Medium-sized hospitals such as Orillia’s Soldiers’ Memorial Hospital (OSMH) require a prescription for change.
“We have, as an industry, come to recognize that medium hospitals in the province are all challenged,” OSMH president and CEO Pat Campbell said at a city council meeting this week.
As part of a 48-page presentation that also included ambitious plans for the future redevelopment of the hospital, Campbell said she and other hospital officials are lobbying for changes to the funding formula that “disadvantages” medium hospitals.
“What we really want our elected officials in our area to understand is we don’t need some tweaks to the funding formula, we need fundamental rethinking around medium hospitals,” she said, noting the ‘medium’ designation is based on how many patients are served and the scope of services provided.
“There’s recognition for the needs of patients in our community, the rights of patients in our community to receive the services at equivalent levels at some of the more well-endowed hospitals in the province and to do that in a sustainable way.”
The advocacy has “had a certain amount of impact.” The provincial health minister, who recently left office for the private sector, “understood and articulated for the advisory committee on the funding formula that there is a need to continue to focus on ensuring funding is appropriate and sustainable with a particular focus on medium hospitals.”
While lobbying efforts continue, in the halls of the hospital, reality can be challenging.
“We have worked very hard over the last six years to balance our budget,” said Campbell. “We’ve made some difficult choices … (and) as we’ve made choices we’ve always tried to make them focusing on what does care delivery need to look like for the future.”
Driving the choices is the desire to see more care provided within the community. “All that being said, it’s always been difficult,” Campbell conceded. She said the hospital, on paper, has a balanced budget plan for 2018-19, but “that is contingent on some assumptions awaiting confirmation.”
Campbell said OSMH, which serves about 70,000 people in a vast geographic area, is not fighting this issue on their own.
“We are working together as medium hospitals in conjunction with the Ontario Hospital Association to advocate for change, for support for medium hospitals in the short term and the long term,” she said.
Part of that effort revolves around stressing “the tremendous importance in a community the local hospital has from the point of view as an economic driver and how challenges to the role we play can have a ripple effect.”
The bottom line, Campbell told city councillors, is that OSMH “continues to struggle to meet the needs of our patients.”
She noted there are “long waiting times in a growing number of areas. Those waiting times disadvantage people.”
She explained the ripple effect of a patient forced to wait for a bed. “They are our sickest patients, generally,” she said of those who come to the emergency ward and idle in the department, sometimes for days, waiting for a bed. She said the delay translates into longer wait times, increases potential for complications and is “not something that helps” anyone.
“We want you and the community to be aware we are out championing change that’s in the interests of our patients and we may need your help in talking to elected officials at the provincial level in the coming months,” Campbell said.
The hospital CEO also presented detailed drawings of three potential future redevelopment plans for the hospital. Two include demolition of several aging buildings to make way for a new ambulatory care centre; a third plan calls for a new hospital campus to be built on a greenfield site elsewhere in the city. The greenfield plan is very unlikely, however, is mandated to be included in future plans by the province.
‘We are planning for tomorrow’s hospital now,” Campbell said, noting it’s likely a 10-year process. “It’s an exciting project and one that’s very much needed.”
She said redevelopment is necessary to update an aging infrastructure and to better capitalize on provincial dollars.
“To win under the funding formula, you have to be efficient and that means in all aspects of your operation,” she said. “When you are configured as we are with facilities that go back to the 1920s, our facilities are not very efficient in terms of meeting the needs of today’s patients … just as buildings they are not very efficient.”
Local officials envision the development of an Ambulatory Centre of Excellence. “This may, for some, fly in the face of the idea that we’re trying to see more care in the community, but there are lots of things as a hospital that we used to provide as inpatients that we now need to provide to patients who come in, have their service and leave on the same day,” said Campbell. She said that volume of patients grows year by year as technology improves.
“What we’re looking at is continuing to develop the acute care in-patient hospital, but also augmenting that with an ambulatory centre that links to the hospital but is focused on patients that come in and go out on the same day,” she said.
That idea makes sense for several reasons, said Campbell. She said such a facility can be built to different standards than a hospital, making it less expensive. In addition, it can be locked down at night, when possible, allowing for savings.
“There are a number of benefits to going down this path and still meeting the needs of our patients in a very effective way,” she said.
OSMH officials submitted their plans to the ministry in February. “We are right at the beginning of the planning process,” said Campbell. “We have a long journey ahead.”
