Churning through patients leads to mass resignation


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It’s a classic case of the tail wagging the dog. And unfortunately, the losers in this administrative boondoggle are the close to 200 patients who have taken advantage of the services offered at the Central Community Health Centre

To set the scene, the CCHC opened its doors at 359 Talbot St., in St. Thomas on Oct. 4 to serve residents of the city, Southwold and Central Elgin who don’t have a family doctor.

On opening day, three nurse practitioners, a doctor and a registered were at the clinic to greet patients.

Little more than two months later the staff has resigned citing serious safety concerns for patients of the CCHC.

Physician Janice Owen spoke to City Scope on Friday to explain why she handed in her resignation on Dec. 3.

“We walked in there are all excited about doing the right thing and we had a great group of nurse practitioners and myself. We had great ambitions, but we found out quickly it was the tail wagging the dog.

“It was management and the administration deciding how we were going to practice, based on how long we were going to be allowed to see patients, no matter how complex. Bringing patients in in a rapid manner without being able to deal with very complex issues.”

In other words Owen and the nurse practitioners were caught in a numbers crunch. There was pressure to up the patient intake to 800 by March of next year to meet budget requirements.

“We felt very uncomfortable,” Owen advised. “We felt we were letting people on the boat, and we’ve got way too many people on and the boat is sinking half-way down there. I felt very vulnerable as a physician in providing good quality care.

“We discussed this with management and said we can’t do this, it’s not good.”

Management in this case is executive director Judith Wiley and a board of directors, none of whom have healthcare experience in a clinical sense, suggests Owen.

The centre is funded through the Ministry of Health and Long-Term Care via the Southwest Local Health Integration Network, with a first-year budget of approximately $500,000.

Owen told this corner her concerns encompass more than the quickly escalating caseload.

Less than half of the full complement of staff has been hired at this point, placing an extra burden on Owen and the nurse practitioners to deliver comprehensive care without adequate nursing support.

She added numerous administrative staff have been hired who have little if any experience in community healthcare centres or primary-care offices and they are unaware of how to process patient reports in a timely fashion.

Owen said she had concerns the work environment for administrative staff appeared to take priority over clinical staff requirements for supporting patient care.

Part and parcel of that, the physical space is not conducive to efficient work flow.

The management and administrative offices are located where the clinical space should be, Owen points out, and information technology support is not accessible for electronic charting problems because of the location of the IT office.

“Stop the madness,” Owen told the executive director, prior to tabling her resignation. “We’re not supposed to be churning patients through.”

The decision to terminate her contract was with great regret, stressed Owen.

“When it starts to challenge your own personal integrity as far as your ability to practice, and when you’re on the phone calling our professional bodies about this, you know we’re a little worried.”

There is little doubt the Southwest LHIN will be looking into this embarrassing situation that has resulted in a mass resignation of staff, less than two months after the clinic opened with great fanfare.

Especially when the CCHC was to help address lengthy wait times at St. Thomas-Elgin General Hospital and offer hope to those who have no access to a family physician.

So what went wrong?

Next week in this space we’ll talk to Wiley and the CEO of the local LHIN to determine how this train jumped the tracks minutes after leaving the station.

QUOTE OF THE WEEK

“I’m a strong believer in emergent design so if there’s something that’s coming down the pipe that we need to grab hold of and sink our teeth into, to be at the ready.”

Huh? All right, who gave Ald. Lori Baldwin-Sands a corporate management book of bafflegab as a gift? You know, the ones where you take a cliche each from column A, B and C and then paste them together into a sentence in the hope of answering any question.

City Scope appears every Saturday in the Times-Journal. Questions and comments may be e-mailed to: mccallum@stthomastimesjournal.com.

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