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Quinte Health Care Corporate Master Program Summary Overview Quinte Health Care (QHC) has developed a corporate master program, which will serve as the foundation for QHC’s long term capital plan to address the physical space requirements for the organization’s four hospitals, within the requirements for future stages in the Ministry of Health and Long‐Term Care’s (MOHLTC) and the South East Local Health Integration Network’s (SE LHIN) joint capital planning process. QHC’s corporate master program (CMP) was created following a request by the MOHLTC to provide a service delivery context to support facility regeneration for the Prince Edward County Memorial Hospital (PECMH) as a result of the MOHLTC review of a Pre Capital Submission for that site in Picton. The CMP will inform QHC’s strategy for the organization, within the context of the QHC Strategic Plan and the SE LHIN’s regional planning, including Health Care Tomorrow and initiatives toward the enhancement of community based support services.
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The CMP provides a service delivery model for each of the four sites, current and projected workload volumes (2016 through 2035) and projections for departmental space requirements, based on current standards. The program also provides an assessment of priorities for redevelopment based on current conditions and expected service volume changes (demographics and technology). While the immediate redevelopment of PECMH remains the organization’s highest capital priority, the organization’s Tier 1 capital priorities are: Redevelopment of PECMH Trenton Ambulatory Clinics Trenton MDRD Support Belleville Orthopaedic Fracture Clinic
MOHLTC/LHIN Planning Process The MOHLTC/LHIN capital planning process shown below (Figure 1) consists of five separate stages, starting with a needs analysis within a Pre Capital Submission through several stages of detailed program planning and facility design and construction that progresses over a number of years. Figure 1: MOHLTC/LHIN Planning Process
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Planning Process Service delivery planning was built on QHC’s visioning and clinical services strategy. Clinical and service leaders met over a series of facilitated sessions to consider future service delivery at QHC by reflecting on the following: Where services will be provided in the future (home, community or hospital) Where services will be consolidated in the future Use of flexible and adaptable spaces Building in an evolving digital world Creation of patient and family centred spaces Supporting evolving regional models Clinical validation occurred in a workshop held to share the program plans across service groups and to discuss opportunities for synergy. Agenda items included: Scope of service by program Location of services Organization of services Workload projections The Steering Committee, comprised of clinical, support services and physician leaders, provided the planning parameters/assumptions and reviewed draft material before it was submitted to Senior Leadership for approval. Development of the corporate plan was based on a foundation of community and broad stakeholder input during 2015. A Director‐led planning team identified clinical and operational opportunities to align with health system funding reform and local, regional and provincial priorities. The opportunities were based on community engagement which defined top health care priorities, recommendations of the Brighton/Quinte West Health Services Advisory Committee, input from physicians and staff, internal data analysis and external consulting support.
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The community engagement process provided QHC with clear direction on the community’s desired health care system. A summary of the feedback is shown below in Figure 2. Figure 2: Overall Summary of Feedback
Source: QHC, 2015.
Summary of QHC Corporate Master Program QHC System of Care QHC will continue to deliver acute and selected specialized services including medicine, surgery, obstetric, paediatric and intensive care, oncology, children’s treatment centre, ambulatory clinics, complex continuing care, rehabilitation, mental health and addictions services to its local community and contribute to the local and regional health system as a partner that promotes collaboration and integration of services. This clinical vision was developed through a comprehensive process that has engaged internal and external stakeholders and is supported by the QHC Board and broader organization.
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Figure 3 illustrates QHC’s future service delivery model. Figure 3: Future Service Delivery Model
Source: QHC, 2015.
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Figures 4 to 7 (below), outline the site‐specific service profiles of each QHC site. Figure 4: Future Belleville General Hospital Service Profile
Source: QHC, 2015.
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Figure 5: Future North Hastings Hospital Service Profile
Source: QHC, 2015. Figure 6: Future Prince Edward County Memorial Hospital Service Profile
Source: QHC, 2015. © Agnew Peckham, 2016. All rights reserved; unauthorized use, distribution, publication or reproduction prohibited.
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Figure 7: Future Trenton Memorial Hospital Service Profile
Source: QHC, 2015. Highlights of the Master Program for each of the four QHC hospitals are as follows: Belleville General Hospital (BGH) Growth in beds for medicine/surgery from 170 beds (2016/17) to 215 beds (2034/35). Growth in orthopaedic volumes from 12,907 cases (2016/17) to 14,298 cases (2034/35). Growth in overall program space from 409,295 square feet (current) to 495,530 square feet (2034/35). Tier 1 Priority for redevelopment at BGH: Orthopaedic/Fracture Clinic: 690 square feet (current) to 3,000 square feet (2034/35). Proceeding with this Tier 1 priority will require completion of Part B, Master Plan for BGH and a Pre Capital Submission.
