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October 03, 2001
Media Relations, LHSC
519-685-8500, ext. 77642
London Health Sciences Centre defines future direction
(LONDON, Ontario) - The Board of Directors of the London Health Sciences Centre (LHSC) today announced a new strategic direction and their approval of recommendations resulting from the latest phase of LHSC’s four-year renewal plan. The strategic direction defines a clear vision for LHSC and a detailed plan to provide future healthcare to the communities it serves. It also helps us maintain and strengthen our international reputation as a leading, innovative research and academic health centre.
The decisions approved by the board will allow LHSC to best align its financial and human resources, and other key operational and capital planning projects, to provide the highest quality of care to patients in London, Middlesex and beyond in selected specialty programs and services.
"As a foundation for our renewal work, LHSC established a clear vision - to focus our efforts on providing the London/Middlesex communities with excellence in patient care, education, research and innovation" says Board Chair Geoff Davies. "In addition LHSC will pursue a leadership role in the development of a regional network of health and academic services to make the right choices for patient care across the region."
LHSC initiated its renewal plan in May 2000 to determine how best to preserve the high standards of patient care and internationally recognized academic leadership for which it is known. An Operational Review conducted by the Ministry of Health and Long-Term Care (MOHLTC) at the request of LHSC found that LHSC had achieved a high level of efficiency, however, the report also indicated that LHSC needed to redefine the scope and size of its clinical and academic programs if it was to sustain itself within the challenging realities of today’s healthcare system.
"We have accepted the reality that we can not be all things to all people. The recommendations which the board approved have been made to sustain and develop our reputation as a centre of excellence," explains Tony Dagnone, President and CEO of LHSC.
"Advances in medical science and technology hold promises of unprecedented benefits to patients. We recognized that we needed a plan to guide our future direction and to ensure the future wellbeing of our patients. We needed a plan that would enable us to keep pace with advances in knowledge and technology and, at same time, successfully respond to the increasing challenges facing all hospitals - challenges such as a national shortage of medical specialists, increasing costs, an aging population and the need to balance budgets," says Mr. Dagnone.
In March 2001, Phase One was completed with the development of planning principles and criteria. LHSC’s first, and foremost, priority is to provide primary, secondary, and some specialized services to the people of London/Middlesex. The hospital will also continue to operate as a regional referral centre for selected, highly specialized clinical services and lead in the development of a regional health network.
On Oct. 2, the LHSC Board of Directors approved the scoping recommendations put forth by the Steering Committee. The Committee wrote its recommendations following an intensive and consultative process involving more than 250 people, including physicians, staff, third-party consultants, government, and community partners from London Regional Cancer Centre, The University of Western Ontario, and St. Joseph’s Health Care London.
"The decisions that have been made ensure that LHSC will continue to meet the fundamental health care needs of London and Middlesex County, and support our essential academic capabilities. More than that, these decisions also allow LHSC to continue to provide highly specialized care in a number of areas for which it has earned national and international reputations," says Mr. Davies. "LHSC will coordinate access to care with other providers for those patient care services that are being scoped out of our program delivery."
For the vast majority of LHSC’s patients, doctors, staff and students, these decisions will have little or no impact. These people will receive and deliver the high standard of care they do today from a stronger, more-focused LHSC.
"While the numbers may be small, we recognize that there will be some disappointment and a sense of loss for those patients and their families within the programs which we are redirecting. Without question, staff and physicians directly impacted will also feel a sense of loss. These decisions are about far more than numbers - they are about the people we care for and care about," says Mr. Dagnone.
Our first priority has been to preserve access and excellence in those programs that so many of our patients in London-Middlesex and surrounding areas rely on and where our scoping evaluations clearly indicate we can remain strong. As a result, vital specialized programs such as emergency/trauma, adult cardiac bypass surgery, orthopedics, renal care, high-risk obstetrics, pediatric critical care, kidney and liver transplants, and cancer care will continue to be part of LHSC’s extensive future focus. (See background document "Scoping Summary" for a complete list of future services)
The recommendations approved by the Board will also mean redirecting a small number of specialties where, analysis showed, LHSC would not be able to sustain its leadership in the future. LHSC will continue to provide pre and post treatment care to many of these patients, however, they will be referred for treatment to other hospitals that are focused in these areas and, therefore, better able to support the high quality of care LHSC believes their patients should expect.
