Thursday 8 March 2012

Trickle effect of ORNGE






1.    What is the link to Crisis Management?
As discussed in the ORNGE post, this article on York Central Hospital (YCH) is exactly the trickle effect of a larger health care scandal. The large scandal of ORNGE has raised other concerns with health care spending in other health care facilities, raising more awareness in the public which could result in a potential crisis if there is enough backlash from the public.

2.    What stage of Crisis Management does the system appear to be at?
The system appears to be at the cusp of an issue towards a risk. As more and more cases arise in the many health care facilities in Ontario and as more information is disclosed to the public and is available, more accountability will be expected and the public will be less understanding and sympathetic to every case reported in the news to a point where earning the public’s trust in the government’s ability to manage health care funding is at great risk.

For York Central Hospital this is a risk as they are under scrutiny in the eyes of the community.

3.    How well does the system appear to be handling the situation?
The system appears to be handing the situation well. The issue was raised and no doubt has been written with a negative perspective in both papers. Both the hospital spokesperson and Chief of Staff addressed the issue and apologized for the issue. The Chief of Staff took responsibility for this in the article that followed in York Region and mentioned that they will review and strengthen policies to ensure funding is within best health care practice.

4.    What level of crisis preparedness does the system appear to have?


The system seems to level 4 for preparedness. Melina Cormier was the hospital spokesperson and confirmed and explained the meeting to the public and provided further comments. She further clarified the funds where part of physician’s professional allowance. In the second article, Dr. Fonberg took full responsibility for this and apologized to the public. They further provided next steps as to what will happen what the community can expect.

5.    What personal reactions/feelings does the description trigger in you?
Having YCH as my community hospital growing up and having spent time there in my previous co-op term, I was surprised to see this in The Star because I have been exposed to the rigor, accountability and culture of patient centred care at YCH. In the Quality Improvement Plan (QIP) that has been legislated mandatory by government is an example of the commitment this organization has to being accountable and transparent. Furthermore, there QIP states their commitment to having a Total Margin of + $1.5 M. If the organization were running huge deficits in budget, I would expect this to be in the paper. But having a Total Margin of +1.5 M and really driving towards larger positive impacts, I would say really shows the hospitals commitment to spending wisely.

While an incident like ORNGE was a result of $1.4 Million spending on one person’s salary, which is completely unjustifiable, I found it was interesting to read a story about a small community hospital and their roughly $22,000 conference spending. Given that this funding is an annual stipend that is given to Physicians for professional development, whether they decided to spend it in Florida or in a conference in Europe is up to them so long as the quality of care and pertinent health issues are discussed.  I was surprised that it made it onto the front page that day, which I believe the media has taken this particular case out of proportion in light of a much bigger case such as ORNGE. It certainly does speak to the power of the media and depending on the perspective in which they take can definitely make a situation that seems reasonable into an unreasonable one in the eyes of the public.

6.    What advice would you offer to those involved?
My main piece of advice would be to follow up with the local community on how what policies have taken place to ensure the community is informed of their commitment to ensuring future spending is kept with industry practices and to ensure they gain the communities trust in ensuring dollars are spend in the best interest of patients.

Article Sources:
Article from The Star:
By Theresa Boyle | Sat Feb 04 2012
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At a time when the provincial government is planning to shake up the health system to eke out more value from every taxpayer dollar, 11 doctors from York Central Hospital have travelled to Florida for a retreat.
The chief of staff of the Richmond Hill hospital and chiefs of 10 departments held a meeting in Boca Raton on Thursday and Friday, paid for out of the hospital budget.
Hospital spokesperson Melina Cormier confirmed the meeting, explaining the physicians gathered to discuss enhancing the clinical management of the hospital’s medical services.
When asked why doctors didn’t meet locally, she said: “Our experience has shown that conference retreats are extremely helpful in terms of team building and perspective. It also helps when you take people off site to ensure the focus in on the strategic objectives of the conference.”
Cormier did not know how much was spent on the trip, but said funds came from an annual stipend for professional development.
“The annual stipend covers the cost of professional development and they can use these monies to attend professional development events separately or together,” she said. “This year they chose to seek their professional development together so they can collective focus on enhancing the quality of care here at the hospital.”
She declined to name the hotel they were staying at for “privacy reasons” and said she did not know if spouses attended.
Among the issues discussed at the meeting, according to a copy of the agenda, was “accountability.” A guest speaker, the chief medical officer of health of the Boca Raton Regional Hospital, was to talk about “pay for performance.”
Linda Haslam-Stroud, president of the Ontario Nurses’ Association, was stunned to learn of the getaway and said it’s “absolutely demoralizing” for nurses who are struggling to work at the hospital with limited resources.
She said there have been problems getting hot water to certain areas of the hospital and nurses have had to boil water to bathe newborns and new mothers. Cormier denied there were any hot-water problems.
As well, Haslam-Stroud said nurses who call in sick are not replaced because of budgetary reasons, leaving units short-staffed.
“It’s a sad day for our patients when taxpayers’ money and health-care funding dollars are being spent frivolously,” she said.
Progressive Conservative MPP and health critic Elizabeth Witmer said this is another example of poor oversight of the health system by the provincial government.
“Whether it’s eHealth, ORNGE or (hospital CEO) entitlements, this government is simply not providing the oversight that is necessary to put out the message that we need to do away with this type of spending. We need to make sure that health spending is focused on patient care and frontline services,” she said.
“They tell us they need to reduce health spending,” Witmer said, referring to a soon-to-be released report by economist Don Drummond, who will be making recommendations on slashing government spending. He is expected to take special aim at the health system.
“With the Drummond report on the horizon, the average person looking for a job in Ontario would be infuriated that this was paid for out of the public purse,” said NDP MPP Cheri DiNovo.
“It’s ridiculous. This is a time when they just closed Ontario Place, people are losing jobs right, left and centre,” DiNovo added.
Health Minister Deb Matthews was not available for comment.
Theresa Boyle can be contacted at tboyle@thestar.ca or (416)869-4915.
York Central Hospital medical chiefs at Florida retreat
All doctors are members of the hospital's medical advisory committee
Dr. Eric Fonberg, Chief of Staff
Dr. John Barrett, Chief, Obstetrics & Gynecology
Dr. Brian Berger, Chief, Continuing Care & Rehab
Dr. Victoria Chan, Chief, Medicine
Dr. John Doucet, Chief, Pathology
Dr. Jeff Weisbrot, Chief, Pediatrics
Dr. Indy Ghosh, Chief, Emergency Medicine
Dr. Stanley Herman, Chief, Anaesthesia
Dr. Philip Solomon, Chief, Surgery
Dr. Nicholas Voudouris, Chief, Family Practice
Dr. Peter Zelina, Chief, Psychiatry

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