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GBGH Board wraps up year-long review

GBGH Board wraps up year-long review

GBGH Board wraps up year-long review

After nearly one year of scrutiny, the Board of Directors of Georgian Bay General Hospital (GBGH) has arrived at final decisions for the 14 contentious clinical recommendations made by a third-party review in 2015.

The Board has decided not to implement those 14 recommendations, made by private consulting firm Geyer and Associates, which would have reduced or eliminated a variety of hospital services. Instead, with the approval of the North Simcoe Muskoka Local Health Integration Network (NSM LHIN), the Board has used those recommendations to craft a made-in-GBGH plan designed to improve hospital services and find new efficiencies.

“The analyses and consultation period that began last December has required a lot of hard work by a lot of people,” said Board Chair Ralph Befort. “What began as a request for a third-party review of our hospital operations due to our ongoing deficit issues consumed hundreds of hours caused angst in our community and put the Board at odds with our physicians and community.

“We had to perform our fiduciary duties as Board members and spend this time doing our homework; we needed to take a good look at the review produced by Geyer and Associates, we needed to listen to community, our staff and physicians. We, the Board, are made up of community members but we needed to wear our Board hats as we navigated through this process. We believe that through all of this we now have a plan that not only allows us to retain obstetrics, maintain our ICU and trial some home-made changes in our surgical program, but also doesn’t lose sight of the fact we need to ensure a place for our hospital within our community into the future.”

Last December, a third-party operational review conducted by Geyer and Associates containing a total of 108 recommendations was tabled. Fourteen of those recommendations had direct clinical implications. The other 94 were more tactical in nature, dealing with matters such as appropriate behaviour and education opportunities for frontline staff and management, and have been dealt with in a work plan made available to the public through the hospital’s website.

The review, in collaboration with the NSM LHIN, focused on key areas such as governance, medical staff, clinical services and the role of the hospital within the LHIN.

Just after the Geyer Report was tabled, meetings were held internally with staff and physicians as well as the hospital’s foundation board, volunteers, community advisory committee and the local mayors. From there, seven public meetings were held in January and February in Midland, Penetanguishene, Tiny Township, Tay Township, Elmvale, Port Severn and Christian Island.

Those meetings, Befort and hospital CEO Karen McGrath agree, illustrated the passion for preserving hospital services within the public, and were instrumental in helping to form the road map for the journey the Board would take in the coming months.

First, though, the Board had to convince the NSM LHIN that taking the report’s 14 clinical recommendations off the table was the correct way forward. Most of those recommendations had to do with OB, Surgery and ICU, and the Board felt further study was needed before any final decisions were made.  The LHIN agreed.

The journey began with the creation of three task groups made up of staff, physicians and community members to review the recommendations for OB, ICU and Surgery. Those reports were brought to the Board in May and then turned over to three internal committees to elaborate upon and see how they could work at GBGH. The committees had their recommendations ready for a fall, 2016 presentation as requested at the outset of the process. Those committees were led by independent advisor Dr. Keith Rose (brought on board in April through collaboration with the Ministry of Health and Long-Term Care, the NSM LHIN and the GBGH Board), Chief of Staff Dr. Martin Veall and Chief Nursing Executive Liliana Canadic.

What those three groups came back with are made-at-GBGH plans the Board feels confident will carry the hospital forward.

After direction from the Board to retain OB within our community, the committee came back with a plan for OB which includes low-risk births continuing to be delivered at GBGH and strengthening the current partnership with the Orillia Soldiers’ Memorial Hospital (OSMH) OB program. The specifics of the partnership agreement need to be worked out over the coming months but Ms. McGrath noted it may allow for some shared education opportunities for GBGH OB nursing staff to join with OSMH staff, a shared leadership model and more formal collaboration of a long-standing arrangement with OSMH.

“The Board agreed that we wanted to look at options that provide a quality OB program at our hospital,” said Mr. Befort. “We tasked Dr. Rose and his group to find a way to make it happen.”

The surgical group, led by Liliana Canadic, has been given approval to pilot a four-day-a-week program based on current and historical use patterns that provides more efficient use of time. That plan included a great deal of input from the nursing staff and will result in about $140,000 savings annually. Further, the group determined that leaving ophthalmology and pregnancy termination in the OR was the most efficient route at this time; they will continue their work on developing clear procedures for after-hours surgery and continue to provide both elective and emergency surgery.

Dr. Martin Veall, Chief of Staff, led the ICU group, noting a bed will be added as they work toward incorporating three higher-acuity beds and four critical-care beds into that department. They will also be working through the NSM LHIN’s Critical Care Lead to develop partnerships with RVH and OSMH to expedite transfers. In the end, he said, the team’s vision is to have a unit with two defined levels of care. In ICU, the provincial body – Critical Care Ontario – was consulted and they deemed removing beds or changing the level designation as suggested by the Geyer Report was not feasible for the province at this point in time.

“We want to acknowledge and thank everyone for the hard work they put into getting this right for our hospital and our community. We also need to recognize the outpouring of support from our community. As community members ourselves, the Board is very aware of the importance of GBGH to our community from both a health and economic perspective. It was a ringing endorsement of the good work at our hospital when thousands of people stood up to support the future of our hospital,” Mr. Befort said.

“To say this was a tough year is an understatement, but we know we didn’t volunteer just to look after the easy stuff. I feel compelled to recognize my fellow board members for their efforts throughout this year. We are community members as well, and it has always been important to us to be respectful of the needs while we try to operate the hospital within our fiscal reality.”

The hospital, noted McGrath, started this fiscal year with a projected $2-million deficit after ending last year with a slight surplus. That deficit projection has now been lowered and the financial picture is on track to be better than earlier anticipated.

“We have, over the last several years, undertaken many initiatives to save money and our efforts are bearing fruit. Our staff and management have worked on things like the cost of supplies, overtime and sick leave in an effort to cut down our costs. We have also been working with the NSM LHIN and the Ministry of Health and Long-Term Care as they review the funding models for medium-sized hospitals like GBGH, and we feel confident their recommendations will be in our favour going forward,” said McGrath. “We will continue those efforts and continue to be a high-performing hospital.”

 “At the end of the day, while we may not have moved forward with everything the Geyer report recommended, that was a catalyst for us to take a deeper look at everything we do. And if we aren’t taking those deep looks, we can’t be the continuously improving hospital we want GBGH to be for all of us,” said Befort.

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For more information, please contact:
Jackie McLauchlin-Welch
Director, Communications & Health Information
mclauchlinj@gbgh.on.ca
705-526-1300 ext. 5016

 

 

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