"We want you to understand that these decisions have not been taken lightly, nor without consideration of the impact they will have," says Mr. Dagnone. "But they are the right decisions for the future health of all of our patients, both those we will continue to serve directly, and those whose specialized care will be provided by our health partners."
The Board of Directors approved the removal of a total of 18 services from the list of services currently provided by LHSC including some that can be provided through clinics and physicians. These services are:
-Sleep Apnea (index less than 20)
-Lung Reduction procedures
-Lung Transplant procedures
-Bowel Transplant procedures
-Burns (> 20% adult, > 15% pediatric)
-Cosmetic Surgery uninsured by OHIP
-Complex Ankle Surgery
-Cardiac Transplant pediatric / adult
-Cardiac Arrhythmia surgical procedures
-Pediatric Cardiac surgery
-Complex pediatric Cranio-facial procedures
-Endovascular Aneurysm surgery
(See attached background document for definitions of each of the services listed above.)
"Over the next few months we will be working with our clinical leaders to implement these decisions. During the transition process the needs of our patients and staff who are affected by these decisions will be our foremost consideration. No changes will occur until we are satisfied that the appropriate transition plans are in place for our patients," Mr. Dagnone adds. "I have every reason to believe that our new strategic direction will enhance our ability to work with our Ministry of Health to address our waiting lists for those programs that will remain integral to our academic centre."
"In the case of pediatric cardiac surgery, which is being scoped out of our range of services, we used benchmarks established as a result of the Justice Sinclair Report and others in the field which clearly indicates that a minimum patient volume of 150 cases per surgeon is required to sustain a program," says Dr. Murray Girotti, Vice President, Medical Staff. "LHSC/CHWO currently performs approximately 120 cases. As well, it was determined that if we were to not only sustain, but develop this program, we would need to make significant investments in technology upgrades and staff recruitment and development."
"The challenges that we face are shared by healthcare providers across the country, and they need to be addressed today if we are to secure strong and vibrant healthcare services for our patients tomorrow. Our staff, management, government partners and Board have devoted considerable time and energy in arriving at these decisions. We are confident that, with this plan for the future, we will be in the best position to not only sustain our organization, but to make the most of the opportunities that lie ahead," adds Mr. Davies.
Note: a community telephone line has been set up for the public to call with questions and comments. The number is 519-685-8500 ext. 50150.
Dermatology Clinics: outpatient care treating conditions of the skin.
Ultraviolet Therapy: outpatient clinic treating conditions such as psoriasis using sunbeds.
Travel Clinics: outpatient services providing information and immunization for overseas travellers.
Sleep Apnea index of less than 20: will only operate on more severely compromised patients with a sleep lab assessment index of greater than 20. Sleep apnea is a disorder where patients suffer episodes of cessation of breathing during sleep.
Lung reduction procedures: experimental surgical procedure to treat emphysema by surgically reducing size of lung to increase lung volume.
Lung transplant procedures: removal of damaged lung tissue followed by transplant of healthy lung tissue from either a living or deceased donor.
Bowel transplant procedures: removal of damaged bowel with healthy bowel from deceased donor transplanted into patient.
Burns (> 20% adult, > 15% pediatric): extensive burns or non-extensive burns which require patient ventilation (life support). Minor burns will continue to be treated by plastic surgery.
Pediatric rheumatology: outpatient clinic to manage conditions such as arthritis and lupus in children.
Obesity procedures: high gastric surgical procedure for patients defined as morbidly obese
Cosmetic Surgery non-insured by OHIP: cosmetic surgery such as breast augmentation, liposuction or face lifts.
Complex ankle surgery: highly specialized and complex surgical repair of foot and/or ankle.
Cardiac transplant surgery (adult and pediatric): removal of damaged heart followed by transplant of healthy heart from a deceased (cadaveric) donor.
Cardiac arrhythmia surgery: surgical treatment of irregular heart rhythm (majority of cases now treated medically).
Pediatric cardiac surgery: highly specialized procedures to repair defects in the heart such as a hole or poor pumping function.
Complex pediatric craniofacial surgery: complex reconstruction of facial and skull deformities.
Endovascular aneurysm surgery: surgical intervention to treat patients with aortic aneurysm by insertion of a stent to repair damage. Currently not considered standard of practice and therefore not funded by Ministry of Health.
Therapeutic radionucleotides: experimental pharmaceutical treatment of pain management in cancer patients using nuclear medicine approaches. Alternate pain management techniques will be used.
The Final Recommendations by Service Grouping
Obstetrics and gynaecology
Head and Neck