Planning for Our Future with a Made-in-Muskoka Healthcare Solution

The past year has been an exciting progression of Muskoka Algonquin Healthcare’s capital redevelopment planning to replace our aging hospital sites in Bracebridge and Huntsville with two new hospitals in the future.

Just last week we announced the future location where we plan to build a new hospital in Bracebridge. Also in December, we were encouraged by Infrastructure Ontario’s December 2023 Market Update that indicates our redevelopment project could officially start with contract execution in 2029.

We are fortunate to have the financial commitment of our local communities, the Ministry of Health and our Hospital Foundations to build the best future for health care for everyone we serve. These milestones are all great news to demonstrate our project is on track!

Planning the programs and services for our new hospitals in the future has been an iterative process over the past several months. It has given us opportunity to consider changes in the healthcare environment, advances in technology, and how we could continue to transform Muskoka Algonquin Healthcare that will ensure a sustainable healthcare system for decades to come. One that will position us to expand services to our communities and solve current challenges, some recently amplified by the pandemic such as ongoing staff shortages that contribute to frequent service disruptions.

More than 250 subject matter experts (staff, credentialed staff, volunteers, patient experience partners, hospital leaders and key healthcare partners) have gathered together as User Groups to explore different service delivery models. They have been working to define the future scope of programs and services and projected future volumes, and identify opportunities to leverage technology and improve their workflow while also looking at how we can close existing gaps in service.

As we worked through our planning process, it became clear this past fall with preliminary costing of new hospitals that replicating the existing status quo model is not viable. With drastic cost inflation that has driven healthcare building costs up nearly 50% in just the last year, it’s crucial that we develop an affordable future, not only in what we build but also in how we operate services to end repeated annual budget deficits.

Muskoka Algonquin Healthcare is committed to a creative solution for the future that looks forward instead of back with new hospitals that are built green and are flexible in design. Where our two sites are complementary to each other rather than identical, both providing 24/7 Emergency Department care, and inpatient beds tailored to how we will provide care in the future.

Together, we are investing in and building Made-in-Muskoka Healthcare and through innovation and partnerships we will expand the healthcare services we can provide both within and beyond our walls to bring care closer to home in outlying areas of the region.

User Groups are still working through the final pieces of a Made-in-Muskoka Healthcare solution to meet the needs of Muskoka and area decades from now and ensure our hospitals survive and thrive. As that work wraps up, I am looking forward to sharing the details later this month of how we will deliver Made-in-Muskoka Healthcare to all our communities; healthcare that is focused on excellence, quality care and long-term sustainability for the next 40 and 50 years.

Applauding a year of achievements

Looking back on my first year as President and Chief Executive Officer at Muskoka Algonquin Healthcare, I have so much pride for the remarkable things our team has achieved as one organization operating two sites.

Recovery and revitalization from the COVID-19 pandemic has been a significant focus over the past 12 months, but so too has been our focus on new initiatives to improve the patient experience. Our accomplishments are a credit to the hard work and dedicated efforts of our entire team and system partners, and we look forward to more achievements in the year to come. Here are some of my favourites from the past year:

Furthering our commitment to quality and safety, we earned the top rating of Accredited with Exemplary Standing from Accreditation Canada following a four-day onsite survey at both sites in November 2022. Evaluated against 2,150 best-in-class standards of care, MAHC met 100% of all Required Organization Practices, and 99% of the accreditation program standards the organization was measured against across eight quality dimensions. 

Accreditation Canada surveyors with our team

Through an increased focus on partnerships and collaboration with the Muskoka and Area Ontario Health Team and other key peers we:

• opened a Heart Function Clinic at the South Muskoka site for care of patients in our community with Congestive Heart Failure to provide a higher level of cardiac follow-up and care for Muskoka residents within their own community; 
  

  

  Heart Function Clinic
  

• launched the Hospital to Home program with Closing the Gap to create a seamless transition for patients to leave the hospital and successfully return to their home with dedicated resources and support before, during and after their discharge;
• partnered with Muskoka Hills Retirement Villa in Bracebridge for seven transitional care beds to relieve occupancy pressures;
• marked one year of partnership in palliative care with Hospice Muskoka to designate five transitional care beds at Andy’s House in Port Carling for MAHC patients seeking end-of-life care in a homelike environment; and

Partnership with Hospice Muskoka

• launched SeamlessMD, a patient portal using an app, to provide remote support to a patient’s surgical journey using an interactive guide to prepare for their surgery beforehand and recover faster afterwards, all from the comfort of their own home.

