Community steps in to help fix overcrowded hospitals
Aging population puts unprecedented demand on health care and social services
Health and social service providers are coming together to improve care as Hamilton’s hospitals struggle with significant overcrowding.
“We spend buckets of money on health care and relatively speaking we’re not getting very good outcomes,” said Terry Cooke, president of the Hamilton Community Foundation and co-chair of the new collaboration. “We’ve got all of the significant players around the table and they acknowledge that these are not problems they can solve within their institutions. It will inevitably take a higher level of co-operation, a greater seamlessness and a greater focus on early intervention and prevention.”
A small group of health and community leaders have been meeting twice a month since November to discuss what needs to be done to break down barriers between dozens of providers in Hamilton. The idea came from Hamilton Health Sciences CEO Rob MacIsaac.
HHS and St. Joseph’s Healthcare are stretched thin, with more patients than beds since the fall. Hamilton Paramedic Service raised alarm in its annual report May 18 that Hamilton hospital overcrowding is increasingly leaving the city with too few ambulances on the road to respond to emergencies.
The consensus is that the system has to change before hospitals reach their breaking point and the aging population puts unprecedented demand on health care and social services.
“You’ve got an acknowledgement by the hospitals that they’ve got huge pressure points,” said Dr. David Price, co-chair of the collaboration and head of family medicine at McMaster University and HHS.
“They’ve created as many efficiencies as they could … Now they are starting to say, ‘What else can we do? We can’t cut anything more. There is nothing to trim’ … Maybe we need to look at how we do things and do it differently.”
The collaboration met with roughly 70 health and social service providers at the beginning of May and came up with a proposal to the province.
It will ask the Ministry of Health for an undetermined amount of cash to organize, oversee and analyze a variety of changes in how providers interact with one another starting in three distinct neighbourhoods: Stipley in east Hamilton; Rolston on the west Mountain; and Dundas.
The plan is to add more neighbourhoods in years to come.
“If we could start to understand what are the pressure points and what are the barriers to really good collaboration, maybe we can start to improve how we deliver health care,” said Price.
“Is it creating a clinic? No. It’s starting to think about how we are going to work better together. How do we have a shared after-hours services for our citizens? How do we have a centralized referral process? How do we understand what the needs are in each neighbourhood?”
Price points to the example of a patient who was going to the emergency department about three times a week.
“One of our highest users of health care in this community was somebody who had recurrent emergency room visits,” he said. “It turns out they were actually seeing them because of itchiness and discomfort because of bedbugs. What is the treatment? It isn’t an antipruritic cream. It’s fix the bedbugs in their house.”
Currently it’s difficult for social services to refer clients to healthcare providers and vice versa.
But the need for the two to work together is apparent in The Spectator’s ongoing Code Red project. Started in 2010 by investigative reporter Steve Buist, the series examines the impact that social determinants of health have on people in Hamilton including linking poverty and a shorter life expectancy.
“The Code Red work over a decade has shaped the conversation,” said Cooke. “How is it that we have a 21-year life expectancy gap between rich and poor neighbourhoods? Clearly that is not a problem that is going to be solved at the emergency room door.”