About Access to the Best Care    Introduction Hamilton is fortunate to have many great health care services and facilities but, like so many other cities, we are facing challenges meeting the demand for care. As community members and health care providers, we know that maintaining the status quo is not an option. The future of our regional health care system is at risk if we do not make changes. In January 2008, Hamilton Health Sciences introduced the 'Access to the Best Care' plan. This plan is about making some crucial changes to strengthen our local and regional health care systems so they are sustainable over time. None of these changes will take place overnight - in fact, this reorganization and redevelopment has been underway since 2008 and will be complete by 2011. Ultimately, we will be working to further refine the role of our various hospital sites to ensure the best outcomes for patients, optimal use of resources and better access to care. Better Organized and Coordinated Services Hamilton has a national reputation for taking a collaborative approach to health care planning. It is this approach that has enabled us to better align services within our own facilities (McMaster University Medical Centre including McMaster Children's Hospital, Hamilton General Hospital, Juravinski Hospital and Cancer Centre, Chedoke and St. Peter's Hospital.) It has also made it possible for us to work more effectively with other community and regional health care providers to meet the needs of the more than 2.3 million people who live in the region our hospitals serve. Hamilton Health Sciences has medical experts and special services that community hospitals across our region do not have. So, besides serving as Hamilton's local hospitals, we care for patients referred to us from throughout south central Ontario. In order to coordinate our resources and make the system easier to navigate for both local patients and those from outside Hamilton, we have been working hard to arrange our programs and services by site.

Click here for the latest Redevelopment Review newsletter Click here to read a brochure about Access to the Best Care       Click here for a graphic overview of the plan Click here to watch a video about Access to the Best Care Click here to read the LHIN submission on 'Access to the Best Care' Click here to read the LHIN submission on the Urgent Care Centre Click here to read the LHIN Board decision about Access to the Best Care

Through this approach, we have created three distinct centres for patients who require specialized care. These centres are:

• Hamilton General Hospital - specializing in cardiac, trauma, neurosciences and rehabilitation
• Juravinski Hospital and Cancer Centre (formally Henderson General Hospital) - specializing in orthopedics and cancer care
• McMaster University Medical Centre /McMaster Children's Hospital - specializing in a comprehensive range of acute pediatrics, high risk obstetrics, women's health, adult outpatient clinics, adult same day surgery and digestive diseases

We often refer to these sites as "Centres of Excellence". They are where we gather together the experts, the technology and the services that address the special needs of patients with particular types of complex health problems. By focusing our programs in this way, patients benefit from convenient, coordinated care and health professionals are able to work together more effectively to ensure that all the patient's needs are met.

The research on consolidating services is clear -- by concentrating health care teams at fewer locations, we can care for more patients more effectively. Through 'Access to the Best Care' we will focus on doing more of this and doing it even better.

Expanded, Modern Clinical Care

As a result of changes in medical practice and advances in technology, many patients who come to the hospital do not need to stay overnight. To support this trend, we will be enhancing care and services in clinic-based settings. At McMaster University Medical Centre, for example, we will be expanding adult outpatient services including same day surgery, women's health, high-risk obstetrics and outpatient clinics.

Diagnostic imaging, lab tests and diagnostic testing of the cardiac, respiratory, neurological and vascular systems will continue to be available at McMaster. In addition, we will be enhancing our internationally renowned Digestive Diseases Program with the construction of an expanded high-volume Endoscopy suite. (a technique used to scan the digestive tract)

More Care for Children McMaster Children's Hospital is the second busiest pediatric hospital in Ontario. As the only children's hospital in the region, McMaster Children's Hospital has a mandate to provide care to nearly 600,000 children - something we can't do, simply because we don't have room. In fact, in 2007-2008, we were closed to new inpatients more than 50 per cent of the time. This means that half of the children and families who needed our care had to go elsewhere - to London or Toronto, and sometimes as far away as Ottawa. Premature babies born in this region requiring critical care were also turned away. Last year, 65 per cent were sent elsewhere because we just didn't have room for them in our Neonatal Intensive Care Unit.

This does not happen in any other city or community in Canada and it should not be happening here.

By moving many of our adult beds out of McMaster, we will be creating space to accommodate children who must be admitted to McMaster Children's Hospital. We will also be able to expand and build:

• a new state-of-the-art Pediatric Critical Care Unit
• a Child & Youth Mental Health Inpatient Unit
• a dedicated Emergency Department for children

All of these changes are long overdue, particularly the creation of an Emergency Department for children. By giving children their own Emergency Department, they will be receiving the same standard of care enjoyed in other major Canadian cities including Ottawa, Toronto, Montreal, Vancouver, Calgary, Edmonton, Winnipeg and Halifax, all of which have dedicated pediatric EDs staffed by experts in pediatric emergency care.

Our Chief of Emergency medicine has met with representatives at both Sick Kids and Children's Hospital of Eastern Ontario to discuss the Pediatric-only Emergency Department structure. If an adult shows up in a pediatric Emergency Department they will not be turned away. The Emergency Department staff are skilled to stabilize the adult patient, and the patient will then be transferred to one of three other acute care sites in the city. This structure works well in both Toronto and Ottawa. It will be the model of care that we also follow.

More Access to Urgent and Emergency Care

One of the most exciting components of ‘Access to the Best Care' is the new Urgent Care Centre that Hamilton Health Sciences is proposing to establish at the West End Clinic on Main Street West. The City of Hamilton's urban development staff has indicated population growth will be concentrated within current urban boundaries, largely in the downtown core. With excellent proximity to Highway 403, public transit as well as ample parking and good visibility, the West End Clinic is an ideal location for a new Urgent Care Centre.

Urgent Care Centres are similar to Emergency Departments in that they are staffed by physicians and nurses trained in emergency medicine. These professionals treat illnesses or injuries that cannot wait for a scheduled appointment with a primary care physician. These injuries can include:

• lacerations (deep cuts or wounds that may require stitches)
• sprains, strains or deep bruises
• mild to moderate asthma attacks
• ear infections
• urinary tract infections
• coughs, congestion, sore throats
• diarrhea
• insect bites and rashes

Urgent Care Centres do not accept ambulances or admit patients, however, they are fully equipped with many medical services and devices. Our Urgent Care Centre will offer patients urgent medical care as well as convenient access to blood tests, ultrasound and X-ray services.

By locating this centre on the west side of Hamilton, we will be able to meet the needs of many adult patients who may have normally been seen in the Emergency Department at McMaster University Medical Centre. We are also adding a sixth access point for people who need immediate care.

The other five are: The Emergency Department at the Juravinski Hospital (which is being increased in size by 64 percent as the Juravinksi Hospital is redeveloped) The Emergency Department at the General (which is being renovated) McMaster Children's Hospital's dedicated Pediatric Emergency Department at McMaster University Medical Centre The Emergency Department at St. Joseph's Healthcare on Charlton Ave. which was recently expanded and renovated St. Joseph's Urgent Care Centre in Stoney Creek While Emergency Departments and Urgent Care Centres are very different, it is important to note that many patients who go to Emergency Departments could be cared for just as effectively in an Urgent Care Centre. For example, in 2007, 60 per cent of adult patients came to the McMaster Emergency Department for care that could have been provided at an urgent care centre. By offering another option for patients, we will be taking some of the pressure off the Emergency Departments and helping all patients be seen more quickly.