At Chatham-Kent Health Alliance (CKHA), the endoscopy team is ready, the space and equipment is all set up and come Monday morning, procedures will start in the brand new Endoscopy Unit, located at the Chatham Campus. This state-of-the-art unit is purpose built to support safe, quality care and designed to accommodate CKHA’s current and future volumes of endoscopy procedures.
The opening of the new unit is part of a long-term plan to create a leading endoscopy service among community hospitals. The stand alone unit (inclusive of registration, waiting area, two endoscopy suites and recovery room), was designed with the support, advice and engagement of clinicians and patient & family advisors. Together, their insights created a unit that meets the needs of patients and providers alike. To celebrate their contributions, staff, patients and key stakeholders were invited to tour the space before it opens for operations on Monday, October 6.
As a high volume and critically important service, CKHA maintained full endoscopy operations throughout the unit’s development, with today being the only day of service closure to support the move to the new unit. Today officially marks the program’s transition from day surgery areas at the Sydenham and Chatham Campus into the new Endoscopy Unit, located in A3 area (west wing of Public General) of the Chatham Campus.
Best suited to delivering high quality, safe care, the new unit design will also accommodate an increase in volume of procedures. CKHA currently performs over 30 endoscopy procedures, five days a week or approximately 7,000 annually.
The new location and its self-contained registration process will help ease patient navigation. By routing endoscopy patients to the Ambulatory Care entrance, it is now just a short walk to the first set of elevators (marked as elevator #1 and #2), which takes them directly to the unit where they can register. This is a significant benefit to patients as they often arrive at CKHA feeling weak, largely due to eating or drinking restrictions prior to their procedures. Patients coming to CKHA beginning on October 6 for endoscopy procedures no longer need to go to the front entrance for registration, it will occur on the unit. They can be dropped off at the Ambulatory Care ramp which offers a shorter walk for the patient. Patient flyers have been circulated to physician offices to support the communication of this new process.
Endoscopy is a critically important screening and prevention procedure that reduces the risk of colon cancer by up to 90 per cent while also supporting investigations related to gastrointestinal illnesses. As well, colonoscopy, a test that allows the physician to look at the inner lining of the large intestine (rectum and colon) can improve survival by 80%.
What is endoscopy and why is it an important service for CKHA to provide to the community?
Endoscopy is a minimally invasive procedure that allows specialists to see the tissue of the rectum, colon, esophagus and stomach. Endoscopy is an important part of the prevention and screening of colorectal cancer as well as for gastrointestinal investigations.
According to the Ministry of Health and Long-Term Care, colorectal cancer is the second leading cause of death in Ontario and the third most common cancer diagnosed. Moreover, there is a 90 percent chance that if caught early, one can be cured and often, through less invasive surgical procedures.
How many endoscopy procedures are done annually at CKHA?
The Endoscopy Program operates five days a week and does over 30 scheduled procedures a day. Additional emergency procedures are also done for a total of approximately 7,000 in 2013.
Is CKHA’s Endoscopy Program a high-performing service?
Yes. CKHA’s Endoscopy Program is a designated Cancer Care Ontario ColonCancerCheck cancer screening site. The ColonCancerCheck program is a province-wide, organized screening program designed to raise screening rates and reduce deaths from colorectal cancer.
In addition, CKHA is a designated Erie St. Clair Regional Cancer Program Colorectal Cancer Diagnostic Assessment Program (DAP). DAPs were created across the province for various cancers to improve the patient experience offering a “one-stop shop“ for diagnosis. This means improved coordination of care for Chatham-Kent patients which includes support and information for the patient, a strong link to their care team, decreased wait times, minimized disease progression, improved survivorship and a better patient experience.
CKHA’s multi-disciplinary team includes both a surgical focus as well as internal medicine, supporting patients with gastrointestinal diagnosis and conditions.
Who was involved in the planning?
The key stakeholders in the process were the clinicians and staff that will be delivering service in the area. Their insight and expertise in creating an efficient, effective and safe environment for patients and the team of providers were essential. They also informed the procurement of new technology and equipment to support quality care delivery. As the new space took shape, patient and family advisors were also engaged to ensure that the environment and patient navigation process were designed with patients in mind.
What are the features of the new unit?
It’s built on a foundation of innovation with state-of the-art technology and equipment to support the efficient delivery of quality, safe care by our providers. This also makes it ripe for medical teaching and learning opportunities within CKHA as well as the potential for research with the Schulich Medical School.
It’s a purpose built unit meaning it is designed around the endoscopy pathway and optimal patient flow from entry to exit, supported in large part by a “U” shaped design. This also allows the unit to isolate patient populations (those waiting do not cross paths with those exiting).
The space can meet our current and future volumes. CKHA currently performs over 30 procedures a day. The unit is built to be able to support up to 50 procedures daily, should funded volumes increase. For our community and the surrounding region, the level of capacity translates into better access to services, close to home.
What changes will patients experience?
Starting on Monday, October 6, 2014 patients coming to CKHA for endoscopy services will use the Ambulatory Care entrance, which along with the in-unit patient registration, greatly reduces the total travel distance for patients. This is particularly beneficial for endoscopy patients as dietary restrictions in advance of their procedures can leave them feeling weak. Once registered, patients will enter the new unit where they will experience large, natural light filled waiting and recovery areas as well as barrier-free washrooms and change rooms. These are just some of the many features the space provides that creates a modern healthcare environment delivering care that meets patient expectations of accessibility and privacy with recognition of the stress patients and families experience normally at these times.
How is the program funded?
Endoscopy procedures are known as “Quality Based Procedures” (QBP), which are services the hospital is funded to provide by the Ministry of Health and Long-Term Care. The government provides CKHA with a volume of procedures (number of procedures done annually) and a set funding allotment for each procedure.
Why did CKHA build a new unit?
Endoscopy is a critically important service for both cancer and gastrointestinal investigations; it is a service the organization anticipates will grow in response to the aging population in Chatham-Kent. However, the organization was previously delivering the service across two campuses, making it an inefficient and unsustainable model under the new funding system. In examining the options available and with the support and recommendation of physician leaders, the service was consolidated to a new, purpose built unit that can support current and future volumes. CKHA aims to be a leader in the provision of endoscopy services in a community hospital setting.What changes will patients experience?
What impact does the funding model change make on organizations like CKHA?
The Ontario government is moving to what is known as “patient-based funding”. Essentially, this means that hospitals are now funded to provide core services, such as Emergency Services, at a level that matches the patient population they serve. For CKHA, this funding model has a negative impact on the organization, given the declining population in Chatham-Kent. The government is also funding select procedures through “Quality Based Procedures” funding, which means that the hospital is provided with a number of procedures it is funded to provide, and a cost within which it must provide the service. These changes require the hospital to continually examine its services and make program delivery changes to ensure quality and safe care is delivered within the funds available to the organization.
How long did it take to build the new unit?
CKHA initiated its business case in spring 2013 as part of the organization’s overall annual operating plan process. Once approved in November 2013, it took approximately 10 months to create the state-of-the-art space and fully transition the Endoscopy Program, delivered at two sites, into the new unit.
