The Cranbrook business community heard about the challenges of delivering rural health care during a presentation that included Susan Brown, the president and CEO of Interior Health, on Thursday in Cranbrook.
Brown, who took over the IHA leadership from Chris Mazurkewich last year, participated in a Q&A session during a Chamber of Commerce event and spoke about ongoing challenges at the East Kootenay Regional Hospital, issues with patient transfers to Alberta and health care staffing and recruitment to the area.
Bill Bennett, the president of the Cranbrook Rotary Club and former MLA, led the session with questions gathered from the community, as well as those submitted from the audience.
Bennett led with a question on the IHA’s development of a master plan for East Kootenay Regional Hospital.
Brown said the organization opted for a space utilization plan to take a closer look at four areas of need at the hospital, which include oncology, pharmacy, dialysis and the laboratory.
“We know that all of those specific areas need new space, either to grow and expand or better space just to accommodate new standards of care,” Brown said.
The space utilization plan allows the consulting team to gather information and better understand a higher level cost-estimate of what it would take to make those projects come alive, she added.
Coming in at roughly $200 million, Brown says those proposals will be included as one project in a grouping of 10 priority investments that the IHA brings forward to the provincial government.
Currently, there is a $1.45 million project to renovate the pharmacy and move the compounding rooms into a new area with proper ventilation in order to meet new incoming national standards. Other projects include a renovation of the biomedical lab and adding new urology diagnostic equipment.
On cancer care, Brown said the EKRH sees roughly 220 patients in various stages of treatment and notes that oncology is one of the projects that carries priority. However, Kelowna is only place within the IH jurisdiction that delivers radiation therapy.
“It is a hardship on families and patients to go for radiation therapy when it’s far away from home,” she acknowledged.
A study is currently in the works in partnership with the B.C. Cancer Agency to look at radiation therapy needs in the Interior Health region, Brown added.
Addressing the self-described elephant in the room, Bennett asked about patient transfers from the East Kootenay to Alberta, specifically Calgary or Lethbridge, and why health care options across the border have all but dried up.
Brown said that Interior Health has reciprocal agreements with Alberta on time-sensitive health care issues, such as trauma, stroke or dialysis.
However, it’s a different story for scheduled care, Brown said.
“For people who want scheduled care, to go to Alberta is definitely increasingly challenging,” she said. “Alberta has signalled to us, we’ve done some work through the Ministry of Health, that they have increasing wait times in their own province and, as you know, health care is governed provincially, for the most part. So their priority is their residents and we will be focusing as much as possible on wait times within our own jurisdiction.”
Recruitment is always an ongoing issue for rural areas, but Brown said two anesthesia specialists are in Cranbrook, stabilizing a shortage that the area had been experiencing.
Two additional pathologists have been hired on at the EKRH lab and two orthopaedic surgeons are coming as well, Brown added.
“This year, there’s been quite a concentration of recruitment within this area and we continue to showcase other opportunities within the Kootenays as a whole,” Brown said.
On seniors care, Brown said Interior Health is focusing on wrapping services and programs around seniors with the goal of prolonging home-based care as long as possible. Brown said there are better health care outcomes when seniors are able to remain in their homes, while it also reduces impacts on health care facilities.
The conversation got a little spicier when the topic shifted focus to the emergency department at the EKRH.
Brown explained that IH has been working with family physicians in various regions to set up primary care networks, with the East Kootenay Division of Family Practice and other stakeholders providing input for a local plan.
The goal is to reduce pressure from the emergency department resources by engaging with primary care providers or home care providers.
“It’s a substantial amount of people that we’ve asked for, it’s in the multi-millions [dollars], and we’re just waiting on approval for that,” said Brown. “So that would really help people who don’t have access to a physician or a nurse practitioner at this point in time, then the emergency department would be alleviated and more used for that higher level of care.”
A local doctor who works in the emergency department stood up to highlight her concerns working directly inside facility, with issues ranging from less hours of ER doctor coverage, less examine rooms, less specialist coverage, and alleged ER nursing training gaps.
Overcapacity is another issue, as emergency room beds are often filled from a no-refusal policy with referral facilities, the doctor said.
The doctor also noted low morale and high nursing turnover.
In response, Brown said all nurses in training across the province are educated to a universal standard and noted that there are internal processes the doctor can take to address her concerns.
Brown was announced as Interior Health’s president and CEO in October last year, and has been an executive with the organization since 2011, starting first as Vice President of Tertiary Services before moving to Vice President and Chief Operating Officer, Hospitals and Communities.
Before coming to Interior health, Brown worked with Fraser Health in the Lower Mainland. She holds a Masters of Health Studies and a Bachelor of Science in Nursing and has worked in the health care field for 30 years in Canada and the United Kingdom.