Hospital Improvement Plan Implementation

Niagara Health System

• Developing the Plan
  • About HIP
    • Why a HIP?
    • Questions and Answers
    • Case for Change
    • Quality Care
    • Financial Pressures
    • Factors Driving Change
    • How Can We Change?
    • NHS at a Glance
    • Better Ways of Delivering Care
  • Background
    • Key Messages
    • National Trends in Health Care
    • Niagara’s Population
      • Geographic Overview
      • Travel Maps
      • Population Projections
      • Population Characteristics
      • Income and Employment
      • Health Determinants & Practices
      • Health Status, Life Expectancy
      • Hospitalization
      • Prevalence of Chronic Conditions
      • Disease Prevalence Maps
  • FAQs
    • The Hospital Improvement Plan
    • Emergency Care in Fort Erie/Port Colborne
    • Women’s & Children’s Health
  • Vision / Plan
    • HIP Addendum – December 2008
    • HIP Addendum & Site Charts – November 2008
    • Kitts Review & Recommendations – October 2008
    • Consultation Summary Report – October 2008
    • Draft Hospital Improvement Plan – July 2008
    • Health Experts Say …
      • Centres of Excellence
      • Emergency Services
      • Women’s and Children’s Health
    • Vision Details
      • Emergency Services
      • Women’s and Children’s Health
• Implementing the HIP
  • Implementation Plan – Year 1
  • Early Opportunities
    • Surgical Program
    • Medicine Program
    • Emergency Services
    • Maternal/Child Program
    • Addictions & Mental Health
  • Site & Services – Now and by 2013
  • Planning for Changes
  • Effective Use of Patient Care Equipment
  • HIP Implementation Steering Committee
• Stakeholder Relations
  • Community Information
  • Community Advisory Forums
  • Chair’s Message to C.A.F.
  • Vice Chair’s Address
• Contact
• News
• Videos
• Contact

Medicine Program

To ensure that a number of quality measurements are in place, performance indicators will be tracked on an ongoing basis in the areas of; improvements in patient outcomes, monitoring length of stay and hospital readmission rates at improved attendance for clinic visits.

New Acute Stroke Inpatient Unit – Niagara has long needed consolidated services for recovering stroke patients.

Right now, all patients assessed by paramedics or emergency department physicians in Niagara as having a stroke or mini-stroke (TIA) are transported to Niagara Falls. They are seen by a dedicated team with specialty training to administer drug therapies, such as tPA and other stroke treatments. Depending on the case, within a few days, patients are then transferred to a general medical unit, rather than to a centre of excellence.

We have submitted a request to the Hamilton Niagara Haldimand Brant Local Health Integration Network for special funding to create a specialty 10-bed inpatient unit at Greater Niagara General Site. If we receive approval for $360,000 in one-time funding and the commitment of $1.26 million in annual operating costs, we will open the new inpatient unit as early as this summer. It will enable us to provide comprehensive specialized stroke care with a dedicated team of health professionals, and prepare patients for their slow-paced rehabilitation phase of care at Hotel Dieu Shaver Health & Rehabilitation Centre.

This type of service doesn’t exist in Niagara right now. With our higher numbers of people living with chronic illness, including stroke, there is no question we need it. This initiative supports and is aligned with Ontario’s provincial Stroke Strategy and what other communities in Ontario now have.

Niagara Diabetes Centre – By 2013, the Welland site will be the centre of excellence for diabetes, with satellite clinics in Fort Erie, Grimsby, Niagara Falls, Port Colborne and St. Catharines.

This program is transitioning to that ultimate goal by moving the Niagara Diabetes Centre to Welland by July 6. The alignment of the diabetes program with ophthalmology and renal (dialysis) programs, already located at Welland, is a key benefit of this early opportunity.

Identification of Bed Closures – The HIP outlines the eventual closure of 82 acute medical beds by 2013. We are in the process of identifying the location of the first 30 acute-care beds to be closed this year, once new community supports are in place for seniors. Bed closures are contingent on Aging at Home strategy announcements expected in 2009 which will fund new programs to help residents who need more community supports, allowing them to be discharged safely from hospital. Further details, including an impact analysis, are being developed.

It is important to note that when the appropriate community services are in place hospital beds will be closed. Currently, the NHS has 520 acute care beds at our 6 inpatient locations. Of that total, about 150 beds or 29% are occupied by alternate level of care patients, meaning these patients are beyond the acute phase of their illness and no longer require hospital care.

Designating Alternate Level of Care (ALC) Assessment Beds in Fort Erie and Port Colborne – Right now, over 50% of the inpatients at these two sites require a different kind of care than acute hospital care, usually in a long-term-care setting, participating in a slow-paced recovery program or returning home with support services.

By July 6, we will be changing the designation of 53 beds at Douglas Memorial (25) and Port Colborne Sites (28) to better reflect the type of care these patients need. Currently, these beds are designated acute medicine/surgery, but the reality is that most patients in these beds are beyond an acute illness and require an alternate level of care.

This clustering of ALC beds will mean we change the skill-mix of nursing staff (RN, RPN, Personal Support Worker) delivering bedside care. There will be at least 4 acute-care beds kept in place at each site to serve patients needing acute care, until the urgent care centres with their observation beds are fully up and running.