Feature photo: Crossing out the word “proposed” on the billboard located at the County Road 42 site of the future Windsor Essex Regional Acute Care Hospital from left are: Tom Bain, Lakeshore Mayor and Warden of Essex County; David Musyj, President & CEO of WRH; Janice Kaffer, President & CEO HDG Healthcare and David Cooke, former NDP Minister and MPP.
Have a Cup of Joe with Joe and David Musyj and get Ready for the Transformation of Healthcare in Windsor Essex
Christmas Day 2017 arrived 24 days early for the Windsor and Essex region.
For it was on the first of December that Ontario Minister of Health and Long-Term Care, Eric Hoskins, visited the Ouellette Campus of Windsor Regional Hospital (WRH) to announce the official go-ahead of the region’s new acute care hospital on County Road 42, the signature facility of a totally revamped healthcare system for this region.
In the opinion of many, this was one of the most positively consequential announcements this region has received in some time.
Among his many remarks, Hoskins cited Windsor Essex’s community engagement as one of the strongest aspects in pushing their bid ahead over other communities in the province.
“The community process that has been undertaken throughout this, over the years, with regards to the new hospital has been exemplary,” says Hoskins. “I do not know if I have seen a stronger community process in the province, quite frankly. You have done an exemplary job with regards to the community engagement process.”
Laying to rest the lingering concerns of some over the final site selection, Hoskins comments, “you know, typically, the Ministry looks to the LHIN (Local Health Integration Network) and the local hospital to make decisions with regard to siting of new hospitals. There is an expectation, however, that there is a strong community process that underpins that recommendation. I am confident that process was undertaken here in Windsor; but the Ministry and the government are not in the business of site selection. We really look to local leadership and local experts to make what they believe is the best decision and to do that through community consultation.”
And, so we begin 2018 with great optimism and enthusiasm that our local health care system has officially moved forward to Stage Two in the process of ushering in medical facilities and programs that we have been sadly lacking.
I had the opportunity to sit down with David Musyj, CEO of WRH, and discuss the impact of this decision for Windsor Essex and look back at the very beginning of what brought us to the announcement by Hoskins. Here are a few highlights of our discussion.
Biz X: David, I don’t want to rehash the process of actual site location, but focus on how the decision was made to go from two general hospital systems — WRH (Met and Ouellette Campuses) to one acute care or “mega hospital.”
Musyj: Joe, what many people don’t realize is that though we have two hospital facilities, we actually have one general hospital system operating at two different locations, each one providing services and medical care that the other doesn’t. Last year alone there were between 600 to 1,000 in-patient transfers between the two facilities. Patients at the Met campus for example, who needed to cath had to be transported to the Ouellette campus and then returned to Met.
Joe: How will one acute hospital remedy this situation?
Musyj: With one acute care hospital, all services will be under one roof and accessible to the region we serve.
Biz X: When did the concept of the one acute care hospital facility begin for Windsor Essex?
Musyj: In approximately 2008, the then WRH (Met Hospital) and the HDG Hospital (Hôtel-Dieu Grace Healthcare on Ouellette) were required to submit to the Ministry of Health 10, 20, and 30 year plans on the viability of their facilities. Now remember, HDG has been in existence for more than 125 years, and Metropolitan Hospital since 1928. Through the years both hospital systems have undergone major reconstruction and expansion numerous times. The problem with both sites, aside from them having aged infrastructure, is that they are both landlocked, which limits future expansion. For example, HDG is located on just eight acres of property.
Biz X: What was submitted in the plans to the Ministry of Health?
Musyj: After extensive examination of facilities in consultation with building experts and authorities, it was deemed that $2.2 billion would be required to upgrade the two facilities. And with that, residents would be getting a deficient product, one that at best might provide adequate care in the short-term, with no possibility of improving in the years to come. WRH Met Hospital considered building a new facility on their current property where parking is located in the front, and tearing down the existing facility and replacing it with a parking structure. HDG really had no available land on which to expand. At HDG, there are actually floors that do not line up with one another; and elevators that go to certain floors, but not others. It has reached the end of its road in terms of updates.
Biz X: Were there any other factors that worked against maintaining the two hospital locations?
Musyj: One of the most significant drivers for one acute care hospital was the establishment of the satellite Schulich School of Medicine at the University of Windsor. Both hospital campuses needed to find teaching space for the students; this is a requirement for communities obtaining a medical school. There was little or no classroom space for the medical students.
Biz X: So how did the concept of the one acute care hospital enter the discussion?
Musyj: In 2012, Ontario Deputy Premier, Dwight Duncan, aware of the reports tendered to the MOH and the shortcomings of both hospital locations, recommended that a nonpartisan task force be established to investigate whether one acute care hospital would meet the needs of the Windsor Essex region. The task force consisted of David Cooke (NDP), Tom Porter (Conservative) and Teresa Piruzza (Liberal). They conducted exhaustive community consultation across Essex County examining the positives and negatives of moving to one acute care centre site. They conducted town halls, met with Mayors, city councils and variety of community interest groups, conducted radio call-in shows and a number of other information gathering sessions. That started in the spring of 2012 and the report was tendered in November 2012. The report concluded that there was overwhelming support for Windsor Essex to move to one acute care facility.
