LITTLE CURRENT—While Manitoulin Health Centre (MHC) faced a year of uncertainty and many challenges, the biggest challenge over the past year has been the crisis in health care human resources, the MHC was told at its annual general meeting last week.
“Thank you for joining us this event at MHC’s annual general meeting. The past year has proven to be a year of uncertainty, challenges, preparation and advocacy,” stated Paula Fields, MHC president and chief executive officer. “The perseverance and resilience of the team was evident throughout the year as MHC navigated uncharted waters of financial uncertainty, health human resource challenges, pandemic recovery, and the largest health information system implementation in Canada.”
And while the successful landing of the MediTech Expanse has taken place, the dire human health resources consequences and shifting landscape in the Ontario health care system would be the background explained Dr. Stephen Cooper, chief of staff for MHC when he made his report.
“While Meditech Expanse will be the signature event of the last year, the crisis in health human resources is the real story. Last year I was concerned, but remained hopeful, about the shortage of physicians,” said Dr. Cooper. “I did truly believe that we would be able to replace Dr. Mitchell, but we have not. For both sites (Little Current and Mindemoya) there are no prospects for physician recruitment for the next six months. I have reached out to Ontario Health to help work on a plan in case the current group of physicians are unable to continue to provide core physician services on the Island.”
“I believe that while there is a shortage of physicians in the province, the biggest issue is distribution and the current program of the emergency funding of clinicians (physicians and nurses) to keep programs like the emergency departments open is exacerbating the shortage,” said Dr. Cooper. “We are currently going through a significant investment and reorientation of the health care system. Whether this investment opportunity will solve the perennial problem of cyclic health human resources shortages remains to be seen, but I do remain hopeful.”
“I am hopeful that the Ministry of Health will let Ontario Health and the Ontario Health Teams take the leadership in tackling problems like health human resource shortages. The recent successful roll out of MediTech Expanse across the Northeast demonstrates that we can come to an agreement to solve a common problem,” said Dr. Cooper.
“It was a year of advocacy for MHC,” said Ms. Fields. “Small rural hospital leadership teams have been vocal in advocating for sustainable health care in our communities. MHC sought out opportunities to meet with political representatives including MPP Mike Mantha, Minister of Health Sylvia Jones and Associate Deputy Minister of Health Catherine Wang. Topics of discussion included the strengths of small rural hospitals as leaders and health hubs in our communities, the unique challenges that we face, and how we can be supported to grow, be innovative and sustainable.”
“The advocacy by the Ontario Hospital Association (OHA) for small rural hospitals has been unprecedented,” added Ms. Fields. “Small, rural hospitals such as MHC are often a central point of entry into the local health care system, striving to offer timely, high-quality, culturally safe care to diverse populations across vast geographies.”
“Right-size funding envelopes are required in order to equitably reflect the service delivery requirements of small, rural Northern hospitals, such as MHC, and introduce policy supports to urgently reduce our reliance on agency nurses and locum physicians, increasing sector sustainability and reducing associated costs,” Ms. Fields said. “The coming years will be transformative in addressing these challenges.”
“The past year has been one of financial challenges. However, due to the hard work of the MHC team and professional staff, MHC service levels were maintained as it experienced growing volumes of patients, especially in the emergency department,” said Ms. Fields. “I want to thank the MHC team for adapting to the challenges of a shortage of health human resources and the professional staff for their sacrifice and commitment in ensuring that both emergency departments remained open for our communities.”
Ms. Fields explained, “in June 2023, our leadership team was complete for the first time. After two years of vacancies, we welcomed Emily Bond as the manager of human resources. Emily has brought much experience, enthusiasm, and spirit to the organization.”
