The following are brief reports from the Haliburton Highlands Health Services board meeting held virtually on May 26.
By Sue Tiffin
The Minden and Haliburton hospital emergency departments will remain open this summer despite the ongoing threat of temporary closure during continued staffing shortage challenges.
Carolyn Plummer, HHHS president and CAO, said the organization continues to struggle to find sufficient staffing of both nurses and physicians, with a 40 per cent shortage in coverage for all emergency department and hospital nursing shifts, and a 25 per cent shortage for emergency department physician shifts. The organization is filling nursing shifts with non-local agency staff, and physician shifts through an emergency department locum program.
“With that in mind we need to continue to plan for what will happen in the event that we aren’t able to fill those positions,” she told the board. “For now, we have decided that we will continue with both emergs remaining open throughout the summer months, continuing to use nursing agency staff to support that. We recognize with the increased volume this community sees over the summer – that we see every summer in both of our emergs – that there’s merit to keeping both open, that it’s critical in fact for us to do that, without any alternatives in place to help manage that extra volume.”
Plummer said there are still plans in place should there be last-minute shift changes or an inability to fill a shift.
Last month, Plummer responded to community concerns including a rumoured permanent closure of the Minden hospital emergency department, noting that no decision has yet been made about which emergency department might close or reduce services as a result of the ongoing staffing shortages, nor has a date been set for said closure.
“We’re continuing to explore all avenues and try different strategies to attract staff to the organization, to the community,” she said.
She said HHHS has been accessing provincial programs to fund recruitment of internationally-educated nurses and nursing students; engaging in virtual career fairs to attract nursing students; meeting with local municipal leaders; hiring a dedicated recruiter and focusing on retention.
A community survey to gather ideas about incentives and programs to encourage nurses, registered practical nurses, personal support workers and physicians to join HHHS was open until May 31.
Plummer said additionally the organization is looking at formal master planning, looking at a short-term plan for the fall and winter months, as well as a longer term plan for a sustainable healthcare model in the community.
HHHS ends year with surplus
David O’Brien, vice-chair of the board and chair of the finance committee said he had a different message to bring to the board after previously reporting challenging years with a deficit.
“The good news coming out of the review of our draft audit is that we actually are going to end the year, March 31, 2022, with a $71,000 surplus, so that is a very positive thing,” he said. “Now, it would be remiss of me if I did not continue on a little bit and say that doesn’t mean we are out of the woods completely, because there are still many years ahead of us to go where we are depending on provincial funding, and no doubt I will appear at some point in the future and say we have some financial issues again, so I continue to plead with the province to keep up with the funding that they promised us – don’t let six months go by before you fund us, give it to us right away.”
Plummer appreciated the good news, also noting there are “certainly a lot of pressures already,” for HHHS to consider in the current fiscal year.
Advocacy in an election year
Plummer acknowledged the advocacy by healthcare groups occurring during the provincial election campaign, with issues facing healthcare taking centre stage prior to the June 2 election day.
“The Ontario Long Term Care Association is calling on parties to implement new legislation that puts residents at the centre of care, enables high quality of life and care, and provides new frameworks for accountability,” said Plummer’s report. “They are also asking for action to stabilize the sector, by providing resources to respond to the pandemic, ensure stable planning and funding supports, and increasing staffing and supporting morale. Finally, they want to see a transformed sector that builds for tomorrow by enabling high-performance quality improvements, integrating long-term care into the seniors’ care ecosystem, responding to the health human resource crisis, accelerating home re-development, and fostering a just culture.”
The Ontario Hospital Association, she said, is calling on parties to address hallway health care.
“[They] note that the need to do this has never been greater,” she said. “They call for action and funding to ensure that hospitals and the wider health care system are supported with financial resources to meet the needs of Ontario’s rapidly growing and aging population, that the province has enough health care professionals and workers to provide care, that the government builds off the momentum of recent investments with long-term health services capacity planning, and that there is renewed support for research and innovation.”
Meanwhile, reads Plummer’s report, the Ontario Community Support Association is calling on parties to ‘commit to care’ with three actions to bolster resilience in Ontario’s home and community care sector, and guarantee Ontarians the ability to obtain services where they want.
“They call for increasing the volume of home and community care services, investing in the infrastructure of home and community care organizations, and implementing wage parity for home and community care staff and develop a system wide health human resource plan,” she said.
HHHS supports and appreciates the advocacy of those organizations, said Plummer, and will also be focusing on advocating.
“For better funding for small hospitals, more support for long-term care and community programs, support to address health human resources, and support for housing development and housing affordability, as this has a direct impact on the health of our community as well as our ability to recruit and retain healthcare workers,” said Plummer.
Ethics resources soon available to HHHS
Plummer said HHHS will engage in a one-year contract with Ontario Shores Centre for Mental Health Sciences for support through their regional ethics program.
“This will help strengthen our ethics committee, build internal capacity, and provide support (including moral distress debriefing) for staff and physicians as they work through challenging situations,” said Plummer.
Checking in on the Epic system
Plummer said HHHS staff is “ironing out the bugs” occurring with the Epic program, a clinical information system that went live in December.
“The system is generally working quite well, and it’s a big change,” said Plummer. “Once we get through the initial first months and things are working as smoothly as they can be it’s going to give us an awful lot of opportunity for improvements in things like patient safety, etc.”
Plummer said staff are getting more comfortable with the new system, though there are still areas to find additional efficiencies for staff to work with the program and also minimize the amount of extra time patients may need to wait.
“Once we get there, I think there’s going to be a lot of positives,” said Plummer.
Previously, Plummer has said Epic will enable one medical record for patients in the system, and would also help with patient-safety issues and quality of care, with the system designed to help reduce errors in healthcare. Additionally, patients will be able to access their chart online from home.