Biz X: What direction did the province give you with respect to the coverage area that a regional acute hospital, if built, would cover?
Musyj: When we received the letter from Deb Matthews, then Minister of Health, approving us to move forward in applying for funding for a mega hospital, she made it very clear that part of Stage One required that we not only do all the work that was outlined, but that we needed to site the hospital. In doing so we needed to take into account the regional aspect of this facility. We are not only serving Windsor Essex, but we serve the whole Erie St. Clair LHIN (Local Health Integration Network). We will have to provide service to cardiac patients, cancer patients, NICU patients, and other tertiary services for the entire Erie St. Clair LHIN. So, we not only have to take care of residents from Windsor and Essex, but the entire LHIN — from Sarnia, from Chatham — all the way from London down. To illustrate this point, on December 3, 2017 two days after the Hoskins’ announcement, the following was tweeted on Twitter by Lori Marshall, President and CEO of Chatham-Kent Health Alliance: @LoriBMarshall “A strong regional system needs all levels of care – thank you @DrEricHoskins for investing in @WRHospital to support residents of Chatham-Kent who access those services.” This area of responsibility benefits Windsor and Essex because we wouldn’t be able to support or sustain a cardiac — angioplasty program, neurosurgery program, NICU, cancer, etc. Windsor Essex benefits by serving the entire LHIN. With just volumes from Windsor and Essex, physicians would not have the critical mass to support a practice, and they wouldn’t be able to develop the expertise they have.
Biz X: Are you saying that with the new acute care hospital, we will not only retain current programs and services, but possibly expand into new areas where patients currently travel to Detroit or London to receive them?
Musyj: I always prefer to “under-promise” and over-deliver. Two game changers have occurred in the past 10 years that have allowed us to recruit specialists far better than 20 years ago — the start of the Schulich School of Medicine in Windsor, and the planning of a new state-of-the-art acute care hospital. In the past when we recruited we were lucky to get one application. Now we are actually choosing from a list of recruits and conducting interviews because specialists are excited to participate in medical education and in the planning of a brand-new state-of-the-art acute care hospital.Biz X: Hoskins seemed to surprise us in his announcement with news that he would like to have your group examine further the feasibility of maintaining perhaps part of the Ouellette Campus for some emergency/ambulatory surgical procedures. What is your response to this?
Musyj: In our Stage One submission we proposed to construct a state-of-the-art Urgent Care Centre on the old Grace Hospital site which would function like an emergency room for the many non-life-threatening cases that tend to clog up the ERs. Minister Hoskins announced, and further explained in a later media scrum, the following: “Part of the discussions that are taking place on going forward, we’ve made the commitment to fund the health services required including the new hospital. But, specifically today, I said, and deliberately, that we are now, continuing and deepening the discussion with regards to maintaining health services in the downtown core. So, what that looks like, I don’t know . . . the leadership that had been involved at every level on the conversation thus far, needs to continue that conversation and discussion when it comes to services for the downtown core. So, I’m not going to predict, or preempt, or suggest what that might look like because it’s obvious these are recommendations and proposals, so they’re best suited by those who are closest and have the expertise to determine what they might be.”
Biz X: So the Urgent Care Centre proposed for the Grace Hospital site is not necessarily a done deal . . . would you consider this statement correct?
Musyj: Throughout the process we have looked at the possibilities of the reuse of existing facilities. The Ouellette campus will still have a presence with Outpatient Mental Health Services and Chronic Disease Management. The province would like us to examine the feasibility of maintaining some emergency/ambulatory outpatient services. As you know, funding has been budgeted for the construction of a new Urgent Care Centre on the old Grace Hospital site. This is in addition to the construction and redevelopment of the current HDG Tayfour campus with a new 60-bed acute mental health wing, the addition of dialysis services and the expansion of diagnostic imaging. So, as we move forward, we will continue to examine Urgent Care delivery.
It should be noted, however, that the recently completed Humber River Hospital in Etobicoke went from three facilities to one acute care hospital, and during their process local authorities were asked to examine maintaining limited emergency/ambulatory outpatient care in one of the existing facilities. After exhaustive research, it was determined that could not occur, and everything was eventually located in the one new acute care hospital.
Biz X: Thank you and congratulations David, and to David Cooke, Janice Kaffer, President and CEO of HDG, and to all the many volunteers who have worked tirelessly to bring this to fruition.
Musyj: The Minister himself stated he knew and heard about the many volunteer hours that went into this process and submission. He stated his government was impressed regarding what they have heard throughout the years about our Windsor Essex hospitals project and how our community rallied around it. I cannot be prouder to have been born, raised and live in this region. It shows all of us anything is possible . . . nothing is impossible.
To view more of my report and for video coverage check out my blog.