Northern Life managing editor Vicki Gilhula and reporter Heidi Ulrichsen recently talked to Sudbury Regional Hospital CEO Vickie Kaminski and chief of staff Dr. Chris McKibbon. The subject was health care. The following is part one of that conversation which has been edited for length and continuity.
NL: People want to know SRH will be there when they need it, and they will be able to get a hospital bed or an MRI test (when they need it). What is the state of health care in Sudbury?
Kaminski: The hospital is built to serve a certain population. So they (provincial government) give us a number of beds on the basis of per thousand population, and they say this is how many beds you should have if you have this many people over this age.
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??If I were the government, I would want to know there isn?t a lot of waste in the system,? says CEO Vickie Kaminksi. |
That?s all good in theory. And when everything in theory works exactly the way it should, then we have the right sized hospital, we have the right access to health care.
When you don?t have enough of the kind of specialists somebody needs, or you don?t have enough nurses, or if at that moment in time the machine is broken and you haven?t got it repaired, people aren?t going to get what they want right away.
Sitting on a stretcher in emergency is uncomfortable, and they hate to see mom or dad or grandpa or little Johnny sit on that stretcher and wait, but they have to wait.
Those are some of the challenges we face.
As we go forward and build our new facility, one of the questions is, is it the right size? There?s been a lot of talk about it being too small. At 429 beds, again, it?s the right size as long as everything goes exactly the way it should.
NL: Has OR time been cut?
Kaminski: OR time is different now than it was before, but not because we?re saving money. We?re not altering OR time to save money. We have some challenges in the operating room. We?ve had some anesthetic shortages that have made it more difficult for us to do the same number of ORs and the same hours of care.
That?s been our biggest challenge. And we?ve seen numbers cut in numbers of operations...but it?s not been a money-saving endeavour. It?s not been at our instigation. We?ve tried to help the anesthetists with this issue. But it?s a recruitment issue.
The anesthetists are taking a study day Feb. 11, so we will have about 35 elective surgeries that day.
It will mean less OR time, but not because we?re trying to save money...We?ve re-booked them, but that time is lost.
NL: When SRH finally goes to one site, it will require less staff. Does this mean job losses?
Kaminksi: We?ve been looking at that for a couple of years. We know that efficiency in the service side takes place when you move to one site.
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?The public is demanding efficiencies,? says chief of staff Dr. Chris McKibbon. |
So, what we?ve done is look at the age of our workforce, planned retirements...we?ve taken all of that into account and said...if we?re going to reduce our workforce, can we do it through attrition, so we don?t actually lay people off?
And that?s why taking so long to get to one site has been a benefit. It?s given us a lot longer to do it. If we?d actually been on one site in the year 2000, we would be having a different conversation about that. We?ve had a lot more time to plan it.
We expect overall that yes, there will be a reduction in the number of people that have full-time jobs with SRH, but we shouldn?t be seeing layoffs associated with it.
NL: What do you think of the McGuinty government forcing hospitals to balance budgets by March, 2006?
Kaminksi: I think if I were the government, I would want to know that every dollar that was being spent needs to be spent, and that there isn?t a lot of waste in the system.
Really, the legislation made us pay attention to that far more than the premier or the minister of health would have.
If it compromises patient care, then I think it?s the wrong thing to do.
McKibbon: I cast this in terms of what the public expects, rather than a piece of legislation. The public is demanding efficiencies. Survey after survey has suggested the public wants to invest in health care. They want to have confidence the costs of health care are delivering real returns. I think the government?s accountability agenda is completely in line with what the public expects.
Now, they also want to be sure that services are provided. And I think at this point in time SRH is fully responsive to that public pressure.
NL: The hospital is bringing down its deficit by finding efficiencies. Where are these efficiencies coming from?
Kaminski: Some of it?s in how many days you stay in the hospital. We might have brought you in a day earlier and kept you a day later than we do now...It makes a difference in how many beds we need to do the same amount of work.
Some of it is in moving things out of the hospital that don?t need to be done there, or moving things out of the operating room that can be done in a cheaper environment. So if you were having a scope of some sort done, and it was done in the operating room, you might now have it done in the GI unit, which is a cheaper place for us to do that.
Some of it comes from looking at our food services...We?ve reduced cost there. We changed our cafeteria. We were operating our cafeteria at a loss, so we?ve reduced the hours, and made it a vending machine type place.
We didn?t cancel a service, we didn?t reduce the number of patients that we see.
In Friday?s issue, SRH CEO Vickie Kaminski and chief of staff Dr. Chris McKibbon talk about challenges of creating a one-site super hospital and completing phase two. Read Friday's article here>>