We invested in mental health care through a new Mental Health Navigator who provides immediate support to patients in need in our Emergency Departments who are experiencing mental health crisis. 

Desiree Reisenburg, Mental Health Navigator

Understanding that culturally relevant care close to home in the communities we serve is important, we collaborated with the Barrie Area Native Advisory Circle to introduce Indigenous Patient Navigator services to patients at the South Muskoka site.

Mary Sue Robinet, Indigenous Patient Navigator

Clinical research also continues to be supported by MAHC with four additional studies approved in the past year.

Over the past year, we have onboarded six new Patient Experience Partners, growing our Patient and Family Advisory Council to 13 members with increasing participation in organizational and capital redevelopment committees, working groups and projects.

We hired 123 new staff to the health care team, and welcomed seven new associate staff to MAHC with two Emergency physicians, two midwives and three family medicine colleagues. We supported 72 medical learners over the course of the past year as part of their training to become physicians.

Having received a provincial announcement of operating funding for Muskoka’s very first MRI (Medical Resonance Imaging), we started the planning for Muskoka’s first MRI machine that will support our stroke centre and provide access to MRI closer to home for the entire region.

Keeping pace with advancements in technology and the need for new and replacement hospital equipment is directly supported by the outstanding work of our two Foundations, which collectively raised over $4 million over the past year through donor giving. Because of their dedicated efforts, we have a new anaesthesia machine and laparoscopic instruments for the operating room at the South Muskoka site, and a new nuclear medicine machine, an echocardiography machine, and a new digital X-Ray at the Huntsville site.

New Nuclear Medicine Suite at HDMH

New anaesthesia machine at SMMH

We have also been proceeding with long-range future planning for hospital redevelopment that would build a new site in Huntsville on the existing land at 100 Frank Miller Drive and a new site in Bracebridge on new land through a site selection process. Reimagining local hospital care with two new hospitals in Muskoka involves extensive engagement with our staff, physicians and volunteers, patients and families, and our community at large.

Health care in a community takes a team – many players working together from many departments and many agencies. All of this has been possible because of the guidance of the Board of Directors, the direction of the Leadership Team, and every staff member, physician, midwife and volunteer, as well as our Foundation partners working together with our community to support better health for everyone we serve. You can also see our Annual Report to Our Community for more!

Identifying a Preliminary Preferred Site for a Future SMMH

President & CEO Cheryl Harrison speaks at a community information session.

Our redevelopment project for two new sites continues to move along as we work through what the Ministry refers to as the ‘Functional Program’ or Stage 1.3 of its capital planning process for hospitals until the early part of 2024. This stage of planning has three components:

1. Program and service planning to meet our community’s future needs based on population projections, and considering future changes like expanded technology;  
2. Site selection for a new location for the South Muskoka Memorial Hospital (SMMH); and
3. The financing plan for the community’s local share of $225 million of the $967 redevelopment project.

Most recently, our greatest progress has been to evaluate various land options within the urban centre boundary of Bracebridge to identify a preliminary preferred site for a future SMMH Site. In Huntsville, the property at 100 Frank Miller Drive is large enough for us to build a new hospital on the existing land, so no site selection is necessary.

