Summary of March 26, 2007 Board Meeting

The Miramichi Regional Health Authority Board of Directors held its monthly meeting March 26, 2007 at the Miramichi Regional Hospital. The following are highlights of the meeting:

1. Health Authority experiencing overcrowding in the ER

Through the Medical Advisory Committee’s report, Dr. Michael Hayden, chief of emergency medicine reported that the continuing problem of patients awaiting admission to hospital and being cared for in the emergency department for prolonged periods of time is causing concern. The situation is directly related to the consistent high occupancy rates of medical beds available in the hospital. “This is very demanding and stressful for emergency department staff and provides a less than ideal setting for patient care,” said Dr. Hayden. The pressures this is causing include greater than normal wait times due to a lack of space to assess and treat incoming patients, increased risk to patients as the department is not designed to care for inpatients, and a greater level of stress placed on the department’s staff and physicians. The number of patients waiting in the emergency department for a hospital bed varies from 0 to as high as 11.

As a result of this continuous problem and its impact, the Medical Advisory Committee passed a motion that the emergency department will only be holding a maximum of four patients waiting for a hospital bed. When this number is exceeded, patients will be disbursed to overflow beds within the hospital.

Gary Foley, president and CEO indicated there are many causes to the problem, although it is recognized that alternate level of care patients awaiting nursing home placement are occupying medical beds in the facility that could be used for acute patient care. “In past years, we experienced these pressures during the flu season however there are no longer relief periods. This is a consistent and continuous situation.” Over the last ten months a total of 20 to 25 patients have been occupying medical beds while waiting for either an assessment or placement to a nursing home. The Board unanimously passed a motion for the Board chairperson to write a letter to the government endorsing Mount Saint Joseph’s proposed expansion of 25 beds in which they have their own capital funding.

Foley informed the Board that stakeholders have been meeting on a daily basis to review appropriate bed utilization. He will be meeting with the deputy ministers of Health and Family and Community Services later this week to discuss the impact of this issue on the Miramichi Regional Hospital and possible solutions.

2. Financial Summary

It was reported that at the end of January 2007, the Miramichi Regional Health Authority had a ten month operating deficit of $1.2 million. Contributing factors of the deficit include costs associated with physician locums, recruitment, high occupancy rates of patients in the emergency department waiting for a hospital bed, and high patient days in the operating room and outpatient clinics.

3. Recruitment Update

Gary Foley, President and CEO provided the committee with a recruitment update. He was pleased to inform them that anesthetists, Dr. Morales and Dr. Rai had arrived. Their arrival completes the full complement of anesthetists. He was also pleased to advise them that Dr. Mahfoudi, psychiatrist also had arrived bringing the complement of psychiatrists to four of which two are bilingual. Discussions with an urologist have been successful and he is expected to begin work in August. Active discussions are ongoing with internists and family doctors.

Foley thanked Dr. Carl Hudson for his contribution to the organization over the last number of years as the vice president of medical services. Dr. Hudson will be leaving the position at the end of March to pursue his family practice full-time. He indicated that discussions are ongoing to fill the position.

In other areas of recruitment, Foley was pleased to inform the board that 15 graduate nurses had been recruited to join the float team upon graduation in the spring. He said a physiotherapist and medical radiation technologist had also been recruited. The First Nations Liaison position interviews have been completed and are in the selection phase.

He reported that a new structure will be implemented for Maternal Child Health Services that will have one nurse manager responsible for the pediatric and obstetrics nursing units. A resource nurse will be hired to support the staff in their clinical and professional development in order to improve patient care standards. This change is based on the recent resignation of the pediatric nurse manager and recommendations made from the Nursing Leadership review in early 2006.

4. Mango awarded grant

In her report to the Board, Marilyn Underhill, vice-president of professional services was pleased to announce that Mango had been awarded a grant from the National Collaborating Center for Healthy Public Policy based in Quebec. The grant will be used to fund a part-time position that will be responsible to develop healthy public policy that addresses obesity in the region. Miramichi is one of four sites across the country that was chosen to receive this funding.

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