The new chair of the South Bruce Grey Health Centre told the corporation’s annual meeting that change is coming to the way health care is delivered.
That doesn’t mean hospital closures, said Dan Gieruszak, but it does require communication among community agencies, the hospital and Family Health Teams.
“To ensure that we’re minimizing the overlaps and we’re maximizing the communication between all those organizations to make sure we’re getting the maximum impact with the limited financial and human resources that we have,” Gieruszak said about the goal of that communication. He foresees efforts to cut duplication and give efficient service.
Gieruszak, a Brockton councillor and director for six years, was acclaimed chair of the South Bruce Grey Health Centre at the annual meeting in Chesley. He replaces retiring chair John Haggarty.
Roy Mullen of Walkerton was acclaimed vice-chair of the board.
Gieruszak wants the South Bruce Grey Health Centre board to focus on the strategic plan in the coming year. That includes communication and engagement with the community about what the plan means to local hospital services.
“We know that there’s limited funding, there’s unlimited demand for services. We want to provide better services basically with a flat funding model, so it’s going to take working a little bit smarter. I think we’re (already) working as hard as we can work,” he said.

 Health care changes

The CEO of the South Bruce Grey Health Centre served notice to the annual meeting that change is coming to health care.
Occupancy at small hospitals across Ontario has dropped radically and funding has flatlined, Paul Davies told the annual meeting. At the South Bruce Grey Health Centre, occupancy of the 106 beds averages 48 per cent.
“We are experiencing reduction in inpatient activity levels,” he said. “It gets down to the point that certain places the number of patients becomes impractical to try and keep staff on.”
There are cases where the hospital has just seven patients but regulations require two registered nurses to be scheduled for the shift, Davies said. That creates an expensive patient ratio.
The low occupancy rate is not unusual in small hospitals and is the result of more efficient surgery techniques, more home care support, and the impact of Family Health Teams.
“Tinkering” with small efficiencies won’t make up for flatlined budgets and record low occupancy.
“I think because of the financial situation we can no longer do business the way we have in the past and expect to remain viable,” Davies said.
But that doesn’t mean reduction in services or hospital closures, he told the annual meeting. Closing hospitals isn’t “politically viable”. At the same time, with 49 per cent of the provincial budget already going to health care it’s not realistic to expect more funding.
Instead hospitals will have to consolidate services, get rid of duplication, and create centres of excellence to stretch health care funding. It’s a matter of small hospitals catching up with changes in funding and health care that have already happened, Davies said.
Exactly how health care will be delivered and how hospitals will look as a result of those changes is still an unknown.
“I think there has to be some form of change. I’m not 100 per cent sure what form that will take,” Davies said. “If I knew that I probably could make a fortune writing a book.”

Infection control

South Bruce Grey Health Centre will stop isolating patients who’ve been transferred from or had recent admission to another hospital.
That move comes after a London infection control specialist team said the hospital has been over-doing it on infection control.
The isolation practice was adopted because experts thought it would reduce the spread of superbugs. It was most noticeable in the wake of the SARS outbreak. Davies said the specialist team reported that research since then shows the practice is of little or no value in changing infection rates among hospital patients.
Dropping the practice on isolating transfer patients will save the time and expense of deep-cleaning the rooms, and save on the cost of masks and gowns for staff and visitors who enter the patient room.
“By reducing this (cleaning and gowning requirement) you reduce the costs dramatically,” Davies said.
The London infection control specialist team had praise for the overall work of the infection control department at South Bruce Grey Health Centre. The team rated the centre as going “above and beyond standards” in infection control, and remarked on the high standard of cleanliness and staff cooperation.

ER coverage

South Bruce Grey Health Centre is keeping its fingers crossed on emergency room coverage this summer.
Shifts at Walkerton, Chesley and Durham are filled, CEO Paul Davies told the board’s June meeting, while Kincardine has additional resources this year.
“There is a new physician that is just coming on board. Last summer we didn’t have the services of Health Force Ontario. Each of these changes helps out with trying to ensure continuity of service there,” he said.  
Davies told the board that Kincardine is the only question mark when it comes to ER coverage this summer.
Emergency room coverage can become a problem when an area has a shortage of doctors, and in summer when doctors want to schedule holidays.
 

 
Hospital costs

The Friends of Kincardine Hospital group won’t get the line by line budget it wants from South Bruce Grey Health Centre.
The group has requested the information as part of its lobby for deamalgamation and a return to Kincardine as a stand-alone hospital.
But CEO Paul Davies said with sites in Kincardine, Walkerton, Durham and Chesely managed as one corporation, there is no break out for individual hospital costs.
Revenue and bills for such things as insurance and administration are dealt with for the corporation as a whole.
“We don’t allocate out corporate costs by site. So when our insurance bill comes in, we don’t say so much of that goes to Kincardine, so much goes to Chesley. It’s one big bill. The same with our revenue. Our revenue comes from the Ministry of Health – it is one lump sum,” Davies said.
“We have people that work in all four sites. We don’t allocate their costs out. I would venture to say that about 50 per cent of our costs are corporate costs at all sites and they are not allocated out (to each site).”
Friends of Kincardine Hospital began in the wake of community protest over the end of free outpatient physio at the Kincardine hospital.
That service has since been removed from all sites of the South Bruce Grey Health Centre. The hospital blames a two per cent grant increase and need to balance the budget for that move.