Let's Talk

This is an exciting time for health care in Durham Region. In 2016, five hospitals, a residential treatment centre and more than a dozen community health care locations came together to create the new Lakeridge Health. Today, as one of the province’s largest community health systems and the acute care provider for Durham Region, Lakeridge Health together with our community and partners has the opportunity to reimagine the future of acute care to ensure people have access to the services most needed by our community.

Opportunities to help shape Lakeridge Health’s future:

If you missed our telephone town hall on Wednesday, November 28 focused on building a stronger acute care system, an audio replay is available at this link. A summary of the Q&A is included below.

Thank you for your support as we embark on this tremendous journey together.

 About the telephone town hall

What is the telephone town hall?

The telephone town hall is a live discussion with experts and leaders held over the telephone with thousands of residents of Durham Region. It is on Wednesday, November 28, 2018 at 7:00 p.m. and will last about 45 minutes. Participants can ask questions, answer polls or just listen in.

Why is Lakeridge Health doing this?

This is an opportunity to reimagine the future of acute health care for everyone in our community. It is a chance for people to share ideas, suggestions and feedback about how our growing communities can continue to have excellent health care, close to home. This feedback will inform Lakeridge Health’s future.

Who will be on the call?

Hosted by Jerry Archer of KX96, the telephone town hall will feature Lakeridge Health President and CEO Matthew Anderson and Chief of Staff Dr. Tony Stone. Participants will include thousands of randomly-selected Durham Region households, plus anyone who registers in advance.

How can I participate?

10,000 randomly-selected households in Durham Region are automatically called. If you would like to ensure you are on the list, please call 905-721-7792 ext. 2160 and leave your name and telephone number, or email letstalk@lakeridgehealth.on.ca.

Can I ask a question?

After you have registered, all you have to do is answer your phone when it rings a few minutes before 7:00 p.m. on November 28. You will automatically join the telephone town hall. You can also live-stream the event at https://vekeo.com/lakeridgehealth/

 Telephone Town Hall Frequently Asked Questions
 

 Please click on the tabs below for questions and answers related to:

  • Emergency Departments
  • Hospitals and Operations
  • Mental Health and Addictions
  • Access to Services
  • Quality and Availability of Care
Emergency Departments
What can be done about overcrowding and long wait times in the emergency department?***

As one of the busiest community hospital systems in Ontario, Lakeridge Health is working across all of our sites to ensure that people get the care that they need, when and where they need it. The high volumes in emergency departments (ED) across Ontario continue to be a significant challenge.

One factor causing ED overcrowding is “ALC” or Alternate Level of Care which refers to people who are ready to be discharged but remain in the hospital waiting to move to a more appropriate place to meet their needs such as a rehabilitation centre, long-term care home or home care. Like all hospitals in the province, Lakeridge Health is working hard to help people who are in a hospital bed to transition to the next phase of care, so that people who require an inpatient bed can get there as quickly as possible.

At the same time, Lakeridge Health is working on innovative ways to improve access to health care including our partnership with Carriage House Retirement Home and Saint Elizabeth Health Care to provide transitional beds in a retirement home setting for people who need additional time and support before they can return home from the hospital. This program is helping to free up inpatient beds for patients in the ED who need to be admitted.

Another example is the North Pickering Health & Wellness Centre, which will be a one-stop shop for outpatient services, including urgent care. Further, Lakeridge Health is exploring innovative virtual care models, and working closely with family physicians and other primary care partners to improve how patients access the services they need.

Should there be a section in the emergency department for people who need simple, non-critical attention?***

If a visit to a primary care physician is not a viable option in the circumstances, a variety of urgent care options are available in the community. Please see a list of options on our website at https://www.lakeridgehealth.on.ca/en/ourservices/emergency-and-urgent-care-options-.asp

For those who need to visit the emergency department, hospitals use a rigorous triage process to ensure that the patients with the most serious and urgent needs are seen first. It is better for everyone if people who have non-critical, non-urgent conditions can access care elsewhere, and Lakeridge Health is committed to working with our health care partners to make this easier for people.

How does the triage process work?

When someone first comes to the emergency department, they will see a nurse who will ask some questions about their condition and may take their temperature and blood pressure.

