Flagship – “The long-term care gap is even wider!” – Alana Bishop

THUNDER BAY – I am here tonight to plant a seed…hoping to open your minds to a new approach for delivering Health Care in Thunder Bay. I will be presenting a concept that I believe could change the face of our health care strategy for Northwestern Ontario.

We are presently faced with two very critical issues…the rapidly growing alcohol and addiction plight, and the debilitating Code Gridlock at Thunder Bay Regional Hospital.

Let me remind you…the “integration” of health services does not suggest that all aspects of Health Care have to be “under the same roof” or in a hospital setting.

By re-aligning our care mandate, we could:

(1) Establish a Flagship Facility for Northwestern Ontario, specializing in Mental Health and Addiction Issues…and in turn;

(2) Free up 52 bed spaces at the Thunder Bay Regional Hospital, helping decrease the need for Code Gridlock!

I visualize a facility incorporating all aspects of Mental Health and Addictions that would not only streamline care but provide a continuum for communication and healing! This “under one roof” concept… moving away from the hospital setting is not going backwards. Let me share with you the following example.

In Toronto, 1001 Queen Street West was home to a mental health facility for over 150 years…commonly known as 999 Queen. The original buildings were demolished in 1975.

CAMH (Centre for Addiction & Mental Health) was created in 1997 from a merger of three facilities…the former Addiction Research Foundation, the Clarke Institute and the Queen Street Mental Health Center. The CAMH was asked to address four key challenges: quality of care, access to care, fragmentation of services and stigma.

They have embarked on a redevelopment project on the original site.

They are striving to provide a healthy environment that promotes patient recovery. They want to bring together in one location, inpatient services, outpatient services, along with education and health promotion… to change the future of mental illness and addiction. They will continue to break down barriers to eliminate stigma! This project will integrate a variety of programs…in support of the patient.

They want to Transform Lives. Northwestern Ontario too can Transform Lives!

Points for consideration:

1. Thunder Bay Regional Hospital in 1995 was created on paper…with the amalgamation of McKellar General Hospital and Port Arthur General Hospital. Before 1995, these two facilities functioned with approximately 500 beds. From its inception, public interpretation has eluded to the Regional’s dilemma of being, “a hospital undersized for its current mandate”.

2. The new Regional Hospital has 375 funded beds…32 assigned for Adult Mental Health, and 20 for Forensic Mental Health. Having a Forensic Mental Health Unit within a general hospital setting is “NOT” the norm in Canada!

3. The Thunder Bay Regional Hospital emergency department sees more than 5,100 visits annually, by substance abusers or those with mental illness. This is an increase of 25% over 6 years. The increase in drug and alcohol addictions has been followed by an increase in crime statistics in Thunder Bay.

4. The Balmoral Centre, mandated for substance withdrawal, has 7 crisis beds and 15 after-care spaces. They treat about 1400 cases per year, but have had to turn away over 1000 patients. These people end up in the hospital emergency department or in Police Station Detention.

5. Since 2008, Code Gridlock has become more frequent and of a longer duration. Patients are often cared for in hospital hallways and alcoves.

6. The Closson Report of 2005 was mandated to find solutions for the problems at Thunder Bay Regional Hospital. It was proposed that enhancements to services outside of the Thunder Bay area would improve the Regional Hospital’s problems. There have been negligible improvements in health care services for Thunder Bay and district.

The long-term care gap is even wider!

Alana Bishop

Councillor, Municipality of Shuniah

December 1, 2010.

To:

Hon. Deb Matthews,

Minister of Health & Long-Term Care,

80 Grosvenor St. 10th Flr. Hepburn Block,

Toronto, Ontario, M7A 2C4.

From:

Alana Bishop,

Councillor Municipality of Shuniah,

RR#1, Pass Lake,

Ontario, P0T2M0

Re: Health Care (Code Gridlock) Northwestern Ontario.

I am writing this letter to present some alternative care concepts, in order to recover our health care dilemma in Thunder Bay. My initial concerns were sent out to the previous Minister of Health in 2008. I received a general reply that vaguely addressed only the long-term bed problem. The problem is much more complex and needs some “Out-of-the-box” thinking.

Presently I am wearing three hats…one of a municipal councillor, one of a registered nurse, and one of a tax-paying citizen, who at any time could need emergency care.

So, you can appreciate my interest is a valid one.

Thunder Bay Regional Health Sciences Centre services a vast area in Northwestern Ontario. Code Gridlock is a frequently occurring scenario at this facility.

