Determining a final recommendation on Maternal Child

Yesterday an important meeting was held to discuss the future configuration of the Maternal Child / Obstetrics, Gynaecology, and Paediatrics programs. In the 12 months I have been working in Niagara, I have heard from literally thousands of people on a myriad of issues. No issue perhaps draws more attention and comments than the question of whether or not to consolidate Maternal Child services. There is not a consensus among our providers, nor in the community at large, and clearly we must come to a resolution. This issue has been debated in the Niagara Region for approximately 10 years, and this is the third time it has attracted external experts to offer advice.

For many reasons – foremost quality of care and patient safety, but also provider quality of work life, future retention and recruitment and financial realities – it is imperative that we land on a model for this program, and move forward as a Region. It is also essential that we consider how the broader LHIN will increasingly plan and work together to ensure comprehensive care in all services – including maternal child.

While I am never keen on redoing work, in this case I felt the need for a last look by maternal child experts who are leading the evolution of models of care nationally and internationally. Last night I convened an Expert Panel to hear formal presentations from the two options – distributed services and consolidated services. The Expert Panel also has all available data and material related to the two options. This Panel will give me a final recommendation, and they are challenged to use the best possible evidence to determine what will be the best model for safe and high-quality patient care, quality of work life for healthcare providers, and financial sustainability.

We were very lucky to attract an Expert Panel composed of remarkable individuals who are known locally, nationally and internationally for their expertise in maternal child issues. The expert panel members are follows:

Mary Jo Haddad is the President and CEO of The Hospital for Sick Children, or Sick Kids, in Toronto, holding this important role at one of Canada’s and the world’s most distinguished children’s hospital since 2004. Previous to this role, Mary Jo held other important roles at Sick Kids, including Exec VP & COO, Chief Nursing Officer, VP Child Health, and Director of Neonatology and Critical Care. Among her many provincial appointments, Mary Jo is also the Chair of the Provincial Council for Maternal Child Health.

Lennox Huang is the Chair of the academic department of paediatrics at The DeGroote School of Medicine, McMaster University, and the Chief of Paediatrics for both Hamilton Health Sciences and St. Joseph’s in Hamilton. Dr. Huang was trained at the University of Toronto, and then completed a paediatric critical care residency at Rainbow Babies and Children’s Hospital in Cleveland. He actively practices paediatric intensive care and is certified by the American Board of Paediatrics for Paediatrics and Paediatric Critical Care. His other interests include patient safety and hospital quality, and he is known for bringing together evidence, research, patient safety, technology and clinical practice together.

Nicholas Leyland is the Chair of the academic department of Obstetrics and Gynaecology at the DeGroote School of Medicine, McMaster University, and Chief of Obstetrics and Gynaecology at Hamilton Health Sciences. Dr. Leyland also chairs the clinical practice committee for the Society of Obstetricians and Gynaecologists of Canada, a committee responsible for the development of the National Clinical Practice Guidelines.

Brenda Flaherty is the Executive Vice President, Clinical Operations at Hamilton Health Sciences, and is responsible for the clinical programs of Hamilton General Hospital, Henderson General Hospital, McMaster University Medical Centre and Chedoke Hospital. She is an RN and has a Master’s of Public Administration from Queen’s University. Brenda also currently serves as Supervisor, Waterloo Wellington CCAC. She is a member in many provincial and national health care initiatives.

All of these panelists have expertise and knowledge, both in large academic centres in large cities, and in more rural health areas and smaller communities. They are all extremely well qualified to advise our Region as we plan our future, and we can trust in them to endorse the best model for care. I expect this panel will submit their final recommendations to me shortly.

On reflection, I can say with certainty that last night’s presentations were heartfelt and passionate as both sides made a case for what they believe is the best possible model for care. The meeting was also attended by obstetricians and paediatricians from the region, Mayors and other elected officials, NHS staff, and media partners. To ensure complete transparency, we videotaped this session and will make it available to all in the public for viewing along with this blog posting. We are grateful to the presenters and those that attended the proceedings.

One point of clarity should also be made concerning my process as Supervisor. I had previously mentioned that I would be submitting a report to the Minister of Health, but that the two issues of the alignment of the Maternal Child program, and the final site recommendation for the New Hospital in the Southern Tier would be forwarded at a later date. Due to the fact that we were able to bring the Expert Panel together more quickly than anticipated, my plan is now to submit a complete and final report to the Minister at the end of this month. Please note I have also engaged an external expert in Urban Planning to review the report of our Mayors and Regional Chair on siting and provide a recommendation on this important matter.

This final report to the Minister will include my final recommendations on both of those outstanding topics. The decision on the timing of the release of the final report to the community will be determined by the Minister following her review.

Presenters

Non-centralized model:

Centralized model: