Monday, 24 January 2022

Weathering the storm as the pandemic drags on

Having only just joined the Muskoka Algonquin Healthcare team less than a month ago, this is my first blog as Interim President & CEO. I don’t think anyone would have imagined back in March 2020 that we would still be consumed by an ongoing pandemic nearly two years later and that it would still be the subject of the CEO blog.  

The current COVID-19 landscape with Omicron is likely the biggest test of the hospitals’ response with rising case numbers in a relatively short period of time from a highly contagious variant amidst a shrinking workforce.

In addition to heavy inpatient occupancy from increasing admissions at both sites, we are also seeing our highest COVID hospitalization rates in two years – at one point topping double digits this month with 15 COVID-positive inpatients at one time.

Creating additional challenges is the significant absence of human resources across the entire health care industry. Every hospital is working through staffing shortages, especially as team members become sick or exposed to COVID-19 and isolate at home away from the workplace. And MAHC is no different.

In line with provincial direction, we have had to scale back scheduled care, including non-urgent surgeries, some diagnostic testing and clinic activity to redeploy our staff to maintain urgent and emergent services and look after our admitted patients. This directive, which is in place for a while longer, helps to bolster the workforce for a limited time. But postponing non-urgent care is very difficult for those who have been waiting for care. We are deeply sorry this measure has to be taken, and will do our best to resume those ramped down services as soon as we can.

Rest assured our hospitals across North Simcoe Muskoka are working closely together to maintain consistent access to urgent and emergent care. This may require transfers of patients to services further afield, and that means loved ones may not be as close to home.

To those who need the hospitals, we’re still here for. Your patience and kindness is appreciated, recognizing that everyone is exhausted and frustrated.

Our staff and physicians are doing their best during extraordinary times. They also need the full support of the community and everyone’s help in slowing down the transmission of this virus and using our precious health care resources in the most effective way possible.

Please remember to be kind and follow all public health measures to protect yourself and those around you. Please get vaccinated, including the third vaccine dose as soon as you are able. Three doses of vaccine is very effective in reducing COVID spread and almost eliminates serious complications of COVID infection and even the chance of being hospitalized, which in turn helps keep hospital beds available.

We can only hope that this wave of the pandemic will soon peak and provide some relief on an immensely taxed system. We will get through this together.

Monday, 20 December 2021

Looking Back Fondly on a Decade with MAHC

Natalie Bubela head shot
After over a decade at Muskoka’s hospitals, I am writing my final blog as President & CEO at Muskoka Algonquin Healthcare before I retire on December 23, 2021. Taking the pen this last time before it is turned to a new writer is bittersweet to say the least. I look back fondly on so many special and meaningful moments, great advances in local health care, and a rewarding career that has been bolstered by the many people who work so hard to ensure we are providing the best patient care.

It has been my distinct privilege to work with so many intelligent, capable, caring and compassionate people who give their all every day to provide outstanding care for their communities. From the front line to the back office, physician colleagues to community partners, health care in a community takes a team – many players working together from many departments and many agencies. Hospital leadership is a tough job no doubt, but it is also so rewarding when you have been as blessed as I have to have led a great team.

During my tenure I have been fortunate to work with six Board Chairs who believed in me and supported me over the years, and countless Directors who volunteered their time and energy to work through both the good times and the more difficult times of financial challenges and future planning.

I am so proud to have championed a strong and effective management team that puts patient- and family-centred care at the forefront of everything they do. Our hospitals have truly evolved as a result of their efforts and leadership.

I am humbled to witness our hospitals benefit from the great work of two hospital foundations and two auxiliaries that have made our organization better through new equipment and technological advances, educational opportunities for staff, and dedicated volunteering.

I am grateful for the hundreds of MAHC staff and credentialed staff who work exceptionally hard and do what they do every day because they believe in what they do and how they can help others. I have always believed in you and I’m so proud of the team you are.

I would be remiss if I didn’t acknowledge my family’s support for the opportunity to spread my wings over Muskoka for the past 11 years and the sacrifices they made while encouraging me along.

What makes it hardest to leave is the people you leave behind.

I always wanted to work in an organization that achieved exemplary status from Accreditation Canada and now I can say that I have. There are more clinical services available to serve our communities today than only 10 years ago when I first started. And I’m so pleased to leave MAHC in a state of improved financial health.

It has been said that success is measured by what others achieve. I thank each and every person in the hospitals, in the community, and beyond Muskoka for the success you have fostered in what MAHC has been able to achieve. It has been my privilege to work in a community that is passionate about their hospitals. Until our paths cross again out and about in the region, take care of yourself and each other.

Yours in health,
Natalie

Thursday, 30 September 2021

COVID-19 Vaccine – An Added Layer of Protection

COVID-19 vaccination efforts continue across Ontario and throughout the world as a significant step forward to fight the COVID-19 virus and to one day ease the impacts of the global pandemic.

The vaccine is not a bulletproof vest against COVID, but is a scientifically-recognized layer of protection in addition to public health measures of masking, physical distancing and frequent handwashing to protect yourself and others.

Hospitals are where some of the most vulnerable patients receive care. In response, the Chief Medical Officer of Health issued Directive 6, mandating hospitals and other high-risk settings to develop and implement a COVID-19 vaccination policy by September 7, 2021.

Muskoka Algonquin Healthcare’s COVID-19 vaccination policy meets the requirements of Directive 6, which requires unvaccinated and partially vaccinated staff and credentialed staff to submit to weekly rapid antigen testing. All team members also continue to wear personal protective equipment and adhere to infection control guidelines to safeguard themselves and patients we care for.

We respect there is a public expectation for health care workers to roll up their sleeves for a vaccine and at MAHC we are actively encouraging staff our team members to get vaccinated. Vaccination is one of the most successful public health strategies to prevent the spread of infectious diseases.

It is important to remember that staff and physicians may not be vaccinated because of medical exemptions or exemptions-based grounds protected by the Ontario Human Rights Code (such as religion). It is not solely based on a personal decision to decline for reasons unrelated to medical or human rights exemptions.

At MAHC, more than 90% of our team is vaccinated and we know that 100% may never be achieved based on the allowed exemptions.

Nevertheless, we encourage the public to get vaccinated to increase a person’s immunity to the virus. While vaccinated people may still contract and transmit COVID, we know it has been scientifically proven that the effects of the virus are minimized.

Your community hospitals continue to work tirelessly to provide the highest quality health care in Muskoka. You too can all do your part to keep them safe by getting vaccinated.

Friday, 23 July 2021

Gearing up for Accreditation 2022 – our ‘Journey to Excellence’


We are on a ‘Journey to Excellence’ as our entire team starts to gear up for Accreditation 2022.

For years, Muskoka Algonquin Healthcare has voluntarily participated in the Accreditation Canada program to constantly improve the quality of care we provide to patients. “Qmentum Accreditation” is tool that ensures we are meeting the best standards of care while also identifying recommendations on how we can improve.

Every four years, independent surveyors with health care expertise complete a multi-day onsite survey to examine all aspects of the health care we deliver – from patient safety and ethics, to staff education and training, governance and partnering with the community. During this survey, both sites are measured against specific Required Organizational Practices (ROPs) associated with close to 2,500 national standards of excellence. An ROP is an essential practice that organizations must have in place to enhance patient safety and minimize risk. They are categorized into eight quality dimensions: accessibility, appropriateness, client-centred services, continuity, efficiency, population focus, safety and worklife; and six patient safety areas, each with its own goal, as follows:

Safety Culture: Create a culture of safety within the organization;

Communication: Promote effective information transfer with clients and team members across the continuum of care;

Medication Use: Ensure the safe use of high-risk medications;

Worklife/Workforce: Create a worklife and physical environment that supports the safe delivery of care and service;

Infection Control: Reduce the risk of health care-associated infections and their impact across the continuum of care; and

Risk Assessment: Identify and mitigate safety risks inherent in the client population.

Preparation for accreditation starts with self-assessments by core teams. The results of individual staff surveys also help to identify any gaps, supporting our preparation for the actual Accreditation Canada survey where surveyors evaluate our compliance with the ROPs and standards that contribute to high quality, safe, and effectively managed care.

To achieve an ‘Accredited’ decision, an organization must meet a minimum of 80% of all criteria, and a minimum of 70% of high-priority criteria and Required Organizational Practices in every standard set.

Our most recent survey in 2018 awarded us the highest possible rating: Accredited with Exemplary Standards, having met 95.8% of the 2,438 standards. Once again we are striving for the top award and to demonstrate we are committed to quality improvement, every day.

Our Accreditation 2022 theme ‘Journey to Excellence’ was chosen from a variety of suggestions generated through a staff naming contest. It is supported by strong branding that plays on our MAHC acronym with imagery of a person actively on the journey.

Year after year, with the accreditation process, we have continued to build on our commitment to work together to provide outstanding integrated health care to our communities and deliver best patient outcomes with exemplary standards and compassion.


MAHC acronym with the C in the shape of a stick person

MAHC's Accreditation 2022 logo


Tuesday, 25 May 2021

Time is Heart – Be Sure to Call 911 for Heart Attack Symptoms

While our team at Muskoka Algonquin Healthcare (MAHC) has been busy responding to the many changes that have resulted from the COVID-19 pandemic, our commitment to implementing new models of care and different ways to deliver care to improve patient outcomes has remained steadfast.

