Chesley ER closure tops discussion during SBGHC board meeting

BRUCE-GREY – The board of directors of South Bruce Grey Health Centre remains determined to resolve staffing issues that have led to the temporary closure of emergency departments at its hospitals.

The most severely affected is Chesley, but closures have hit Durham recently. All four sites have seen at least one overnight ER closure.

Board chair Bill Heikkila gave the final word at the Nov. 2 meeting by stating, “We are not going to be satisfied until we restore full services at all four sites.”

In the absence of CEO Michael Barrett, interim chief nursing executive Mandy Dobson and chief financial officer Drew Braithwaite presented information on the reduction of services in Chesley at various points throughout the meeting. There was little on that front in terms of good news, other than the fact that efforts continue to resolve the issues that led to the two-month ER closure. However, a number of positive items were discussed during the meeting.

The Chesley matter first arose during discussion on finance.

A year-end deficit of $2.3 million is forecast at this point, due to a number of factors: the Ministry of Health cutting off COVID financial assistance, the need to pay for agency nurses, sick time and overtime, and Chesley physician coverage.

As discussed during Doug Harris’ Corporate Resources Committee report, there are 50 positions open at present, representing 25 per cent of the SBGHC workforce. Many of the nurses at SBGHC are new, novice nurses. The use of agency nurses was also discussed.

The item of good news is scheduling software has been purchased to facilitate filling shifts in a fair and efficient manner.

Chris Oberle said he’d like to see a financial comparison on a monthly basis of the cost of using agency nurses, as opposed to staff nurses.

Braithwaite and Harris commented that in general, agency nurses cost three times more than staff nurses, pointing out that a “significant” amount goes to the agency, not the nurse.

There was also discussion about communication as it relates to the Chesley situation.

Heikkila noted that it was pointed out during the public meeting in Chesley that social media isn’t necessarily the best way to reach certain demographics. A lot of older people want to read information in printed form, and that’s been done in Chesley.

Dobson updated the board on a number of points involving Chesley. Effective Nov. 7, a scheduling supervisor has been hired. In response to questions from the board, she said that while multiple-site positions allow more flexibility in covering sick calls and vacations, single-site positions are an asset in hiring, allowing “more desirable schedules.”

She also provided an update on the nursing extern program – SBGHC has nine, and an interview is scheduled for another. This program “helps build their knowledge and skills,” meaning student nurses are more confident when they begin regular full-time positions.

The New Graduate Guarantee Program offers 12 weeks of mentorship to new nurses. Both programs attract new nurses to join the SBGHC team.

Dobson presented a review of the situation with the Chesley emergency department. Much of the information isn’t new – it’s been discussed at previous board meetings and at the recent public meeting in Chesley.

The main elements are the fact that SBGHC has been facing significant staffing shortages for the past five years, especially in nursing. At the same time, there’s a national nursing shortage that has put a strain on the entire health-care system, forcing many hospitals to reduce services.

In September 2019, the decision was made to close the Chesley ER overnight. It reopened in June 2022. However, toward the end of the summer, staffing deteriorated, resulted in intermittent overnight closures and even full-time closures, often with little notice. All sites have experienced at least one overnight closure.

The staffing situation finally resulted in the decision to completely close the Chesley ER for eight weeks, beginning Oct. 7. The measure was considered preferable to intermittent, last-minute closures.

All options for resuming service Dec. 3 are presently being explored.

SBGHC’s COVID vaccination policy was reviewed. While SBGHC did not terminate any staff due to vaccination status, all new staff must be vaccinated.

Another staffing situation that generated discussion involved when a nurse or doctor accompanies a patient being transferred by ambulance to another location.

Dr. Lisa Roth, chief of staff, commented that “we like it when ORNGE (air ambulance) comes because no nurse will be needed.”

She noted that when a patient is stable and going to another site for tests, it isn’t necessary for a nurse to accompany the patient. However, should that not be the case, one of the three nurses on duty at the Kincardine site would go with the patient, leaving a potential problem “if something serious comes in the door.”

There are a number of factors involved besides the care needed by the patient. There are also varying levels of training among paramedics.

Kincardine redevelopment right on track

One bright point during the board meeting was the Kincardine Redevelopment Oversight Committee (K-ROC) report.

Heikkila said, “Construction crews are working around the clock” on the building that will house the new CT scanner. Startup is still scheduled for late March.

Heikkila noted the redevelopment is going well too. The board will be submitting the Phase 3.1 package on Nov. 18. Construction could begin in late 2025, Heikkila said. He added that the hospital foundation will be ramping up its fundraising efforts after Nov. 18.

Pauline Kerr, Local Journalism Initiative Reporter, The Walkerton Herald Times