Niagara and Peterborough hospitals struggle with “improvement” plans

The Niagara Health System and the Peterborough Regional Health Centre are frequently on the radar of the public, and presumably, the Minister of Health and Long Term Care.

While hundreds of kilometres apart, both have accumulated significant debt from years of running operational deficits and both are struggling with unrealistic hospital improvement plans (HIP).

This week both made the news.

Niagara’s HIP has come so far off the rails that the province took over the hospital last September when it appointed Kevin Smith as supervisor. That means legally the hospital is being directly operated by the Ministry of Health.

Public confidence wasn’t restored by Niagara’s HIP, a pie-in-the-sky venture that included closure of ERs in Port Colborne and Fort Erie. The HIP also included proposals to centralize many key services in a very costly privatized 375-bed hospital facility now under construction in a much criticized St. Catharines location. Unlike Peterborough, Niagara did receive additional funding to cope with its situation and still slipped deeper into the red. Smith’s appointment came at the end of a summer when more than 30 patients died as a result of complications from C-Difficile (three more cases were reported in December). Shortly after Smith’s arrival, the public was horrified about the hospital requiring a patient to call for an ambulance after she had fallen inside the hospital.

This week Smith showed signs that something was actually happening. NHS announced six senior members of the management team were departing, including the vice-president of patient services and the chief operating officer. Municipal councillor Frank Campion told the Welland Tribune that “the appointment of a supervisor led me to believe there would be changes in upper management.” While Campion calls it a step in the right direction, he says the NHS still needs to listen to concerns raised by the city.

Smith was quick to note the six individuals were departing as a result of restructuring, not because of their individual performance. He said the Chief Operating Officer would not be replaced — duties would be redistributed.

Over in Peterborough questions have been mounting about the impact of 219 HIP-related job cuts at the hospital. For months the hospital has missed its overtime targets by a wide margin. Now an independent assessment committee review of Peterborough’s hemodialysis unit has concluded that it is understaffed, making a series of recommendations for change.

Oddly, the hospital says the situation in the unit hasn’t negatively impacted patient care.

How can a continually short-staff hemodialysis unit not impact patient care?

The Peterborough Examiner reports that the Ontario Nurses Association “sparked the Independent Assessment Committee review through a request under the collective bargaining agreement between the hospital and the union.”

The results of the review would suggest that other services of the hospital may be due for similar scrutiny in the wake of so many job cuts. While other collective agreements at the hospital may not contain the same opportunity to trigger a review, the hospital owes it to the community to do a more thorough analysis of the impact of staff cuts on services at PRHC.

As a footnote to this story, OPSEU took note that the reporting measures Peterborough is using to track its performance on absenteeism and overtime have changed. The hospital says it did so to better align itself with the Ministry’s performance measures. However, changing midstream does make it difficult to compare quarters after a summer where staff were being denied vacation and overtime was said to be sharply on the rise. None-the-less, while the change in measure may be modest, there appears to be significant alteration to the targets set for these performance categories. One way to successfully meet your target is to change it to better reflect your current reality.

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