Friday, 29 August 2014

What option do you like for hospital care?

What’s the best model for delivering hospital care and services 20 years from now? That is what Muskoka Algonquin Healthcare is trying to determine and you can be part of it!

It is with excitement that I write this month’s blog to update your about planning Hospital Care for Our Future Generations. My June blog outlined the purpose of completing this capital planning for the future and described the process that the Ministry of Health and Long-Term Care requires us to follow. Since that time, more work has been occurring and I’m thrilled to share where we are at in this journey and some of the options we are considering for delivering hospital care, programs and services in the future.
It is important to remember that this planning work is for the future and any changes contemplated are not going to happen tomorrow. It takes several years – 15 to 20 in fact – to go through all of the stages in the Ministry’s planning process and there are several checkpoints along the way to go back and rethink and refine our plan and assumptions as new technology comes on board or other things change in health care. The Ministry requires us to look at and explore all potential models, even if they might be unpopular. We must ensure no stone is unturned, and so together with our consultants and architects we have developed three models (which include four options in no particular order) for serving MAHC’s catchment area.

Option 1 is to construct one new acute care hospital on a single site. The existing sites and hospitals would become surplus. At this point this is a theoretical model and no site has been identified.

Options 2 & 3 are an Ambulatory Site/Acute Site model to redevelop the existing buildings on the current sites. One site would be developed as an acute hospital, and the other site developed as an ambulatory care centre with urgent care. We have modeled this as two scenarios, one with the HDMH Site as the Ambulatory Site and the SMMH Site as the Acute Care Site and another with the SMMH Site as the Ambulatory Site and the HDMH Site as the Acute Care Site. This model assumes a combination of renovating the old buildings and building new space. The Ambulatory Site would not have inpatient beds and would deliver ambulatory care services such as dialysis, chemotherapy and cancer supportive care, fracture clinic, diabetes education, diagnostic procedures, and cardio-respiratory services, for example. The Ambulatory Site would also include an urgent care centre. The Acute Care Site would house a 24-7 Emergency Department and all inpatient beds for MAHC. The key difference is that traditionally urgent care centres do not receive ambulance traffic. If a patient arrived at the urgent care centre with complex medical needs, they would be stabilized and transferred as appropriate to the acute care site or another hospital.

Option 4 is to maintain two acute care sites through a combination of renovating the old buildings and building new space. Investments would be prioritized to the higher technology areas.

There are several guiding principles that the architects are considering in the potential design of these options. Designing for health is about human experience, connection, emotion, understanding and orientation. We want to create an environment of wellness, a strong connection to our community, flexibility for future change, a positive work environment for our staff and physicians, and operational efficiency.

The three models – (one-site model; ambulatory site/acute site; two acute care sites) will be evaluated using criteria such as: affordability, ease of implementation, sustainability, travel times, capacity for future growth, compliance with municipal planning, alignment with LHIN/Ministry priorities, and others including funding capability.

The Board of Directors has a goal to receive a recommendation for a preferred model in December or January. Given the importance and complexity of this planning, we are prepared to take the time to make our Master Plan the best it can be.

Our Pre-Capital submission (which is the first step in the Ministry’s process) will then need to be revisited and submitted to the North Simcoe Muskoka LHIN and Ministry of Health and Long-Term Care with the Master Plan in September 2015.
We also know that a portion of any capital build must be borne by the community, so affordability is a serious consideration. Having said that, it can’t stop us from visioning what our future should look like. The Ministry will cover 90% of the capital cost of a new build, while the community must raise 10% and the cost of all internal furnishings, equipment, beds, etc. Because of challenges with affordability, developments could be staged and funded incrementally.

While we are planning for the future, we will continue to renew and enhance our existing facilities now through minor renovations with the strong support of our Foundations and Auxiliaries to meet evolving standards and the needs of our community.
What an exciting opportunity we have to really think and plan for how health services will be delivered in the future in Muskoka! I encourage you to get involved, review the material on our website and provide your feedback. This is your opportunity to help shape the future of care in Muskoka. Feedback will be accepted until Sept. 26, 2014. Please visit our survey at