Health Care in Northeastern Ontario: Transforming the Patient Experience
chronicles the changing role of community hospitals, as well as the shifting economic landscape and demographics of the region. In addition, it examines new tools to help hospitals overcome their often remote and rural locations including advancements in science, technology, pharmacology, and communications.
"In many ways, the North East’s community hospitals are at a new crossroad with patient care – they face the challenge of contributing to the care of an older population with chronic health problems, and the desire of people to remain living at home in the communities they helped build," said Louise Paquette, CEO of the North East LHIN. "Their acute and emergency care use are also changing as complex and critical cases are often transferred to our larger hub hospitals. And, many hospitals are experiencing financial challenges with the prospect of replacing older infrastructure, with diminishing capital reserves. "
In this publication, the NE LHIN also examines various models for community health care from other countries and provinces.
"It’s clear the status quo can’t continue. Northerners have told us they want change," said Paquette. "This is a call to collectively contemplate what our community hospitals’ roles can be so that they can best meet the needs of fellow Northerners."
Not only is this a launch of the history of these community institutions built by several generations of Northerners, it’s also the beginning of a conversation on what their next chapter should bring.
Quotes from the book jacket:
"As we work together to transform our health care system, we will continue to focus on improving patient care. Northeastern Ontario is experiencing demographic change as the population ages and there will be increasing demand for home and community care for its rapidly growing number of older adults. This publication describes the important role that community hospitals have played historically in Northeastern Ontario, and opens a very important conversation about their future role in providing the best model of care to meet the needs of Northerners. This is a timely and important conversation for all hospitals in all our communities to consider. I applaud the North East LHIN for initiating this useful conversation-starter."
– Dr. Eric Hoskins, Minister of Health and Long-Term Care
"The Canadian Red Cross commends the North East LHIN on the release of
Community Hospitals and Health Care in Northeastern Ontario, which will prompt continued conversation regarding the future of health care in our region … Thoughtful conversation and consultation, as this publication encourages, is critical to informing our way forward. The Canadian Red Cross looks forward to participating in this dialogue and supporting the health and wellness of Northeastern Ontarians for years to come." – Tracy Browne, Director of Regional Operations – North, Canadian Red Cross
Additional quotes from fellow Northerners:
"As a long-time hospital administrator, the one constant we face is change. If we are not changing and adapting we are moving backwards, the status quo no longer exists. Whether it’s new technology that permits improved testing or treatment, the realignment of services that means people get the right care in the right location, or working with partners to problem-solve and innovate, I know that survival in today’s health care world depends on providers being adaptable to change. We need to embrace change as an opportunity, as opposed to fearing change as a threat."
– Hal Fjeldsted, CEO, Kirkland and District Hospital, 2000 – 2010; Chair of the Rural and Northern Health Care Panel, established in 2009; Interim CEO for MICs Group of Health Services (Anson General Hospital in Iroquois Falls, Lady Minto Hospital in Cochrane and Bingham Memorial Hospital in Matheson), 2013.
"Health Care in Northeastern Ontario has changed considerably since I began practice in Smooth Rock Falls in 1969. Then isolation was the accepted norm. The electronic age has removed the isolation, giving us almost instant access to expertise and support. The Ontario
Telemedicine Network (OTN), air ambulance and IT have made for timely response to any health crisis. Increasing life expectancy presents new challenges. Care of the elderly remains an urgent priority in Northeastern Ontario. Health care providers and the NE LHIN have a tremendous task to remain current with the constantly changing demography of health."
– Dr. André Hurtubise, Family Physician – Temiskaming Shores (New Liskeard)
"Northern hospitals have historically demonstrated both an ability and willingness to adapt, evolve and embrace positive change. The challenges before us call for collaborative and innovative solutions, and so hospitals must continue to reach out across their communities, to help knit together networks of care, making the health journey for our patients more seamless.
– Derek Graham, CEO, Manitoulin Health Centre
Backgrounder – Challenges Facing Community Hospitals*
*For the purpose of this report, we are calling all hospitals located outside of the region’s four urban centres (North Bay, Sault Ste. Marie, Sudbury and Timmins) community hospitals, of which 17 can be considered small and three medium (Temiskaming, Elliot Lake, Parry Sound)
? Financial Challenges: Community hospitals face the challenge of managing aging infrastructure to meet the needs of a once thriving population base, within a defined budget.
? Low Occupancy Rates: On average, community hospitals have lower rates of occupancy, at about 75%. This rate varies from hospital to hospital, with some as low as 50% and others at 100% capacity.
? Changes in Bed Use: Acute care beds at community hospitals are sometimes occupied by patients who no longer require acute care. These patients are often the frail elderly and are known as Alternate Level of Care (ALC) patients. In 2013/14, 15% to 20% of acute beds in the NE LHIN’s small hospitals have been occupied by ALC patients. Some community hospitals operate Complex Continuing Care (CCC) beds which, by definition, are intended for complex, chronically ill patients who are stable but need ongoing medical attention. Over the past year, more than 70% of the 160 CCC beds in community hospitals have been occupied by patients requiring an alternate level of care, such as
supportive housing.
? Less Acutely Sick Patients Visiting the Emergency Room (ER): In general, community hospitals in the NE LHIN see a lower percentage of high acuity (very sick) patients as compared to the four large urban hospitals. For small hospitals, about 23% of ER visits are high acuity, as compared to about 64% in the larger urban hospitals.
? Fewer Visits to the ER: Small hospitals in the NE LHIN accounted for just over 228,000 ER visits in 2012/13, or 52% of all visits. The number of ER visits varies markedly by size of community, ranging from as few as 1,000 to over 20,000 across small hospitals.
? Demographics: Currently more than 19% of the population in the North East is age 65 and over. By 2036, this proportion is forecasted to increase to 30%. Since 1996, the overall population in the North East has decreased by 6%, while that of Ontario has grown by 21%.