JOSEPH BRANT MEMORIAL HOSPITAL
Review of Complex Continuing Care Bed Allocation

A Request for Stakeholder Input

Joseph Brant Memorial Hospital (JBMH) presently has 50 beds designated for Continuing Complex Care (CCC) as defined by the Ministry of Health and Long Term Care. A major study published by the Halton District Health Council in 2003 projected the needs for CCC beds at JBMH to be 91 beds by 2008-09. Joseph Brant wishes to revisit these numbers and explore community based alternatives to delivering CCC services. As a starting point, this discussion paper is being distributed to our various community partners. Please read it carefully and consider the questions posed.

Feedback is sent directly to the consultants working on this project. Focus questions have been provided to guide discussion and feedback. Responses must be received by Friday, December 9th. This will enable us to assemble the feedback received and submit a preliminary report to the Ministry in December. Depending on the findings from this phase we may conduct some further stakeholder research early in 2006.

Background

Halton-Peel is projected to have the fastest growth in residents between 1996 and 2016. By 2016 it is estimated that there will be almost 2 million people living in the region, representing an increase of over 700,000 people. The population is also aging, and Statistics Canada estimates that by 2016 there will be 227,000 individuals over the age of 65.

Complex medical conditions may include the following:

• Labile medical conditions requiring frequent assessment (complex diabetes, complex respiratory management, etc.)
• Conditions that require a combination of complex interventions such as the care of a tracheotomy, ventilator, PEG tube, IV mediations, transfusion, central line)
• Complex wound care (stage 3 and 4) requiring specialist evaluation
• Frequent assessment and management of pain and other symptom control

In addition to the 50 CCC beds at Joseph Brant, Oakville has 22 and Milton has 21 for a total of 93 beds. Based on 2006 projections there will be 22,309 people over the age of 75 in Halton, and using the planning ratio of 8.23 beds per 1,000 people over age 75, this suggests that 184 beds will be needed.

The existing CCC beds at JBMH are currently configured as follows:

Four East- Complex Medical/Palliative

A 24-bed unit providing services to patients who typically have medical problems that result in an inability to improve over time. These patients may display acute disabling episodes along with multiple chronic illnesses. Within these 24 beds, four are offered to long stay palliative patients. Respite services that provide relief to families caring for relatives with complex continuing care needs are offered based on bed availability.

Patients who benefit from care on Four East are those who, among other criteria, have a chronic, complex condition that requires continuing medical management, skilled nursing, and a range of interdisciplinary, diagnostic, therapeutic or technological services. Those that that have a terminal illness are patients whose illness is clinically unstable.

Four South - CCC Reactivation Unit

A 26-bed unit providing services to patients who are typically older and/or frail, with multiple medical problems. This program is intended for people who require more time and less intensive therapy than is offered by the Acute Rehabilitation Program, but have the potential for functional improvement and eventual discharge home or to a variety of other settings. Expected length of stay is from two weeks to four months.

Discharge guidelines and processes are in place for both units with clear outcomes depending on patient progress and ability to meet goals.

Focus Questions

We are interested in your response to the following questions. You may use the dialogue boxes below to record and submit your answers.

• If CCC beds at JBMH were increased to meet the 2003 District Health Council projections, what would be the impact on other agencies in the community?

• If CCC beds at JBMH were decreased from the present level, what would be the impact on other agencies in the community?
• Would your agency have the capacity to accept and care for CCC patients?

• What other community based models could be used to deliver continuing complex care? How could your agency participate in these approaches? What resources and supports would be required?

• What is the preferred environment for meeting the needs of the young adult disabled population?

• What is the preferred environment for meeting the needs of those requiring end of life care?

About Us | Services | Clients | Our Team | Resources | Links | Surveys | Papers