Randy Penney, CEO, Renfrew Victoria Hospital & St. Francis Memorial Hospital - May 01, South Renfrew Health Link Dev't

1. Randy Penney, President & CEO
Renfrew Victoria Hospital &
St. Francis Memorial Hospital
May 1, 2013

2. Clinics
• Internal Medicine
• Surgical
• Respirology
• Dietician
• Shared Radiologists, and
PACS Administration
• 2 separate corporations
– Boards of Directors
– Budgets
SFMH Voluntary partnership
with Renfrew Victoria
Hospital since 1999.
• Shared Chief Executive
Officer
• Information Technology
• Shared clinical programs
– Dialysis
– Mammography
– Bone Density
– CT Scan
PARTNERSHIP

3. PARTNERS

4. Pre Dialysis 1993
Pressures on patients and their families
• Sick, elderly patients driving in excess of 300 kilometres 3 times per week
• 3-5 hours total driving time from various communities in Renfrew County
• After treatment feeling fatigued
• Cost of gas, parking, meals
• Driver needed
• Driving in all kinds of weather i.e. snowstorms, ice storms
• Unable to keep a job due to treatment time
• Ottawa at over-capacity
• No treatment - you die
• Everyone left Renfrew County for dialysis services

5. Fast Forward 2013
• Renfrew Victoria Hospital designated by the Ministry of Health
& Long Term Care as the Regional Centre for Renfrew County
Nephrology Services.
• 12 station Hemodialysis Unit at Renfrew Victoria Hospital
• 6 station Satellite Unit at St. Francis Memorial Hospital,
Barry’s Bay
• 6 station Satellite Unit at Pembroke Regional Hospital
• Peritoneal Dialysis offered (home dialysis)
• PRI (prevention) clinics
• Today, very few leave Renfrew County for their treatment

6. 1000
2100
4000
41004300
5000
60006200
6600
10200
11300
12170
13302
14252
16608
16962
16034
16234
16348
16505
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
1993 1994 1995 1996 1997 1998 1999 2000 2001 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Number of Hemodialysis TreatmentsNumber of Hemodialysis Treatments

7. RVH Regional Dialysis Program
• 2 Nephrologists, Dr. Nicole Delbrouck & Dr. Amtul Musawir
• General Practitioners educated with additional knowledge and
experience in hemodialysis in Renfrew, 2 General Practitioners in
Barry’s Bay
• Nurse Manager, Janice Verch-Whittington
• 29 Registered Nurses
• 9 Registered Practical Nurses
• 2 Dialysis Bio Medical Technologists
• 2 Dietitians
• 1 Social Worker
• Pharmacist Support
Unbelievable knowledge and expertise in Renfrew County

8. • Renfrew Victoria Hospital
• Primary Care Physicians
in Renfrew County
• Ministry of Health
• Patient Focus Groups
• Ontario Renal Network
• The Ottawa Hospital
Vascular Access Program
• The Ottawa Hospital
Transplant Program
• CCAC, PD Case Manager
and Palliative Care
Services for end of life
support
• Kidney Foundation of
Canada, Eastern Ontario
Branch, Patient Services
Committee
• Regional Clinical Practice
Committees for
Hemodialysis and
Peritoneal Dialysis
• Champlain LHIN Regional
Chronic Kidney Disease
• St. Francis Memorial
Hospital – Satellite
• Pembroke Regional
Hospital - Satellite
How Did We Get There?
Linkages & Partnerships

9. Stage 2
Chronic Kidney Disease
• Nephrology Clinics
• Initial assessment, diagnosis
and early intervention to
slow progress of kidney
disease
Stage 3 & 4
Chronic Kidney Disease
• Progressive Renal
Insufficiency (PRI) clinic
– Dietitian
– Social Worker
– Nephrologist
– Nurse
– Pharmacist
Goal to slow progression of
kidney disease
PATIENT CONTINUUM OF
CARE

10. Stage 5 – 4 Options
Option 1
Home Peritoneal Dialysis
• Home training at RVH
• RVH support 24/7
• Surgical insertion PD
catheter by The Ottawa
Hospital
Option 2
In-centre Hemodialysis
- 3 sites available
- Vascular access creation/
insertion at The Ottawa
Hospital
PATIENT CONTINUUM OF
CARE

11. Stage 5 – 4 Options
Option 3
Transplant
• Complete pre-transplant
workup at RVH
• Transplant and post-
transplant care at The
Ottawa Hospital
Option 4
Treatment without Dialysis
- Nephrology palliative care
- Working with family
physician
PATIENT CONTINUUM OF
CARE

12. Pre Dialysis 1993
Pressures on patients and their families
• Sick, elderly patients driving in excess of 300 kilometres 3 times per week
• 3-5 hours total driving time from various communities in Renfrew County
• After treatment feeling fatigued
• Cost of gas, parking, meals
• Driver needed
• Driving in all kinds of weather i.e. snowstorms, ice storms
• Unable to keep a job due to treatment time
• Ottawa at over-capacity
• No treatment - you die
• Everyone left Renfrew County for dialysis services

13. VISION

14. The patient must be at the centre of health care.
• Provide seamless access to the continuum of
care in a timely manner.
• Be based on need
• Take into consideration the individual needs
and preferences of the patient and his/her
family.
• Treat the patient with respect and dignity.
LESSONS LEARNED

15. • Provide services that are appropriate,
respectful of individual choice and delivered in
a manner that is timely, safe, effective and
based on the latest evidence.
QUALITY

16. • The health system must support residents in the
Champlain LHIN in the prevention of illness and the
enhancement of their well being.
• The health care system has a duty to provide and
advocate access to quality care sensitive to the
challenges of rural Renfrew County.
IMPROVE POPULATION HEALTH

17. ONE TAXPAYER
• There are significant financial challenges
for all health care providers
• Increasing demands
• Less resources
• How can we provide services to maintain
or improve access especially in rural
communities?