By Lyonel Doherty
Oliver Town council gave Interior Health the third degree on local health care recently.
Health service administrators Carl Meadows and Susan Brown attended the May 28 council meeting to talk about South Okanagan General Hospital (SOGH).
Meadows began by saying that acute care centres and hospitals are like canaries in a coal mine when it comes to telling stories about access.
He said SOGH has 18 publicly funded beds and noted there is “no vision to change that.”
The administrator pointed out that staff and physicians provide excellent care to their patients.
Meadows then listed a number of improvements that the hospital has made or is undergoing. These include renovations to its emergency/triage and reception area, increased security and the formation of a new patient advisory committee. He also stated that SOGH is the first hospital in North America to integrate Pharmanet/Meditech in the emergency department.
“Physicians are not dealing with paper anymore,” he explained.
Meadows also mentioned the hospital’s tele-mental health system where video conferencing is used to link clients with health professionals.
Meadows said Interior Health (IH) is continuing to invest in SOGH with new equipment such as: two new ceiling lifts planned for 2018/19; a chest compressor (donated by the local health care auxiliary); a new touch screen computer for the emergency department; a bariatric commode/shower chair (donated by auxiliary); two IV pumps and one vital sign machine; cardiac arrest simulation equipment for training purposes; and bulk oxygen upgrade.
Meadows presented some statistics on emergency room volumes at SOGH. In 2017/18, there were 16,717 unscheduled visits, compared to 17,336 in 2016/17. Emergent care visits in 2017/18 totaled 978, compared to 807 last year. Urgent care visits totaled 4,331 in 2017/18, compared to 3,956 in 2016/17. And non-urgent care visits – 11,104 compared to 12,207. This has prompted the suggestion that Oliver may need a walk-in clinic to deal with these non-urgent issues.
Meadows said hospitals are discharging patients much faster than before.
Brown backed this up by saying home is the best place to recover from illness and injury when patients are not acutely ill.
“We want people to leave the hospital as soon as reasonably possible,” Brown said.
She noted evidence shows that leaving the hospital as soon as possible and recuperating at home (with support services) is better than waiting in the hospital to fully regain strength.
Brown said the biggest challenge they have to deal with is retiring physicians and recruiting new ones (and keeping them).
Brown stressed that IH really needs the assistance of municipalities when it comes to finding accommodation for locums and new recruits.
During question period, Mayor Ron Hovanes raised a concern about staffing changes and workload and how that impacts patient care. This was followed up by Councillor Petra Veintimilla voicing her concern about the removal of extra beds.
Meadows said the Oliver hospital has three extra beds that can be accessed when needed (when more than 18 beds are required).
Veintimilla also enquired about the proposed alternate payment plan for doctors at SOGH. (This involves paying physicians fair compensation for emergency room coverage.)
Meadows said the provincial government has responded to this, but referred council to talk to Chief of Staff Dr. Brad Raison at Penticton Regional Hospital (PRH).
Meadows said there is still some negotiation regarding clarity of the payment plan.
Dr. Nick Balfour, executive medical director of IH Central, told the Oliver Chronicle that the Ministry of Health has not approved a change to the compensation model under the Alternate Payment Plan service contract. “The current fee-for-service model is consistent with similar sized hospitals in rural settings across the province, so we are working to address challenges in Oliver and determining if there are solutions within the current compensation framework, as well as other options within the community.”
Balfour said IH is committed to working with physicians to seek a long-term solution for sustainable physician staffing of the emergency department at SOGH.
He pointed out there have been positive recruitment efforts to the South Okanagan which has resulted in added physician support for the hospital’s emergency department. He said there are 21 active physicians on the medical staff list at SOGH, 16 of which have emergency department privileges, up from 12 physicians in early 2017.
Veintimilla said she heard a rumour that SOGH may be losing physicians to Penticton’s hospital.
Meadows said this is not true, clarifying that two physicians have applied for privileges to work at PRH. This doesn’t mean they will work their permanently, he pointed out.
Councillor Maureen Doerr said there’s a feeling that local health facilities are understaffed and have no casuals.
“It’s hard for nurses and doctors to work in these conditions,” she said.
Brown replied they are looking at ways to be more creative in how they utilize staff. She noted the model of using casual nurses is changing, noting that many nurses are choosing not to work casual.
Meadows said younger health care workers are not sitting by their phones anymore waiting for calls of employment.
Doerr raised another concern about care aids not being replaced come September.
Meadows confirmed this is true.
“How is that helping the problem?” Doerr replied.
Meadows said they have dealt with the issue of nurse/patient ratios by reducing it from one to nine to one to six.
“This ratio has been fixed at the expense of care aides,” he stated.
Doerr suggested using more nurse practitioners to address the lack of doctors.
Brown said that’s part of the plan which was recently announced.
“We want to put in more nurse practitioners but we have to choose where.”
Meadows admitted that they haven’t been in a stable staffing position for a long time.
Veintimilla said she is looking forward to seeing the emergency room renovations.
Meadows said he will have more positive updates to report in a year’s time.