MHC leadership had the opportunity to engage with both the Wiikwemkoong Chief and Council and the United Chiefs and Councils of Mnidoo Mnising to review the findings of the Maamwewziwining report and look for opportunities to improve. “We are grateful for the partnership and feedback that will allow us to improve and become more culturally sensitive,” said Ms. Fields. The MHC employees took part in a camp put on by Mnaamodzawin Health Services last summer, and will again this August, that includes interactive activities to learn the Anishinaabe language, history of Indigenous people of the Manitoulin as well as cultural practices.
Ms. Fields noted the MHC had the opportunity to collaborate with Indigenous health program managers from other hospitals in learning how we may improve cultural safety and the patient experience for indigenous community members and acting on their recommendations. “We are very excited about our partnership with Manitoulin-Sudbury District Services Board (DSB) in funding for a navigator position at MHC.
“We celebrated the grand opening of the renovation and expansion of the Mindemoya emergency department,” said Ms. Fields. “Amidst the pandemic and during one of the most difficult times of both our personal and professional careers, the MHC team demonstrated their commitment to the community by persevering and ensuring that the clinicians were provided with a state-of-the-art clinical space to provide the excellent care they are well known for. We are very grateful to the facility and maintenance team for their persistence and problem-solving abilities in resolving the air handling concerns in the new chemotherapy suite. After much delay, the suite reopened in January and we are now able to resume administering chemotherapy to Islanders, close to home. We look forward to the potential opportunity to expand the program in the future.”
“MHC, along with 21 hospitals across the Northeast joined a single health information system, Meditech Expanse,” said Ms. Fields. “This project is known as the ONE initiative: one person, one record, one system. The ONE initiative has brought advanced clinical functionality including computerized provide order entry (CPOE), barcode medication verification (BMV), and electronic clinical documentation to MHC.
Ms. Fields explained, “Having a single, connected electronic health information system supporting a single patient record across all Northern Ontario offers significant clinical and patient benefits. Our patients no longer have to remember and repeat their health history to multiple providers because their health records are available wherever they go for hospital care across the Northeast. Having a single, unified patient record will result in faster and more accurate treatment decisions because clinicians will have complete, up-to-date information,” continued Ms. Fields. “It has been a journey, the MHC team has been planning it for years and has been building the new system over the past two years,” said Ms. Fields. “On June 4, the vision became a reality, and we went live with Meditech Expanse. I could not have been prouder of how our team faced this challenge head on and has come out stronger than ever.”
MHC has been working with its partners in the development of strategies to address the opioid crisis, said Ms. Fields. The MHC signed a memorandum of understanding with all police services of Manitoulin after six years of discussions. “The protocol is intended to improve outcomes for individuals apprehended by police under the Mental Health Act, improve transitions between police officers and our employees, and to improve the coordination and collaboration amongst all involved. This protocol has improved the experience of patients, police and MHC employees. However, we recognize there is much work to do in supporting mental health and addictions patients as well as ensuring the safety of MHC employees and professional staff.”
Ms. Fields continued, “The Equipe Sante, Sudbury, Espanola, Manitoulin and Elliot Lake Ontario Health Team has gained momentum over the past year as evidenced by the development of governance tables and team processes, the signing of a three-year transfer payment agreement, planning and process for priority setting and implementation, and the development of a collaborative quality improvement plan. We are fortunate to have engaged collaborative partners on the Manitoulin as local leadership is well represented across the OHT governance tables. MHC along with our rural community partners will continue to advocate for a rural health system planning framework within the OHT to ensure equitable healthcare and outcomes for the people and communities we serve.”
MHC has also begun engagement with board of directors, employees, partners and community members for the development of a new strategic plan that will lead its work for the coming three years.
“I want to thank the board of directors, professional staff, employees and the community for their support and patience over the past year. System challenges, regardless of attempts to mitigate, can unfortunately impact the provider and patient experience. We are grateful to hear of those patients and provider experiences that were not optimal so we can improve, and to hear from those who experienced the excellent care that we are known for so we can celebrate with our staff who stay true to our values of respect, passion and truth,” said Ms. Fields.
