By Mike Williscraft
Shockwaves quickly emanated throughout Niagara West early Monday morning when Hamilton Health Sciences officials unveiled a plan to staff which includes closing operating room at West Lincoln Memorial Hospital – possibly as early as Jan. 1.
The move, which has not been approved by the HHS board of directors, would take with it the prized obstetrics service.
Another immediate casualty of the surprising direction – delivered by Rob MacIssac, president and CEO of HHS in a series of meetings Monday morning – was Dr. Gary Benson.
Dr. Benson is a well-known and highly respected figure at WLMH who, up until Sunday, served as the medical director of the facility and was chief of staff long before the amalgamation of WLMH and HHS took place in 2013.
Blindsided by the turn of events and recognizing the devastating impact this move will have on the hospital, its medical community and all those in the
hospital’s catchment area, Dr. Benson tendered his resignation.
Dr. Benson was informed of the decision last Wednesday.
“I felt that the decision was wrong and it would be a fatal blow to WLMH and to our West Niagara communities,” wrote Dr. Benson in a letter to his colleagues notifying them of his decision.
“Later that evening, I came to the decision that I could not support this drastic move and it made it impossible for me to remain in my position as Medical Director for WLMH.”
HHS officials have a very different view of things.
Simply, they see this as a move to protect patient safety and ensure a quality of care standard they believe necessary.
The decision comes on the heels of an Oct. 5 report which notes $8.5 million and more than two years will be needed to upgrade WLMH to meet satisfactory standards.
As noted in last week’s edition of NewsNow, many questioned why the upgrade for the ORs was included in the cost analysis as the matter at hand dealt with sterilization issues for endoscopy equipment. Endoscopy services have ceased at WLMH and have been transferred, “temporarily”, to other HHS facilities.
“We held a series of meetings this morning (Monday) with both our physicians and staff to release the results of this consultant’s report. We have not settled on a date for anything,” noted MacIsaac.
“We haven’t made any firm decisions around this matter as of yet.”
MacIsaac said that HHS officials are no longer willing to accept the status quo when it comes to delivery of services, but there is little choice.
“First, the facility needs a major upgrade in order to keep abreast of standards of care which are always changing. We have to do that. That is the first big conclusion out of the report,” said MacIsaac.
“While it is possible that you could keep some of the operating room time open, there will inevitably be times when you have to close all your operating rooms.”
For that reason, he said it seemed to be a logical step to shut it right down and get the work done.
One physician who called the NewsNow office summarized the thoughts of many who emailed, called and texted at a hectic rate over the last 48 hours prior to deadline.
“One of my big questions – my understanding is that the WLMH rebuild was never supposed to be on the same footprint as the current site. If we could actually get commitment to start the rebuild, we could keep services going,” noted the physician.
Yes and no, said MacIsaac to anything along that line.
“Standards continue to evolve. There’s no one day where we said, ‘Everything was fine today, and nothing will work tomorrow’. This has been a long coming moment where HHS staff is basically arriving at the conclusion that in order to move forward we will need to act in the relative near future to upgrade our facilities,” said MacIsaac.
We are not comfortable indefinitely operating out of those facilities. There has to come a point where you make that decision. So we’re raising our hands and saying, ‘Look, we have been reasonable to date in terms of making sure that we are providing services effectively and safely, but we are not comfortable doing this indefinitely. So we’re saying now is an appropriate time given what this consultant has told us.”
For Dr. Benson, yes and no, also.
“We have always used patient safety as a guiding principle and we are always looking at ways to ensure we continue to provide excellent and safe care. The drastic measures being implemented go way beyond what is needed to ensure patient safety is maintained,” wrote Dr. Benson.
Further to that he added that this new direction opposes the made-in-West Niagara plan created over several years.
“The proposed changes in services at WLMH completely ignore the “Our Healthy Future” plan that we and our communities worked so hard to develop,” noted Dr. Benson.
While MacIsaac understand the emotion of the situation, he says it is time for HHS to make a move.
“It’s a very emotional topic for staff and the community. We get that, but at the same time, we can’t compromise our commitment to meeting patient safety standards. As hard as this issue is, we need to advance on it,” said MacIsaac.
There has been no plan discussed or implemented to deal with HHS’s “20-minute rule, which is the standard for all staff to be within when on call – or any other issues relating to staff impacts
“That level of detail has not been worked out. I would say that that 20-minute rule is consistent with all our sites of all our employees. People are jumping to a situation that hasn’t been fully worked up,” said MacIsaac.
Dr. Wes Stephen, executive vice-president, clinical operations and chief operating officer for HHS, said those aspects of the decision will come now.
“Typically, what happens is next step, the teams are going to get together to have a conversation to actually design what the program is going to look like. Issues would be addressed in that process. You are asking a very granular, very specific question that I could not answer for you at this moment,” said Stephen.
The 24/7 Emergency Department, as well as diagnostic imaging and in-patient bed care will be continued as well as other services.
“We are sure there is more work to be done, but we have lots of confidence that we can find good solutions to these issues both for out staff involved and for our patients,” said MacIsaac.