Having looked at more than 20 different properties identified through various consultations, five locations met the minimum land requirements to proceed to evaluation. The team evaluated the five properties against broad criteria for location and property, land use planning framework, and capital and servicing costs. Through our open houses and feedback survey, we were grateful to receive community input on our criteria by hearing what was most important to people when considering a future location. We heard from some that people a hospital should be located near downtown Bracebridge and the ability to access the property by means other than a vehicle, such as on foot or cycling should be part of the evaluation. We also heard that environmental impacts were key to consider as well. Environmental considerations have been part of the evaluation criteria from the beginning, but we have expanded the criteria to focus on protecting environmentally sensitive land and natural landscapes, such as avoiding clearcutting of trees and ensuring our new builds look and feel like Muskoka. Top of mind for many we have engaged with is also how future construction will minimize climate change impacts.

The evaluation exercise found that each property had strengths and challenges, and a scoring process helped to rank their suitability for a hospital. We have narrowed the five properties to three that are considered appropriate for a future hospital:

• 1975 Muskoka Beach Road across from Muskoka Brewery, (current preliminary preferred site);
• 300 Pine Street between Walmart and the fairgrounds; and
• Highway 118 West lands, located east of the Muskoka Hills retirement villa.

Our evaluation isn’t fully completed yet. We were pleased to revisit our communities again in April with a series of in-person and virtual information sessions to provide an update, take questions, and validate our findings to date. Thank you to everyone who attended, and if you weren’t able to join us you can watch one of the presentations here.

We are also having ongoing discussions with the Town of Bracebridge to further investigate the potential costs of the required municipal services for these three highest-ranked properties.

Over the next several weeks we will be further validating the 1975 Muskoka Beach Road property, which includes further due diligence such as geotechnical and hydrogeological studies, cost estimates, environmental assessment, and site plan preparation. We anticipate a final decision on the preferred site by the Board of Directors in the fall of 2023.

MAHC’s Continued Focus on Future Planning

Planning for the future has been a primary focus of our Board of Directors since 2012 and continues to be an objective in our Strategic Plan. This long-term development plan for our facilities is imperative for us to ensure a sustainable future for our hospitals in Bracebridge and Huntsville.

There are several reasons why we need new hospitals in Bracebridge and Huntsville. Our buildings from 1964 (SMMH) and 1978 (HDMH) today present many challenges that limit us. They are old buildings that do not meet current best practices and health care standards, including rules around privacy and infection control. Single occupant private rooms are not a nice to have, they are a need to have. Across both sites, only 15% of our rooms house a single patient with the majority as two-bed and four-bed rooms. Our buildings are also very difficult to adapt to advancing technologies within their existing footprints. We don’t have enough space for the care we deliver today, let alone the care our community will require in the future. On top of that, it is so important that our care providers have a work environment where they are equipped with the tools and the space to do their job of providing you with excellent care.

Following years of progress through the Ministry of Health’s capital planning process for hospitals, in April 2022 the Ontario government gave us the green light to move to the next stage of our planning for a new hospital on the existing land in Huntsville, and a new hospital at a new location in Bracebridge. Premier Doug Ford’s announcement was a significant milestone in our future planning journey and included grant money for the planning to continue (not for new construction). Over the next 12 to 18 months, we are working through what the Ministry refers to as the ‘Functional Program’ or Stage 1.3 of their planning process.

This stage involves detailed program and service planning to meet our community’s future needs, resulting in architectural drawings of the buildings and physical space needed to support the programs and services in new, state-of-the-art facilities. Everything we have learned from the pandemic will be considered, and the initial planning assumptions identified through earlier planning work are revisited to reflect the most current information on how people receive care locally through various health services and regionally through more specialized health centres. We are excited to embark on this work with expert consultants, supported by the in-depth knowledge of our staff and clinicians through internal focus groups. Patients and families from our communities will also be key to this work and will be involved at all levels of this project.

Another big component of this stage will be to get a clearer understanding of the cost of the future builds. The Ministry of Health pays for a portion of our project for two new hospitals, and the local community is expected to pay a “local share” of the entire project, which can be up to 30% of the total project cost, including furnishings, fixtures and hospital equipment. Our initial cost estimates will be updated to be more current to today’s economy and will also factor in the various cost inflation impacts of the COVID-19 pandemic. In our last planning submission to the Ministry in 2019, the local share was estimated at $129 million in 2019 dollars. New projections will try to forecast the potential cost by the time we are at the stage of building the two new hospitals, which may not start for seven or eight more years.