The urgency of the person’s condition is assessed using the Canadian Triage and Acuity Scale (CTAS). This is a five-point scale that all Canadian emergency departments use to determine how urgently someone needs to be seen.

People who need immediate interventions (cardiac arrest, major trauma or shock) are considered to be CTAS 1 (the highest acuity), while people whose condition is not urgent are considered to be CTAS 5.

People assessed as having the highest acuity receive immediate care and treatment, while people assessed at lower acuity (CTAS 3, 4 or 5) will register and wait to be seen. People are seen according to the urgency of their condition, and less urgent patients might have to wait while others are seen first, even if they arrived later. If someone’s condition changes while they are waiting, they should let staff know.

Are there provincial standards for wait times in the emergency department?

The Ontario Ministry of Health and Long-Term Care sets length-of-stay targets for the maximum amount of time people spend in the emergency department. These targets are based on recommendations from clinical experts, and vary based on the CTAS scale described above. For example, for people whose condition is assessed at CTAS 5, the provincial target wait from the time a patient arrives to discharge is four hours. Targets vary for more complex conditions that require a number of different tests, a consultation with a specialist, and other factors. For people who need to be admitted to the hospital, the availability of an inpatient bed can affect the length of time they wait in the emergency department.

Lakeridge Health strives to see and treat people within the province’s wait time targets for each CTAS level. We closely monitor our performance against these targets and continuously seek ways to improve.

What is Lakeridge Health doing to educate people about more appropriate alternatives to the emergency department for non-critical care?

Lakeridge Health uses a variety of communications strategies to share information and educate the public about when to use the emergency department including a section on Lakeridge Health’s web site, media stories and social media.

 Hospitals and Operations
Can you confirm reports that a new hospital is coming to Durham Region?

In November 2015, the Ontario Government-appointed Scarborough/West Durham Expert Panel, recommended that a new comprehensive acute care hospital should be constructed for Durham Region. The Ontario Government announced its support for the new hospital in its 2018 Budget. Lakeridge Health initiated a Master Planning process in early 2017 to create a roadmap for the facilities and infrastructure improvements and expansion required to meet the needs of our community for the next five, 10, 20 years and beyond.  A new hospital, in addition to our current hospitals, will be an important part of our Master Plan.

What can you tell us about the Bowmanville Hospital redevelopment? Will it include a children’s wing?***

Last January, the Ontario Government gave the green light for the Bowmanville Hospital redevelopment. This was great news for our community. We are now actively working with the Ontario Government on a plan that will double the size of the hospital and add new enhancements, including a new emergency department, surgical services and diagnostic imaging.

Redeveloping a hospital is a complex journey. It takes a number of years to get from the approval stage to breaking ground for a new hospital, following a rigorous process. Currently, we are at Stage 1 or the “Proposal Stage”. Here we show the overall size and scope of the future hospital as well as the types of services that could be provided. We are on track to give our Stage 1 submission to the Ontario Ministry of Health and Long-Term Care in spring 2019.

Next is Stage 2 – the “Functional Program” phase. This is when we consider how we will staff the new hospital, what kinds of equipment we will need and how much space is required. This phase could take up to two years.

During Stages 3 and 4 we will focus on architectural planning and design. During these phases, it is common to make changes to adapt to new safety requirements and patient care standards. After Stage 3, we will have a better idea about how long it will take to start construction and open the new spaces.

What are we doing to help people who work at Lakeridge Health take care of their own health?

At Lakeridge Health, employee and physician wellness is a top priority. The organization is focused on working with our teams to find the best ways to support all members of the Lakeridge Health team, recognizing that we need to take care of the people who care for others. Examples of how we assist Lakeridge Health team members include: on-site training, confidential voluntary counselling and referral services 365 days a year through our employee assistance program (EAP) and on-site activities like massage therapy and yoga etc.

How can the health system get better at sharing clinical information among health care providers?

Lakeridge Health is working closely with primary care physicians and other partners to find better ways to improve the flow of information across all parts of the health care system.

