Hospital presentation to Council

This article is the continuation of a news release issued today by Sault Area Hospital.

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************************** SAH presentation to Sault Ste. Marie City Council - financial

The forecasted operating deficit for fiscal 2008/09 is $10.8 million, contributing to an overall annual deficit of $12.6 million. In addition, SAH has a long-term debt of approximately $15 million and an operating line of credit of $32 million.

This is after taking into account approximately $7 million in savings over two years identified in a hospital improvement plan which was approved by the SAH board in May 2008.

SAH is required by law to present a balanced budget by the end of the 2009/10 fiscal year (March 31, 2010).

Ongoing deficits will not be acceptable to our funder, the NE LHIN, which acts on behalf of the Ministry of Health and Long-Term Care (MOHLTC).

In depth analysis (IDA)/ hospital recovery plan

The IDA is a comprehensive review of all aspects of the hospital (governance, management, services, operations, efficiency) which was undertaken proactively by SAH in concert with the LHIN, which must approve the final plan.

This review included, but was not limited to:

- interviews

- management surveys

- focus groups with SAH staff and physicians

- satellite visits including interviews with key stakeholders

- in-depth financial review, human resources function review and medical staff review

- review of data analysis, financial analysis and benchmarking

- review of clinical services provided

The goal is to identify and implement “local solutions to a local problem” or risk having those solutions imposed upon us by an appointed supervisor.

Contrary to the belief of some, a supervisor would not simply arrive with additional funding to 'fix' the problem.

By undertaking the IDA proactively and voluntarily, SAH has sent a strong message to the LHIN and the MOHLTC that we are serious in our efforts to address our problems and willing to do what is necessary to achieve financial health while protecting patient services.

The LHIN has acknowledged this and fully supports our efforts.

The IDA was conducted by Geyer & Associates, a highly-respected and experienced firm which has been involved in similar third-party operational reviews for other hospitals, health care providers and/or networks, the MOHLTC and other provinces throughout Canada.

The process was overseen by a steering committee comprised of representatives from SAH management, physicians and staff, the board and the NE LHIN.

The consultants’ recommendations were presented to the SAH board on January 21, 2009, at which time SAH management was instructed to proceed immediately with its due diligence in the form of an impact analysis of all proposed recommendations.

The impact analysis will examine each recommendation and its ramifications in detail, from an operational, human resources and services point of view.

This will be used in developing a hospital recovery plan which will be presented to the board for its review and approval prior to going to the NE LHIN.

The final approved plan, expected in the spring of 2009, will serve as the blueprint for the long-term sustainability and vitality of SAH, which is in the best interests of the hospital and those SAH serves.

While impossible to predict the details of the recovery plan, it is clear that the status quo will not be an option.

Changes are expected in both operations and culture/ philosophy within the organization.

Successes

Despite the ongoing financial challenges, SAH continues to realize a number of successes:

- Positive patient satisfaction scores have surpassed 94 percent.

- Hospital Standardized Mortality Ratio (HSMR) of 85 places SAH among best 25 percent of all Canadian hospitals. HSMR is an internationally-recognized measure of hospital quality and safety.

- Hospital-associated infection rates down 22 percent versus year ago. SAH infection control practices and processes are now hailed as models for others.

- At 3.5 hours, emergency room average throughput (wait) times of 3.5 hours are nearly 25 percent shorter than provincial cohorts. This is total time from arrival to discharge or admission.

- Average wait times of 15 days for CT scans ranks in top 10 in Ontario.

- MRI wait times of 28 days are number two in entire province.

New hospital

The new SAH will be 20 percent larger than the combined Plummer and General sites with the same 289-bed complement.

Some of the other features include:

- emergency department double the size of current facility 31 percent increase in clinical space

- three beautiful courtyards for patients and visitors

- temperature controlled environment with modern heating and cooling systems

- infant abduction security system and other enhanced patient monitoring systems

- automated medication dispensing systems

- enhanced, state-of-the-art nurse call system

- dedicated hand wash sinks in all patient rooms, clinical areas and outpatient areas such as dialysis and medical daycare

- negative pressure rooms throughout hospital for better infectious disease management

- dedicated clean and dirty service elevators connecting SPD (sterile processing & distribution) to operation rooms

- ambient experience MRI

- large bore 16-slice CT scan (one of two CTs)

- articulated arms in operating room - no cords on the floor

- wireless networks and infrastructure

- patient bedside terminals in all patient rooms

- first large community hospital in Ontario to offer 50 percent private rooms

- radiation therapy services for some forms of cancer, reducing the need for many patients to travel to other centres for treatment

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