Sunday, February 23, 2020

Independent review of Emergency Services needed


The SDH board in Wallaceburg is calling for an independent review of emergency services for all across Chatham-Kent.

In response to a public media conference held by the senior clinical leadership and the Medical Advisory Committee for the Chatham-Kent Health Alliance, the Sydenham District Hospital Board authorized a confidential consultation with ER physicians and with family physicians serving the Sydenham – Walpole – St. Clair Health Planning District within the north Chatham-Kent and south Sarnia-Lambton regions.

The media conference referenced various data and statistics prepared by CKHA’s senior administrative leadership proposing a re-design of the delivery of Emergency Department services across Chatham-Kent.

In a press release the Sydenham District Hospital board says they raised questions regarding the data and statistics referenced at the media conference, which remained unanswered by CKHA leadership.

In addition, the senior physician team present at the media conference suggested that they had a “robust” conversation with physicians impacted by these proposed changes and that they had heard from physicians who believed the Sydenham ER service was an unsafe place to work.

“The SDH Board was concerned that the views of physicians being relied upon to give legitimacy to the proposed redesign were not representative of the views of ER physicians at Sydenham and family physicians whose patients rely on the ER services at Sydenham,” the SDH board stated.

“No information was provided about the nature of the “robust” conversation with physicians or the number of physicians consulted.”

In an effort to better inform itself and its members about the delivery of ER services across Chatham-Kent and to meaningfully respond to the proposed re-design, the SDH Board decided to consult directly with ER physicians that work shifts at Sydenham and with the family physicians whose patients rely on the ER at Sydenham.

“This decision was also made in order to ensure that the views of physicians are properly taken into account before significant changes are made to the delivery of ER services in our region,” the SDH board stated.

The consultation process is outlined here, while the topics and questions asked of each physician is outlined here.

The consultations were made over a three week period in May of 2016.

“Results of the consultations are inconclusive,” the SDH board stated.

“Feedback from physicians indicated that some were fearful for their job security and reprisals should they participate in the consultation. In addition, the SDH Board made a request for assistance from CKHA staff in reaching out to ER physicians, which was not accommodated.”

Moreover, CKHA staff (other than physicians) were not permitted to participate in the consultation.

As a result, the SDH Board was unable to consult with a statistically significant number of physicians and any information cannot be relied upon as representative of the Physician groups, the SDH board said.

“Consultations and anonymous feedback raises many concerns. In spite of the small number of consultations, those that were held included very senior and influential members of the ER physician group. An anonymous letter from a number of staff at Sydenham was also received and given due consideration.”

The SDH board said from this anecdotal information, the following concerns emerged:

– ER physicians consulted reported that they were not consulted prior to the media conference where it was reported that “robust” consultations had been held.

– ER physicians consulted feel that the views of these physicians was not accurately presented.

– ER physicians consulted expressed concern that the CKHA Chief of Emergency Medicine, who was newly appointed on March 1, 2016, has spent insufficient time in his role, and specifically has spent insufficient time working, or observing work being done, at the Emergency Department at Sydenham Campus, which calls into question his legitimacy to make such far-reaching determinations that would transform the delivery of ER services across Chatham-Kent.

– ER physicians consulted support maintaining a 24/7 Emergency Department at Sydenham.

“Consultation confirms good working relationships at the staff level between the two CKHA campuses,” the SDH board said.

“As a result of the consultations, the SDH Board is aware of and pleased that, in spite of unresolved governance issues, staff at Sydenham Campus are able to rely upon a good and professional working relationship between the Sydenham and Chatham sites.”

Some examples of this include:

– ER Physicians report a good working relationship with departments and specialists at the Chatham Campus and that this working relationship should be maintained.

– Sydenham ER has the capacity to operate independently as an ER service in some respects, but relies upon other, larger hospitals to provide tertiary care. Many patients are referred to Chatham, Windsor and London for care after being stabilized at Sydenham ER.

– Many local physicians refer patients to specialists in Chatham, Sarnia, Windsor and London.

The SDH board says they believe the data and the statistics used to support the proposed re-design of emergency services across Chatham-Kent were inadequate and inconclusive.

“It was inappropriate for the CKHA administrative and clinical leadership to have drawn the conclusions that they drew, and to purport to represent the views of ER physicians, without demonstrating that their information was verifiable and representative,” the SDH board said.

“SDH is concerned that any consultation that may have occurred with ER Physicians prior to announcing the redesign was not adequate and certainly not representative, which casts doubt on the decision by CKHA’s senior clinical leadership to move forward with its plans.”

The SDH board is calling for an independent review of Emergency Services across Chatham-Kent by an expert panel, before any changes are made to the delivery of Emergency Services across Chatham-Kent and to patients within the Sydenham – Walpole – St. Clair healthcare planning district.

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