SOUTH MUSKOKA DOCTORS RESPOND WITH PLAN FOR 90 INPATIENT BEDS IN BRACEBRIDGE, 50 IN HUNTSVILLE AHEAD OF TONIGHT’S MEETING WITH MAHC
Mark Clairmont | MuskokaTODAY.com
MUSKOKA — South Muskoka doctors aren’t waiting for a meeting tonight with Muskoka Algonquin Healthcare and have released a counter proposal that would see 90 inpatient beds at South Muskoka and 50 at Huntsville.
As well as obstetrics at both sites and no Level 3 ICU beds at Huntsville.
They’re calling it more equitable — while also calling for more “transparency” and access to all site selection reports now.
MAHC’s plan for the early 2030s calls for 139 beds in Huntsville and 18 beds in Bracebridge.
Citing data they say indicates higher inpatient volumes at South Muskoka Memorial Hospital and higher population density in south Muskoka, the 48 physicians propose flipping MAHC proposal almost upside down.
The physician proposal says “given the higher inpatient volumes and higher population density in South Muskoka, it makes sense for patient care to have the majority of inpatient beds at the Bracebridge site.”
And “keeping sufficient inpatient beds at the Huntsville site will minimize the need for patient transfers.”
Their response that they call ‘Care Close to Home’ —‘Innovative model by Muskoka Doctors’ — was endorsed by four dozen active and retired doctors who all signed their names.
It was posted on social media Tuesday.
This is what they will present to MAHC’s re-development committee Feb. 20 after the hospitals board offered to meet with them following nine public meetings across Muskoka earlier this month.
Tuesday’s meeting is closed to the public. And to the press — we were refused permission to attend when we requested a right to audit and report on it.
BRACEBRIDGE:
- Broad Inpatient Services
- 90 inpatient beds with slow stream rehabilitation
- 7 ICU beds to support critical illness
- Obstetrics Services
- Inpatient Surgical Services remain
- 24/7 Emergency Department
- Outpatient/Diagnostic Services
- Broad diagnostic services including Mammogram, Ultrasound, CT
- Continued Outpatient Surgical and Endoscopy Services
HUNTSVILLE:
- Specializing in Stroke Care
- 50 inpatient beds including 12 beds for stroke rehabilitation
- 7 ICU beds to support acute stroke treatment (low volume service with ~20 fibrinolytic treatments given yearly)
- Preserved capacity for inpatient surgical and endoscopic services
- Obstetrics Services remain 24/7 Emergency Department
- Outpatient/Diagnostic Services: Chemotherapy and Dialysis Unit; Specialized Diagnostics including Nuclear Medicine, Bone Density; MRI
Patient Transfers:
They say minimizing patient transfer is in the interest of patient care, operating costs, and the environment. Scientific evidence has demonstrated poor patient outcomes associated with patient transfer and it must be minimized.
Obstetrics:
Services at both sites is necessary to ensure equitable access to care. Reducing obstetrics provision to only one site will create some of the longest distances to obstetrics care in all of Ontario. Studies have demonstrated a decrease in neonatal morbidity and mortality when obstetrical and antenatal care occurs in communities closer to home.
And that it will provide equitable, appropriate services close to home. They say prenatal care supports recruitment and retention of prenatal care providers.
As well, it will continue emergency access to obstetrical providers for local population and seasonal residents of south Muskoka.
They add SMMH obstetrics services will also avoiding overcrowding and burdening Orillia Soldiers’ Memorial Hospital with increased volumes that cannot be supported
Critical care unit:
- 7 bed Level 2 ICU at both sites
Doctors say Level 3 ICU is not necessary for either site and will not significantly reduce transfers out of region.
Currently transfer to level 3 ICU is only rarely required.
That evidence, they claim, demonstrates that Critical Care Outreach Teams do not improve clinical outcomes.
According to the doctors recruiting sub-specialist staff to manage a large Level 3 ICU will be extremely difficult and is not feasible A 7 bed level 2 ICU can be managed by one internist
Physcians’ rationale:
The say their Care Close to Home model makes geographic sense to keep stroke services and outpatient chemotherapy and dialysis in Huntsville.
Given the higher inpatient volumes and higher population density in South Muskoka, they say it makes sense for patient care to have the majority of inpatient beds at the Bracebridge site.
Keeping sufficient inpatient beds at the Huntsville site will minimize the need for patient transfers.
- Stroke services remain in Huntsville
- Geographically sensible to keep Chemotherapy and Dialysis in Huntsville
- Data indicate higher inpatient volumes at Bracebridge site
- Higher population density in South Muskoka
‘Care close to home’:
The doctors will conclude by saying their model offers “sufficient inpatient services at both sites to allow for care close to home South Muskoka will require less new staff (“hospitalists”) as family physicians continue to see their own admitted patients at the south Muskoka site.
The say their change avoids creating some of the longest travel times in Ontario and maintains medical education at both sites.
Next step:
The next step for the doctors, they say, is that consultants’ reports — including those for site selection — “must be made public.”
“Full analysis on costs to renovate/improve existing sites vs. tearing them down and rebuilding.
And “transparency and engagement with community and healthcare providers.”
MAHC has said it will consider the meeting feedback — much of it opposed in south Muskoka — and will decide when to present their final report to the province in the spring or later.
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