The Almonte General Hospital (AGH) held its annual general meeting on Monday June 25.
The guest speaker was Chantal LeClerc, CEO of the Champlain Local Health Integration Network (LHIN), one of 14 regional health networks in Ontario. The Champlain LHIN includes the urban and rural centres in and around Ottawa and extends to Carleton Place, Deep River, Cornwall and Hawkesbury. . She explained that the vision of the LHIN is to help communities to access quality health care across the province. THE LHIN is leveraging technology to increase accessibility, with a secure website for doctors and nurse practitioners to exchange information and the opportunity for video conferences to link patients with nurse practitioners and physicians. The LYIN is also implementing a funding formula initiatives around palliative care which should allow dying patients to remain at home or in a hospice rather than an active treatment hospital.
Ms. LeClerc noted that 1-5% of the population uses 60% of health care services and steps are being taken to better coordinate the care of these high users and to reduce hospitalizations.
The Millstone asked about the Community Care Access Centre (CCAC) which we understand is being collapsed. CCAC provides home care services. Ms. LeClerc stated that existing CCAC contracts with health providers would move to the LHIN, if proposed provincial legislation is passed.
Mary Wilson Trider, CEO of the AGH who will now assume that position for both the Almonte and Carleton Place hospitals presented her sixth AGM report.
Among the positive developments at the hospital over the year she listed the new medication carts in the Medical/Surgical and Rosamond units and new dispensing units in the Medical Surgical and Emergency departments, funded by the Small Rural & Northern Hospital Transformation Fund.
She also cited the partnership with Shoppers Drug Mart for an automated medication administration system which has been implemented in Fairview Manor. Both initiatives will reduce medication errors.
Staff, midwives and physicians in the obstetrics program have completed the third and final year of the MOREOB Program which includes independent study, workshops, skills drills and emergency simulations and Lanark County Paramedics have received training in the administration of Naloxone to patients with a suspected narcotic overdose, and have learned how to disconnect and troubleshoot home dialysis machines. Both are important new services for patients across Lanark County.
The annual Ministry of Health and Long Term Care quality inspection of Fairview Manor was successfully completed last August with no compliance order issued and Fairview Manor’s operating licence has been extended to 2037.
Ms. Wilson Trider noted that the hospital met or exceeded its’ Quality Improvement Plan targets for reducing readmissions and falls, for appropriate length of stay, for medication reconciliation quality and length of stay management as well as the accountability agreement targets for emergency department wait times. Once again, there were no hospital-acquired cases of VRE, MRSA or C-Difficile. Fairview Manor also met its Quality Improvement Plan targets for medication reconciliation quality score and pressure ulcers.
A new visiting policy was introduced in April to extend visiting hours to between 8 am and 8 pm, giving staff full authority to make compassionate exemptions where patients are seriously ill or nearing the end of life.
Ms. Wilson Trider is quite proud that 95.9% of respondents to a recent NRCC inpatient experience survey answered yes definitely to the question “would you recommend this hospital to your family and friends”, 100% of residents would recommend Fairview Manor and Lanark County Paramedics received an average score of 4.78 out of 5, or 96%.
The hospital continued work with the North Lanark Palliative Care Network and now includes a common element for advance care planning in the Quality Improvement Plans of Almonte
Along with Carleton Place & District Memorial Hospital the AGH acquired new digital xray equipment, which will be installed later this summer, and the Rural Assess & Restore project has brought new programming to the day hospital and a geriatric emergency management nurse to the AGH Emergency Department.
Ms. WIlson Trider noted that paramedics responded to 19,000 calls across Lanark County. Fairview Manor provided 40,313 days of care in its 111 residential beds, which equates to an occupancy rate of 99%, and 240 days of care in the respite bed that helps families in the community to keep their loved ones at home. .
AGH provided care through 15,800 emergency department visits, 8,825 days of care in the Rosamond unit and 546 discharges from the medical/surgical unit as well as nearly 1,000 surgical procedures, almost 13,000 diagnostic imaging procedures, 1,530 visits to day hospital.406 babies were born at AGH this past year . The addition of Dr. David Caloia as a permanent member of the obstetrics department last September as well as the contributions of Dr. Enobong Ekong and several locums who assist with call schedule coverage have helped Dr. Bahaa Awwad, Chief of Obstetrics and Gynaecology, towards his goal of no closures due to lack of obstetrician coverage.
As the Globe and Mail had that morning published a two full page article on medical errors in hospitals that cost 30,000 patient lives in Canada each year, the Millstone asked Ms. Wilson Trider about the reporting and prevention of medical errors at the Almonte General Hospital
Ms. Wilson Trider responded that the hospital uses an electronic incident management system to record, track and follow up all reported incidents whether there was harm to a patient or not. Incident data is reported quarterly to the Quality Improvement Risk Management Committee and the Board’s Quality Committee, both of which include a physician member. Critical incidents are reported quarterly to the Medical Advisory Committee and medication incident trends are reviewed by the Pharmacy and Therapeutics Committee. Reported data includes trending that helps to identify systemic issues. All incidents are investigated by the manager of the unit or department in which the incident occurred. Follow up actions implemented following investigation of an incident are reported to all the committees. Future incident reports monitor the effectiveness of those actions.
AGH provides data to numerous external bodies which track, trend and report indicators of the quality of care for hospitals across the region and the province. These include the Canadian Institute for Health Information, BORN Ontario and the Champlain LHIN.