SFMH & RVH Partnership
A HISTORY OF THE ST. FRANCIS MEMORIAL HOSPITAL AND RENFREW VICTORIA HOSPITAL PARTNERSHIP
In February 1997 the (Health Services Restructuring Commission (HSRC), as part of their mandate to evaluate health services across the province, completed the Pembroke Health Services Report. In this document it was directed that the Pembroke Civic Hospital would close and the Pembroke General Hospital would become the only community hospital. The report also issued direction that that a study of the remaining four Renfrew County Hospitals (Arnprior, Renfrew, Deep River, and Barry’s Bay) be conducted under the direction of the District Health Council (DHC)
An extensive steering committee was struck which included Jim Douglas as the representative for Barry’s Bay Hospital, and Stephanie Graham as the community representative. In the midst of the study the Minister of Health announced a new Rural and Northern Health Care Framework for Ontario. This new framework identified Pembroke, Barry’s Bay, Renfrew, and Deep River as the West Champlain Health Care Network (WCHN). Arnprior was changed from Renfrew County to the Ottawa Carlton network and therefore not included in the final report.
The report “ Meeting the Challenge: Redefining the role of Hospitals in Renfrew County” was released in November 1997. Among the many recommendations was the direction to create a single board to govern all the Hospitals in the WCHN, and to reduce the bed capacity in Barry’s Bay from 31 beds to 16 (9 Acute Care and 7 Complex Continuing Care)
This raised grave concerns related to not only the reduction in services but also in the prospect of being combined under one governance structure when there was so much unrest and dysfunction between the two Pembroke Hospitals. Over the next year the already high level of frustration at SFMH continued to increase, especially within the Medical Staff. Opportunity for growth was almost non-existent and in fact, there was a real fear that SFMH would soon loose services that were currently being offered.
The Board of Directors adopted a decision that rather than wait for a governance structure to be enforced upon us they would choose their own strategic path.
Renfrew Victoria Hospital was identified as an ideal partner. The philosophy of commitment to community care in both Hospitals was compatible and the reputation of RVH as a positive, progressive, organization offered SFMH an excellent partner.
In December 1998 the timing for the move was right since both organizations had recently experienced a vacancy at the Senior Administration level that would be filled through the new arrangement. A model was designed in which the Hospitals would be integrated under one CEO and a shared Senior Administration Team (Director of Nursing, Director of Operations, and Director of Finance) The new arrangement would maintain separate Boards, corporate identities and budgets. It was felt that through a voluntary partnership both Hospitals could demonstrate support of the MoHLTC’s new direction in a way that would benefit the communities they served.
The overall operational goals of the agreement were to:
- Maintain and enhance the range of services provided at each site
- Better-manage the use of human resources
- Develop inter-hospital collaboration beyond planning and current complexities
- Realize the fullest possible leverage of management strengths in both organizations
- Avoid any voluntary job loss
Advances by the new team on the SFMH side were soon evident and included:
- Outpatient programs which include the return of the Surgical Consultations Clinic, and the introduction of an Internal Medicine Consultation Clinic, a Pre-op Assessment Clinic, an Ophthalmology Clinic, an Ear, Nose and Throat (ENT) Clinic, and a Cardiology Clinic
- Ultrasound services were expanded
- Plans for the introduction of mammography services as a satellite of the Renfrew Victoria Hospital Ontario Breast Screening Program (OBSP) were implemented
- Capital renovations to replace all the windows, doors, signs and an elevator retrofit were approved
- A shared IT Management position was introduced
- A shared patient recreation program
- Interim long term care beds were introduced
Despite the excellent skills of the Team the extra workload and most significantly the demands for travel created by the distance between the two facilities took a toll on the people in the shared positions and a year later it was necessary to re-evaluate the structure of the Senior Administration Team. With the departure of the Director of Finance and the Director of Operations in September 2000 it was decided to create the current organizational structure where both sites support their own Senior Administration Team but share the CEO. This arrangement was a new organizational hybrid. Other mergers being directed by the HSRC across the province, required either a closure of one facility or a complete merger of corporations including Boards, staff etc. The RVH/ SFMH model, as a voluntary partnership, was unique to both hospitals and their communities and therefore had the option of being designed to meet specific needs. There was a strong desire by the Board to maintain the growth in clinical programs and to sustain the professional external connections and leadership of the current CEO, a key attribute that, it was felt, had been missing in past administrative structures. To achieve these objectives however it was realized that the demands on the position of CEO would be unattainable if the expectation was to double the workload of on-site administration at the two organizations, and still expect involvement at the national, provincial and regional level that had been coveted in the original agreement. It also had to be realized that the RVH operation is four times the size of SFMH in clinical programs, budget, and staff and that many of the advantages in growth in clinical programs that had been realized was as a satellite of the RVH base.
The Board agreed there was a need to be flexible. They reduced Board meetings to every second month and it was decided to invest in current staff and allow the new SFMH structure time to develop. It was felt that progress in realizing the strategic objectives of the Board would be indicators of the appropriateness of this decision.
In the past three years this new SFMH team has realized the strategic objectives of the Board and has set new ones.
Performance Indicators include:
- The implementation of the Satellite Hemodialysis program (interim program and the move to the new area)
- Successful implementation of the OBSP/Mammography
- The construction of the SFMH Health Center - operating at full capacity
- An efficient and productive MAC relationship
- The creation of the SFMH Foundation
- A successful 1 Million dollar Capital Equipment Campaign
- Repatriation of the Laundry service
- New clinical services: i.e. Respiratory Therapy
- Bone Density services
- Telehealth – clinical program and educational program
- Physiatry, a return of Internal Medicine
- Radiologist services and the stabilization of all Diagnostic Imaging Services)
- An internal information infrastructure that meets regional and provincial standards to provide high speed communication access
- Performance Funding
- Balanced budgets
- An upgraded telephone system
- Competitive HR compensation
- Partnership with Dynacare Lab service
- Upgraded capital equipment. E.g. electric beds, cardiac monitoring systems. Bone density machine, etc
- Three year accreditations
- Recruitment of a new Family Physician
- Underserviced Area designation
- Increased level of collective knowledge within the organization to provide for succession planning and greater stability of the organization
For those who were part of SFMH in 1997 and are still part of the organization today the transformation is astounding. Six years ago the future of the Hospital itself was threatened, there was no growth, and the morale of the staff was very bleak. Today, we are prosperous and creative; we cultivate a positive staff environment and are recognized with pride by our community. Sometimes we have to look back to appreciate how far we have come.