Friday, 24 August 2018

Two Acute Sites Model Selected for the Future! Now What?

In August, the Muskoka Algonquin Healthcare (MAHC) Board of Directors supported the recommendation from the Capital Plan Development Task Force for a Two Acute Sites preferred service delivery model for the future, replacing the Board’s 2015 recommendation for one hospital. The Two Acute Sites model includes a full range of emergency, inpatient and surgical services at each site, 61 more inpatient beds including a new stroke rehabilitation unit, and also proposes the addition of MRI technology. 

Some people have asked why a different model was recommended in 2018 compared to 2015. Quite simply a different process led to a different result. In Stage 1 planning MAHC followed a more inclusive, community- and system-focused process that looked beyond the MAHC organization. The past year’s work has involved a broader membership at the decision-making table, including municipal representatives. The criteria used to evaluate the potential models were different, including land-use planning and economic impact, which may be outside of the health care purview but were determined to be important considerations when planning for the future. Perhaps the most influential finding was the land-use planning study that resolved that a central location between Bracebridge and Huntsville was not recommended. The analysis recommended that hospitals exist in urban centres, which meant if a One Site model was only in Bracebridge or only in Huntsville, average travel times in Muskoka would become some of the longest in the province. It could also negatively impact MAHC's market share. Access to care has always been critically important. We also know from extensive community engagement that the Two Acute Sites model was preferred by most people. One of the key deliverables for a Stage 1 Proposal is a Local Share Plan that demonstrates how we collectively (the community) will pay our 10% ‘local share’ of the redevelopment project. No model would ever be completed if those responsible for helping fund the model were not supportive of it.

Now that a model has been selected by the Board, the consultants will prepare Part A of the Stage 1 Proposal, which gets submitted to the North Simcoe Muskoka LHIN for review and comment. Part A is essentially a Service Delivery Model Report made up of a refreshed Master Program looking out 8, 15, 20 and 30 years, a Human Resource Plan for a five-year timeframe and a preliminary operating cost estimate.

The next step is Part B where the Task Force will study the bricks and mortar needed to support the programs and services identified in Part A. We know the Two Acute Sites will be in the two urban centres of Bracebridge and Huntsville. Part B will look at specifically where they will be located. Will we reuse all or parts of the existing sites? Will it happen as large projects or be split into phases? What is the cost of the best approach and how will the community pay for the required local share? The Task Force will continue to oversee this work over the fall and winter, engage stakeholders and communicate our progress. Once that analysis is completed next year, the Task Force will make a further recommendation to the Board on the infrastructure approach and Part B will be completed by the consultants. Then the entire Stage 1 Proposal (Part A & B) is submitted to the Health Capital Investment Branch of the Ministry of Health and Long-Term Care for review and approval for MAHC to go on to the next stage of the five-stage capital planning process.

We are still very much at the front end of a long process that all hospitals have to go through. The important point for all of us to remember is that every stage in the Ministry’s process is an opportunity, and really an expectation, that the planning gets refined or adjusted based on the best information available at that time. We need to be near the top of the Ministry’s queue and convince the Ministry of Health that a two-site hospital is what Muskoka and East Parry Sound needs and deserves in the future.

Why are we planning for the future?
  • Future generations – your children and grandchildren – deserve to have the best possible care in a safe and high-quality way.
  • Their health care needs will be different. What you need from your hospital today is different from the care your parents needed. That’s because technology and best-practice care have advanced over time. Your grandchildren’s needs will also be very different.
  • Staff and physicians deserve to work in an environment where they are safe and equipped with the tools and the space they need to do their job and provide excellent care
  • We are running out of space now. There is no extra room at the inn to meet the community’s needs. We face chronic over census issues, which means we have more patients than we have beds and rooms for. We’ve seen occupancy as high as 140% and other patient volumes are steadily rising. This is the new norm all four seasons of the year. Where are we going to put people and make sure they are safe and receiving quality care? 
  • Both sites are getting older and have been rated ‘poor’ in condition. The South Muskoka site was built in 1964 and the Huntsville site in 1978. We can’t wait any longer to start planning for what our future will look like.
  • We need to keep people safe and the buildings are getting harder and harder to adapt. There aren’t enough wheelchair accessible washrooms. Most patient rooms should be single occupancy to protect them from infection, and MAHC has three- and four-bed wards. 
  • Our facilities don’t meet current best practices for health care delivery. Rules around privacy and infection control are getting more stringent and are constantly evolving. We need an environment that helps patients leave the hospital healthier than the way they came in.
  • The Ministry requires it and every hospital contemplating a building project or renovation of $10 million or greater has to do it. We need to get in the queue because there are 141 hospitals in Ontario who are all looking ahead and competing for a piece of the redevelopment pie.
  • We have $40 million in infrastructure needs today just to keep both sites up to snuff. We need a recognized future plan so that investments in the shorter-term are sensible and sound.
  • This isn’t just about money. Planning for the future is about ensuring safe, quality, sustainable health care for future generations.

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