Read more: http://www.blogdoctor.me/2008/02/fix-page-elements-layout-editor-no.html#ixzz0MHHE3S64

Wednesday, April 14, 2010

Time for a reality check

In this morning's newsclip at GoNorthumberland.net sits the following:

"The C-E-O of Northumberland Hills Hospital says hospitals can't be all things to all people.

Robert Biron says the decision to cancel diabetes education and outpatient rehab services will allow N-H-H to focus on its core mandate of providing acute care.

Biron says diabetes education is already provided by the Port Hope Community Health Centre but admits outpatient rehab available in the community is not publicly-funded."

You can pay me now or pay me later! If we don't treat diabetes properly, and it is one of the epidemic diseases of modern times, you will have to deal with it drasticaly after a while. In other words no treatment/counselling now or we will cut your toes/feet/leg off in a couple of years time.

The lack of non-acute care follow up - like rehab - will mean that readmissions are going to be the norm (Hey that's good for the hospital business, readmission gets paid more than outpatient care). So the hospital will be generating more money on readmissions but at what cost to human health?

One can see a hospital cannot just concentrate on acute care and if it does it so at its peril. See the light folks and make your voices heard in this issue.


4 comments:

Deb O said...

For years now we've been told the solution to rising health care costs is community based preventative services, yet now there's a financial crunch, community based preventative services are the first to be axed.

Why is that? Why do hospitals see community based services as prey instead of partners, even when the community based service is their own, like the diabetes clinic and rehabilitation department?

They have bickered for years with their own Lakeshore Community Mental Health Services, who insisted successfully they should be located in their own facility outside the hospital. The hospital brass couldn't understand the excellent reasons for doing so, and even some doctors continue to resist. Again, why?

Sometimes I think plain old resistance to change from the Old Guard is at the root of the problem, as much as the money at stake, which is substantial.

Where is our local doctors' association in this debate anyway? Perchance they stand with the Old Guard too? Or just hoping nobody will start asking questions about their own compensation as part of this problem?

Armchair QB said...

The strategic plan for NHH for 2008 - 2011 deals with several clinical priorities, which form the cornerstone of the path forward for the perceived success of the hospital. The document can be found at (http://nhh.ca/AboutNHH/Publications/tabid/191/language/en-US/Default.aspx).

What I find fascinating is that on page 5 there is a strategic priority to "increase services in conjunction with the provincial Diabetes Prevention Strategy". How is closing the clinic that deals with this fitting with the priorities developed in the strategic plan?

Secondly, same page, in fact immediately below the above referenced, there is another "strategic priority", which identifies "Seamless Care For Seniors", and includes "design and implement a hospital-based slow-stream rehabilitation program", as well as "Collaborate with community partners to ensure appropriate community-based resources for seniors, including long-term care, supportive housing and other initiatives aimed at supporting aging at home."

How has the hospital been responding to these self-identified multi-year priorities?

Apparently shutting the clinical services down and closing 26 beds that deal with the "strategic priorities" somehow achieves appropriate outcomes for the strategic plan.

If these were the priorities of the hospital, developed by management and approved by the community-oriented Board, then why are they abandoning them?

Greg H said...

Armchair QB:
Congratulations on your detective work.

Your question "why are they abandoning the plan" has few logical answers that make any sense .

However in practical terms it might be:

1. The new CEO didn't make the plan and has no commitment to it.
and/or
2. The plan was put together well, but only as a public relations exercise and nobody in the hospital or on its board has any knowledge of it.

Armchair QB said...

Greg H - agree with your assessment that there are few logical answers indeed!

the strategic plan has been approved by the Board, and as such, the CEO is required to fulfill it to the best of their ability. I guess the CEO doesn't have much ability! As to the Board, they have a fiduciary and ethical responsibility to ensure they are fully aware of these matters, particularly their governance role with ensuring the appropriate elements are in place to guide the strategic growth, management and economic security of the organization.

Given the above, it seems a case of neither management nor the board undertaking their duties in a responsible manner.