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Prince Edward County Memorial Hospital (PECMH) Growth in beds for medicine from 12 beds (2016/17) to 20 beds (2034/35). Most other service volumes relatively unchanged; some increase in radiography to support the growth in beds. Growth in overall program space from 45,335 square feet (current) to 57,980 square feet (2034/35). The priority for the Prince Edward County site is for construction of a new hospital, co‐located with the Family Health Team and other community healthcare agencies. A pre‐capital submission has been submitted to the SE LHIN and MOHLTC Approval to proceed in the capital planning process is outstanding and requires MOHLTC review and approval of the QHC corporate master program. Proceeding with this priority will require completion of the Part B site Master Plan for PECMH and submission of a Stage 1 Proposal. Trenton Memorial Hospital (TMH) Growth in beds from 26 beds (2016/17) to 38 beds (2034/35) to support growth in complex care (increase 9 beds) and medicine (3 beds). Increase in surgical volumes from 4,174 cases (2016/17) to 6,255 cases (2034/35); increase in ER visits from 30,737 visits (2016/17) to 32,850 (2034/35). Most other service volumes relatively unchanged. Increase in overall program space from 110,465 square feet (current) to 111,840 square feet (2034/35). Increased space is projected for the inpatient unit and emergency department with decreased space requirements in Laboratory, Pharmacy, Administration and Support Services. The Tier 1 priorities for redevelopment are Ambulatory Clinics and MDRD (Central Sterile Reprocessing). The master plan will incorporate the work of the Trenton Task Force. This will likely reflect the development of a health care “HUB” to include the Hospital, the Quinte West Community Health Centre and other community health services. Additional recommendations regarding site location are expected in October 2016. North Hastings Hospital Growth in medical beds from 6 beds (2016/17) to 9 beds (2034/35). Small increases in emergency volumes and diagnostics. Increase in overall program space from 20,515 square feet (current) to 28,125 square feet (2034/35). Increased space is projected for the inpatient unit and emergency. There are no immediate urgencies for redevelopment at this hospital.
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Priorities for Redevelopment The priorities for redevelopment were established by the senior leadership team in consultation with Agnew Peckham Healthcare Facility Planning Consultants to guide master planning and were based on the following criteria: addresses serious deficiencies of space, arrangement of space or circumstances which affect patient or workplace safety and quality supports achievement of patient focused care principles supports achievement of operational efficiency Four tiers of priorities were identified reflecting the relative magnitude and impact of the deficiencies. Priorities for redevelopment were determined based on the degree to which existing conditions met contemporary guidelines and best practices, organized as Tier 1 Tier 2
Tier 3 Tier 4
Urgent priority project; extremely poor conditions compromise patient safety, quality of care and/or efficient operations. Requires immediate attention; conditions are poor (i.e., well below contemporary standards) and space is insufficient for current and future volumes. Requires attention; conditions are poor but less urgent than Tier 2. Must be addressed through redevelopment but conditions are less poor and/or less numerous relative to Tier 3.
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QHC has identified the following corporation wide priorities, which are shown in Figure 8. Figure 8: Tiered QHC Redevelopment Priorities
Tier 1 PECMH Trenton Memorial Hospital
Ambulatory Cliniics MDRD (CSR) Belleville General Hospital
Orthopaedic Fracture Clinic
Tier 2 BGH 2A Medical Day Care/Oncology Medical Surgical Unit 2B Critical Care Special Care Nursery Diagnostic Imaging Endoscopy and ECT Suite
Tier 3 Trenton Memorial Hospital
A and B Wings No immediate priorities have been identified for North Hastings Hospital as it is a relatively new facility.
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Next Steps for QHC The immediate next step for QHC is to formally submit the corporate master program. The QHC organization will work diligently to obtain SE LHINand MOHLTC approval for the corporate master program. The next steps for the Tier 1 priorities at each hospital site of QHC are:
PECMH
Obtain approval from the SE LHIN and MOHLTC to immediately proceed with Stage 1B planning for PECMH’s redevelopment and complete the Stage 1 Proposal submission. Develop a communication plan to further raise community awareness. Prepare a plan for fundraising PECMH’s local share.
TMH Ambulatory Clinics and MDRD Support
Prepare and forward a Pre Capital Submission to the SE LHIN and MOHLTC. Develop a communication plan to further raise community awareness. Prepare a plan for fundraising TMH’s local share.
BGH Orthopaedic Fracture Clinic
Prepare and forward a Pre Capital Submission to the SE LHIN and MOHLTC. Develop a communication plan to further raise community awareness. Prepare a plan for fundraising BGH’s local share.
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