Through advancements in cardiac care and incredible partnerships we have developed, earlier in May Muskoka joined the Simcoe Muskoka Code STEMI Protocol. ST-Elevation Myocardial Infarction (STEMI) is a very serious type of heart attack during which one of the heart’s major arteries is blocked. Using Percutaneous Coronary Intervention (PCI, formerly known as angioplasty with stent), a catheter is used to place a balloon and stent to open up blood vessels in the heart that have been narrowed by plaque buildup. It is a non-surgical procedure that can be facilitated in the Cardiac Intervention Unit at Royal Victoria Regional Health Centre (RVH). This protocol partnership with RVH provides a direct line to interventionist cardiologists and the gold standard of care where a patient receives advanced cardiac care in less than 120 minutes from first medical contact.

This means that some Muskoka residents with heart attack symptoms may now be transported by Muskoka Paramedic Services directly to RVH in Barrie for their lifesaving treatment. Paramedics have the cardiac monitoring equipment and the clinical expertise and training to quickly and accurately identify elevations in the heart rhythm, and more specifically a STEMI. That is why it’s so important to call 9-1-1 if you experience symptoms of a heart event like chest discomfort, sweating, neck and jaw discomfort, shortness of breath, nausea and light-headedness. The ambulance will bypass our hospitals and go straight to RVH. Time is heart and the sooner a blockage can be opened, the less damage to cells in the heart muscle.

Code STEMI simulations with nurses, doctors and paramedics were held at both sites in preparation for the new protocol.


MAHC is also participating in the protocol for patients who present to our Emergency Departments with symptoms. One week after the protocol went live in Muskoka, three patients presenting at each of our sites received cardiac care through the STEMI protocol, and a further patient bypassed our two sites altogether and went straight to RVH through local EMS.

Dr. Megan Stephenson, a longtime Emergency physician in Huntsville, says it’s exciting to be a part of the joint initiative of Muskoka hospitals, RVH’s Interventional Cardiology program and Muskoka Paramedic Services to bring state-of-the-art cardiac care to the community’s doorstep.

“For heart attack patients who meet the criteria, cardiac catheterization can be performed at RVH in a timely fashion to reduce morbidity and mortality,” explains Dr. Stephenson. “Our first patient encounter on Tuesday, May 11, demonstrated a true collaboration among nurses, paramedics, ward clerks and physicians to expedite the care of a heart attack patient.”

Dr. William Hemens has been an emergency medicine physician in Bracebridge for 35 years and was on shift at the South Muskoka site when two patients presented the morning of May 11. As a clinician, he is pleased at how cardiac care has developed over time, and proud as a local resident to have access to advanced cardiac services in the region. He praised the partnerships that have conquered geography and distance to achieve a streamlined protocol that supports timely care.

“This protocol is so important to facilitating the patient’s coronary intervention to return proper blood flow to the heart muscle to diminish the potential damage of a heart attack faster than before, which is so reassuring for our communities” says Dr. Hemens. “It’s also important for communities to support hospitals in achieving these advancements by donating to the equipment and facilities that allow for these services to grow and develop. It’s because of donors that health care providers can deliver state-of-the-art care.”

This is a positive and progressive change that provides access to care that residents of Muskoka deserve and we couldn’t be more thrilled to be part of it!

Thursday, 25 February 2021

Looking forward after one year with COVID-19

As January 2020 rolled in and the first reports of COVID-19 started circulating from abroad, hospitals across Canada started planning, knowing it was just a matter of time before this new and highly contagious coronavirus arrived on their doorsteps.

On January 30, the World Health Organization (WHO) declared that the novel coronavirus was a Public Health Emergency of International Concern. At the time there were fewer than 100 cases of the disease we now call COVID-19. Just a week earlier, we had issued our first communication to staff introducing the coronavirus, and preparations at MAHC were well underway when the WHO declared COVID-19 a pandemic on March 11.

In the days and weeks that followed, there was a whirlwind of activity as we worked quickly and efficiently to roll out the many Ministry of Health directives put in place to assist hospitals in creating capacity to deal with a potential surge of COVID-19 patients. Non-urgent and elective procedures and many ambulatory services ramped down while our Emergency Departments remained open. Screening for travel and symptoms was introduced for both patients and staff. Cleaning and disinfection practices were enhanced, isolation needs soared, and spaces were converted to prepare for what may come. Personal Protective Equipment was a concern in the early days as supply into the country and flow through to hospitals failed to keep up with demand. On March 25, we cared for our first inpatient with COVID-19. In April, more cases followed requiring inpatient care. To date, 16 people with COVID-19 have received inpatient medical care at MAHC; sadly, two succumbed. Others have received care in our Emergency Departments and discharged home to isolate.

