Niagara Health System Niagara on the Lake Site Hamilton Niagara - - PowerPoint PPT Presentation

Niagara Health System Niagara on the Lake Site

Hamilton Niagara Haldimand Brant (HNHB) Local Health Integration Network (LHIN) Quality and Safety Committee December 3, 2014

Niagara Health System (NHS) – Niagara on the Lake Site (NOTL)

• The Niagara Health System (NHS) is

a multi-site hospital comprised of six sites:

• Three larger sites that provide a

range of acute care services including emergency department (ED) and intensive care (ICU) services

• Three smaller sites that provide

complex care, short stay acute care beds and urgent care services

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NHS Larger Sites

• St. Catharines
• Greater Niagara

General Hospital

• The Welland Hospital

NHS Smaller Sites

• Niagara on the Lake
• Douglas Memorial

Hospital

• Port Colborne

NHS’ Request to Reclassify the NOTL Site

• NHS is requesting the LHIN approve a number of service changes at the Niagara-on-the-

Lake (NOTL) site. These changes include:

• Conversion of 18 complex care beds to six acute care beds
• Transfer of 10 acute care beds from NOTL site to be distributed across the three

larger NHS sites (Welland Hospital, St. Catharines and Greater Niagara General)

• Reassignment of the NOTL site under the Public Hospitals Act (PHA) from a Group C

(general hospital with less than 100 beds) to a Group V (hospital that operates ambulatory care) hospital

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NOTL Current Services

NHS Operated Services

• 22 inpatient beds comprised of 18

complex care beds and four acute care beds

• Walk-in clinic staffed by a Nurse

Practitioner (operates Mon-Fri 9:30AM to 12PM, 2PM – 4:30PM).

• X-ray and Ultrasound
• Physiotherapy for both inpatients and
• utpatients

Non NHS Operated Services

• NOTL Family Health Team – separately

governed and operated

• Outpatient laboratory operated by Life labs
• Internal Medicine physician who leases office

space

• Outpatient audiology service operated by

Hotel Dieu Shaver Health and Rehabilitation Centre (once a month)

• Massage therapy and NOTL Community

Palliative Care (at the Byron street property).

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LHIN Role in the Approval Process

Reclassification of Beds

LHINs have the authority to reclassify hospital beds (i.e. from complex care to acute). The LHIN’s decision is expected to consider:

• rationale for the change, including an

articulation that the reclassified beds will not be needed in the immediate future,

• cost benefit analysis,
• service availability
• labour relations and the
• impact of the classification of the hospital

under the Public Hospitals Act (PHA) Reg. 964.

Assign/Reassign Hospital Group

Ministry of Health and Long-Term Care (ministry) approval is required to assign or reassign a hospital to a Group under the PHA and Reg. 964. The LHIN’s role in this process is:

• provide a written recommendation detailing its

rationale for supporting or not supporting the hospital’s request.

• The LHIN’s assessment is to consider the impact

the removal will have on local programs or services provided by the hospital and whether the removal is consistent with the strategic objectives

• f the LHIN and local health system.

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LHIN Analysis

• The methodology used by the LHIN to evaluate NHS’ request to reclassify and

relocate inpatient beds and reassign the NOTL to an ambulatory care site incorporated:

• relevant policies and guidelines
• population projections and demographic profile of NOTL residents
• health care services available at the NOTL site and population served
• NHS’ rationale for reclassification and relocation of beds
• NHS’ plan to meet the needs of the clients served at the NOTL site
• financial review
• NHS’ communication and community engagement plan.

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Population Served by NOTL Site

• 50% of patients discharged from NOTL inpatient beds are residents of NOTL.
• In 2013-14, there were 135 reported discharges from the NOTL site complex care

program, of these 65 discharges (48.1%) were residents of NOTL. Of note, 59 or 43.7% were residents of St. Catharines.

• NHS’ review of the NOTL site population for period March 2013 to July 2014 revealed

that:

• 51% of admissions were residents of NOTL
• Of 133 patients receiving care in complex care beds at the NOTL site the

majority (100) were admitted for restorative care, 10% were admitted for end of life care

Source: intellihealth Ontario, CCRS & NHS

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NOTL Current and Future Services

Current:

• 22 inpatient beds comprised of 18 complex

care beds and four acute care beds

• Walk-in clinic staffed by a Nurse Practitioner
• X-ray and Ultrasound
• Physiotherapy for both inpatients and
• utpatients
• NOTL Family Health Team
• Outpatient laboratory operated by Life labs
• Internal Medicine physician who leases office

space

• Outpatient audiology service operated by

Hotel Dieu Shaver Health and Rehabilitation Centre (once a month)

• Massage therapy
• NOTL Community Palliative Care (at the

Byron street property).

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Future:

• Walk-in clinic staffed by a Nurse Practitioner
• X-ray and Ultrasound
• Physiotherapy for both inpatients and
• utpatients
• NOTL Family Health Team
• Outpatient laboratory operated by Life labs
• Internal Medicine physician who leases office

space

• Outpatient audiology service operated by

Hotel Dieu Shaver Health and Rehabilitation Centre (once a month)

• Massage therapy
• NOTL Community Palliative Care (at the

Byron street property).

NHS’ Proposed Plan to Accommodate NOTL Inpatient Beds

NHS’ plan to accommodate inpatient volumes transferred from the NOTL site was developed to consider:

• Patient Resident Perspective
• Access and Patient Flow
• Health Human Resources
• Financial Impact

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Summary of Staff Analysis

• NHS’ business case to relocate the beds from the NOTL site to other sites aligns with:
• NHS’s Hospital Improvement Plan; Dr. Kitts’ (Supervisor) report and Independent Operational

Budget Review

• Will result in operational savings that is consistent with the conditions associated with the additional

funding provided in 2013-14.

• NHS has identified a plan that
• prioritizes, where possible, ensuring patients who are residents of NOTL will receive palliative care

and restorative care as close to home as possible

• accommodates the NOTL patient volumes/beds at existing sites while maintaining patient flow
• increases acute care capacity across the NHS
• ptimizes local health system capacity e.g. Linhaven Home for the Aged Convalescent Care

Program, Hotel Dieu Shaver Health and Rehabilitation Centre and the community (Community Care Access Centre (CCAC) - Home First)

• maintains ambulatory services at the NOTL site until an appropriate transition plan has been

developed in consultation with community stakeholders.

• commits to work with the NOTL community to develop a Community Health Centre (CHC) for the

long term provision of community-based ambulatory services.

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NHS Community Engagement

• NHS detailed a comprehensive community engagement plan including the following:
• Collaborating with the NOTL Health Services Steering Committee (HSSC) on messaging and

community engagement sessions. A series of six ‘Community Dialogue Sessions’ have taken place with140 attendees.

• Community Dialogue Series were facilitated by an independent facilitator
• Stakeholder debriefing of elected officials
• Debriefing with providers currently occupying the NOTL site
• Physician engagement
• Patient and family interviews
• The NOTL HSSC has established four working groups as follows:
• Site Selection Working Group
• Collaborative Services Working Group
• Corporate Start-up Working Group
• Communications Working Group

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