We are working within all Lakeridge Health hospitals and community sites and with providers across the region to improve connectivity between systems. For example, MyChart™ is a free, secure online tool providing patients and designated family members and care partners at Lakeridge Health with access to medical records and personal health information such as test results, a medication record and other health information. 

We are also partnering with the six other acute care organizations within Central East Ontario to secure a new clinical information system. Having the same system across all 15 acute care hospitals from Scarborough to Peterborough will help connect providers, giving them access to state-of-the-art information management and clinical tools to advance the quality of care in our region.

Does Lakeridge Health have plans to improve the availability of food and meal options?

The type of food people receive is a very important part of a healthy and healing hospital environment. The meals served to patients in the hospital must be balanced and nutritious while avoiding excessive amounts of sugar and salt.  

We always want to ensure that there is good quality food available for visitors and the Lakeridge Health team for longer hours and are working with partners to look at different ways to provide additional on-site food services at our hospitals. 

What is the role of the Foundations at Lakeridge Health?

Lakeridge Health is fortunate to be supported by four wonderful Foundations which raise funds to purchase vital equipment and supplies to support our patients, families and communities. The Port Perry Hospital Foundation, Ajax Pickering Hospital Foundation, Bowmanville Hospital Foundation and the Lakeridge Health Foundation (supporting Oshawa Hospital and Whitby Hospital) provide a way for people in these communities to give to their local hospital. The four organizations collaborate closely to support the needs of all people who live and work in Durham Region.

Mental Health and Addictions
What is happening to improve access to mental health and addiction services, including for people who are addicted to cannabis?***

Lakeridge Health has introduced a number of strategies to assist people with opioid and other addictions, including two Rapid Access Addiction Medicine (RAAM) clinics which are open four days per week at Oshawa Hospital and the Pinewood Centre in Oshawa. People with substance abuse who come to the emergency department (ED) are connected with a RAAM clinic for further support. An emergency department physician and an addiction counsellor work together in these low barrier walk-in clinics. Some patients have said that these clinics have saved their lives.

Lakeridge Health will also be opening a new, 22-bed mental health unit at Ajax Pickering Hospital as well as making improvements to that hospital’s emergency department to enhance the safety of patients and staff as well as the privacy and dignity of people with mental health conditions. 

What happens when a person comes to the emergency department in a mental health crisis?

Every situation is different, but here are some typical steps that take place when someone arrives at an emergency department (ED) in crisis.

The first step is to seek information about the reason the individual is in crisis.  At the beginning, a nurse tests their vitals such as blood pressure and respiration. Once the individual is confirmed to be medically stable, a physician in the emergency department does an assessment and a crisis worker and/or psychiatrist may be brought in to see the individual, if needed. Together, the health care team develops a care plan in consultation with the individual and the individual is usually either admitted to the hospital for treatment or discharged home with support such as follow up care from their family physician and connection to a community agency for ongoing support with mental health and addictions and other needs. 

This entire process can take several hours and we strive to make it as quick and effective as possible and to always deliver care with empathy and respect.

Access to Services
What are we doing to improve access to long-term care or home care services?

“ALC” or Alternate Level of Care refers to people who are ready to be discharged but remain in the hospital waiting to move to a more appropriate place to meet their needs such as a rehabilitation centre, long-term care home or home care. ALC is an ongoing challenge which requires a collaborative approach between hospitals, other health care providers, the Ministry of Health and Long-Term Care and the LHIN. 

Lakeridge Health and our partners are focused on ensuring patients are well-supported at discharge, preventing readmission to hospital, and supporting patients to safely return home and to the community after a hospital stay. An example of how we are doing this is our partnership with Carriage House Retirement Residence and Saint Elizabeth Health Care to provide 10 off-site transitional beds for people who need additional support to be able to transition home. The multidisciplinary care team works to restore patients’ physical functioning and supports them to move home or to the next stage of care when they are ready.

We are also exploring ways to enhance support for patients with chronic conditions in the community and at home.

Why can’t surge beds be open all year?

Lakeridge Health hospitals are now constantly overcapacity, which means there are not enough beds for the people admitted to the hospital. Our surge beds are now open all year to accommodate additional patients requiring inpatient care in our hospitals.  During the winter season we see a higher number of patients as a result of flu and other factors. As a result, Lakeridge Health has opened additional surge beds over and above the surge beds already in operation. We have also equipped all inpatient rooms to accommodate additional patients.

