Currently, admission rates from HSN’s emergency department are the third highest in the province, according to the final report from Murray Martin, president and CEO of Hamilton Health Sciences, who was charged with leading the peer review of the hospital.
HSN's ongoing high rates of alternate level of care (ALC) patients, challenges in moving patients from the emergency room through to discharge, and the overall impact of hospital operations on the community, were among the concerns prompting the North East LHIN’s decision to call a review process.
The final report, presented to the NE LHIN Oct. 2, contains 55 recommendations, many of which are focused on the ALC issue. The report notes that only 30 per cent of the existing bed pressures at HSN are related to ALC and that solutions can be found by HSN taking a leadership role in working with community partners to help address the challenge.
The report also notes that 70 per cent of the ALC pressures are internal and must be managed by HSN.
Report recommendations also focus on the need for HSN governance and management to ensure stronger accountability for the hospital's performance.
“As recommended, HSN must align themselves with the priorities of the NE LHIN and develop a plan with clear goals and measures for success,” said North East LHIN board chair Elaine Pitcher in a news release. “HSN's board of directors must measure the hospital’s performance on an ongoing basis.”
Pitcher was chair of the Sault Area Hospital Board when it underwent a peer review in 2011.
“I have witnessed first-hand, the value of a review,” Pitcher said. “HSN must act on the peer reviewer’s recommendations and the NE LHIN board of directors will support them in their efforts.”
Every year, the NE LHIN provides close to $300 million to HSN to operate 454 beds (429 at the Ramsey site and 25 at the Kirkwood Site). HSN ended 2012 with a deficit of $3.3 million and is currently operating under a NE LHIN-approved improvement plan. The report concluded that a balanced budget can be achieved with consistent execution and clear accountability structures in place.
“I hope this report will be beneficial to HSN in dealing with their challenges,” said Martin. “It is imperative that HSN move towards a more disciplined goal-oriented environment that aligns the organizational priorities and expectations with both the Ministry of Health and the NE LHIN.
“Seventy per cent of the wait times in the emergency department result from variables that are influenced and controlled by HSN. These are opportunities for HSN to effectively reduce the wait time for admitted patients being held in the Emergency Department.”
Read the HSN Peer Review Report at nelhin.on.ca.
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