I am excited to provide this update on our redevelopment project and the work that we are undertaking over the next year or more. We are so grateful to our two hospital foundations and all of the local municipalities for their continued support and collaboration in determining the best path forward in how our communities will fund the local share. Working together will ensure this very important project for future hospital care in Muskoka continues to move forward.

Introducing President and CEO Cheryl Harrison

My name is Cheryl Harrison and I am excited to lead the Muskoka Algonquin Healthcare (MAHC) team as its newest President and CEO.

Over the past 14 years, I have been working in North Simcoe Muskoka where I have been privileged to work in partnership with MAHC in my previous role at Orillia Soldiers' Memorial Hospital.

I have witnessed firsthand the high-quality health care that MAHC delivers by the outstanding team members — team members including staff, credentialed staff, volunteers and Board Directors who demonstrate the MAHC values of accountability, respect, optimism, leadership and engagement every day.  It is clear they are committed to MAHC's mission to work together to provide outstanding integrated health care to our communities and deliver best patient outcomes with exemplary care and compassion.

So let me introduce myself a bit… As a proud registered nurse, with a Master’s degree in Health Policy, Evaluation & Management, I have worked in hospitals my entire career.  My clinical and leadership experience has been largely in medium size, rural community hospitals in Ontario.  My husband and I live in Severn Bridge at our cottage turned home, where we enjoy family time with our three daughters and three delightful grandchildren.  The last two years of the pandemic have tremendously affected health care services and we are all looking forward to recovery, recalibration and revitalization. 

I am grateful to get to know the team and work alongside the community to continue delivering quality health care to area residents and those from beyond the region.  You can count on me to work with all of you and our community partners to continue to move MAHC forward in the future.

I am excited to start a new chapter in the CEO Blog, and encourage you to keep up with everything we do by frequenting our website and following our Facebook, Twitter and Instagram social channels @MAHCHospitals. 

Stay safe and well!

#WheretoGetCareMuskoka – Help With Knowing Where and When to Go

This blog has been written by Dr. John Simpson, Director & Chief of Emergency Services at Muskoka Algonquin Healthcare

With pandemic restrictions easing, people are getting back to their regular lives and engaging in activity and adventure once again. In some cases, people are only now following up to get medical help for care they may have deferred during the pandemic.

We are seeing both scenarios in our Emergency Departments in Bracebridge and Huntsville where volumes are on the rise and wait times are getting longer. In May, Emergency Department visits across our two sites rose 17% year over year. And in June, there were more than 4,100 visits to the two departments. COVID-19 has had a profound impact on health human resources across the health care system. In addition to the toll that the pandemic has taken on health care workers dealing with the pressures of responding to COVID-19, our hospitals are also experiencing unprecedented hospital use and unrelenting high occupancy. For us, this is not just another summer in Muskoka. The hospitals are still in the midst of the pandemic, working in a fragile state with strained staffing.

We know that sometimes accidents happen and that’s why the Emergency Department is a 24/7 operation. We also know that how people access care has changed dramatically since the pandemic, and more than ever, different mental wellness services have come on line and virtual care is providing greater options.

We want to make sure people are informed about different options for care in Muskoka, so they can support their local hospital by knowing when it’s appropriate to go to the Emergency Department and when to access primary care or other community-based supports. It’s about knowing what is available for non-emergencies and the choosing the right care in the right place at the right time by the right provider. This helps to ensure that safe and high-quality emergency care is accessible close to home and the cottage for people when they need it most.

