Summary of February 25, 2008 Board Meeting MRHA

The Miramichi Regional Health Authority Board of Directors held its monthly meeting on February 25, 2008 at the Miramichi Regional Hospital. The following are highlights of the meeting:

1. Patient occupancy rate remains high

The occupancy rate for medical beds at the Miramichi Regional Hospital is 109%. This includes beds on the Restorative/Rehabilitation Unit, Medical Stepdown Unit, Pediatrics, and Medical/Palliative Care Unit. Currently there are 25 alternate level of care patients in the Miramichi Regional Hospital, 17 of these patients are approved and waiting for a nursing home; four patients are in the assessment process for a nursing home; and four patients are waiting for a special care home.

The Board was advised in January that the Department of Health had not accepted the region’s proposal to temporarily relocate alternate level of care patients to a hospital unit currently used for office space. In response, the Board chairperson, Georges Savoie has written a letter to the Department of Health expressing disappointment in this decision and has requested to meet with government officials to discuss other options. For the last two years, an average of 25-30 alternate level of care patients have occupied acute care medical beds while waiting either for assessment or placement in an alternate setting such as a nursing home or special care home. This is the equivalent of one patient care unit in the hospital. This limits the ability to provide space for acute care patients who require hospitalization and adds additional pressure on hospital staff who is dealing with an increased workload.

2. Financial Summary

It was reported that at the end of December 2007, the Miramichi Regional Health Authority had a nine month operating deficit of $2.2 million. This is half a million dollars less than the anticipated projected deficit. Contributing factors of the deficit include costs associated with a high hospital occupancy rate, higher volumes of orthopedic and ophthalmology surgeries, increased activities in the obstetrics department, and an increase in medication and surgical supplies for the outpatient clinic department.

3. Recruitment Update – Internist recruited

In his report to the board, President and CEO Gary Foley provided a recruitment update. He was pleased to introduce Dr. Koos DuToit as the new Vice President of Medical Services. Dr. DuToit has worked in the Miramichi as an obstetrician/gynecologist for the past five and a half years. He has served as a member of the Surgical Care Team, the Pharmacy and Therapeutics Committee, and the Medical Advisory Committee representing obstetrics. Prior to joining the medical team at the Miramichi Regional Health Authority, Dr. DuToit practiced obstetrics/gynecology in his home country of South Africa. “I accepted this position as a means to give back to the medical and Miramichi community whom has been so welcoming and supportive of my family and I since moving here over five years ago,” says Dr. DuToit. He says he looks forward to working with the medical staff and senior management team in his new role.

Foley also reported that offers have been made to a pathologist and family doctor and discussions are ongoing with two family doctors. An internist recruited from South Africa will begin work in March. Recruitment is ongoing for internists, family doctors, and radiologists.

In the area of professional recruitment, it was reported that ten graduate nurses had been hired and it is hoped that this number will increase by the spring. It was also reported that the Director of Human Resources, Cecilia Mutch had tendered her resignation to pursue a career opportunity out west. Cecilia was thanked for her contribution and dedication to the health authority.

4. Laboratory quality improvement measures reviewed

In her report to the Board, Marilyn Underhill, vice president of professional services provided an overview of quality improvement measures used in the lab. She noted that two previous reviews of pathology services have indicated the work of the current pathologist and lab staff is of excellent quality. The quality improvement measures used are as follows:

· Consultations or second opinions are made with other pathologists at labs that are primarily university centers/ or prominent specialists in the field.

· Quality Assurance Program: Participation in the College of American Pathologists Quality Assurance Program in the areas of Hematology, Blood Transfusion Medicine, Chemistry, Histology and Cytology.

· Process for slide retrieval was formalized in 2005 and is used when a pathologist requests previous slides to compare with present material.

· Continuous monitoring of turn around times. The measurements begin when tissue is received by the lab and ends the day it is signed out by the pathologist. Our turn around times are slightly increased, by 24 hours, to incorporate a longer fixation time; however this has improved the quality of slides and decreased repeats. (Many outside pathologists have offered comments on the high quality of slides our Histology staff produce)

· The process of reviewing 10% of random slides is occurring between our pathologist and our locum pathologist.

· Our pathologist attends continuing medical education workshops related to pathology to keep up to date in current practice.

Board Chairperson thanks staff for work in conducting the retrospective review:
In his report to the Board, Chairperson Georges Savoie sincerely thanked all staff for their work in respect to the retrospective pathology review. “Patient safety is a priority for the Miramichi Regional Health Authority. Two independent reviews have indicated that no concerns were raised regarding the work of the hospital’s current pathologist. We are confident in the current laboratory services and the staff and pathologists who work there. Miramichi Regional Health Authority is dedicated to improving the system. We also fully support our administration, staff and the Department of Health in completing this retrospective review. Our staff does an excellent job on a daily basis in providing patient care.” It was agreed that letters of appreciation and support be sent to the staff involved and the Minister of Health for his support of this review.

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