What are we doing to advance health care for seniors?***

Lakeridge Health has a range of specialized services and partnerships to assist seniors to be as healthy as possible and receive the right care, in the right place, at the right time. We are implementing best practice approaches to support seniors and caregivers with prevention and to improve their quality of life. For example, the Geriatric Rehabilitation and Assessment Unit at Oshawa Hospital helps people who need time to regain their strength and manage other issues such as risk for falls, delirium, or depression that may be preventing them from living independently at home. Find out more at https://www.lakeridgehealth.on.ca/en/ourservices/geriatricassessmentandrehabilitation.asp?_mid_=2600.

We also have a Geriatric Assessment and Intervention Network Clinic (known as the GAIN Clinic) for seniors who live at home or in a retirement residence. It is a nurse practitioner-led clinic staffed by a team of health care professionals who are experts in seniors’ health. The GAIN Clinic supports seniors to remain in their own homes and enjoy the best possible quality of life. Find out more at https://www.lakeridgehealth.on.ca/en/ourservices/geriatricclinic.asp.

The new Geriatric Transition Unit at Ontario Shores, in partnership with Lakeridge Health and the Central East Local Health Integration Network, means seniors with dementia and complex conditions will receive care and treatment in an environment better able to support their transition home or to another community setting.
 

The Transition to Home team at Lakeridge Health is made up of a Geriatric Emergency Management Nurse, social worker, physiotherapist, flow specialist, and Home and Community Care Coordinator. This specialized team supports individuals with complex needs to be safely discharged and well supported when they return home or to 
Quality and Availability of Care
How does Lakeridge Health work with other hospitals for stroke care?

Anyone who thinks they are having a stroke is encouraged to call 911 to be transferred directly to Oshawa Hospital which is the district stroke centre for Durham Region. Oshawa Hospital has 24/7 access to stroke physicians who can assess, treat and manage individuals who may be suffering a stroke. Some people may be eligible to receive clot-busting drugs while others may be referred to another hospital outside of Durham Region for highly specialized care. Lakeridge Health also has an integrated stroke unit that provides stroke care to patients during the acute and rehabilitation stages.

How does a patient get referred in to the fracture clinic?

People come to Lakeridge Health fracture clinics as a result of a referral from a primary care provider, walk-in clinic or through the emergency department. The fracture clinics book an appointment with the first available provider, taking into account the urgency of each person’s situation. While wait times can vary, the fracture clinics aim to offer a first visit within one week.

Does Port Perry Hospital offer orthopedic surgery?

This specialized service is offered elsewhere within Lakeridge Health and patients from the Scugog area would typically be referred to Ajax Pickering Hospital or Oshawa Hospital for this service.

Is there a trauma clinic for diabetes?

Anyone who needs urgent care should immediately visit their local emergency department or call 911. Lakeridge Health has a number of services to support people with diabetes, including nurses and dietitians who are experts in diabetes care. The Diabetes Education Program provides education and support to adults living with type two diabetes. Located at Whitby Hospital, Port Perry Hospital and Bowmanville Hospital, the program offers individual assessment and nutrition counselling, insulin and blood glucose meter instruction, and group education sessions to assist people to manage their condition. Whitby Hospital also offers concurrent care from a diabetes specialist (endocrinologist or internist).

There is also a Centre for Complex Diabetes Care at Whitby Hospital. Referrals are made through the Central East LHIN. Details are available at http://healthcareathome.ca/centraleast/en/Getting-Care/Getting-Care-in-Community/diabetes-services/centre-for-complex-diabetes-care.

What do I do if I have questions after my family member has left the hospital?

Hospitals can only provide information to a family member with the consent of the patient unless a formalized Substitute Decision Maker or Power of Attorney is in place. In these situations, the best place to start is with a member of the care team. You are also welcome to contact the Patient Experience team at any time. They can be reached at patientexperience@lakeridgehealth.on.ca or at (905) 576-8711 ext. 4402.

***A version of this question was asked and answered on the telephone town hall

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