'Dr. Simpson’s five tips' for the summer:

1. Make safety a priority by avoiding risky behaviour that can lead to illness or injury, and make a thoughtful plan to avoid an unnecessary trip to the Emergency Department.
2. Consider what is available for care as you plan outings. Ask yourself… Are my prescriptions in order? Are my immunizations up to date? Does my current health support that trip to the cottage I was planning to take?
3. If you are feeling unwell, your first call should be to your primary care provider for their advice or ability to see you, potentially virtually or even by phone.
4. Consider making an appointment at the COVID-19 Clinical Assessment Centre in Bracebridge for any upper-respiratory issue. Any sniffles, cough, COVID-19 or influenza symptoms? You can be seen by a doctor quickly at this clinic – without a trip to the Emergency Department. 
5. Visit www.mahc.ca/wheretogetcareMuskoka/ to educate yourself about the different options for care locally. Information is provided for people who have a local doctor and provides virtual care options to see a physician for those who do not. Resources are provided for mental health and additions. There is even information about when you should go to the Emergency Department and when a visit to your primary care provider is more appropriate. 

These tips will help you help us conserve the Emergency Departments for real emergencies and preserve reasonable wait times this summer. We appreciate your support! Be safe and well!

Engaging a Patient and Family Voice at MAHC

The patient and family perspective has never been more important or influential in health care than it is today. Patients and their family members provide tremendous firsthand experience and feedback that is important to ensuring we are always providing care that is centred around those we serve. For the past five years, Muskoka Algonquin Healthcare (MAHC) has had a Patient and Family Advisory Council (PFAC) that provides the organization with advice and recommendations on matters where the patient perspective is vital to advancing person-centred care. The council is made up of Patient Experience Partners who bring patient and family input closer to the bedside through input on policies, procedures and processes by sharing their own ideas and points of view. There are different reasons why Patient Experience Partners volunteer to participate and shape patient care in Muskoka, but what they all have in common is their desire to positively influence other patient and family experiences. I am pleased to introduce a handful of our Patient Experience Partners to share what inspired them to join us in making the patient experience better.

Tammy Purvis

Tammy Purvis was an inaugural member of our PFAC back in 2017 because she and her family have used the hospital over the years, and felt it was important to be part of a council that would hear her voice and learn from her experiences while fostering partnerships with health care professionals.

“Being with like-minded people who are sharing ideas and suggestions to make a difference in the quality of care that patients and families are receiving is the most rewarding part of being a Patient Experience Partner,” says Tammy. “It is so rewarding to know that you are part of something that is making a difference in our community’s health care.”

Emily Carty has been on our PFAC since 2019 and serves as the Patient Experience Partner on the Obstetrics Committee and the Workplace Violence Committee.

Emily Carty

“As a child and youth care practitioner I have supported many youth who have accessed and received services from HDMH,” says Emily. More recently, Emily spent time as a patient at SMMH to give birth to her children and says the most rewarding part about being a Patient Experience Partner at MAHC is knowing that her generation has a patient voice in the mix. “With my children and parents needing care from the hospital I am experiencing services from both ends of the spectrum,” she says.

Jan Kindy

Jan Kindy is relatively new to our PFAC and says her decision to become a Patient Experience Partner came after her father’s lengthy hospital stay. “It was during this time I was able to see how important the patient, family and hospital connection was. I can imagine this being positive in many ways… working with others to add value to the patient experience,” she says.

John Lock

John Lock had a 36-year career with Toronto Paramedic Services and was fortunate to serve on numerous hospital committees in the GTA, and around the province. He felt our PFAC would allow him to combine his own patient experience with his past professional and committee involvement to give back to his community.

“My wife and I have been patients of MAHC numerous times over the past couple of years, and we have both commented that we have never experienced the exceptional care that we have experienced at MAHC,” says John. “The compassion, the welcoming atmosphere and the exceptional care begins at the door of the hospital and continues through the experience. We are blessed and very fortunate to have such a great team at MAHC.”

As a member of our PFAC, John hopes that by sharing ideas and expectations of patients and families when they access hospital care that he can shape and influence the same exceptional experiences that he and his wife have had. 

MAHC is actively seeking applications from community members who have been a patient or a family member of a patient at either hospital and want to partner with us to improve the care experience. Might you be our next Patient Experience Partner? Please visit www.mahc.ca/PEPapplication/ to learn more about this opportunity.