Code Gridlock denotes that the emergency unit is full and the hospital has no beds available for admission. When this situation is announced, physicians must make rounds to discharge patients…the best of the worst you might say!

We have just come out of a Gridlock that lasted approximately 2 months.

After studying this problem, I realize our predicament is three-fold.

1. Shortage of Long-Term Facilities for our ever-growing aging population.

2. A facility already too small for the immense area that it services.

3. A huge increase in mental health, alcohol and drug addiction problems that greatly contributes to the overcrowding in the emergency department.

As mentioned in my previous letter, Thunder Bay has become one of the newly-ranked most dangerous cities in Canada! According to police officials here, this problem can be directly traced to high levels of alcohol and drug abuse.

This addiction issue, coupled with a mounting mental health patient number, presents an extremely negative influence in the emergency unit.

I am by no means minimizing the problem of the long-term care bed shortage.

However, the integration of mental health, alcohol and drug addiction into the main hospital facility presents an equally relevant crisis.

These admissions:

(a) Are often chaotic and unruly, causing “mayhem” in the emergency unit

(b) Tie up security personnel for hours at a time

(c) Present distressing conditions for other patients and their families

(d) Cause “burnout” and frustration for staff…both nurse and physician

(e) Occupy bed space that could be used for medical and surgical emergencies.

Segregation of these services is the answer.

1. These emergencies would be initially assessed in the field by paramedics and transferred to a separate appropriate facility.

2. This facility would have an emergency unit with on-site security 24/7.

3. This site would have basic laboratory and x-ray capabilities.

4. This site would be electronically linked with the main hospital for consultation.

5. The staff would be qualified personnel trained specifically in mental health conditions and drug and alcohol addiction and intervention.

6. This facility would have short-term assessment areas and long-term treatment areas for these problems. Ideally, all forensic and mental health beds currently in the main facility should be transferred to the new site. It is sensible to have all of these services under one roof. This would open 52 bed spaces at the Regional!

Does this seem impossible? It is not!

(A) Location: We have many empty buildings in our city, but the one that I feel most appropriate is the Lakehead Psychiatric Hospital. This is a multi-winged complex, which presently has a variety of users. Yes, it is an older facility, but often those older facilities were built better than our newer ones. What a crime to demolish this site when it could be put to such good use. Some in-house renovation would be needed, however this building would be easy to adapt, since its original mandate was health care and bed spaces.

(B) Staffing: Dangle the “carrot” and they will come! Make employment attractive to those specializing in these fields. For those professionals, both physicians and nurses, who have studied to deal with these medical disciplines… crisis situations are much less stressful…a better fit for all. Offer a sign-on bonus, “Money Talks!”

(C) Funding & Promotion: The province must recognize the fact that our situation is “different”. We are “one” primary care institution taking care of an immense geographical area with ever-growing addiction and mental health issues!

Endorse Thunder Bay Regional Hospital as a Pilot Project for Segregation of Services. (5-year trial)

Code Gridlock is happening all too often. It jeopardizes the care and treatment of the patient, and is frustrating both professionally and personally for staff. Northwestern Ontario has a health care problem…that is in need of a solution. We must consider all of the details of crisis and apply resolution that brings a positive effect for everyone…the patient and the health care professional.

This Pilot Project would streamline our health care system in Northwestern Ontario, and create a more healing atmosphere for all.

Sincerely,

Alana Bishop (Councillor Municipality of Shuniah, RN, Regional Hospital) bishopmctavish@hotmail.com

Cc.

Andree Robichaud, President & CEO, Thunder Bay Regional Hospital

George Derbyshire, Chief of Staff, Thunder Bay Regional Hospital

Dr. Dave Wood, Director of Emergency Services, Thunder Bay Regional Hospital

Janet Sillman, VP, Mental Health & Addiction Services

Tracey Buckler, CEO St. Joseph’s Care Group

Norm Gale, Chief of Emergency Services, (EMS, Superior North)

Mayor Keith Hobbs, Thunder Bay

Dalton McGuinty, MPP, Premier Liberal Party of Ontario

Hon. Michael Gravelle, MPP, Minister of Northern Development, Mines & Forestry

Bruce Hyer, MP Thunder Bay Superior North

Bill Mauro, MP Thunder Bay/Atikokan

John Rafferty, MP Thunder Bay/Rainy River

Laura Kokocinski, CEO LHINS (Local Health Integrated Network)

(Copies forwarded to Northwestern Ontario Municipal Reeves and Mayors)