By Mike Williscraft
Not only is Hamilton Health Science’s announcement to transfer key services away from West Lincoln Memorial Hospital illogical, the entire matter appears manufactured, says Dr. Tom Estall.
Estall, a physician with 40 years of experience – including a decade as director of emergency medicine at St. Michael’s Hospital in Toronto – has volunteered his time to become one of the co-chairs of the Save WLMH action group.
HHS announced to its staff Oct. 22 plans which would see a 27-month closure of operating room services to allow for the $8.6 million renovation
to take place. With no ORs, the prized obstetrics unit would also be lost for the same period.
While Estall has been following the extensive coverage of the issues surrounding the decision, he has waited until he had a grasp of all key factors before he added in on the subject matter.
Now, he believes he has seen enough.
HHS officials have repeatedly cited changing standards as the core reason not only for the proposal to shut down the ORs, but also for the transfer of endoscopy services earlier this summer.
Estall cites details from the same 2016 accreditation report which HHS officials have noted as an area of concern.
“Their (HHS’s) overall rating was an ‘exemplary’ standing. West Lincoln’s obstetrics had a 100 per cent review. West Lincoln passed all the previous accreditation measures for infection control. There was no concern mentioned at all. They did mention the facility was old, but that certainly is no secret,” said Estall.
“I have never seen or heard of any facility being shut right down. If targets were not met, they would allow 3-4 years for adjustments. If a facility was on the cusp of one level to another, there may be a proviso to get the work done.”
With the history in black and white, Estall said the future, for the most part, was known and workable – the aging facility needed considerable effort to maintain standards, but they were being maintained.
“Yes, standards change, but in the absence of a completely new set of procedures being brought in, you cannot get from stellar in one review to below standard in the next review,” said Estall.
“In my opinion, you might get a ‘we warned you’ or ‘there’s no wiggle room to get work done’, but you don’t go from the best grade to the worst of the group.”
In an interview with NewsNow last week, HHS president and CEO Rob MacIsaac said the organization will live to the accreditation standards.
“I understand that various people have various opinions about these sorts of things. Our perspective? These are standards that we are intent on making applicable across all of our sites. We are not about to dispute the appropriateness of standards for any of our facilities. We intend to have high standards across every HHS facility,” said MacIssac.
But the debate is not just about accreditation standards, noted Estall.
He pointed to a decided lack of attention and the responsibility for getting WLMH even remotely close to a precarious state with its staffing.
Estall places blame firmly at the feet of the HHS on the critical shortage of OR nurses.
With the departure of an operating room registered nurse recently, the staffing complement at WLMH is one RN above the minimum. The matter has been compounded by the HHS’s not posting any available positions to fill those spots – until last week when positions were posted.
“HHS knows what their staffing need is there (with RNs) and they also know that one above the minimum is not acceptable. They allowed the buffer to erode over many months,” said Dr. Estall.
Fellow co-chair Tony Joosse added one more log to the fire of doubt.
“The full consultant’s report is also clear: there is no suggestion of long-term closures anywhere in the report. The only thing I can possibly think of with HHS’s thinking is they are anticipating the 2019 accreditation process. The consultant’s report only suggests the work to renovate the ORs could be done over a period of time, with some weekend closures and possibly some short-term closures to get it done,” said Joosse.
“The decision to roll that into a 27-month closure is pure HHS. They somehow reached a conclusion that is far beyond the scope outlined in the report, again, to what end? I doubt their motives. What message did they think the public would take from all this?
Aside from the contentious discussions, Joosse said HHS owes it to WLMH’s dedicated staff to take immediate action in a positive way.
“My big concern is for the staff and that the public knows WLMH is open for business. The onus there is on the HHS to provide a demonstrable exhibition of support for the staff. This whole thing was done with no staff input or knowledge. They didn’t deserve that kind of treatment,” he said.
Currently, HHS and WLMH staff are engaged in discussions to root out an alternative plan which would see the preservation of all current services.