Reflecting on the past year, different emotions come to bear for anyone working in health care. Many are sadly grim. By definition novel means new, and in health care novel rightly evokes fear. As the one-year anniversary of the COVID-19 pandemic draws near, I am reminded that in those early days and still today, our staff and credentialed staff show up and provide exceptional care in the face of an ongoing health crisis mired with uncertainty. Our Muskoka and East Parry Sound communities are fortunate to have such a dedicated team at their community hospitals. Through the challenges and uncertainty, we at MAHC have learned more about our adaptability, our individual commitment as health care workers and overall resolve as an organization to come together as a team to look after our communities’ needs in a year like no other.

While each of us will have different perspectives on COVID-19, the optimist in me feels privileged, proud and confident to lead such a tremendous team of professionals. I can’t say enough about the amazing efforts of our people – taking care of patients and their families, and caring for each other with immense respect for their fellow team member’s valuable contributions to our collective response.

Today in Simcoe Muskoka the threat of COVID-19 variants of concern oblige us to stay vigilant by following all public health measures to reduce the risk of exposure and protect ourselves and our loved ones.

Instead of continuing to look back on a year that has challenged us in an unprecedented way, I am looking forward with hope on the horizon as COVID-19 vaccines reach more arms. Many of our staff and credentialed staff are eligible for immunization, and more than half of our team has received both doses. They tell me it’s a humbling moment and one they are grateful for, but still acknowledge that regardless of vaccination it is critical to continue to follow all protection measures to avoid the potential of a third wave of this pandemic.

Monday, 7 December 2020

Gratitude to Hospital Staff Looks Different This Holiday Season

The recent surge of COVID-19 cases in Simcoe County and in the District of Muskoka as the holiday season nears is alarming. It’s also important to recognize that COVID positive cases in Muskoka are likely higher than what is being reported locally when cases are attributed to and counted in another health unit within the province. A surge in cases has the potential to also impact bed capacity within the hospitals and our ability to maintain the provision of outpatient services, such as scheduled surgery and procedures.

As we watch the numbers grow everywhere, we must pause and reconsider traditional holiday approaches. Regardless of a pandemic, the holiday season is a time for giving. Over the years many of our staff and/or their departments have been on the receiving end of tremendous acts of gratitude during the festive season.

Thoughtful gifts to say thank you like boxes of chocolates or Christmas baking warm our hearts and mean a lot to our team members, but they also carry a level of risk to our staff and physicians that is not advisable, and can ultimately potentially hinder our ability to provide high-quality care to you or your loved ones when needed.

Gift baskets for example, similar to boxes of chocolates, typically contain items that are intended for sharing, which results in multiple sets of hands touching products. This has the potential to increase the risk of sharing germs that make people sick. It’s not just the COVID-19 virus we have to worry about, but also seasonal influenza and gastrointestinal illness that can easily spread from person to person if we let our guard down to risk.

The safety and wellbeing of our team members is a priority for our hospitals, and therefore we regret our staff are unable to accept homemade prepared food such as Christmas baking and shareable items in gift baskets this holiday season. We hope you can understand why this is necessary.

We are truly touched that grateful patients and/or their caregivers want to show their appreciation this holiday season. Perhaps the best way you can show our team your love is to give the gift of better local health care by supporting our Foundations that work tirelessly to raise money for our much-needed capital equipment and technology needs.

Both of our Foundations have specific giving programs that allow you to honour a hospital hero by making a tribute gift in their honour. We encourage you to consider gratitude in the form of a donation to your hospital hero:

Huntsville Hospital Foundation “Hospital Heroes” giving program:  https://huntsvillehospitalfoundation.ca/heroes/

South Muskoka Hospital Foundation “Health Care Heroes” giving program: www.healthmuskoka.ca/givetoday

This holiday season, the MAHC organization has also ensured gratitude is shown to our staff and physicians for their dedication and hard work amidst the COVID-19 pandemic. In lieu of being able to hold a Christmas Dinner & Dance, the Team Building Committee, with the additional support of the Joint Credentialed Staff Association and the MAHC Christmas Party Committee, have organized the “12 Days of MAHC-Mas” events, including a $5 “downtown dollars” voucher for Huntsville or Bracebridge to support local business and encourage each team member to stay local, shop local.

On behalf of the MAHC team, I also want to offer my deepest appreciation to our communities for your unwavering support in 2020. Season’s greetings from my family to yours and best wishes for a safe holiday season and a prosperous and healthy New Year.