Hospital Improvement Plan Implementation

What’s changed as of today?

As of May 19, as one of the Early Opportunities in the HIP, the small volume of surgical services is no longer provided at the Douglas Memorial and Port Colborne sites. Eye surgery moved from these two sites and Greater Niagara General as a first step to creating a single surgical Centre of Excellence in Ophthalmology at Welland Site by 2013. Until then, eye surgery will be provided at Welland and Ontario Street sites.

Also on May 19, Plastic surgery moved from the Welland Site to two specialized surgical centres located at Greater Niagara and St. Catharines General sites as these two sites currently have the highest volumes of trauma care. Dental surgery, previously provided at Douglas, Port Colborne and Welland, is now centralized at Greater Niagara General Site.

Conversion of Emergency Departments to Urgent Care

The 24-hour Emergency Rooms (ER) at Port Colborne and Douglas Memorial sites will become 24-hour Urgent Care Centres (UCC), open seven days a week year round and staffed with doctors and nurses who are certified in Emergency medicine. The Port Colborne Urgent Care conversion is targeted for July. The Douglas Memorial Urgent Care conversion is slated to take place by late September.

It is estimated that most (up to 95%) of the adults and children who currently go to these small site ERs will continue to go to the Urgent Care Centres for treatment.

“Adults and children who have non-life threatening illnesses and injuries such as lacerations, sprains and strains, ear infections and mild or moderate asthma can be appropriately treated in an urgent care setting,” explains Marcia Ladouceur, clinical lead for the UCC conversion and ER Clinical Manager for the Welland and Port Colborne sites.

Some patients who present at the UCCs may be determined by the physician to require admission to an acute-care bed. These patients will be stabilized and then transferred to the most appropriate facility where they will have access to high-tech diagnostics tests, on-call physician specialists, intensive care and surgical care should they require.

“Regardless of where you live in Niagara, individuals suffering from chest pain, shortness of breath, severe abdominal pain, dizziness, numbness in arms or hands and serious injuries should call 911,” Marcia explains. “It’s important to know that our Urgent Care Centres will be staffed and equipped to respond to the unexpected – the person who walks in and collapses suddenly or is having a heart attack. If residents experiencing these symptoms come to the UCC, we will stabilize and then send patients by ambulance to the most appropriate acute-care site. This is not very different from what currently happens now at Port and Douglas. This is also the case at the Prompt Care Centre in St. Catharines since the Ontario Street Site’s ER was converted to Urgent Care nearly four years ago,” adds Marcia.

Building Renovations at Port Colborne Site for Urgent Care Centre

“We are also working simultaneously on renovation plans for the Port UCC. We’re looking at two location options for Port UCC – renovating and remodeling the existing ER space on the ground floor or moving the centre to the west side of the first floor.”

Under the proposed first floor option, the Urgent Care Centre would include a children’s play area, a nursing station, an area for patients who need fluids or need to stay for a short period of time, more patient and public washrooms, a fast track area to maximize patient flow, a trauma room, a suture room, an isolation room with negative pressure for patients who require a separate air flow, a working area for physicians and new patient rooms.

“We’re getting further input from our doctors and will be incorporating their feedback. Our team is really excited about the renovation and are looking forward to selecting the plan that we will proceed to build,” adds Marcia.

Complex Continuing Care Beds at Douglas and Port Colborne

Inpatient services will be offered through Complex Continuing Care units, with 40 beds at Douglas Memorial Site and 46 beds at Port Colborne Site.When the Hospital Improvement Plan is fully implemented there will be 46 Complex Continuing Care (CCC) beds at Port Colborne Site and 40 CCC beds at Douglas Memorial Site. CCC patients have two or more complex conditions requiring them to have round-the-clock hospital-based care. The majority of CCC patients are elderly residents.

Patient Testing Diagnostics and Clinics

Many different patient care tests, procedures and treatments will continue to be provided as part of the future vision for Port Colborne and Douglas sites. This includes X-ray, ultrasound, ECG, blood work and other laboratory tests, pharmacy, etc.

“Our health-care teams at both sites will continue to provide this broad range of patient tests and treatments for outpatients and for the complex continuing care inpatients who are hospitalized there,” explains Debbie. “This is similar to what is provided at the Niagara-on-the-Lake Site.”

Clinic services will also continue. It’s currently estimated that over 70 per cent of the outpatient clinics now offered at the sites will continue to be provided, including the diabetes clinic, orthopaedic clinic and the Ontario Breast Screening Program for the early detection of breast cancer in women over the age of 50. «