As The Scarborough Hospital (TSH) commences its assessment and deeper discussions with our stakeholders on the merits of a possible merger with Rouge Valley Health System (RVHS), I have been approached by many who have enquired as to whether or not this is a predetermined exercise. I can say with all honesty that the TSH Board and administration have not made a decision on the matter. We are letting the process unfold, doing our “homework” and consulting with our many stakeholders to get their valued input.
Many have asked me for my thoughts on the matter. I do have some early observations that I can share with you today. Please be assured that I have not drawn any conclusions at this time. I will be further informed by the results of our work and by the collective wisdom of our stakeholders. In the short time I’ve been part of the TSH team, I’ve met with many individuals and groups – both internally and externally. I’ve listened, observed and reflected. I’ve come to appreciate our numerous strengths that can help shape an exciting future for health care services in Scarborough. Here’s what I see.
I see a hospital that is a leader in health system transformation. In 2012, the provincial government released “Ontario’s Action Plan for Health Care,” which lays out the direction and expected system changes in the years ahead in order to improve quality, access and sustainability. The role that community hospitals provide in Ontario is changing, and we face these fundamental shifts with or without the possible merger with RVHS. So I see the merger question as a strategic one – essentially we are attempting to answer, “Are we stronger together?” In other words, “Can we better serve our patients and communities by joining together?”
I see some obvious facts that should make anyone pause. For example, two of the sites (TSH General and RVHS Centenary) are merely 6.3 km apart. Yet, over the decades limited integration has taken place between the hospitals. We serve the same community, yet we compete with each other for funding and resources. We do need to find ways to enhance “value for money” for the patient and taxpayer.
I see facilities that were designed and built in a previous era with patchwork expansions and renovations over the years. Our facilities require some significant capital investments in order to address their aging infrastructure and to better meet patient care demands. Two striking examples come to mind – the Operating Rooms at the General site that are long overdue for attention, and the Emergency Department at the Birchmount site that is significantly undersized given the number of patients treated. What’s more is that we have some patient care departments that are dispersed in multiple locations within the same facility. This impedes productivity and it certainly isn’t good for patient flow. We know other GTA communities have been quite successful in securing government capital funds for major redevelopment projects or even new facilities. We need to find a way to be more effective in advocating and securing needed investments for the Scarborough community.
I see a future where we build and strengthen local access to specialized services through regional centres of excellence. Both TSH and RVHS are already fulfilling this role through their respective regional programs – TSH’s Nephrology Program and RVHS’s Cardiac Centre. These are shining examples of how we can organize health services that provide world-class care close to home and demonstrate value to the taxpayer. We can and must do more of this for our community!
I see a health care system that is co-designed by patients and their caregivers. Patients are the most underutilized resource in helping redefine and reshape the system. It’s time for providers, including TSH, to think patient-centric when planning, organizing, designing and delivering health services. Such a paradigm shift will be essential not only for the long-term sustainability of the system, but as importantly, to improve the patient experience.
I see a hospital that defines itself not by its limitations, but rather by the strengths of its community relationships and its diversity. To find the best solutions, we need to be creative in our thinking and we need to draw from the richness of our community’s diversity. We serve a global community – it’s our biggest asset – and it must be leveraged as a competitive advantage. If we are to be more holistic at the individual level, then we need to be more global in our approach. We ought to be thinking about alternative and complementary health services, for example.
What’s most important though is that I see a hospital that has gained the trust of its community, staff and physicians. With trust, you can build consensus, and with consensus, you can create a shared vision for the future. I’m reminded of an old African proverb as we contemplate our future with RVHS: If you want to go quickly, go alone. If you want to go far, go together. Collaboration is needed to transform our local health care system; it is key to our future success.
This is what I see for health services in the Scarborough community – what do you see? I do encourage you to participate in the merger discussion – the debate – the conversation – however you wish to describe it. It’s a healthy exercise (pun intended) that can only strengthen the decision, whichever way it goes.